Death Part 4: Signs of children’s grief

Welcome. Today we continue to learn about children's grief. Many parents ask "How do I know that my child is grieving? What are the signs; what am I looking for? Will their grief be the same as mine? How will I know if it becomes unhealthy?" These are all great questions to ask. There are common signs of grief as well as things to watch out for, so let's take a look at them. These can apply to death but also loss in general due to separation, divorce, a move, a natural disaster, etc.)

ALLOW: Just like adults, children grieve uniquely. This is because they each have a unique relationship to the beloved that dies, even if situations or ages are similar or the same. Think about it: you are not exactly the same with everyone in your life; you have a unique relationship with each person. So do your children. This has little to do with how much they love the people (or pets) in their lives; it is simply about their relationship to them and what it holds for them. It is important to allow children to feel whatever it is they feel around a loss, even if it seems strange to us, or is different from how others are responding.

SYMPTOMS: Children go through stages of grief just as adults do. Here are some things you may witness in your children:

• Shock, denial or a lack of feelings: This is a necessary coping stage for many kids. Allow them to feel whatever they are feeling and respect their need to talk or not talk about the situation. Sometimes they need time to integrate what happened before they can talk about it or tap into their feelings. Expecting them to deal with the loss too quickly can damage their emotional body, making it more difficult for them to heal in the long run. Other times, all they need or want to do is talk about it! Do your best to honor where they are, moment to moment.
  
• Body reactions: Children's bodies might react to the stress of a loss, especially if they don't have a safe outlet for their feelings. They may develop a rash or hives, asthma, experience lethargy or a lack of energy, sleep changes, eating changes, etc. These changes are normal in the short-term but if they linger, they signal the need for more support. If you notice drastic changes in behavior, weight, sleeping or eating habits, mood or health that linger 3-6 months (or less depending on severity), seek professional help for them through a pediatrician, counselor or therapist.
• Regression: Loss of a beloved person or pet can leave children feeling vulnerable. Following a significant loss, it is common for them to regress emotionally - meaning that they try to return to a time when they felt more safe. Regression is one way they cope with the pain of a loss and the instability that follows. They may need to be cared for and nurtured more than usual. They may begin to act much younger than they are. These behaviors are signs that they feel vulnerable or scared. During this time, offer them the extra nurturing they need, and reassure them that they are loved and safe.
• Overwhelm: Just as with adults, death or loss can leave children feeling disoriented and confused. They may have trouble concentrating, be distracted or unable to follow-through with tasks. They may get overwhelmed easily or be unable to do even simple things like brush their teeth. When their emotional body is overwhelmed, any request can feel like too much to them. It is helpful to be especially compassionate and gentle with children following a loss. Nurturing them will move them through the healing process more quickly then pressuring them.
• Emotional reactions: Children may go through a phase of having explosive emotions such as hate, blame, terror, panic or resentment. They may begin to act out in dramatic ways to feel in control, empowered or to cope with intense feelings. This type of emotional expression is actually a healthy response to the trauma of a loss. It signals an intact survival instinct and value in the face of painful loss. The intensity of these reactions will diminish as time passes and healthy healing occurs. Your goal as the parent is to set safe, healthy limits for them without a power struggle, anger or violence. If you're not sure how to do this, or if the explosiveness lingers for more than 3-6 months (or less, depending on severity), seek professional support.
• Hypermaturity: Sometimes following a loss, children believe they must "step up" into a role that they are not developmentally ready to manage. Adults often make the mistake of saying things like "You're the oldest; it's up to you;" or "You're the man of the house now; you must be strong;" or "You're Mom is counting on you." It is not healthy to thrust children into roles of responsibility before they are ready and as they are trying to cope with their own sense of loss. Doing this can displace their grief by forcing them to focus on the new role rather then on their thoughts and feelings around the loss. This is not to say that children can't help; it means that parents and other adults keep their expectations within each child's stage of readiness and maturity.
• Fear, guilt or sadness: Children may show other feelings following a significant loss in their lives. Especially young children can experience heightened levels of fear around being taken care of, becoming attached to or close to others. Be open to their questions and concerns so they feel accepted and know you can be trusted. Children might also experience feelings of guilt for surviving, or for what they believe they might have done, but didn't, or for what they feel they did that contributed to the death. Listen openly to their feelings and concerns. Reassure them that death is nobody's fault and that they are not to blame. Like adults, children will feel sad, empty and alone following a loss. Some children go into what is called magical thinking, wanting the situation to magically be different. Other children may experience a sense of relief and joy that they survived, despite the loss. Allow children to talk about it, ask questions and process what happened with you so you can clear up any distortions in their thoughts or beliefs. Accept their feelings so they know you accept them, which goes a long, long way toward their healing.

SUPPORT: Back in the day when I was in graduate school, the rule of thumb for knowing when more support was needed following a death, loss or traumatic event was 6 months. There is no time line for grief; it takes as long as it takes, and it is a completely individual, unique experience. With that being said and very generally speaking, 6 months is sufficient time for the bulk of the emotional distress and intensity of a death to soften a bit. By then, some of the overwhelm has passed, there is less confusion, more stability has returned and things are "getting back to normal," only it's a new normal for those who were touched by the event.

If at 6 months following a death, your child is so depressed or distraught that they can't function - go to school, eat, sleep, take care of hygiene, engage in social activities, get out of bed - then it is time to call professional help, if not before. But 6 months is a reasonable marker, and of course, it depends on the severity of their symptoms.This does not mean that in 6 months children will be completely recovered from a loss; it means that in 6 months, they will be finding their way forward despite the loss.

Death touches our lives forever. Children, just like adults, may have a reaction years after a death because there was a reminder of some kind that touched their heart. Anniversary times and special events such as birthdays and holidays can stimulate grief. Also, as new or special events and opportunities arise in life, children may miss their loved one's presence, such as parent nights or events at school, prom nights, football or other athletic events, dance and music recitals, going to college, graduation, getting a driver's license, dating, marrying, having children, etc. This is normal and to be expected. They will - just as you will - have fleeting reactions over time, even as they learn to live without their loved one. Open to and allow those random reactions as a part of the healing process. Accept children's reactions when they arise; this gives them the spaciousness and safety they need to heal in a healthy way.

Look for the 5th article in this series, Finding Hope Through Grief, soon. Until then, Peace Be. [Information in this series is adapted from a presentation by Hope Hospice, a non-profit organization based in New Braunfels, TX: 1-800-499-7501. For more information and support through loss and grief, contact your local hospice services.]