Understanding Childhood Grief and How to Help: A Guide for Adults

Grief Reactions Helpful Adult Responses
SHOCK AND NUMBNESS
This often serves as a cushion against the full impact of a tragedy as children may not be able to intellectually or emotionally process the information about the death.
Provide an atmosphere which encourages the open expression of all initial reactions to the event, even the unusual ones such as laughing as a way of reacting to fear.
DENIAL
Blatant denial that the event took place is not an unusual reaction, especially among younger children. Sudden or violent death also creates a sense of denial among survivors.
Communicate all the facts in a clear, concise way and avoid a power struggle about the truth. Children often accept tragic facts in a gradual way, and over time. They may ask repetitive questions about the event as a way to understand and gradually accept what happened. Don't get unduly concerned if denial seems to wax and wane. Children may approach and avoid the truth as they come to terms with the painful realities.
ANGER
Anger may be expressed at the deceased or at the event: "Why did this happen to me?" Anger might also be displaced onto adults in the environment: "How could they let this happen?
Accept the anger and allow children to express it. It may be helpful to encourage physical activities like athletic sports as a way to release the tension generated by angry feelings.
ANXIETY
If a parent has died, a young child may experience fear of abandonment, and they may worry about who will take care of them now. They also may worry about the death of the remaining parent. If a peer or sibling dies, there may be fear about their own safety, and that they may die too. These worries may show up in going back to behaviors the child stopped doing long ago, e.g., bedwetting, thumb sucking, fear of the dark. It may also show up in irritability or angry outbursts. Older children may engage in risk-taking behaviors and drug and alcohol abuse.
Reassure children that arrangements have been made for their caretaking within the extended family system, even though it is very unlikely that something will happen to the remaining parent. Encourage children to resume routine activities such as scheduled meal and bed times, school attendance, and play rituals as soon as possible, since both the structure and the routine of the familiar will bring a sense of order and control to the chaos they are experiencing. Also encourage their taking part in rituals for the deceased, which will provide them with mutual sharing and the support of others.

Help older children talk about their feelings instead of acting them out.

SHAME
When a child experiences a death of a loved one, the reactions of friends and school personnel are important to them. Unlike most adults, children do not want to be seen as "grieving", something that makes them different from their peers. Children have a strong need to fit in and feel accepted by their peers. When they lose someone to death, they feel different from their peers, and this increases their discomfort.
Friends and teachers may need to remind the child with words and actions of their continued importance and that they are still part of the group.

Encouraging normal peer activities as soon as possible can help children see that, despite their loss, they can still be the same with their friends. Recreational activities also provide them with relief from their grief and provide an outlet for difficult emotions which is also very healthy.

GUILT
As a result of "magical thinking", young children may worry they were the cause of the tragedy: "Did my bad behavior make this happen?"; "If I had loved my brother more, he'd still be alive today!” Older children may worry about negative encounters they had with the deceased prior to the death. There may also be guilt related to the fact that the child does not feel he/she is as "sad" as the rest of the family about the loss.
Help children see that the death was not their fault, and it was not related to their behavior. Explain that no matter what we think or feel, we don't have power over another person's death. Reiterate that every relationship includes negative as well as positive feelings, but again our feelings cannot cause another's death. Also, clearly give permission to children to go on enjoying life and living. Because their expression of sadness and loss may be different from yours does not mean their grieving is any less meaningful.
PHYSICAL PROBLEMS
Frequent illnesses and physical complaints are common reactions in children during the process of grieving.
Create an atmosphere where children have permission to talk about their physical concerns. For example, tolerate frequent visits to the school nurse if necessary. It may also be helpful to point out how we use our bodies sometimes to express feelings that are difficult to put into words.
ACADEMIC PERFORMANCE PROBLEMS
Confusion, difficulty in concentration, memory lapses, and preoccupation with thoughts of the deceased are common, and these may interfere with academic work.
Provide additional help or tutoring for children of all ages. Children may benefit from temporary reduction of their work load or more time to complete assignments and tests. This will help decrease anxiety about falling behind in their assignments.
REFUSAL TO TALK ABOUT THE LOSS
Children may feel uncomfortable with an invitation to openly express their emotions. Younger children may not have the language with which to express their feelings. Older children may consider crying babyish and refuse to talk for fear of becoming upset.

