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How children grieve

Children may express their reactions to a death openly or not seem to be concerned about the event. Often children grieve in “doses” and may fluctuate between appearing to be unaffected and bouts of expressing grief. They may also hide their own feelings to protect a parent or another family member who may be grieving or distressed.

A child’s level of understanding about death changes over time. They may ask questions about death e.g. What is death? Death is when the body stops working. Be aware that they may want to know more about the death as they get older and gain more capacity for understanding. They may raise the subject weeks and months later to check out questions and their feelings, so be prepared to revisit and repeat conversations. It is also natural for children to process their grief through their play – for example, playing funerals or having themes of death in their play.

There are a number of normal reactions young children may have to loss. There is no ‘typical’ reaction. Children react differently depending on things like proximity, age, developmental stage, temperament and previous experiences.

What to expect from bereaved preschool aged children

• Be greatly affected by the emotions of those around them
• May not stay sad for long – often alternating between crying and playing
• Be openly curious about death, possibly asking questions that you find confronting
• Become fussy, irritable, withdrawn, or show signs of insecurity
• Experience distressing dreams and nightmares
• Behavioural regression e.g. bed wetting, sleep problems or clinging
• Feel bewildered and physically search for their loved one who has died

What to expect from bereaved school aged children

• Experience a difficult transition period and want to see death as reversible, but are beginning to see death as final
• Be very curious about death and burial rituals and ask detailed questions
• Can imagine death as a bogeyman or ghost
• May play games pretending to die
• May be angry over the death and focus their anger at certain people such as anyone involved with the death i.e. doctors, nurses, parents
• Be unwilling to express their feelings
• Take time to absorb the reality of what has happened and initially appear unaffected by the death
• May blame themselves
• Experience disturbed sleep and appetite, poor school performance and experience physical reactions e.g. stomach aches and headaches
• Worry about who will look after them if a parent or other care giver dies
• “Act out” feelings
• Older school aged children may be concerned about what their peers think and feel anxious about being seen as “different”. They may feel isolated, because no one else has had a similar experience.

What can parents and caregivers do for children?

Whilst we cannot shield our children from loss, there are things we can do to support healthy ways of grieving. You are a very important support for your child, but firstly, you need to be aware of how you are coping and attend to your own needs. You may want some support to manage your own natural feelings and emotions such as helplessness, sadness, fear, and anger. You won’t be able to provide support to children until you have some strategies to manage your own feelings and emotions. Children will respond in an environment where they know you care for them and know you will act in response to their signals and signs.

When you have negotiated the support you need, the following can be helpful:

Ensure your responses are age appropriate

Be attuned to children’s perceptions of death. Gently help them understand that the person who has died is not coming back, but also reassure them that the deceased is not in any pain. Try to avoid metaphors such as ‘gone to sleep’, ‘at rest’ or ‘lost’ as this may be confusing for children who can take these terms literally and may develop fears that they or others may die once they fall asleep.

Provide reassurance

Don’t underestimate the impact a loss has on a child even if they do not respond as expected. Reassure them that they will be cared for and that over time their pain will lessen. Maintain routines (including usual discipline) as much as possible, as this creates a sense of safety and predictability for them.

Give children the opportunity to express their grief in their own way

Make time and space for your child to express their grief though drawing, painting, storytelling, collage, and music, making memory boxes, writing poetry or letters to the person who has died. This can provide an avenue to express feelings that are difficult to articulate. Making feelings concrete, and talking about their work is therapeutic in itself. Resist interpreting their work. Allow them to tell you about it.

Don’t hurry grief

Psychological healing time is different to chronological healing time. Children will often break their feelings up into manageable amounts, as it’s difficult for them to tolerate ongoing, intense pain. Therefore, it is not unusual to see a variety of emotions unfold in a short span of time as they slowly work through their grief.

Be consistent

Children may need to ask questions over and over again to make sense of what has happened. Be patient and provide clear, consistent answers that they will understand. Don’t be afraid to ask the child what they are thinking or feeling, as they will often be forthcoming if they feel that they will be heard and accepted.

Model healthy grieving

Model healthy expressions of grief so that children understand that it’s ok for them to do the same. Resist trying to fix children’s pain, by avoidance or distraction.

