Transcript Loss and Grief for Children and Adolescents

Loss and Grief for Children
and Adolescents
Graham Martin OAM, MD,
FRANZCP, DPM
[email protected]
Personal reflections
Death and Children in 2007
Children may experience meaningful loss
through death of
Grandparents, Parents or Siblings
Animals
Death on Television though the News,
or more likely through programs is more
frequent, but may have less impact.
Acute Loss Syndrome
Psychological and Somatic Symptoms
May appear immediately, or delayed
May be exaggerated or apparently
absent
May appear to be a distorted aspect of
one part of the syndrome
Is amenable to support, care, but needs
to run its course
Symptoms
 Somatic Distress - often in waves
 A sense of unreality, with increased emotional
distancing
 Often an intense preoccupation with the image of the
dead
 Feelings of responsibility or guilt
 Disconcerting loss of warmth in relationship, with
irritability or anger
 Changes in patterns of conduct
 Traits of the deceased may appear in the behaviour
of the child
Death of a mother
Universally accepted as more traumatic
Shock, disbelief, denial may be followed
by episodes of panic
Regression
Compensation
Clinging to a mother substitute
Death of a father
All the previous symptoms may occur
Death of a father may be more difficult
for a boy
Death of a sibling
Regret or Guilt may be prominent
Profiting from extra parental attention
Struggling with the reaction of parents
A ‘replacement’ child can have special
problems
Grieving in Infancy
During the first 2 years there may be no true
understanding of death
However, stages of loss (Bowlby, 1958) may
appear:
Protest
Despair
Detachment
There may be later problems with
attachment, or an inability to trust that others
will ‘always’ be there
From age 3
May have more comprehension
May be able to discuss the death
May act out fears and fantasies
May not have concept of death as final;
this may lead to anxieties over sleep
Separation anxiety is common, and
dependency may be strong
Grief work through play
From about age 6
May accept that death is final
May have resulting fears around own
finiteness
Personification of Death
Grief work more verbal
From about age 10
More emotionally mature with an
understanding of the finiteness of death
Most of the intellectual tools to
understand death and its context
Delayed or distorted reactions can
occur
Distorted grief reactions
Overactivity with no sense of loss
Taking on traits of the deceased
A psychosomatic disorder
Alteration of relationships with friends and
siblings
Hostility to certain people (eg professionals)
Withdrawal
Problems at school
Aggressive acting out
Depression with agitation
The Funeral
Whatever our core religious beliefs,
some ceremony is necessary for us to
celebrate a life and acknowledge the
passing
All children should be present and take
part in the mourning as far as they can