Stewarding Children's Grief

Stewarding Children's Grief
Helping Families Heal Together
By Tom Golden LCSW

There is tremendous diversity in the way we choose to heal from grief. We each have our own path, and gender is, of course, just one of the many factors involved in the direction that path may take.

Each person within the family may very well have a different way of healing themselves. Some persons may have a great need to talk, others may need to connect their grief with action, while another might be quietly healing in his or her own private manner. This diversity can often lead to trouble in the family, with barbs being thrown or held in consciousness about some other family member not grieving in the "right" way. This article is meant to get us started in examining some ideas about healing grief within our family.

My son and I were playing a friendly game of catch. As I tossed him the ball, I noticed the mitt he was wearing. It had been my father's baseball glove which he had used when I was in Little League. I remembered the many times my father had gone to Little League practice and coached or hit fly balls to us. Sports was not really his forte, but he made sure to be a part of my life. A scientist and researcher with NASA, he was a dedicated father who enjoyed spending time with his three children and involving himself with their separate interests.

The question arises, "How can we honor such diversity
within a family unit at a time of great loss?"

Luke, my 7-year-old son, had chosen that particular glove as his own, perhaps because it was old and very flexible and perhaps due to it having been his grandfather's. This glove has given us many opportunities to talk about my father and his recent death. As we toss the ball back and forth, it is a link into my father and his history. Luke and I have had many of these conversations, usually quick and to the point. Luke might make a particularly good catch and then say it was the glove that helped him with such a spectacular play. I then might say, "Yeah, that's a special glove. I sure do miss Granddaddy." Luke agrees and points out that he misses his sense of humor; the game goes on. These short interludes serve us both as a way to remember and honor our pain at the loss of my father, and his grandfather. Healing grief is a matter of chipping away at the potent feelings over and over again. Taking small chunks during an activity such as playing catch is certainly a valid form of healing.

My daughter Julia (13 years old) has a very different way to approach her pain. Julia will approach me and request "special time," meaning we are to sit and talk about something. She says, "I miss Granddaddy," and proceeds to talk of her feelings of loss. She already has the agenda and will happily orchestrate the conversation. This, too, is a valid form of healing.

A part of the reason for the difference
between Julia and Luke is their age.

Julia is more developed physically/psychologically and has a more sophisticated understanding of her emotions. But there is also a difference that has to do with gender. Luke loves to do things and maybe talk some while we are actively participating together. I learn more about Luke and his life while we are wrestling than any other time. We will be grunting and groaning as we push at each other's body, and, all of the sudden, he will stop and say something about his day. Just as quickly we are back at it again. This pattern continues with brief flashes of self-disclosure during activities.

Julia, however, doesn't seem to need the activity. She needs the emotional contact and attention. Both ways are healing; both need to be honored. Although I believe this is a gender difference, it could easily go the other way, with my daughter preferring activity and my son more inclined to talk. It is not that boys do it one way and girls another. It is that as parents we are responsible for finding our children's individual gifts in healing themselves and then helping them use it. Grief is a potent force, and we need to find ways to steward our children's connection with feelings of loss and their healing.

Grief is no different than
any other process that
children learn.

As parents, we steward our children's anger, homework, sexuality, social skills, bathroom behavior, and a long list of many others.

We tend to be more active in our assistance with the younger ones and expect more from children as they grow and mature. We make decisions about what the child needs to know at any given time and find ways to teach them the next level when they are ready. Homework might be a good example. Think of a very young child and how you help them with their studies. Usually we tend to be more active in finding an appropriate place for them to work and are also active in our help with their learning. As the child grows older, we expect and teach different things. We do less of the actual work and more teaching skills in how to work.

Stewarding a child's grief is the same. We adjust our approach to their pain based on their level of development and our assessment of their needs. But stewarding grief is a tough task for parents who are actively grieving.

This is stewardship. We give to them what they need at
any given time based on our understanding of their
individual qualities and their level of development.

It is often a time when our "parent" energy to teach, help, and engage our kids is at an all time low. We too are in need of healing. The saving grace, however, is that by stewarding our children's grief we ourselves heal. Each time I have a burst of a conversation with Luke about my father or each time Julia asks me for "special time," I get in touch with my grief and loss. By stewarding I am also healing.

Sometimes parents want to hide their feelings of grief and loss from their kids. Occasionally this can be appropriate, but usually if the parent holds back it stops the healing for both parent and child. The kids sense that there is something not being said and will pick up that this "holding back" must be the adult way to do things. We need to be open with our kids about our grief in a way that helps them to see that we are grieving.

