Example of a discussion/support group for parents and children
This is a discussion and support group with a large didactic informational component. This enables the leader to model for the participants an experience of allowing the sharing to feeling while also providing encouragement and information. It is hoped that parents will learn effective ways of balancing helping their children to express feelings while also providing information and possibilities of religious faith.
If the group is comprised largely of professionals and parents not experiencing bereavement but wanting to educate themselves to more effectively help their children the group could be run more didactally with less time left to discussion, encouragement and sharing.
The anecdotes suggested are ones with particular meaning to the writer; should others use this as a model, their own favorite stories and anecdotes might be added to all sections of the program. The sessions have been divided to cover a wide range of material but they are by no means complete. It is also possible to shift the order of presentation of material.
It is suggested that the group be kept small enough to allow for seating in a circle. There ought to be enough time for sharing and even grieving together and for a period of refreshments and informal socializing at the end of each session.
A Time to Learn, to Mourn and to Mend
A General Introduction to the Series and a Discussion of the Concept of the Death of a Loved One as a Life Crisis
1. Leaders introduce themselves and speak briefly about their own training and life experiences that have brought them to wish to offer this series.
2. Introduction to the concept underlying the series, that mourning is a process in which time, knowledge, and the supportive care of others are essential.
3. Acknowledgment that many of those present may also be themselves bereaved, even as they are attempting to meet the needs of a child who is in distress. In our group may be parents who have lost a spouse, grandparents who have lost a child, aunts and uncles who have lost a sibling. Life being as painfully democratic as it is, all who are present will in the future or in the past have lost someone they have loved and need to be of comfort to others who experienced loss.
4. Recognition that we may come to our sessions with different questions, with wisdom to offer one another and information to share. Setting of basic format and guidelines. This is an informational support group in which there will be some opportunity to share personal experience and considerable opportunity to gain understanding and support. It is an educational group and cannot substitute for psychotherapy, but the leaders can help participants to find additional support and are available to speak privately with participants. People have different styles of learning and of coping---all are invited to share something of their own experiences, but all are welcome to pass and may participate by listening if this is more comfortable and appropriate for them. Request that all that is discussed in the room will remain confidential so that participants will feel free to raise concerns and seek guidance.
5. Going around the room for introductions including a brief description of the circumstance or concerns which led them to join the series and what they are most hoping to gain from it. (Group will function most effectively if it is limited to twenty participants)
Death of a Loved One as a Life Crisis
1. Introduce Anne Klimans conception of the experience of the death of a loved one as a natural although painful part of the life cycle whose reality we cannot change. Through psychological first aid we can provide opportunities for growth and recovery, to find better and less painful ways to live with the loss.
2. Death as an event that results in a state of bereavement among the survivors, which in turn requires the work of mourning so that they may live in the least stressful, most gratifying way. (Kliman) There is no timetable for mourning, people take various amounts of time and need varying degrees of help to get through it
3. Different circumstances of death have different impact. When an old person dies the loss is not less but there is not a feeling of tragedy. When a child dies before parents and grandparents it is tragic, an outrage against nature. The death of a young parent is frightening, overwhelming of the survivors. Death by suicide is especially confounding (Kliman). Sudden, accidental and violent death is particularly difficult.
4. Reactions of shock, sense of betrayal, despair, fear of going crazy, fear of being unable to function, feelings of guilt, numbness, disbelief and denial, sadness, rage, irritability are all expectable reactions to a crisis, to having ones life and sense of security turned upside down. Children show distinctive reactions, often different from those of adults. We will discuss these in subsequent sessions.
5.The work of mourning involves remembering and reviewing happy and warm, sad and anger and disappointing memories of the person who died. Facing the full range of reactions to the one who has died keeps us from idealizing their memory and finding fault with all current and future relationships. This is particularly important for children.
6. People can grieve and mourn and move on to a new chapter in their lives without forgetting or dishonoring those they have loved. Life will never be the same as it would have been had the loved one lived, but it can include love, trust and hope again. Our sessions will be addressed to understanding the state of bereavement and the work of bereavement required when reestablishing a fulfilling life, focusing most especially upon the special situation of bereaved children.
Explaining Death to Children
This is conceived of as one or two sessions because of the likelihood of lots of questions, examples and discussions which in a situation involving bereaved adults cannot be fully anticipated or hurried. Allowing two sessions is helpful for the leader who can provide more support and explanation as needed. Additional anecdotal examples can be given if time is not used in discussions.
