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Special Situation: Childhood Bereavement by Rea Ginsberg, LCSW-C, ACSW, BCD

Monday, 08 Jul 2013 02:45

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adult-and-child-holding-hands

In the case of childhood bereavement, the death of a parent, the term “bereaved caregiver” no longer applies.  The tables are turned.  The child is indeed bereaved, but he himself is in need of a caregiver.

It seems senseless to debate which types of grief are the worst; Which are the hardest to bear.  Every form hurts so very far beyond what feels like normal limits and ordinary words.  Every form requires extraordinary coping skills.  Every form holds its hazards.  However, this childhood form does appear to be among the very worst.  “When his parent dies, a child finds himself in a unique situation because of the special nature of his ties to the deceased….[He] invests almost all of his feelings in his parents….This single relationship is therefore incomparably rich and intense, unlike any close adult relationship.  Only in childhood can death deprive an individual of so much opportunity to love and be loved and face him with so difficult a task of adaptation….The death of a parent engenders a longing of incomparable amount, intensity, and longevity.” 2

The child’s loss of a parent is one of the most difficult forms of bereavement.  The mind of the child is immature.  It is filled with magic, denial, narcissism, and self-reference.  It says he is omnipotent and responsible for all external and internal events.  If he is omnipotent, all-powerful, then his thoughts and/or actions must have caused the death.  “Bad boy!” he imagines.  Furthermore, he may well believe that the dead parent left him because he is unlovable.  He may wonder about, and fear for, his own survival and death.  Reality testing has not been mastered.  Abstract thinking is only embryonic.  Emotional coping skills are primitive, undeveloped..  He is more likely to express his feelings in physical actions rather than in words.  Hyperactivity is a frequent defense against grief and anxiety.  Adequate, nuanced verbal vocabulary is still narrow and unformed.  The concept of “waiting” is virtually nonexistent.  Postponement of gratification is merely a work in progress.  It is not yet a reality.

Death makes no sense in these formative years.  The child’s experience tells him: that which disappears may eventually reappear.  Fear tells him otherwise.  This thought of reappearance co-exists with the fear and outrage of abandonment.  Fear of – and outrage about – abandonment become a sustained, screaming, breathless reality in the case of death.  The loss is far-reaching.  Recovery is arduous, exhausting, and hard to accomplish.  The death of a parent is life-altering on a permanent basis.  It is a severe emotional wound.  It is traumatic.

Although we know that, after such a loss, acute mourning will subside, we also know that a part of us shall remain inconsolable and never find a substitute.  No matter what we believe may fill the gap…we will nevertheless remain changed forever…” 3

This troublesome outlook for the child can be mitigated by the understanding and compassionate presence of the other parent or another adult.  Even an older sibling can soften the hardship.  Someone must be there to receive and relieve the child’s distress.  The child cannot be left alone to cope with loss and still remain healthy.  Every person needs to know he is not alone with grief.  The child is especially vulnerable and needy in this respect.

The optimistic side of this equation is the malleability of the child’s mind.  In important ways, he is easily influenced, persuaded.  His thinking and feelings can be shaped by sympathetic others.  The “bad boy” of the child’s imagination requires immediate recognition and attention by at least one caring adult.  The fear and rage need the mature balance and moderation of others’ views.  The child needs the gentle guidance of a perceptive, patient, and capable caregiver.  The caregiver must have a strong, intuitive understanding of children and their varied ways of expressing emotions.  The adult was once a child.  The caregiver should be in touch with the child within himself.  That is one primary route to the necessary and sufficient comforting of the bereaved child.  Also, “the child…profits especially when the [surviving] parent can reassure him that the family will remain together, that his needs will be taken care of as best possible, and that he will be told step by step as each arrangement is planned..” 4

Experiences tend to build on each other.  Certainly, if this is the child’s first major experience with bereavement, it may well set the stage for many future experiences with death and dying.  An appropriate grief experience could help the child to manage future loss experiences successfully.  The child at any stage of development possesses both character strengths and character weaknesses.  Those and the impact of the psychosocial environment determine the outcome of bereavement.