When we allow our kids to see our grief,
we give them the best teaching
we could give: a role model.
This can be helpful to both
parents and children.

With this said, let's look at a couple of ideas of ways families can heal together.

1. The first idea is to make sure that the name of the person who died is spoken in your household. Speaking the name of the person has a powerful effect. If the name is not spoken, it sets up a situation where it seems that the topic of this person (or pet?) is not one that is open for conversation. Saying the name out loud states clearly that the topic is indeed open. Children will respond to this in their own way. Watch carefully how they respond and you will learn their ways of healing.

Speaking the name can manifest in a number of ways. It does not have to be on a rigid schedule or formally spoken. The best ways I have found are to bring up my father's name in spontaneous situations. For example, as we are having dinner I might mention my father's love of something related to what we are talking about. This gives a green light for the kids (or the adults) to speak up if they wish, or to remain silent; both are acceptable. Sometimes kids have very introverted ways of healing and can benefit from listening to another's conversation. We need to honor all ways. Another way of speaking the name is to include the person's name in the prayers you use, such as requesting special blessings for this person or using a prayer that may have been a favorite of theirs.

2. A related idea is to have pictures of the person who died in different places in your home. In my house we have pictures of my father on the refrigerator, stuck to some cabinets, and in some other spots. This has a similar effect as speaking the name. It includes and honors the person who died and gives a similar green light for discussion and healing.

3. Creating family activities in honor of the person who died is a great way to accommodate all of the differences within your family. The activity allows both a place to talk about the loss and an opportunity to connect one's action with the grief.

Let's say the person who died loved fishing. In this case you might plan a family activity for everyone to go fishing. You make it clear that this trip is in honor of the person who died. On the trip you make sure that the person's name is spoken and that the participants know the nature of the honoring. If conversations come up about the person, then that is great; if not, that is okay too. Doing something together as a family in honor of the person who died is healing in itself. What generally happens is that the kids get into it in their own ways. In my family Luke would say that he is going to catch the biggest fish for Granddaddy. In that way he connects the trip and his action (fishing) with his grief for his grandfather. There is healing in this. The activity provides a "ground" in which the entire family can plant the seeds of their grief in their own way. Some family members may talk and cry about the loss, while others may connect their pain and tears with their goal to catch the biggest fish. This same idea is important with regard to holidays and anniversaries. There are many ways to honor the person who died, and you can use your creativity to find an activity that fits your family.Let's say the person who died loved fishing. In this case you might plan a family activity for everyone to go fishing. You make it clear that this trip is in honor of the person who died. On the trip you make sure that the person's name is spoken and that the participants know the nature of the honoring. If conversations come up about the person, then that is great; if not, that is okay too. Doing something together as a family in honor of the person who died is healing in itself. What generally happens is that the kids get into it in their own ways. In my family Luke would say that he is going to catch the biggest fish for Granddaddy. In that way he connects the trip and his action (fishing) with his grief for his grandfather. There is healing in this. The activity provides a "ground" in which the entire family can plant the seeds of their grief in their own way. Some family members may talk and cry about the loss, while others may connect their pain and tears with their goal to catch the biggest fish. This same idea is important with regard to holidays and anniversaries. There are many ways to honor the person who died, and you can use your creativity to find an activity that fits your family.

4. A traditional form of the activity idea is that of visiting the grave. But often this is impractical due to distance or other reasons. The kids also sometimes think it is "dumb." A variation on this is to create a place that becomes linked to the person who died. Maybe that person had a favorite spot, or maybe your family has a beautiful spot that everyone enjoys visiting. As a parent you can link that spot with the person who died. You can declare it a spot that the person who died loved (or would have loved), and your family visits there can include the memories of this person. It might be a waterfall, or like a family I know, an amusement park. No words need be spoken as long as the family knows the link has been made. Most times I think you will find that the person becomes a topic of discussion when visiting that place.

5. Another family I know created a needlework (counted cross-stitch) memorial in honor of a family member who had died. The father laid out the pattern, and the mother and children did the sewing. With the help of the kids, the father made a frame, and the needlework was dedicated to the person who died and put in a place of honor in the family home. It was a family project that used everyone's energy and involved everyone in the healing process. The examples could go on and on: one family put together a video, another created a sculpture for their yard. The important point is that these families found a project that could be used as a means of honoring the person who died while at the same time giving the family a joint space to honor their grief. By doing things together as a family in honor of the person who died you are creating a healing space for the whole family.

