Helping Children in the Mourning Process

If we compare mourning in early childhood with mourning in adulthood, we can emphasize that children generally use more denial, they can easier maintain the ability to enjoy pleasant situations, and they don’t lose their self-esteem. In this post, our collaborator Mª Victoria Sánchez López, specialist in clinical psychology at GrupoLaberinto helps us answering a question that we are not ready to deal with, when it arises:

How to communicate the news of a death to a child?

When there has been a death to be communicated to a minor, it is important to decide first, who will be responsible for transmitting this information.

In this sense, if for example one parent is deceased, it is recommended for the other parent to forward the information, or at least for someone close to the child with an emotional bond. It is not recommended for this to be done by health workers, for example, if the parent has died in a hospital.

It is important to inform the children as soon as possible, this will allow them to understand what is happening around them, for example, the emotions and behaviors of the adults.

The communication of the information must be direct and honest, avoiding euphemisms. Phrases like “he/she is in heaven”, “he/she is asleep”, etc., can cause a lot of confusion in the minor and hinder the evolution of the tasks of mourning, as well as generating inappropriate expectations.

Once the information is given, it is necessary for the adult to check if the children have understood what has been explained. For this, we must ask them to explain what they have understood using their own words. We must also be available for the children, so they can ask us any questions they may have.

At the same time, it is convenient to explain them what will be happening during the days following the death, so they can anticipate what will be occurring, thereby reducing the feeling of uncontrollability. Giving this information will also allow us to offer the children the opportunity to bid farewell to the deceased, participating in the rituals of farewell. If the children want to be in the rituals, an adult should always be available accompanying the children during the process in order to answer all questions they may have.

Once the children know the news of the death, we can follow these recommendations:

• It is essential to ensure continuity in the care of the child: We must quickly organize their routines and establish who will be the people responsible for meeting their instrumental and emotional needs.
• We must not make significant changes in the child’s environment: To the extent that the same home and school can be maintained, with the same caregivers of reference.
• It is necessary to report on what has happened in the usual contexts of the child, such as school: This will allow you to provide the necessary support and to be vigilant if there were indicators of pathological mourning.
• We must not force the child’s emotional expression: We should not insist the child in expressing sadness, fury, worry, anger… Each child will have his way and his time to grieve; we must be absolutely respectful in this sense.
• It is convenient to facilitate the expression of emotions: This can be done helping to develop symbolically, for example, through playing and drawing. In this sense the adult’s role is to provide the child with the material, the space and the time to do so.
• Adults should anticipate emotional reactions on key dates: It is for example very common to see a rising of the emotional and behavioral reactions in anniversaries, birthdays … Keeping this in mind will help the adult to make sense to what is happening.
• It is necessary to enable the child to maintain a symbolic connection with the deceased loved one: This means for example, to preserve significant memories (photos, letters …), to allow speaking about the deceased, etc.

Adults have to take into account that the death of someone close, will shoot the child’s attachment system, resulting in frustration, stress, fear, anger and anxiety. This often leads to emotional deregulation and uncontrolled impulses.

Specifically, the psychopathology associated to mourning in childhood follows like this:

– Internalizing symptoms:

• confusion
• isolation
• anxiety
• fears
• apathy
• sadness
• irritability
• somatic: disturbed sleep, feeding, enuresis, encopresis and abdominal pain

– Externalizing symptoms:

• behavioral problems
•  tantrums
•  rejection

– Mixed symptoms:

• Regressive behaviors and language
• difficulty concentrating or attend homework
• hyperactivity
• hyper protection to the loved ones

During the elaboration of mourning the above symptoms are expected. However, there are a number of factors that are related to pathological mourning, in which case we will need the professional help of a psychologist specialized on children, working with families.

On the event that the deceased person is a parent, the risk factors of pathological mourning are:

• insecure attachment
• psychopathological background in the child or primary caregiver
• simultaneity of stressful life events
• bad relationship with the parent who has died
• insecure attachment with the surviving parent
• aged between 10 and 14 years
• mismatching the surviving parent
• type of violent or sudden death

In order for children to be able to develop bereavement in a non pathological way it is necessary for the adults of reference to do it too. If the child or the adult have difficulties, it will be necessary to get psychotherapeutic care. This intervention will help to improve recognition, awareness, exploration, expression and emotional regulation.

“The loss of a loved person is one of the most intensely painful experiences that can suffer a human being, and it is not only painful to experience but also painful to witness, if only because we are so impotent to help” (Bowlby, 1980 )

Author: Mª Victoria Sánchez López, Psychologist. Specialist in Clinical Psychology. .