At the beginning of each of the two sessions provide a brief review of the previous session; i.e. .discussion of loss of a loved one as a life crisis, of bereavement and of the work of mourning.
Talking to Children about the Definition of Death
When it is it best to talk to children about death?
1.Sometimes we have no choice but to be discussing death for the first time when the child has lost a deeply cherished person like a parent. Some of us here have recently faced this situation. In general it is easier for both child and parent when the loss is of a pet, a neighbor or a distant relativeeven of a character in a book, television show or movies.
2. Importance of seeking opportunities for such discussions: Inevitably every child will ultimately have to face the death of someone cherished. When those upon whom the child relies are also bereaved they have far less wherewithall to respond with calmness and patience. It is better to have a chance to discover these painful realities in an emotionally titrated way.
3.When forethought or life has not afforded us the chance to discuss it earlier, it is important to acknowledge that we are sad and angry and hurt ourselves over the loss, but we are not angry at the child even if we seem more impatient and short-temperedwe are angry at what has happened. It is especially important to enlist the help of relatives, friends, clergy, neighbors who are less directly involved who can interpret the surviving relatives behavior and emotions to the child. Encourage discussion within the group of their own experiences and questions.
Defining and describing death
1. Death is not like a game, or like in the cartoons where the character pops up again moments later. It is not like sleep. It is final and irrevocable. The dead person does not breathe, nor move. There is no more hurt and no more pain but there is also no more life. Seek memories of encounters with dead bird or bug. This is very difficult for a person who is describing the state of someone they also loved, so if this is occurring at the time of bereavement the help of others can be sought.
2.Why the need to speak of finality? This clearly varies based upon the age of the child. The younger child believes people can be dead and then un-dead and hard as it is to confront the child with pain, it is a reality to which he or she will have to accommodate eventually.
Telling a child a grandparent or parent has gone on a long trip may seem kind at the time but holds out unrealistic hope and does not allow them to give vent to their true feelings.
We often do this because it is so very painful for us to not to be able to protect young children and to manage their distress but they need our truthfulness to master the realities. Clearly such statements which confuse death and trips will in the long run confound separation problems because children will come to fear that those who go on long trips will never return.
3.What about saying the person who has died has gone to heaven? We will have a longer discussion of speaking to children of the after-life, but it is important to make a distinction between heaven and being alive again on earth. We need to be sensitive and allow for hope even if we ourselves dont believe in an after-life. After all, we dont know for sure and such thoughts have been of comfort throughout time.
On the other hand, promoting beliefs which we really dont hold eventually fail to help the youngest members of a family. It is natural to wish for a reunion and Judaism offers many ideas about life after death which we will explore in sessions 3 and 4. It is important not to spin elaborate visions of heaven as a way of diverting the childs real expressions of griefno matter what, the child has suffered a real loss for the rest of his or her life.
4.Why the need not to describe death as sleep? For a similar reason. Many children become anxious that they too will die and will fear going to sleep. Bedtime is difficult enough for children who may long for a lost parent who previously put them to bed without inadvertently adding to this a fear that they themselves may not awaken.
5.Why the need to be so graphic about deaththe lack of breath, of feeling, of movement? It is important for the child to be able to differentiate his or her state from that of the dead. The dead person in a coffin is not being suffering nor needing air, the burial under ground or cremation is not painful and could not happen to a living person. The loved person does not come to the child, laugh with the child, hold the child because he or she cannot do those things any longer, not because he or she has rejected the child.
6.How much can children understand about death?Distinctions based upon age and developmental level. Even children who are old enough to speak of death may not fully understand its permanence. Importance to recognize that despite what we tell them, young children may persist in their belief that the dead person will return. Not understanding the finality, they often seem to be callous and unfeeling. They are likely to turn back to playing in a way that adults find unsettling. We will discuss these particular reactions children show to learning of a death a little later.
Talking to children about death as a natural part of life
1.There is a time for every living thing to grow and to die. Give examples of this with leaves, animals and people.
2.Joy and pain as parts of life, happiness and tears. It is natural for there to be tremendous sadness and tears when we lose people to death
Our memories do not die
1.The person we loved is dead, we are sad, we will always remember that person and the life and the love we have shared
2.David Techners story from A Time to Mourn, a Time to Comfort about the child on an airplane who was looking for his grandpa in the clouds. Techner, who had himself been bereaved, asked the boy to close his eyes and tell him the best, most favorite story about his grandpa. The boy went on and on about a favorite memory. When he was done, Techner asked him if he had just seen his Grandpa. The boy smiled and said he did. Then Techner told him that he had a daughter who died who he had with him always in his mind and heart, even if he couldnt find her in the clouds.
