When a child loses someone who is significant to them it can be one of the hardest and most testing times of their lives. Bereavement affects children and young people in different ways and grieving is a natural part of recovering from bereavement. The grieving process is an individual journey and there are no rules as to how a person should grieve.
Grief is a response to the death of a loved one or a reaction to any form of loss. Childhood losses may also include: loss of a pet; separation of a family; loss of a community and friends following a house move or any other kind of significant loss.
Children grieve differently depending on their age and developmental stage:
Two Years and under – Whilst children do not have an ability to understand the concept of death at this stage they sense and reflect the reactions of their care givers. Children will experience a sense of loss through separation and a sense of a situation being different.
Possible reactions: Crying, clinging, feeding or sleep difficulties, an increase in restlessness and a possible regression in potty training.
Strategies: Keeping the normal routine in place provides a sense of security. Your child may need more holding and soothing than usual. Increasing special time together, whether that is singing, massage or toddler play will reassure your child.
Three to Five years – Death is understood as temporary and reversible. Dead persons or animals can be fixed or awakened. Sometimes 4 – 5 year olds can become interested in death and want to see and touch dead things (bugs etc). They have no fear of death at this stage.
Possible reactions: Your child may show no emotional reaction initially. They may regress to younger behaviour patterns (bed wetting) and they may fear and fight separation from significant others (i.e. attending nursery or school). There may be a reluctance to settle at night time or begin waking at night with bad dreams. They may develop tummy aches, headaches, seem more tired or restless. They may ask repeated questions about the person who died or about the death. You may find that your child becomes aggressive towards younger siblings or friends in school or nursery.
Strategies: Maintain the normal routine to help your child to feel secure. Speak clearly and openly at a developmentally appropriate level for your child. Keep explanations short and simple. Answer questions even when they are repetitive, it can take time for children at this stage to process information. It can be helpful to use stories and drawing to help children to express their grief. Making a special play time for your child during the day of 10 minutes to half an hour whereby they have all of your attention can be very reassuring. Let them be in charge of your play session and lead the way. Physical activity such as swimming or a run around the park can help dissipate the physical stress.
Six to Nine years – Children tend to fear personification of death, for example, skeletons, werewolves and ghosts. They have a clearer understanding of death and that they can die. Children at this stage may believe that the body goes but the spirit lives on. This is a good age to help children to understand death and misconceptions of death. Children are beginning to understand that death is a permanent state and that all living things will die. It’s not unusual for children at this stage to feel some responsibility for the death.
Possible reactions: High anxiety, especially for the health and safety of significant family members. Children may become clingy and fight any separation (not wanting to go to school). At this stage children become more afraid of death and less willing to talk. Grief reactions may be intermittent. You may see physical reactions such as stomach aches, headaches and unusual tiredness. There may be a new reluctance to settle to sleep, bad dreams and sometimes a regression to younger behaviour such as bed wetting. You may see aggressive behaviour to siblings or friends.
Strategies: Maintain the normal routine and boundaries to help your child to feel secure. Make time to talk about the lost loved one and give short and clear explanations. It can be helpful to put up photos of loved ones to aid discussion and the sense that it is okay to think and talk about the lost loved one. Avoid using clichés such as ‘past away’ or ‘gone to sleep’ which may not be helpful in their understanding of death as a permanent state. Use stories and art to help in the expression of grief. Plan a daily special play time of 10 minutes to half an hour whereby the child is in charge of the games, let them lead the way. Getting out to the park on the bike or scooter or just running around can be a helpful way to release the tension built up during the grief process. Encourage your children to maintain their normal playtimes with friends which can provide a valuable outlet for children at this stage. Allow your child some sense of control over life by giving them choices where possible.
Ten to twelve years – Children at this stage view death as an inevitable fact. They can be curious about the biological facts about death. In order to hide fears, they may joke about death. Children may still feel a responsibility for the death at this stage.
Possible reactions: You may see temporary separation anxiety and fear which may manifest as a disruption to the bedtime routine and a reluctance to go to school. Children may be more prone to day dreaming at school and lose skills due to disruption in concentration. Children may distance themselves emotionally from adults. There may be a deep sense of sadness that they cannot ‘fix’ the situation. Again, you may see a physical reaction to grief with tummy aches, headaches and tiredness. There may be a temporary disruption to settling to sleep at night or waking through the night with bad dreams. There may be a regression to younger behaviour such as bed wetting.
