LOSS OF A CHILD

The death of one’s own child is a profound and devastating experience.  It is one of the worst blows a person can experience.  The overwhelming suffering and intense emotions that flood a person in the days, weeks, months and years following the loss is called grief.

Grief is very painful and personal.  Some of the emotions of grief can be shared with others, while other emotions, such as the intense feelings of loneliness, may never be put into words.  The ways in which the feelings and emotions of grief are experienced and expressed differ from person to person.  One person may need to talk a great deal about the loss and the pain, while another may become quiet and withdrawn.  Some persons may try to avoid facing their pain by holding all their feelings inside and acting as though they are fine.  Although painful and difficult, grief expression is necessary.  A person must work through the pain of the loss before recovery and growth can occur.

THE GRIEF RESPONSE

When parents first learn of the death of their child, the response is often one of shock, denial, disbelief, and numbness.  These reactions help to cushion the full impact of the loss until they are ready and able to face the devastating reality of the child’s death and the meaning that this terrible loss has for the persons involved.  These shock reactions may last only a few minutes or they can last for hours, days, or weeks.

If a child has died after a long, lingering illness, parents may experience a sense of relief along with shock, denial, disbelief, and numbness.  When you have faced tragedy, anticipating it for weeks or months, it is normal to feel relieved when you feel your child is at peace.

When the sense of shock wears off, there is often a period of emotional release when the parents begin to become aware of the devastating meaning of their child’s death.  Some parents will weep and cry, others might talk incessantly.  The emotional release is important; it should never be discouraged.  Parents should not put off expressing these feelings until there is a more convenient time or place.  The time to deal with the emotion is when it is first experienced.

Sooner or later, grieving parents are flooded with other emotions such as guilt, anger and fear.  All of these are normal feelings for bereaved parents but the can be difficult to understand and to share with others.

Feelings of guilt occur as bereaved parents begin to grope for the reasons for their child’s death.  During this process, many bereaved parents blame themselves by thinking that something they did or something they neglected to do may have in some way contributed to the child’s death.

For example, parents may feel guilty because they think they should have detected the symptoms of the illness earlier or because they signed the operative permit giving their approval for the surgery from which the child did not survive.  When the death was caused by an accident or suicide, parents often feel guilty because they did not prevent the incident from occurring in some way.  Since parental guilt feelings are often closely related to the cause of death, it is virally important that parents have a good grasp of the cause of their child’s death.  If this is unknown, or if there are still unanswered questions, parents should contact someone who can help them find the answers.

Guilt also floods parents in other ways.  Parents often begin thinking of all kinds of things they wish they had done with or for their child.  For example, a father may feel guilty because he didn’t spend much time with the child.  A mother may feel guilty because she had gone back to work.  Sometimes parents feel guilty because they did not take the child to a requested activity or did not buy the child some desired object.  Some parents experience guilt feelings because they think that the child’s death was somehow a punishment for past sins and transgressions.  Examples of experience which cause this kind of guilt include pregnancy which occurred before marriage, extramarital affairs, poor attendance at church, or a past abortion.

Most of the time, the causes for these guilt feelings are irrational thoughts.  It is helpful for grieving parents to find someone with whom they can share their guilt feelings, sort out the various causes of the guilt, and identify the irrational aspects of these feelings.  Bereaved parents also need to learn to forgive themselves so they are not haunted by the guilt for months and years.

Anger is another common reaction to loss.  Parents may feel angry toward the child, the doctor, other health care professionals, other children, their spouse, or themselves.  Some parents feel anger toward their friends who have normal healthy children.  Parents may also feel anger toward God which may cause them to question their religious beliefs.  Angry feelings toward God may be difficult to accept because they cause guilt and anxiety.  Yet, they are normal and should be discussed openly.

Angry feelings are difficult to deal with because they may not be recognized or the reasons for the anger may be hard to admit openly.  In addition, anger may be hard to express openly since it is not always socially acceptable to do this in our culture.  Anger that is not expressed may lead to a general feeling of irritability that is hard to understand and very hard to shake.  A father may become grouchy at work or with the children.  A mother may find herself shouting at her husband or at a friend.  As with guilt it is important to be able to talk about angry feelings with some neutral person who cares and understands.