Children also worry about causing others pain by bringing up the deceased.

Offer opportunities to talk without the expectation that the child will always respond. Help children to communicate in other ways such as drawing, writing, and music.

Be open to times when your child approaches you with questions. If you feel like crying explain to your child that even though you sometimes cry when talking about your loved one, it is important to keep doing so. Let them know it is OK to talk about them and that you are OK.

INTERMITTENT GRIEVING
Children grieve intermittently because of their low capacity to tolerate acute pain for long periods. It is not unusual to see a child crying one minute and out playing soon after. It does not mean the child is not sad about the death.

Teens may express a desire to be with friends instead of with family at times during the grief process. This is normal, and it is not a reflection of their feelings for their family or a sign of disrespect for the deceased. It is a way of experiencing the pain in manageable doses and seeking comfort in peer relationships.

Comfort your child when they are expressing their sadness, but also give them permission to play even during this sad time. Play is the language of childhood, and they often use it as an escape from the pain of grief and as a way to understand and master the complex and confusing feelings they feel regarding the death.

Let your teenager know that you understand their need to sometimes be with friends during this time. Encourage them to do things that take their mind off the grief such as talking with friends, or engaging in physical activities to help them discharge tension and sad feelings.

TRAUMATIC GRIEF REACTIONS
These reactions interfere with movement through the grief process because the child can’t stop thinking about the traumatic aspects of the death. Children who are experiencing these reactions should be referred to a mental health provider that is experienced in helping children with traumatic grief.
DISTURBING THOUGHTS OR MEMORIES
When a loved one dies in a violent way, the child may become preoccupied with the way in which the person died. They may describe the experience of “not being able to stop thinking about how it happened.” These images may haunt their dreams and make it difficult to sleep. They may also invade their waking life and pop into their minds at any time. The child may avoid conversation about the deceased because thinking about their loved one brings back the images of the way they died.

Children may avoid talking about memories of the loved one, even happy ones as a way of avoiding disturbing death images. Adolescents may begin to use drugs or alcohol to help them numb out from these thoughts and images.

Shield children from exposure to images of death and destruction on television or in print. Exposure will increase the images in their mind of their loved one’s death. Children may ask how the death happened, and it is always better to give them facts without sharing too many details. For example, you can tell a younger child that when the building collapsed, their loved one got hit with the building’s falling parts, it made their body stop working, and they died. Older children and teenagers are more sophisticated and may ask for more information. Keep the explanation as factual as you can; don’t talk about disturbing and graphic details.

If a child is having lots of thoughts about the way their loved one died when they try to remember the person, reassure them that what they are experiencing is due to the shock of the news and the sudden death.

PREOCCUPATION WITH THE MANNER OF DEATH
Repeated questions about the way the person died as well as repeated descriptions of the death that are spoken, written or drawn.
Listen to a child’s questions about the death, and pay attention to things they write and draw for clues that indicate they are not able to move beyond the manner in which the person died.
REENACTING THE TRAUMATIC DEATH
Normally, younger children may reenact the death of a loved one in their play or artwork. This type of normal play is like telling the story over and over as the child begins to comprehend its reality. Normal play after a death is imaginative and creative, and the child leaves it feeling better and less stressed.

Post Traumatic play is different. In such play various elements of the traumatic event are acted out in a manner described as grim, ritualistic and sometimes dangerous. This type of play is upsetting to the child. It does not bring a sense of relief, and leaves the child feeling agitated and upset.

Watch the quality of the child’s play for indications that it is not providing the child with a sense of relief or closure. Notice if the child feels better or appears more upset when the play is finished.
SADNESS
Children may appear sad, tearful and may cry easily.
Encourage children to talk about their sad feelings and validate them as normal. Children can create artwork that helps them talk about their sadness, and older children can use diaries or journals to put their feelings into words. Initiate conversations about the deceased so that children aren’t afraid of upsetting you, or making you sad by talking about their loved one. You don’t need to feel that you have to put up a strong front. It is ok to cry with your child. You can help your child understand by your behavior that crying when you are sad and grieving is ok and helps in the grieving process. Reassure them when you are sad or crying that you are going to be all right, and you will all get through this sad time together.