Strategies: Try to give an honest account of death and answer questions clearly. Try to react compassionately to questions which may seem insensitive to adults. Give them permission to express their feelings ‘it’s okay to feel angry, sad and tearful’. Let your child know that you are there to listen to their worries and talk about their positive memories about their loved one. Use stories and art to aid their expression of grief. Put in a daily special time to just talk or read together, let your child lead your time together with what they would like to do. Encourage your child to take part in physical activity such as swimming or running around in the park which will boost their mood. Remember to maintain the normal routine and boundaries to help your child to feel secure. Encourage playtimes with friends who can be an excellent source of support for your child.
Teenagers – More adult processes are evident at this stage. They fluctuate between knowing that the death is final and not wanting it to be true. Teens may have feelings of ‘immortality’ whilst at the same time fearing that life is fragile.
Possible reactions: Teens may assume an adult role with younger siblings or you may see a regression to a younger age needing more reassurance. It is common for teens to show anger and aggression. A behaviour change may be seen in relation to school work, hobbies or peer friendships (spending more time at home or more time out of home). Your teenager may experience disruption to their sleep and eating pattern or may experience bad dreams. Teenagers may also develop headaches, stomach aches or other physical complaints. To defy death, they may partake in ‘risk’ taking behaviour (smoking, drugs, alcohol, dangerous behaviour with peers).
Strategies: Maintain the normal routine to help your teenager feel secure. Encourage communication and expression of emotions. Again, normalise the emotions ‘it’s okay to feel angry and sad’. Maintain clear and firm boundaries in relation to behaviour both inside and outside of the house. This will help your teen to feel more secure. Whilst it is tempting to be more permissive of difficult behaviour during an emotionally challenging time, this may lead to an increase in anxiety. Make special time to be available to your teen. Let your teen lead the way, you might go on walks together, look through old photos or just do an activity together such as a bike ride with no talking. This lets your teenager know that you are there when they want to talk. Encourage the maintenance of peer relations, friends are a good support. Physical exercise will boost your teenager’s mood and be a helpful outlet for the tension built up during this time.
Children benefit from being included in funeral arrangements and traditional funeral rituals in order to say goodbye to their loved one. You can create rituals with your child to support them in coming to terms with and understanding their loss. This might include:
- Lighting a candle for a loved one at the local church
- Planting a special flower or tree
- Writing a special note to the loved one (this can be buried under the plant if your child likes that idea)
- Releasing balloons at a funeral
- Drawing a special picture for their loved one
- Creating a special memories scrap book or box
Depending on their ages, children and young people who are encouraged to participate in the funeral by reading a poem or something similar often cope better with their loss.
Remember that it is okay for your child to see you crying and expressing your grief. Avoidance of grief and the emotions associated with grief may give children the message that it is not okay to grieve. Grief is also difficult for adults. Make sure you have support. Remember that children take their lead from the adults. Sometimes the most helpful thing you can do for your child is to get support for your own grief to give you the resources to effectively support your child and family. Try to allow you and your family times when you can have a ‘break from grief’. Make these times when you can have fun, smile and if possible, laugh together. This will be a powerful healing tool for you as a family. Remember to support your relationship with your partner or spouse through the grieving period. Grief is a natural and unfortunately largely unavoidable part of life. We may never ‘get over’ a loss but we can learn to cope with and manage our loss.
It is estimated that about one third of grieving children and their families may need to be provided with therapeutic support beyond that which can be provided by the family. Indicators that your child and family may need some additional support might be behaviour difficulties, sleep difficulties or separation anxiety that is persisting. Whilst there is no definitive time line for grief, if a difficulty is acting as a barrier to you, your family and your child moving forwards, it may be time to take some advice from a professional.
Dr Elise Kearney, Consultant Child and Family Psychologist runs a regular weekly clinic from the Fold Therapy Centre. Contact Elise for a free 15 minute telephone consultation (find Elise’s details here)