How do children generally react to learning of about a death?
Every child is unique. Just as adults do not really follow the timetables set out in many books on bereavement, children also react in highly individual ways. Nevertheless, the childs age, temperament, the circumstances of the death and of being informed of it, and previous experiences with loss will all play a part in determining his or her reaction. Keep in mind the childs age and capacity to grasp what has happened.
1. A very young child is more likely to respond initially to the distress shown by others around him or her. The young childs primary need is for security, affection and caretaking. To the degree that other loved people continue to provide this the child may maintain his or her equilibrium.
If the loss is of a parent or primary caretaker the child is likely to demand the return of the loved person, may not understand why they cannot return and may react with regression, withdrawal, clinging and tantrums. The most important message a young child needs to receive is that he or she continues to be safe and loved and the loved person would be there if he or she could have been.
Children of all ages need more than anything else an opportunity to ask questions and express their fears. The very young child may return to play and superficially bright mood and may show little sensitivity or regard to the grief of those around him or her, demanding trips to the park or ice-cream as if nothing had occurred. Absence or recognizable grief is not a sign of hard-heartedness or lack of loveit is a sign of being a very young child. The young childs grief is harder to recognize and will emerge over time as the absence of the loved person is experienced and the finality is grasped as the childs emotional and intellectual growth continues.
2.A school aged child shows increasing grasp of the finality of death, but nevertheless may have a magical sense that the painful realities can be undone. Children of all ages have a tendency to hold themselves responsible for the death of loved ones, believing had they only behaved better this might not have occurred.
Commonly they have great fears about their own deaths. They may show some grief in a way adults recognize---tearfulness, sadness. Like younger children, they may return to play and peers and be able tolerate being around sadness for only so long. Children are blunt in their questions and reactions. They often are most angry and frightened over the upset in their routines. They are terribly worried about what will become of them. Describe the childs reactions in James Agees A Death in the Family.
3.The Need for New Objects: Both very young children and school age children may express a wish to get a new Mommy or a new Daddy in a way that seems fickle and disturbing to adults. Yet, for children this is an appropriate response as they truly do require the provision of another love object if their development and sense of security is to proceed normally.
Children require parents to love them and to make them secure---and if new love objects arent found withdrawal, apathy and failure to thrive may be the result. (Bowlby) Grandparents and other caring relatives may fill the gap, but their need must not be understood as shallowness of attachment or lack of loyalty.
This is particularly difficult for surviving spouses and grandparents, who may not recognize the health inherent in the childs movement toward others which reflects the depth and positive nature of the original tie to the one they have lost. Story of the Nicky, the orphan adopted from abroad.
He had been cared for by an ailing mother until he was nearly two, and then inadequately cared for after her death and finally placed in a poorly staffed orphanage. He was adopted at age three and had difficulty attaching to his adoptive mother. Ultimately when he had come to accept her and she rocked him he said, I cried so much when you went away, I missed you so much until you came back.
In tears his adoptive mother could say, I missed you so much till I could hold you in my arms too. In time they can sort out which mother is which, but the young child must have a continuance of love and will more readily transfer this love to a new object.
4.Teens are the furthest along in their capacity to understand the finality of their lossand it comes at a time when they so need their parents to survive. Often in conflict with their parents, they nevertheless have an enormous need to know their parents are there when they need them.
They have trouble acknowledging their need and their peers may or may not be adequately able to empathize with their plight. They may feel guilty over what they may have said to the parent who has died, they may feel they have caused their illness, they often fear they too will die.
They may have difficulty turning to the surviving parent, fearing being babyish, fearing their parents over-dependence upon them in the absence of a spouse. They may show a range of reactions from moodiness to denial and attempt to proceed as if the death had not occurred.
They, and school age children may feel intense shame that the loss has rendered them different than their peers. They may feel more afraid to leave home, more afraid of losing the surviving parent.
What can adults do to help?
1.The most important words--I will listen. Nobody really understands death, but we can help each other. I will be here. We will all feel better, even if it takes a long time. It is O.K. to feel better.
2.Help the child to express feelings by remembering together, sharing your own emotions, observing religious rituals.
3.Try to involve the family in a community where others provide support and ongoing care and hopein the next session we will discuss what Judaism offers.
4.Provide professional help in the form of support group or psychotherapy where the child is showing symptoms and unable to communicate with parent or relatives, where the childs anxiety does not abate, where child is unable to re-invest in life. Discuss concerns about how long is too long.