Helping Kids Deal with Overcoming Loss

As we have come to the first year anniversary of the tragic Boston Marathon bombing, we find ourselves again dealing with tragic loss around the world - from natural disasters, to illnesses, to the Ferry Disaster in South Korea. And we all experience loss (we tell ourselves that it is, unfortunately a part of life), tragic disasters and personal loss are difficult for adults to deal with, and we worry about the ramifications even more that our felt by our children. 

Below are suggestions on how parents can help their children deal with loss along with additional resource links.  May all our losses be few and far between, and when we must face them, may we have the strength to face them gracefully and effectively.

Common Ways Children Respond to Loss and Death Children express their grief, feelings/fears of loss, and anxieties in a variety of ways. Here are some of the most prevalent ways:

• Loss of concentration
• Anger and irritability
• Inability to sleep
• Nightmares
• Loss of appetite
• Playing games centered around the event or about dying
• Fears of being alone (or in the dark)
• Withdrawal from friends
• Physical complaints (such as headaches and stomachaches)

NOTE: Children's reactions to trauma are strongly influenced by adults' responses.

The NIMH (National Institute of Mental Helath) notes the following ways children might respond to trauma:

Children age 5 and under may react in a number of ways including:

• Showing signs of fear
• Clinging to parent or caregiver
• Crying or screaming
• Whimpering or trembling
• Moving aimlessly
• Becoming immobile
• Returning to behaviors common to being younger
• Thumbsucking
• Bedwetting
• Being afraid of the dark.

Children age 6 to 11 may react by:

• Isolating themselves
• Becoming quiet around friends, family, and teachers
• Having nightmares or other sleep problems
• Refusing to go to bed
• Becoming irritable or disruptive
• Having outbursts of anger
• Starting fights
• Being unable to concentrate
• Refusing to go to school
• Complaining of physical problems
• Developing unfounded fears
• Becoming depressed
• Expressing guilt over what happened
• Feeling numb emotionally
• Doing poorly with school and homework
• Losing interest in fun activities.

Adolescents age 12 to 17 may react by:

• Having flashbacks to the event (flashbacks are the mind reliving the event)
• Having nightmares or other sleep problems
• Avoiding reminders of the event
• Using or abusing drugs, alcohol, or tobacco
• Being disruptive, disrespectful, or behaving destructively
• Having physical complaints
• Feeling isolated or confused
• Being depressed
• Being angry
• Losing interest in previously enjoyable activities
• Having suicidal thoughts. 
• Adolescents may feel guilty. They may feel guilt for not preventing injury or deaths. They also may have thoughts of revenge.

Examples of problematic behaviors could be:

• Refusing to go to places that remind them of the event
• Emotional numbness
• Behaving dangerously
• Unexplained anger/rage
• Sleep problems including nightmares.

Gene Beresin, M.D. wrote after the Boston Marathon, that after tragic loss, children need to have the answers to the following three fundamental questions:

1. Am I safe?
2. Are the people who take care of me safe?
3. How will these tragic events affect my daily life?

Beresin then continues that these questions can (and should) be answered as often as need be (and often repeatedly, especially immediately following the tragic event) through words and through actions.

How might you show your child they are safe?

• Provide for their needs without them even having to ask (food, laying out clothing, bathing, hugs and nurturance, reading, etc.)
• Let children partake in decision making from choice of meals to clothing to new family rules/routines.
• Let them call, text, and/or email close friends and relatives. Let them feel the love around them.
• Keep to normal schedules as much as possible. 
• Let them be sad and allow them to react in the ways they're reacting (including bedwetting).
• Keep to family rules and structures as much as possible (same rules, bedtime, meal structure, etc.). Don't be afraid to say "no" when you need to. In fact saying  "no" when you need to tells the child that some things are still the same (and that is often reassuring).
• Share your feelings with your children, as you encourage (but don't force) them to share their feelings, letting them know that not only is it okay to be frightened, sad and/or angry, but it is actually part of being human. 
• Let them and/or encourage them to ask questions.  When responding use very concrete words  (avoiding euphemisms such as "dead" and not "passed on" or "the very worst thing"). At the same time, adults should know that it's alright to not always have the answers. Also understand that children may ask the same question(s) repeatedly.  Let them.  This is their way of internalizing the events, questions and responses. Furthermore,  these repeated questions about death are a form of reassurance that the story hasn't changed.
• Explain how these events will effect their daily lives.
• Tell your child what to expect over the next few days/week/months.
• Know that art/play is often an effective way for children to work out their feelings.  IF you see your child "stuck" in one scenario of play (repeating the same event repeatedly), offer some suggestions for change or resolution of that scenario.
• Know that children will often complain of physical symptoms - address them don't ignore them.

