Loss, change, death and grief[1] are a natural part of our human experience. Talking about it, however, may NOT come as naturally. Many adults want to shield children from feelings of loss and to protect them from suffering or they may feel unsure or afraid to talk about death openly. The research[2], however, shows that children (from toddlers[3] to adolescents) benefit from experiencing (not avoiding) loss, change and death. In the long run, without freely talking about the loss or expressing sadness, anger and confusion, the child's recovery will be more difficult. With open communication and support they are able to move effectively through the grieving process.
The following four conversations can be like opening the door; a starting point for children to process their grief. Adapt these conversations to match the developmental age and language level of the child or youth. While these conversation starters focus on helping a child deal with death, they can easily be adapted to cover any other difficult change or loss in their life.
1. Acknowledge the feelings that come with grief.
Allow children to be active in their grieving process by encouraging them to identify the variety of feelings they are experiencing. You can say, “Some people can feel uncomfortable about death and have a hard time talking about it. Everyone responds differently. Sometimes you might feel sad, angry, or confused and other times you might feel happy, supported and peaceful. All emotions are okay and normal. Would you like to talk (or draw, paint, write)[4] about the different feelings you are having?”
2. Offer prompts as a way to tap into emotional bonds.
Prompts can be the gateway into deeper conversations. The following examples invite the child or youth to validate their connection with the person or relationship they are grieving[5].
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I’m sad about _______________.
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When I was with (insert name), I liked to ____________.
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The hardest part right now is _____________.
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I’ll miss _____________________.
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I smile when _________________.
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I most want to remember _______________ about (insert name).
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My favorite thing about them is ________________.
3. Give information about what is happening in order to reduce confusion, anxiety and fears.
Start this conversation by saying, “You have the ‘right’ to grieve. When we grieve there are things that happen in our hearts and bodies that cause us to feel and act differently. Would you like to hear about some of these changes? Would you like to talk about some of your questions or worries?”
It’s important when giving information to be clear and honest in order to create trust. Be prepared to answer questions[6] about the realities and practicalities[7] that loss or change may bring. There may also be questions about the life cycle and spiritual topics.
4. Support the child/youth to find coping strategies.
Learning to cope with grief is a life skill that will foster ongoing emotional and social growth and development. You may choose to start this conversation by saying, “I care about you and I acknowledge this is a tough time. I’m here for you if you would like to talk or if you just want someone to be around. Whenever you feel ready, we can talk about things that might help you get through this time. I wonder if you have ideas of what would support you right now. I can offer ideas, too.”
This conversation could evolve into talking about their social support system and/or self care practices that will allow their grief to be shared and supported. Play is an expressive outlet and an effective coping mechanism for children to process their grief. So, too, is music, storytelling, movement, journaling, and all forms of artistic expression.
These four conversations are a starting place only. Once the offer to connect is made, adults can be ready to follow the child’s lead and walk alongside them as they travel along their journey of grief. Dr Bruce Perry[8], a leading authority on brain development and childhood trauma, suggests that while grieving is normal, if adults observe that a child’s suffering is interfering significantly with life or grief reactions last for six months or longer, professional support is important.
Grief is an individual experience and involves different emotions and an unpredictable journey of acceptance and adjustment.
Dr. Bruce Perry and Dr. Jana Rubenstein draw upon both clinical research and practice to answer frequently asked questions in their article The Child's Loss: Death, Grief, and Mourning.
In a review of developmental theories, researchers look specifically at the grieving experience of children under 3 years old. Helpful interventions for young children are suggested;
- talk to a child about death in a familiar place
- be patient with questions
- include children in memorial services
- revisit memories
- explore feelings through play and children's books
There are many ways to express feelings. Suggest journalling, writing letters, creating art, talking, playing, making music, or being physical active.
In addition to finding ways to expressing feelings, finding the WORDS to describe feelings can help to reduce related stress.
In a healthy grieving process, it is suggested that a child preserve their memory of what they have lost (e.g. a person, pet, relationship, home) through stories, photographs and celebrations.
It is common to see a delayed reaction to death and, particularly from young children, questions may arise for months, may be repeated over and over, and may sometimes appear insensitive.
What, exactly, does happen in our hearts and bodies when we grieve?
- a cortisol response (stress)
- sleep distrubances
- immune imbalances
- inflammatory responses
- heart-rate and blood pressure changes
Dr. Bruce D. Perry, M.D., Ph.D., is an internationally recognized authority on brain development and children in crisis. Dr. Perry's work has been instrumental in describing how traumatic events in childhood change the biology of the brain.