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The Land of Myth and Make Believe

Once upon a time there existed a land wheredeath was never talked about. In this land childrenwere always happy and resilient and bounced backfrom any loss or trauma they might experience.In fact, children in particular were thought to beincapable of feeling depressed or trulyunderstanding or experiencing loss. Children inthis land held their heads high and were “stronglittle troopers” when faced with issues like death,divorce, or other life transitions. In this land,parents and other adults decided that it would bebetter not to talk about traumatic events with theirchildren so as not to “confuse” them or make themfeel upset. The less said the better. In fact, theparents and other adults around these childrendecided that they should also hide their ownfeelings so as not to upset the children. The adultswere very surprised then when the children beganto behave differently, act sad or angry, or engagein risky behaviors after they experienced atraumatic event or life change. “How could thisbe,” the parents thought, “when we have tried ourbest to insulate our children from pain?” “Couldwe have been wrong all along?” “Do childrengrieve?” (Fiorini & Mullen, 2006, p. 10)

This passage illustrates a fundamental problemin how our society handles grief and loss issues withchildren and adolescents. In general, as a society welive in a very death-phobic culture. We use a variety ofeuphemisms such as passed away to describe death asthough to even say the word died was taboo. We valuepeople who are strong when faced with adversity.Counselors must help parents and other adults tounderstand the manifestations of grief and loss inchildren and adolescents.

Defining Grief and Loss

Defining grief and loss is very difficult because asense of loss is very personal and idiosyncratic. Sincethere are many different definitions of grief, we

challenged our students to come up with an all-encompassing definition of grief and loss. We wereimpressed with their definition:

Grief is an inevitable, never-endingprocess that results from a permanent ortemporary disruption in a routine, aseparation, or a change in a relationship thatmay be beyond the person’s control. Thisdisruption, change, or separation causes painand discomfort and impacts the person’sthoughts, feelings, and behaviors. Althoughloss is a universal experience, the causes andmanifestations of it are unique to eachindividual and may change over time.(Fiorini & Mullen, 2006, p. 10)

This definition suggests that grief and loss occurnot only as a result of an end to something (a death,end of a relationship) but also as a result of a change ordisruption in the person’s life (moving, divorce). Thisaccurately implies that even what we might considerto be happy events in our lives, such as going to school,getting married, and graduating from high school, arelife-changing events that can and often do producefeelings of grief and loss. Our definition of loss alsosuggests that what is considered to be a loss is uniqueto each person and that grief can be expressed in aninfinite number of ways. It is important to view griefas a normal and natural reaction to loss, not as apathological condition. Although grief is often equatedwith a feeling of sadness, it is more realistic to viewgrief as a process which is expressed in thoughts,emotions, behaviors, and physical sensations.

In relation to children, we very often expect certainevents in a child’s life to be exciting or happy when inactuality the child responds with fear and anger. Forinstance, parents might assume that moving to a nicer,larger home within the same school district would be arather exciting, positive opportunity for their child sincethe disruption would seem, from their perspective, tobe minimal. Therefore, when the child responds withanger or sadness the parents are dumbfounded.

Article 7

Understanding Grief and Loss in Children

Jody J. Fiorini and Jodi A. Mullen

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Mourning

Mourning used to commonly be seen as a taskthat required detaching from a lost loved one or object.For example, Worden (1991) defined mourning as a“process of separating from the person who has diedand adapting to the loss” (p. 10). More recentdefinitions suggest, however, that mourners do not justmove on and relinquish the relationship to the lostperson, but continue to have a relationship with the lostperson or object throughout their lives (Webb, 2002).This approach is a much more hopeful and satisfyingone for counselors who work with children andadolescents who have experienced grief and loss.Instead of insisting that the children work through and“get over” their feelings of grief, counselors are able tohelp children and adolescents redefine their relationshipwith their lost loved one or object and hold on tomeaningful memories.