Living with the pain of loss

For some children, this may be the first time that they have experienced profound loss. Fears may arise that they might be abandoned again or that the pain they feel will continue indefinitely. They may try to protect the feelings of others by avoiding displays of emotion. Talk through your child’s fears at a level they can understand.

What about adolescents?

Adolescents are starting to think much more like adults. They have the capacity to understand the nature of death and its finality, and they also understand that they themselves could die. Young people in this age group also have very strong bonds with their friends and are likely to experience great distress over the deaths of their friends. They will be very different from each other in the way they grieve with some wanting to be surrounded by friends and family, whilst others may want to deal with their grief privately. Adolescents may:

• Understand more fully that their lives will be different and that their opportunities and security may be affected, especially by the death of a parent.
• Feel fearful, angry and / or resentful that death has come to their lives
• Act with bravado, as though they are not affected.
• Try to take on more responsibility, to look after others
• Experience a roller coaster of emotions, with unexpected changes in mood, which may seem demanding and non-supportive by others
• Experience feelings of guilt when they appear to be getting on with their lives
• Act out through risk taking behaviours.

Be available

Adolescents may try not to show their feelings of loss. Provide an accepting, open, communicative environment in which to grieve. Let them know it is okay to feel the emotions that they feel, and that you will be there for them if they need to talk.

Talk about the loss

Invite your teen to talk about their loss and / or the person who has died but respect their choice to do so. Ask specific questions and answer their questions honestly and clearly. If you don’t know the answer to something, say so. Share memories, thoughts, beliefs without pressuring them to adopt your perspective.

Allow for adjustment, and monitor for warning signs

Because grief is not linear, adults need to understand the range of emotions that can surface for the grieving adolescent. Allow some leeway while providing a secure, consistent environment. Where possible, maintain routines. Be aware for signs of depression, violence, drug/alcohol abuse, or changes in personality.

Support connection

Think about the nature of your adolescent’s loss, and closeness of the relationship they shared with the person for whom they are grieving. Acknowledge the depth of their loss. Set aside your time, attention, and availability. Facilitate connection with friends when desired.

Mourn together

Be aware of the messages adolescents may be receiving from those around them about how to grieve. Model healthy communication and the appropriate expression of the many feelings associated with loss. Let the young person show you how they grieve.

Sleep hygiene is the term that psychologists use to describe getting set up for bed time. Sleep hygiene is probably a term that conjures up images of not having a shower before bed, but actually is a term used to describe good pre-sleep habits to give yourself the best chance of a refreshing night’s rest. I imagine that, when you read this list, it will all seem like common sense but as we all know this doesn’t mean these good ideas are always acted on. If you have trouble falling asleep, here are a few things to try before resorting to medication.