The fear that may accompany the parents’ grief involves a general fear that something else terrible and devastating could suddenly happen to hurt them when they know they are so vulnerable. Some parents have lingering fears about the safety of their other children or a husband may fear for his wife or vice-versa.  Parents have also reported fear of being alone, especially at night.

Parents eventually experience intense feelings of emptiness and loneliness accompanied by a deep aching desire to hold and touch their child again.  Parents also report feeling dead inside, as if a part of them had died too.  One mother described this feeling poignantly, “A child is a part of you in a way that no other human being can ever be.  When my child died, a part of me died with him.” For a long time, parents may find themselves preoccupied with thinking about the child.  Everything touched, felt or heard reminds the parents of the child.  Some parents are haunted by the memory of the child as he appeared at death or during an acute illness.  With a sudden death, parents may be haunted by visions of the death scene whether they were present or not.  Sometimes parents feel like the child is still around.  Parents have reported thinking that they heard their child cry, saw their child in a crowd, or felt their child’s presence in the room.  Sometimes parents find themselves getting up at night to check on the child or to give a medication, only to be suddenly faced with the reality there may be an intense desire to hold and touch the child and, at the same time, a desire to run away to avoid being near the child.  It is important for parents to realize that all of these feelings are normal unless exaggerated or prolonged.  During these periods of intense pain, grieving parents need someone who can listen to the feelings and experiences and stay with them in silence when there are no more words to express.

COPING WITH LOSS IS DIFFICULT

To cope with the painful memories of their child, parents may try hard to forget the child and recover from their grief.  When they find themselves doing so, it is not unusual for them to fell a sense of panic followed by desperate attempts to recall the way the child looked, the sound of his voice, or some other aspect of his being.  It is important to know that in time it will be possible for them to think about the child with more happiness and clarity and less pain.

As a result of this struggle to come to grips with the inner feelings that result from the loss of a child, depression often occurs.  Depression can be described a s painful state of feeling blue and unhappy.  People experience depression in different ways.  They may look preoccupied with sad thoughts; they may feel devalued, worthless, tired, and listless.  They may have difficulty concentrating on tasks, become confused easily, and have trouble keeping up at work.  Mothers may find that their housework is piling up and the other children’s needs are often unmet.

Grieving parents may also find it difficult to make decisions, even simple ones.  One major decision which seems to face all of them sooner or later is what to do with the child’s clothing, furniture, and toys.  Relatives may pressure them into quickly removing these items from the home.  For some parents, the child’s possessions may cause too much pain and are best given or put away soon after the death.  Many parents, however, have reported that looking the child’s things for a time helped them face the reality of their loss and helped them to grieve.  Late, some of these items became important memories of their dead child.  It is imp9ortant, however, that the dead child’s room and toys not be turned into a museum which can never be changed or moved.

If this happens, it may be an indication that these parents are not accepting the child’s death and they may need counseling to help them face the death more realistically.  Some parents have found it meaningful to donate some of the child’s clothing and possessions to a pediatric ward, children’s home or other charity.

While some parents find decisions difficult to make, it is also possible to begin making decisions impulsively and without foresight and planning.  Their attitude may be: “What do I have to lose…?” Thus, important decisions should be made carefully and with deliberate thought and planning.  The needs of all family members and the long term effects of all decisions should be carefully considered.

One of the biggest decisions parents often need to discuss is whether to have another baby, if that is possible.  There is an intense desire to replace the child that died.  However, no child can ever replace another child.  It is probably best not to plan another pregnancy until the grieving process has begun to diminish.  This is especially true if the decision to have, or not have, another child has arrived at a result of the child’s illness and death.  Sometimes parents have conflicts because one parent wants another child, while the other does not.  If this occurs, the couple may need to talk over the problem with a skilled professional. Once the decision is made to have another child, the couple may experience difficulty in getting pregnant because of tensions and anxieties.  Patience is very important.

