Grief in Children and Adolescents

When a child, or a boy, lives the loss of a loved one often it is a traumatic death, linked to a violent and sudden episode. It is of crucial importance to consider that mourning in children is similar to that of adults, but may differ in relation to possible answers, the intensity, duration and especially the time when problems may be experienced (Fava Viziello & Feltrin, 2010) and that these events are related to cognitive and affective child abilities.

 

The factors that influence the mourning process in children are: age and psychic structure of the child, the maturity of his emotional world, the type of death, the bond that the child had with the deceased, family functioning, and presence of a supportive network (Oltjenbruns, 2001).

 

Childhood bereavement

 

A child of five/six years of age can hardly conceive death as a one way event; it is seen as a reversible state. For a small child, in fact, death is a completely new concept and when it is to live the loss of someone dear to him/her (such as a parent or sibling, for example) they need to be guided through this experience. They do not understand what death is, but they intensely perceive the painful emotions at that moment surrounding them (Ronchetti, 2012).

 

Inevitably the family balance is upset and the child lives the emotional atmosphere and significant people’s reactions, without fully understanding what is happening. In childhood, in fact, reactions to grief tend to occur more on the physical, somatic and behavioral level (Oltjenbrunts, 2001): new fears can appear; typical age-related anxieties may increase; there may be a regression in certain behaviors to previous phases of development. The child may become aggressive, oppositional, or isolate themselves, have difficulty at school, with peers and relationships in general.

 

In such a difficult situation to deal with, the child may feel confused and disoriented, so they will need to be reassured and pampered; they will need to understand through words and simple and sincere gestures what happened: in this way, they can then live their pain and their suffering.

Around 8 years of age the child begins to understand the irreversibility of death and its universality, lives intensely the loss and pain because it is already able to understand what suffering is. It is therefore important to help them to voice their emotions, feelings, doubts, answering their curiosities about death, reassuring them, not leaving them alone with concerns and questions, even in absence of definite answers (Ronchetti, 2012); everything can be done together with the child, being close to him.

 

The mourning process in adolescence

 

The tragic event of the death of a loved one in adolescence is a difficult experience that happens in a period of life already chaotic and of difficult management. The boy, as an adult, understands the meaning of death, but has not in himself the psychological and emotional maturity to express emotions related to such a great pain, especially if he believes that it is required to be strong and supportive to other family members (eg, surviving parent or younger siblings).

 

Even with the adolescent is important to open an authentic and sincere communication, help them to open up and talk about what they are living, without forcing them but being available to them.

It is also important to try to tell the truth to the boy about what is happening, even if they look angry or annoyed at hearing things that make them suffer. Teenagers will often show themselves more angry than sad, because anger is a feeling with which they are more familiar. They need to be reassured that the emotions they feel (crying, anger, guilt, sadness, apathy, feelings of worthlessness, longing, fear, despair) are normal, so that they may not be afraid to express their emotions and can express their pain too.

 

The most common reactions to bereavement in adolescents are, at the individual level, lack of energy, sleep disturbances, appetite disturbances, restlessness and irritability, guilt, social withdrawal, concentration problems and academic difficulties. Some may appear angry, frustrated, have suicidal thoughts, be depressed or anxious; others may have an altered self-image or identity crisis, particularly in the case of a death by suicide (De Leo, 2011).

It is Important to consider that the way in which children develop and overcome the pain depends greatly on how friends and family are close to them. Sharing the suffering can help them to cope with the loss.

 

The biggest difference between mourning in adults and children and adolescents is that generally in younger individuals the pain lasts for shorter times and therefore they may experience easier and faster alternations between mourning and daily activities. Even the language in which they express the pain is different from that of adults, and in fact some of mourning reactions can emerge only after several years. For this reason the support to children and teenagers should be available long term (Oltjenbruns, 2001), just to keep them from becoming the “forgotten survivors” (De Leo, 2011).

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