Types of Losses

Children and adolescents experience a widevariety of losses throughout their lives such as death,divorce, moving, parental job loss, parental militarydeployment, breakups, changes in friendships, schooltransitions, birth of a sibling, or even natural disasters.Parents and other caregivers often feel particularlyhelpless in trying to help a child or adolescent who hasexperienced loss. They are confused as to what to sayand how to react. They are torn between the urge toprotect their child and the desire to be honest with them.In addition, parents and even counselors tend to focuson the presenting loss without examining the hidden orintangible losses that surround the presenting loss thatare often most troubling to the child. Examples ofintangible losses include loss of trust, safety/security,control, stability, and/or support.

Manifestations of Grief and Loss in Childrenand Adolescents

Emotional Manifestations of LossThe grief and loss experiences of children and

adolescents are often demonstrated emotionally.Regardless of the type of loss, the child may experiencefeelings of emptiness, anger, confusion, desertion, andinsecurity. In addition, he or she is almost certain tofeel responsible, and guilty, about the loss he or shehas experienced (Mack & Smith, 1991). According toMcEntire (2003), children express guilt aboutremembered misbehavior or missed opportunities toexpress affection. Even the normal developmental tasksof adolescence with regard to rebelliousness and

withdrawal from the family may prompt guilt feelingsafter the death of a loved one. Often adolescents feelthat they should have spent more time with the lovedone, not gotten angry with that person, or told theindividual that they loved him or her. Children andadolescents may also feel that somehow they wereresponsible for the death and will often become anxiousover the safety of other loved ones or themselves (Glass,1991).

Cognitive Manifestations of Grief and LossIt is helpful to view cognitive reactions to loss

through a developmental lens. Emswiler and Emswiler(2000) concluded that prior to age 3, babies may sensean absence among those in their immediate world andmiss a familiar person who is gone, but they are unlikelyto understand the difference between a temporaryabsence and death. A preschool child may talk aboutdeath but may still expect the person to come back.Before age 5, most children do not realize that allpeople, including themselves, will die. By age 9 or 10,however, most children have developed anunderstanding of death as final, irreversible, andinescapable (Emswiler & Emswiler, 2000; McEntire,2003; Worden, 1996).

After a significant loss, older children or youngadolescents often will feel helpless and frightened.They may want to retreat to childhood, where they hada sense of protection from death or loss, but they oftenfeel a compulsion by social expectation to act morelike an adult. Therefore, they may suppress theiremotions (Glass, 1991). Since adolescents function inthe Piagetian stage of formal operations, theoretically,teens should be capable of abstract and formal thinking,problem solving, and deductive reasoning. At this age,adolescents can comprehend concepts of death, whichserve as a vehicle for more in-depth spiritual andconceptual thought (Schoen, Burgoyne, & Schoen,2004).

Behavioral Manifestations of GriefThe inability to handle grief feelings may result

in angry outbursts, irritability, sleeping and eatingdisorders, and persistent questioning about the detailsof death. Other frequent expressions of grief inchildhood and adolescence may include fear of personalfallibility, psychosomatic ailments, difficulties withschoolwork, nightmares or sleep disorders, changes ineating patterns, temporary regressions, and shock(Schoen, Burgoyne, & Schoen, 2004). Those with nonotion of the irreversibility of death may want to “visit”a loved one. In adolescents, specifically, expressionsof anger give them a sense of power to counteract theirfeelings of helplessness and fright (Glass, 1991). It is

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crucial to assess for suicidal risk in both children andadolescents who have experienced loss.

Disabling Grief in ChildrenNot all children who experience loss become

disabled by it. We often assess complicated grief interms of time, but disabling grief is not dependent ontime but on how intrusive it is in the child’s life. Canthe child carry out his or her usual activities? Can thechild proceed with normal developmental tasks despitethe grief? If the answer is “No,” then the child may beexperiencing disabling grief. Symptoms of disablinggrief include prolonged shock and numbness long aftermost grievers have returned to daily activities;continued denial many months after the loss; prolongedbodily distress; persistent panic; extended guilt;increasing idealization; enduring apathy; and increasinghostility.