FINAL NOTE: Reading aloud is a wonderful way of providing a SAFE environment, while providing a vehicle to problem solve and talk about trauma and loss.  Here are a few reading suggestions:

• Always and Forever by Alan Durant (picture book ages 3+) When Fox dies, Mole, Hare and Otter are devastated. When Squirrel visits she reminds them of all the warm and funny things about Fox and they realize that in their hearts, Fox is still with them.
• Dead Bird by Margaret Brown Wise (picture book ages 4+) With sparse text and warm images and design, the author shares feelings about death and provides a starting point for discussion about the feelings and fears young children may face with the loss of a pet or loved one.
• Everett Anderson's Goodbye by Lucille Clifton (picture book ages 5+) We see Everett Anderson come to grips with his father's death as he goes through the five states of grief in this sparse and moving poem.
• The Scar by Charlotte Moundlic (picture book ages 5+) A boy struggles with severe emotional swings following the death of his mother (sadness, sympathy and fear). He tries to deal with these emotional fluctuations by closing all the windows, holding his breath and running until his heart pounds.
• Someone Special Died by Joan Prestine (picture book ages 3+) An unencumbered explanation of death for children that addresses the feelings they may have about death.
• When Dinosaurs Die: A Guide to Understanding Death by Laurie Kransky Brown and Marc Brown (picture book ages 4+) This book answers common questions kids have after experiencing the death of a loved one. The questions are answered honestly and frankly, and are paired with wonderfully gentle illustrations.
• A Terrible Thing Happened: A Story for Children Who Have Witnessed Violence or Trauma by Margaret M. Holmes; published by the American Psychological Association, ages 4+) The story of Sherman Smith who saw the most terrible thing happen. He meets Ms. Maple who helps him talk about what he was trying to forget (and as a result had bad stomach aches, nightmares, was angry and got into trouble). The story is told with text and pictures and has an afterward by Sasha J. Mudlaff with extensive suggestions for parents and caregivers on how to help traumatized children.
• Bird by Zetta Elliott (ages 7+) Mekhai (a.k.a. "Bird"), struggling to understand the death of his grandfather and his older brother's drug addiction, retreats into his art. This story provides a look at a boy coping with his real-life troubles and traumas.

For older kids:

I Kill Giants by Joe Kelly and J.M. Ken Nimura (graphic novel grades 5+) Barbara, a fifth grader must come to terms with her mother's death. A MUST READ book. 

Found at :http://www.deeprootsathome.com/wp-content/uploads/2011/08/reading-aloud.jpg

Additional Resources and Related Links:

• http://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-violence-and-disasters-parents/index.shtml (my favorite link)
• http://departingthetext.blogspot.com/2011/01/helping-kids-deal-with-violence.html  - helping kids deal with violence
• http://departingthetext.blogspot.com/2011/03/do-we-still-need-pbs-or-has-mister.html - dealing with bullying (and related loss)
• http://www.nasponline.org/resources/crisis_safety/Books_for_Children_Dealing_With_Loss_or_Trauma.pdf
• http://kidshealth.org/parent/emotions/feelings/death.html 
• http://www.psychologytoday.com/blog/stop-the-cycle/201202/five-ways-children-overcome-tragedy
• http://www.thirteen.org/edonline/coping.html
• http://journeyofhearts.org/grief/kids_loss.html
• http://commonhealth.wbur.org/2013/04/talk-children-marathon-bombs

As always, thank you for your visit.  Please leave your own means of helping your kids cope with loss and trauma in the comments below.

May all your lives be blessed wi

th joy and as little loss as possible.