The depression which comes with grief may lead to subtle bodily distress and physical symptoms.  It is not unusual for a grieving parent to have difficulty sleeping, to have a diminished appetite, to become easily fatigued or to develop constipation or headaches.  Sexual interest may be greatly diminished or importance may occur.  Frank medical problems such as ulcers, allergies, or blood pressure elevations may occur.

In order to cope with the difficult emotional feelings and the nagging physical symptoms, bereaved parents may turn to the use of drugs or alcohol to help shut out the pain.  Although drugs are often prescribed by a doctor bereaved parents must be aware that a drug which causes one to feel “better” in a short time or causes one to sleep most of the time may be dangerous.  Such drugs mask the pain of grief and do not allow one to work through the sorrow.  Buried sorrow will often cause problems in future years.  Alcohol is an even more accessible drug which may be tried to ease the pain.  Alcohol, however, can increase such symptoms as depressions, anxiety, sleeplessness, digestive disorders, and problems with concentration.  In addition, the use of either drugs or alcohol can quickly become addictive and lead to serious problems that affect every aspect on one’s life.  Bereaved parents who find themselves becoming dependent on alcohol or drugs need to be honest with themselves and find help through a doctor, clinic, or self-help group.

RECOVERY IS POSSIBLE

The final stage can be called recovery or reorganization. Recovery comes when one is able to deal with reality, to become re-involved with life activities, and to see options and possibilities for the future.  The pain of the loss becomes less intense, the good days outbalance the bad ones, and the child can be discussed and remembered with more happiness. Recovery isn’t “being one’s old self again,” for parents are never their old selves after the loss of a child.  They are always different from what they were before.  Tragic loss can, in time, give rise to renewed meaning and personal growth.

The time frame for grief cannot be sharply defined; there are marked differences among individuals.  One person may recover from the loss in a relatively short time while another person may grieve for a much longer time.  With the death of a child, however, it may take several years for a parent to enter the stage of reorganization.  This does not mean that the parent experiences pain and sorrow every day.  One day or week, a grieving parent may feel better and think the difficult times are behind.  However, some minor experience can suddenly cause the grieving parent to experience sudden, sharp, piercing pain.  Special dates such as the child’s birthday, major holidays, and the anniversary of the child’s death can trigger these periods of pain.  It is extremely important for grieving parents to be patient with themselves and with their spouse when they bad days come.  Gradually, the painful episodes become shorter and less frequent.

          FEARS ABOUT GOING CRAZY CAN OCCUR

Because of the many reactions caused by grief, the resultant depression and the frequent crying, some parents feel like they are going to pieces, fear that they are going crazy, or experience a period when they have no desire to continue living.  It is not uncommon to have these feelings, but most people who are grieving do not go crazy or commit suicide.  It is important, however, that grieving parents have someone with whom they can share and discuss their grief and pain.   Since grief and depression are discomforting, both to the grievers and those around them, some parents may try to deny or cover their feelings.  Our society tends to give grieving persons the impression that strength consists in covering up your painful feelings.  “Look how well she is taking it,” is often said about someone who is externally suffering quietly but inside is deeply hurting.

There are persons who have a more difficult time during the grief process following the death of a child.  Some signs of problems resulting from inadequate handling of grief could include: an inability to cry or express feelings of sorrow, an inability to talk about the child who died, deep depressions, poor self-esteem, persistent guilt, excessive anger, or exaggeration of any of the other normal grief responses.  If a grieving parent hasn’t someone to share feelings and experiences with, or is worried about the intensity or duration of his or her own grief or that of the spouse, it may help to talk with a counselor, nurse, doctor, minister, psychologist, psychiatrist, or other concerned professional.  It is also helpful for bereaved parents to share with other bereaved parents, especially through such self-help groups as Compassionate Friends, Candelighters, Cystic Fibrosis Foundation, and National Sudden Infant Death Syndrome Foundation parent groups.

COMMUNICATING WITH THE SPOUSE

Awareness of one’s own grief and that of other family members is important in the grief process.  It is important to remember that people grieve differently and that family members may exhibit feelings of loss in different ways.