➢ Try to get to bed at much the same time each day. Your body clock will get used to this and you’ll find that you get drowsy as this time approaches.
➢ Try to have your environment sorted out to allow you to hit the bed when you are sleepy like this.
➢ Get up from bed at the same time each day. Again, this will help your body clock to stay tuned in to what are your times to sleep deeply.
➢ Avoid the temptation to make up for poor night’s sleep by sleeping in excessively.
➢ Get some regular exercise into your day. Studies have shown that this can help a lot.
➢ Try to schedule the exercise so it does not occur in the couple of hours before bed time.
➢ Be sure to spend some time outdoors in natural light. This will help your body to produce a chemical called melatonin, which promotes sleep. Sunlight early in the day is particularly good for synchronising your body clock.
➢ Make your bedroom as restful as possible and use your bed only for sleep and sex so that your brain knows that bed is for sleeping and not stimulating activities such as TV watching and video gaming.
➢ Also avoid things that stimulate before bed, such as exciting programs on television, competitive games or having an important conversation that is likely to stir up emotions.
➢ Make a house rule of no ‘screen time’ 30 minutes before bed.
➢ It is hard to avoid worrying about or planning the next day’s activities but try not to do this. If you must, devote a few minutes to this alone earlier in the evening and make notes with a pen and paper. Once your plan is sealed, you may be more able to refrain from thinking about it more.
➢ Avoid things that make noise during the night such as chiming clocks, smart ‘phones and beeping watches by leaving them in another room.
➢ Do likewise with light emitting devices, perhaps draping a shade over your clock radio.
➢ Try to keep the temperature pleasant and stable through the night where possible. Avoid cold hands and feet.
➢ If your bedding isn’t comfortable, get it sorted out. A new pillow or doona is a small investment.
➢ Take a warm bath about an hour before bedtime. This makes the body’s temperature rise and then fall which may promote sleep.
➢ Take your medications as directed, including the stated time of day best taken. Some medications cause alertness and need to be taken in the morning and the opposite is also true.
➢ Don’t have caffeine drinks in the evening. This includes not only coffee and tea but also cola, energy soft drinks and others such as Mountain Dew.
➢ Try not to drink so much fluid during the evening that your bladder will awaken you for a trip, or trips, to the toilet over night. Be sure to urinate just before retiring for the night as well.
➢ Don’t go to bed either hungry or uncomfortably full.
➢ Don’t nap in the evening. If you are falling asleep in front of the TV, go to bed.
➢ Don’t stay in bed all night if you can’t sleep. If 30 minutes go by, get up and do something tedious in another room. Keep the lights low and noises down to avoid getting aroused. When you are tired, go back to bed.
➢ Don’t share your bed with children or pets.
➢ Don’t watch the clock.
➢ Don’t smoke before bed as the nicotine is a stimulant. Consider giving up and you will also avoid being woken by cravings.
➢ Don’t use alcohol to help you sleep as it will cause extra need for toilet trips over night, an increased chance of early waking and will worsen snoring and sleep apnea.
➢ Don’t rely for long on sleeping tablets to help you to sleep.
➢ Many sleeping problems are due to bad habits acquired over a long period. Expect to take some time to improve your sleep habits.
➢ Different things work for different people. Once you find out what works for you, stick with it.
➢ Above all, don’t obsess about your sleep. If you still have troubles with these suggestions on board, make an appointment with your psychologist for some additional techniques in mindfulness and relaxation.
Heather Menzies.

Help:  My Children Aren’t Perfect !

Guess What?  All of our children are Perfectly Imperfect:  What makes the difference is having the right tools to support ‘Good Enough’ Parents to raise secure kids for the real world.

Just because you are reading this column, means that there are some things I know about you already .  You want to do a better job of parenting.  You want to end the conflicts with children that make life at home harder on everyone. You want to stop the fighting between the kids.

PsychEquip is a private psychology practice in Hamilton, Brisbane where we aim to teach you how to practice positive parenting.  We subscribe to a branch of psychology called  attachment based parenting which has been getting great results both in Australia and overseas.  It provides practical parenting skills to manage conflicts within members of the family and the skills to negotiate the outcomes you want from your children.  Positive parenting leads to more secure bonds between parents and children, better healing from past and future traumas,  more tolerance to overcome disappointments and, best of all, creates children that can find their own place in the world more securely.

When we see a family for counselling, we will talk a lot about techniques for behaviour management and disciplining children.  You will learn my favourite tactics such as  the 1-2-3 Magic technique, the benefits of  Triple P training and the use of a framework known as the Circle of Security that you can use to shape your behaviour with your kids and how they in turn respond to you.  We’ll draw strongly on the great work of John Bowlby, Dr Dan Seigal and Steve Biddulph amongst others by learning practical tips that you can take home and use that day.

There are many stressful times in a parent / child relationship. There is the terrible twos, the toddler years, toilet training, dealing with teenagers, coping with the internet, cyber bullying, school yard bullies and divorce. There is also the challenge of seeing your child transition over the cusp of adulthood and become a sexual being. How does that affect your relationship with your child?  How can you best give a child advice about sex? How can you talk to your son or daughter in a way that will matter?

At PsychEquip, we want to keep it real. We can talk about the difficult issues.  Perhaps you resent your children from time to time? Or that sometimes as a parent you really don’t know what you’re doing and it scares you.  Did you know that – and much, much more – is a normal  part of being human.  What matters is how you allow these thoughts to affect your behaviour.  If you build a strong relationship with your child, you are establishing a secure base that you can both return to as a refuge when times are difficult . That is what gets you through.