Interventions

Dr. Sandra Fox (1985) outlined four tasks thatchildren work through as they mourn a loss. Thesetasks include understanding, grieving, commemorating,and moving on. One of the first questions asked whena person has experienced a loss is “Why?” During thetask of understanding, a child or adolescent seeks todetermine what caused the loss and why it happened(Trozzi, 1999). The task of grieving means allowingchildren and adolescents to experience the painfulfeelings associated with a loss (Trozzi, 1999). Incommemorating a loss, children and adolescents areencouraged to develop a personally meaningful way toaffirm and remember the lost person or object. Thelast task in the process of mourning is the task of goingon. During this task children and adolescents discovernew ways to “maintain an inner connection with andrepresentation of the deceased as they develop otherfriendships, attend school, play, and perform all thethings that shape their daily lives” (Trozzi, 1999, p.67).

We have found several interventions to be usefulin helping children and adolescents tackle the tasks ofmourning that they are faced with. Activities such asusing loss genograms; play therapy; narrative therapy,such as a “Letter to Loss”; art therapy, such as drawinga picture of “What happens when someone dies?”; orassisting the child or adolescent to commemorate theloved one or object by creating a CD, tape, journal, orscrapbook are just some of the interventions we havefound to be effective with this population.

Summary

As a society we have not done an effective job ofhelping our children and adolescents through their griefand loss experiences. Our children are hurting becausewe are reluctant to confront issues of loss withinourselves, let alone within children. Helping childrenthrough their loss experiences requires that we actuallyaccept that children feel grief and are bright and capableenough to understand many aspects of loss. In the nameof protecting our children we keep information fromthem and deny them the opportunity to feel their grief.

Counselors have an opportunity to play animportant role in assisting parents and other adults inunderstanding the way grief and loss manifests inchildren and adolescents, helping them to providecomfort and support to their children, and providingthem with useful interventions that will allow theirchildren to work through their feelings of grief withoutminimization or denial.

References

Emswiler, M. A., & Emswiler, J. P. (2000). Guidingyour child through grief. New York: Bantam Books.

Fiorini, J. J., & Mullen, J. A. (2006). Counselingchildren and adolescents through grief and loss.Champaign, IL: Research Press.

Fox, S. (1985). Good grief: Helping groups of childrenwhen a friend dies. Boston: New EnglandAssociation for the Education of Young Children.

Glass, J. C., Jr. (1991). Death, loss, and grief amongmiddle school children: Implications for the schoolcounselor. Elementary School Guidance andCounseling, 26(2), 139–149.

Mack, C., & Smith, T. (1991). Separation and loss: Ahandbook for early childhood professionals.Pittsburgh, PA: University of Pittsburgh.

McEntire, N. (2003). Children and grief. (Report No.EDO-PS-036). Champaign, IL: ERIC Clearinghouseon Elementary and Early Childhood Education.(ERIC Document Reproduction Service No.ED475393)

Schoen, A. A., Burgoyne, M., & Schoen, S. F. (2004).Are the developmental needs of children in Americaadequately addressed during the grief process?Journal of Instructional Psychology, 31(2), 143–150.

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Trozzi, M. (1999). Talking with children about loss:Words, strategies, and wisdom to help children copewith death, divorce, and other difficult times. NewYork: Penguin Putnam.

Webb, N. B. (Ed.). (2002). Helping bereaved children:A handbook for practitioners (2nd ed.). New York:Guilford Press.

Worden, J. W. (1991). Grief counseling and grieftherapy: A handbook for the mental healthpractitioner. New York: Springer.

Worden, J. W. (1996). Children and grief: When aparent dies. New York: Guilford Press.