Children’s Grief and Loss

Grief and Loss

Grief is the acute pain that accompanies loss. Grief reflects what we love and for this reason, it can feel overwhelming and all-encompassing. Any loss can cause grief. We often think about death when we hear the word grief. Still, losses can also include living losses like separations, absences, and departures that are very common with divorce, estrangement from a family member, and having a loved one who is in the military or incarcerated. The loss of connection such as when a person you are attached to becomes chronically ill, struggles with mental health issues or addiction. We must also consider the loss of pets and animals and the experience of moving homes, schools, or even teachers when a child moves from one grade to the next. 

When a person experiences grief they usually report both emotional and physical symptoms. These symptoms and reactions should be normalized and validated. Say, “What you are feeling is normal considering what you have experienced.” There is no right or wrong way to grieve. Grief is individual and unpredictable. Even two children grieving the same loss might respond differently. Let children know it is alright to laugh, play, and have fun simultaneously as they are experiencing grief symptoms and reactions. 

  • Sadness and crying.
  • Loss of appetite. 
  • Trouble sleeping.
  • Headaches and stomachaches. 
  • Disinterest in activities or socializing or may want to be surrounded by people and with many activities. 
  • Fatigue. 
  • Difficulty finding the words to express feelings. 
  • Regression.
  • Anger.
  • Numbness. 
  • Non-linear healing (Feel alright one day or hour but not the next). 

Grief and Trauma

Prolonged, persistent, and complicated grief symptoms and reactions might indicate the experience is traumatic for the child. Sadness following grief is undoubtedly normal but when the reaction turns into one that appears more like terror, that is a trauma response. Similarly, it is typical for grieving children to be mad but when that anger becomes aggressive or assaultive, that too is a trauma response. Another indicator of a trauma response is when a child expresses the death or loss is their fault. For example, “If I wasn’t misbehaving while my granny was home with me, she would not have had a heart attack and died.” A shift in identity is also something to watch. In grief, the identity of the child remains intact but when a child’s identity becomes shifted or distorted as a result of the loss, that is more of a trauma response. For example, “kids with incarcerated parents don’t go to college.” 

Helping Someone through Grief

  • Be patient and listen. Let the grieving person be seen and heard. If you don’t know what to say, that is alright, just be there and listen. Ask what you might do to help them feel even a tiny bit better.
  • Be nurturing. Offer kindness and care. Sensory support is helpful. Your presence, a glass of water or a snack, a blanket or plush animal to snuggle with can be very comforting. Downtime might be more necessary while grieving. 
  • Offer consistency. Boundaries and expectations should be kept in place however, they may require some flexibility during grief. Try to implement a routine so the child feels a sense of predictability.
  • Talk about the loss whether it is a person, place, or experience. Ask questions but don’t demand answers. Invite the child to share memories of who or what they are grieving if they wish to do so. 
  • Offer opportunities for expression. Children will experience relief when they can play, listen to or dance to music, draw, paint, or create other forms of art with simple supplies like paper plates, chenille stems, beads, fabric squares and buttons. 

Posttraumatic Stress Disorder (PTSD) Reactions

REEXPERIENCING

  • Intrusive thoughts, feelings
  • Traumatic dreams
  • Flashbacks
  • Intense psychological distress triggered
    by reminders
  • Physiological reactivity

PERSISTENT AVOIDANCE

  • Of thoughts, feelings, talking of activities, places, people associated with trauma
  • Inability to recall
  • Numbing, detachment, estrangement
  • Restricted affect
  • Foreshortened future

INCREASED AROUSAL

  • Sleep difficulty
  • Irritability, assaultive behavior
  • Difficulty concentrating
  • Difficulty remembering
  • Hypervigilance
  • Startle response

PTSD is diagnosed when reactions persist or develop four weeks beyond the initial traumatic incident and when there exists one or more reexperiencing reactions; three or more avoidance reactions and two or more arousal reactions.

PTSD Reactions in Children

  • Cognitive dysfunction involving memory and learning. “A” students become “C” students; severe reactions cause others to fail altogether.
  • Inability to concentrate. Children who once could complete two and three different tasks now have difficulty with a single task. Parents and educators often react negatively to this behavior because they simply do not understand its cause.
  • Tremendous fear and anxiety. One boy who witnessed his father kill his mother when he was seventeen-months-old is now seven-years-old. He still sleeps on the floor, ever ready to run from danger. Six-year-old Elizabeth, whose sister was killed one year earlier, is also sleeping on the floor. She did not witness her sister’s murder, yet she is experiencing this same hypervigilant PTSD response.
  • Increased aggression, fighting, assaultive behavior – these are the first reactions generally identified as a change since the trauma. Revenge is a constant theme when the incident has been a violent one.
  • Survivor guilt: Students not in school at the time of a random shooting and subsequent death of a fellow student feel accountable and experience intrusive thoughts and images. Another form of survivor guilt is the belief that “It should have been me instead” or “I wish it would have been me instead.”
  • Intrusive images (flashbacks): Two years later, teachers still notice this teenage girl engaging in a plucking motion with her hand. She was home when the beating occurred. She did not know her mother was already dead when she ran to help her. When she rolled her mother over, her mother’s mouth was filled with blood and broken teeth. The daughter began pulling the broken teeth from her mother’s mouth so she wouldn’t choke on them. Two years later, that plucking motion still occurred when she’s reexperiencing her experience.
  • Traumatic dreams: We first met eleven-year-old Tommy one year after his sister had been stabbed repeatedly in the chest/stomach area and was killed by a serial killer. His sister. He was still having dreams of his “guts” being ripped out by “Candyman ” even though he was not a witness.
  • Inappropriate age-related behavior: These include clinging to mother, bed-wetting, and other regressive behaviors. Eleven-year-old Tommy, the boy mentioned above, has started to stutter.
  • Startle reactions: After her father beat her mother to death, the police arrived to take pictures and arrest the father. Two years later, this daughter still cannot allow her picture to be taken because it reminds her of that day.
  • Emotional detachment: Fifteen-year-old Mary, whose sister was also killed by a serial killer, had made friends that her mother described as “real trouble.” Mary never even cried at the funeral. She had received help, but not trauma-specific help.

Children may exhibit the following behaviors:

  • Trouble sleeping, being afraid to sleep alone even for short periods of time.
  • Be easily startled (terrorized) by sounds, sights, smells similar to those that existed at the time of the event – a car backfiring may sound like the gun shot that killed someone; for one child, his dog pouncing down the stairs brought back the sound of his father falling down the stairs and dying.
  • Become hypervigilant – forever watching out for and anticipating that they are about to be or are in danger.
  • Seek safety “spots” in their environment, in whatever room they may be in at the time. Children who sleep on the floor instead of their bed after a trauma do so because they fear the comfort of a bed will let them sleep so hard that they won’t hear danger coming.
  • Become irritable, aggressive, act tough, provoke fights.
  • Verbalize a desire for revenge.
  • Act as if they are no longer afraid of anything or anyone verbalizing that nothing ever scares them anymore and in the face of danger, respond inappropriately.
  • Forget recently acquired skills.
  • Return to behaviors they had previously stopped, i.e. bed-wetting, nail-biting, or developing disturbing behaviors such as stuttering.
  • Withdraw and want to do less with their friends.
  • Develop physical complaints: headaches, stomach problems, fatigue, and other ailments not previously present.
  • Become accident prone, taking risks they had previously avoided, putting themselves in life threatening situations, reenacting the event as a victim or a hero.
  • Developing a pessimistic view of the future, losing their resilience to overcome additional difficulties, losing hope, losing their passion to survive, play, and enjoy life.