[The importance of chronological age and developmental stage are emphasized.]  “The total character of the child and…the totality of environmental circumstances…determine the outcome of the experience….The interaction between internal and external forces decides between the possibility of normal developmental progress and the incidence of pathological developmental distortion or arrest.” 5

If the child’s caregiver is the other parent, we have come full circle, returning to the bereaved caregiver.  He must attend to his own grief and to the grief of his child.  Perhaps, in some important sense, parent and child comfort, soothe, and reassure each other.  They support one another.  The feeling of deep sorrow is shared.  The process and progress of the caregiver’s bereavement is then highly significant not only for himself but also for his child.  It is a large responsibility. Honesty and openness are virtually always good policy with children.  The subject of death can carefully follow this pathway – when the caregiver is strong enough and wise enough to pursue it.  Children are resilient despite obstacles.  Grownups are, too.  Parent and child honor the life of the lost loved one by continuing to live.  That is strength and growth.

Rea Ginsberg, LCSW-C, ACSW, BCD, Retired Director of Social Work Services and a Hospice Coordinator http://www.linkedin.com/pub/rea-l-ginsberg/59/34b/623

 

References:

1. A group of highly sophisticated psychotherapists/researchers working with bereaved children wrote:

“Throughout the work, in our direct contacts with our patients and their families, in our private thinking and in our research discussions, we lived with the intense distress, pain, and anguish engendered by bereavement.  We have come to understand that this emotional distress is an inevitable burden for all who work with bereaved children.  It is essential in facilitating appropriate empathy and insight, and helpful in integrating an intellectual grasp of the psychic processes within the patients’ personalities.  Only those willing and able to bear the impact with feeling can hope to work with bereaved children fruitfully and to understand them scientifically.”

Erna Furman, A Child’s Parent Dies: Studies in Childhood Bereavement, New Haven and London: Yale University Press, 1974, p. 9.

2. Erna Furman, ibid., p. 12 & p. 16.

3. Sigmund Freud, letter to Binswanger, 1929, in: E. Freud, editor, Letters of Sigmund Freud, transl. Stern&Stern, New York: Basic Books, 1960, p. 386.  With special thanks also to Joanne Cacciatore, PhD, for pointing to this quote and for her uniquely beautiful word picture showing these thoughts: private communication, 28 June, 2013. [see below]

4. Erna Furman, op. cit., p. 20.

5. Anna Freud, Forward to: Erna Furman, A Child’s Parent Dies: Studies in Childhood Bereavement, New Haven and London: Yale University Press, 1974.

(photo credit:http://tarabodong.org/?event=mindful-parenting-an-interactive-workshop-for-parents )

 

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6 thoughts on “Special Situation: Childhood Bereavement by Rea Ginsberg, LCSW-C, ACSW, BCD

  1. Sue Wintz

    Excellent piece. HealthCare Chaplaincy and the New York Life Foundation are currently working to create a pilot program that will take a unique “first aid” approach towards child bereavement situations. The goal is to help hospitals create best practices and protocols for chaplains and other hospital staff on how to care for children following the acute death of a beloved family member. You can learn more about it in an open access article in PlainViews at http://bit.ly/17n2mzl

    An essential part of the program is a survey we are currently conducting to identify practices and challenges for the clinicians involved in providing bereavement care to children when an acute death occurs. The link is in the PlainViews article and directly at http://bit.ly/13K6tTC We would greatly appreciate any feedback that professionals in any discipline would provide.

    Reply
  2. Pingback: Special Situation: Childhood Bereavement by Rea Ginsberg, LCSW-C, ACSW, BCD | It’s OK to Die | Loss, Grief, Transitions and Relationship Support

  3. Pingback: Child Bereavement Needs Special Attention | Scotto Funeral Home

  4. Julie Tinberg

    I was 13 when I lost my mother. At age 56 I can say this was definitely the “biggest” thing that ever happened to me. It has colored my whole life. I’ve read a lot on the grief of a child, but your article was the most poignant, honest and clear discussion of the grief I felt at that time. For 15 years after her death I still had dreams of her coming back to life. I felt the guilt of causing her death and the scary possibility my 5 siblings and I would be split up and sent to live with relatives. In this way, I have been able to face adversity now, knowing that nothing could EVER be this bad.

    Thanks so much for the wonderful article!

    Reply
    1. Rea Ginsberg

      Thank you, Julie. Your comment is so valuable. Very sensitively expressed. Not easy but certainly the right thing to do. Sometimes I ask myself how so many people can presume to “know” grief when they have no intimate experience with it.

      Childhood bereavement holds perhaps the greatest potential for healthy growth. Pleasure in living. Love of self and others. Creativity. It is the hidden value of adversity. The hint of later beauty, sensitivity, and wisdom in adulthood. Grief has its own very special, enduring bonuses.

      Reply

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