Fathers, for example, may express their grief differently than mothers. Men in our society have often been programmed form early childhood not to show feelings; thus some fathers may tend to hide their feelings and have difficulty talking about the child.  Fathers may also hide their feelings because they have been lead to belie that they must “act strong” for the sake of their spouse who is grieving deeply.  In addition, fathers are often not given the same kind of support from friends and relatives that is shown to the mother.  One father complained bitterly that whenever he ran into a friend or relative they asked how his wife was doing and totally avoided asking how he was doing.  The resultant bottled-up feelings may lead to physical symptoms or behavioral change such as extreme irritability or bossy, demanding comments.

Since our ability to share feelings is based on many variables including our experiences with feelings as a child, mothers may also have difficulty in expressing their pain. More frequently, however, mothers seem to need to talk frequently about their child, about the circumstances of the death, and about their feelings.

Sometimes mothers attempt to do the majority of their sharing with the child’s father. If the father cannot face his wife’s expression of pain, he may begin to stay away from home. The mother, on the other hand, may begin to think that her husband doesn’t really care about the child or about her when he refuses to listen to her or to talk about the death himself. In addition, both the mother and father may become irritable and jumpy which also affects their relationship with each other.

It is important during these difficult periods to keep open the lines of communication, even though communication when under stress is very difficult. Both parents may feel it is important to appear “strong” so as not to upset the other person. In addition, it is difficult to face and share these very personal and painful feelings even with one’s spouse. However, sharing the pain is an important aspect of recovery and is vitally important in maintaining the relationshi9p. To keep the communication open and to restore a feeling of closeness, parents may need to plan times to be together—alone. A night out for dinner or a weekend away from the family may be necessary. Communication with one’s spouse also involves developing an understanding of what he or she is experiencing or may need to communicate. Talking to a professional or to other bereaved parents may help to enhance communication if there are problems.

COMMUNICATION WITH CHILDREN

It is easy for parents to overlook the needs of the siblings or playmates when a child has died. There are probably several  reasons for this problem, such as: 1) Parents are so involved in their own pain, grief, and depression that it is hard to help someone else; 2) In some instanced, especially after a child died following a long chronic illness, parents may have a hard time relating to the remaining children for a time; 3) Parents may want to protect the children from the pain they are experiencing by not talking about the death; 4) Parents may be too uncomfortable themselves to talk  about death; 5) Parents may mistakenly think that the siblings are too young to understand and that the death had no impact on them.

Death of a sibling is upsetting to the children in a family. There is no way of protecting them from the fact of the death and the resultant grief of the parents. The impact of death and the way they respond to the loss of a sibling depends on many factors: their age and developmental level, the relationship they had with the child who died, the relationship with their parents, their previous preparation for the experience with death, and their perception of parental response to the death.

Like parents, children may experience feelings of anger, fear, guilt and loneliness. Sometimes children feel guilty about bad feelings they had toward the child who died or fights they had in the past. Young children may mistakenly believe that their bad thoughts could have somehow contributed to the death. Fear in children usually involves fear of separation and they become frightened that they too could become separated from their parents. Children can also experience symptoms of grief such as irritability, depression, difficulty concentrating, preoccupation with morbid thoughts, fatigue, loss of appetite, sleeplessness, confusion and general feeling of worthlessness.

Children are more apt than adults to work out their grief in their behavior. Some children cry frequently, while other talk incessantly. Children may use play activities to help them understand or express feelings. Playing dead or acting out funeral scenes is not uncommon. Some children also draw or paint sad pictures. Children can also become boisterous and noisy or they may laugh a lot more than usual. Some children become hyperactive for a time. Because of the fear of abandonment and separation that often accompanies death experiences in childhood; children may also become more clinging and dependent on parents. This is especially true of preschool children. Some of the behavior of children is aimed at getting the attention of parents because they desperately want to know that parents understand them and care about them.

Parents, on the other hand, may be having a difficult time coping with the demands and needs of the remaining children. Parents are absorbed in their own grief and have little energy to help others. After a long illness and subsequent death of a child, parents may feel that their relationships with the remaining children seem less intense than the relationship they shared with the dead child. They may fear that they have lost their ability to love. This is a normal and temporary part of grief. When this happens, parents should allow other sensitive relatives or friends to spend extra time with the siblings so their needs are met.