As parents we need to find a variety of ways to help ourselves and our family heal our grief and pain. By doing it together, we not only heal, we come closer as a family unit.

About Tom Golden

Tom Golden is well known for his first book Swallowed by a Snake: The Gift of the Masculine Side of Healing which opened the conversation about men and emotions. The book was acclaimed by Elisabeth Kubler-Ross, Hope Edelman, Robert Bly, and many others. Since then Tom has written The Way Men Heal and Helping Mothers be Closer to Their Sons.

Tom enjoys giving workshops in the United States, Canada, Europe and Australia having been named the "1999 International Grief Educator” by the Australian Centre for Grief Education. Drawing on thirty years of practical, hands-on clinical experience, Tom brings a gentle sense of humor and a gift for storytelling to both his workshops and his writing. His work and his web site webhealing.com have been featured in the New York Times, the Washington Post, and U.S. News and World Report, as well as on CNN, CBS Evening News, ESPN, and the NFL Channel. He served as the Vice Chair of the Maryland Commission for Men’s Health and presently lives outside Washington D.C. and does online consultations.

Tom Golden, LCSW
 P.O. Box 83658
Gaithersburg, Maryland 20883
www.webhealing.com

The Use of Anti-Depressants
After Death of Loved One

Dear Dr. Neimeyer

Is the best and probably only way to get through complicated grief through the use of anti-depressants? Thanks, Demi

Dear Demi,

Both clinical experience and clinical research suggest that antidepressant medication is a mixed blessing in the context of bereavement for several reasons. In fact, for many years psychiatrists agreed that depression could not be diagnosed in the early months following the death of a loved one, because profound sadness and its disruptive effects on the survivor’s life could be understood as essentially normal, rather than a “mental disorder” that required medical intervention. However, this has recently changed, as bereavement is no longer excluded from the diagnosis of a depressive disorder, opening the door to more widespread use of drugs as a treatment option from the early weeks following loss. However, evidence suggests caution in following this path.

"... antidepressants rarely 'fill the bill'
as an adequate treatment for
bereavement ... grief and
depression are substantially
different things."

One reason for caution is that reaching for a solution to a profound and very real existential challenge in the form of medication could lead professionals, potential social support figures, and the bereaved themselves to neglect other forms of support and coping that have been shown to be at least as effective as medication in addressing depression. For example:

• Closely retelling and reviewing the circumstances of the loss.
• Processing the meaning of the loss for our lives via journaling.
• Prompting ourselves to actively re-engage the world and circumstances we have avoided since the loss.
• Seeking the practical and emotional support of others in our lives.

These have all been found to improve adjustment to bereavement in general, and depressive reactions in particular. Sometimes medication can help people find the energy to engage in these other forms of self-help, but it does not in itself accomplish the many psychological, social, and family changes that bereavement requires.

A related reason that antidepressants rarely “fill the bill” as an adequate treatment for bereavement is that grief and depression are substantially different things. Granted, sadness, lack of energy, and withdrawal may be common to both, but the key symptoms of complicated grief (profound separation distress, preoccupation with the death, feeling that our future is without meaning in the absence of the loved one) cannot be found in any list of symptoms of depression, and in fact have more in common with anxiety states than with depression, per se. Accordingly, multiple studies have shown that these core features of separation distress simply are not helped greatly by antidepressants, even if medication does improve symptoms of depression (inability to experience pleasure, loss of energy, disrupted sleep, etc.) more narrowly defined.

So what might be the appropriate role
for antidepressants in treating
complicated grief?

Perhaps the most enlightened view would be that they can play a useful role in addressing depression triggered by the loss, though not separation distress, when both conditions co-occur for several months following a loved one’s death (as one study suggests might be the case for approximately 25% of survivors of a loved one’s violent death, for example).

In other words, antidepressant medication is rarely if ever a sufficient treatment for bereavement distress, though it can contribute to survivors’ adaptation when depressive symptoms compound complicated grief.

Used alongside social support, personal efforts to process the loss and re-engage life, and professional counseling or psychotherapy, anti-depressants can sometimes provide a partial answer to the many biopsychosocial challenges of loss, though not a comprehensive one.

About Dr. Robert Neimeyer

Robert A. Neimeyer, Ph.D., is Professor in the Department of Psychology, University of Memphis, where he also maintains an active clinical practice. Dr. Neimeyer also serves as Director of the Portland Institute for Loss and Transition, which offers training and certification in grief therapy. He has published 30 books and authored nearly 500 articles to advance a more adequate theory of grieving as a meaning-making process. 

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