Many times parents become distressed because it appears to them that the siblings have adjusted too quickly, have grieved too little, or have appeared totally unaffected by the death. Children have difficulty knowing how to express their grief and may handle their confusion by trying to get back to their own business of living. They may also be hesitant to speak of the dead child or to express their feelings for fear of upsetting their parents even more. Like adults, children may also try to deny the reality of the death and pretend it didn’t happen. When this occurs, the child may experience a delayed reaction several weeks, months, or even years later. The reaction may occur at the time of another significant loss. Lastly, sometimes young children do not have the vocabulary necessary to explain their feelings. It may take several years before the experience can be put into words.

But children, like adults, often need to talk about the sad and scary feelings caused by the death of a sister or brother. They need to be involved in funeral and grieving rituals of the family. Some of the tears, grief, and pain of the parents should be shared with them also. They need to know why parents are behaving so differently now. Yes, children do notice the grief and depression of parents.

DEATH IS REAL: NEVER HIDE IT FROM CHILDREN

One of the main challenges confronting parents is how to explain death to the remaining children. Explaining death to children forces parents to come to terms with it themselves. This is not easy. When explaining death to children, there are three approaches that can be used: Physical explanation of death, social/psychological aspects of death, and philosophical/religious beliefs of death.

Children need to have an understanding of physical death. The correct terms “dead”, “death” and “died” should be used when discussing the situation. Even though young children don’t know what the words mean, they will eventually develop an understanding. Death is a physical event can best be discussed as part of the cycle of nature. “Dead means not alive anymore. It’s like the leaves on the tress in the winter or flowers that die. Life is over. The body doesn’t work anymore. It doesn’t move or hear or breathe or feel pain or sleep or need to eat. It just stops.” A clear simple explanation should also be given to each child about the cause of death. It should be geared to the developmental level of the child and may need to be repeated several times. It is important to reassure them that they did nothing to cause the death. They also need to be assured about the normality of their body.

Explaining death as a social or psychological event means that the child be helped to understand that the child who died is missed very much and that the parents feel very bad that he has died. Even though painful, it is good to talk about the memories of the child who died. Eventually, it will be possible to remember the child with more happiness. The social meaning of death is the basis for explaining why grief is expressed and why people are sad.

 The religious or philosophical explanation of death involves helping children understand their family’s beliefs about life and about death. Belief in some sort of continuation of the soul after death has prevailed almost universally in human history. Most people in our culture have beliefs that stem from a Judeo-Christian background. Ultimately, parents can help children understand an outlook on life and death which the parents really believe. Children are sensitive to dishonesty in parents. Remember when discussing religious beliefs with children that the abstract concepts involved are very difficult for young children to grasp. Young children can understand only what they can see and feel. They will want to know in concrete terms where God and Heaven are located. It may be many years before they can understand and accept religious concepts.

Children have different ways of coming to grips with the full meaning of death. Some of them will ask many questions while other children may mull over things quietly for a long time. Through the years children will continue to ask questions about death. As they grow and mature, they will try to master full meaning of the death. It is not abnormal if they suddenly ask a question six months or two years later. Their questions will come in the most unexpected time and place. Sometimes the real questions will be disguised. One should try to find out what the child is really asking: “I’m not sure what you mean, can you explain a little?” Questions should be openly and honestly answered with simple, brief explanations. Remember feelings and attitudes are picked up by children as well as words. Maintaining an open and hones communication system between the parent and children, although difficult, will be rewarding in the long run.

In summary, children need parents who will listen to their questions and concerns; who will tell them the truth in simple, understandable terms; who will accept their feelings and behavioral reactions to the death; who will reassure them frequently of their love and understanding; and who will let them resume normal life activities as soon as possible. It is very helpful to arrange to spend periods of time alone with each child, as this will create better opportunities for communication and understanding. It is also important to share activities as a family to reinforce a feeling of family closeness during this time of stress.

The Grief of Parents When a Child Dies

By: Margaret Shandor Miles