When a child—or anyone—experiences the death or other loss of a loved one, the mind, heart and body may go through any or all of the 5 stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
These stages don’t occur in any particular order and each grieving person experiences the stages differently. Some people express their emotions outright and it is evident which of the stages the person is experiencing; others may hold their emotions inside so that no one knows which of the stages the person is experiencing.
Since grieving requires a cognitive understanding of death and the finality that comes from death, cognitive development plays a significant role in how adults grieve versus the way children grieve. Adults are more likely to use their cognitive mind to talk through what happened—internally or with another person—and process all of the loss related information. But, since children’ don’t have the cognitive capacity yet to do this, they will not be able to use words to express what they are feeling, and will instead use emotions and behaviors to process the loss.
INFANTS AND TODDLERS
Infants and toddlers cannot grasp the finite concept of death. Children of this age will notice that the people around them are sad and distressed, but aren’t advanced enough to know why. Older infants and toddlers can notice that an important person is missing and has been missing for a while, but are not able to link this to the sadness and distress that the family is experiencing.
Children this age do not have the slightest understanding of death or what it means to be dead. While they recognize that a significant person is missing, they can’t differentiate this from the scenario in which a parent goes to work or grandparents head home after the weekend is over. Their brains cannot understand the fact that this person is gone and will be gone forever.
As a result, their emotional and behavioral reactions may be similar to those that would occur if a parent unexpectedly went on a trip. While they don’t know the severity of the situation, they do know that they want their loved one back desperately, so their emotions and behaviors may become extreme before they get better.
BEHAVIORS THAT MAY BE COMMON IN INFANTS AND TODDLERS WHO ARE EXPERIENCING GRIEF INCLUDE, BUT ARE NOT LIMITED TO:
- Separation anxiety
- Distress when left alone in a room or dropped off at daycare or with others
- Nightmares
- Temper tantrums
- Excessive tearfulness
- Fatigue
- Aggression
- Anxiety
- Excessive worrying about the safety of important people
- Excessive clinging
- Difficulty calming down
- Hypervigilance
- Increased fears of monsters and other dangerous characters
- Regression in toilet training
PRESCHOOLERS
At this age, children start to recognize that the word death means something, but the word appears more in play and imagination than in real ¬life. At this age, characters die and come back to life again in play and the child still doesn’t have a grasp that death is final. A child this age may be able to verbalize what he or she thinks death means, but it is likely that the child believes that someone who is dead can wake up or be revived from death.
The child may play out magical themes in which he or she can bring the dead person back to life or perhaps may play out scenes that suggest that the person who died is being punished for bad behavior. This is the way that the child is processing the meaning of death and the fact that the loved one hasn’t returned yet.
Even though children have become much more advanced in their language from toddlerhood to the preschool years, children this age still don’t have the cognitive and verbal capacity to really connect their extreme emotions with the words. Therefore, their emotional responses to grief continue to show up in their displays of emotion and their behaviors.
BEHAVIORS THAT MAY BE COMMON IN PRESCHOOLERS EXPERIENCING THE LOSS OF A LOVED ONE INCLUDE, BUT ARE NOT LIMITED TO:
- Fantasy or magical play that places the burden of saving the loved one on the child; or play that blames the child for the death of the loved one.
- Anger and aggression
- Separation anxiety
- Fear of being left alone without the primary caregiver or inappropriate need to be with anyone, even a stranger
- Excessive questions about death or the bereaved
- Headaches, stomach aches or other somatic symptoms
- Temper tantrums
- Regression in toilet training
- Unrealistic fears of monsters and other dangerous characters
- Nightmares
SCHOOL AGERS
Once children are about six years old, they start to develop the cognitive capacity that helps them to recognize the finality of death, although not to the adult level. Children of this age may view death as “something” that comes to get people. They may have visions of a death character that comes to take people away, like the Grim Reaper. They recognize that once the death character takes you away, you can’t come back, but their fear of death is related more to the death character than the actual concept of death.
Children still struggle with this vision of death until age 9—although for some it may happen earlier and others it may take longer—when they develop a more adult-¬like concept of death. By that age, the obsession with the death character diminishes. Kids of this age who actually want to talk about their feelings related to the loss are much more capable of talking about it than they are in younger years.
These kids may choose to talk with a parent, teacher, grandparent or friend about how they are feeling. These kids will handle the emotions related to the loss much better than those who refuse to think or talk about the loss, although it’s common for anyone, even adults, to have behavioral and emotional symptoms when experiencing a significant loss.
CHILDREN GRIEVING THE LOSS OF A LOVED ONE MAY STILL EXPERIENCE SOME EMOTIONAL OR BEHAVIORAL SYMPTOMS, INCLUDING BUT NOT LIMITED TO:
- Anger and aggression
- Opposition or defiance
- Anxiety
- Excessive worry about the safety of loved ones
- Over¬protectiveness
- Obsession with another person, game or activity
- Difficulty concentrating
- Controlling behaviors like bossiness or bullying
- Under or overeating
- Nightmares
At Encompass Mental Health, we offer therapy for grieving children that is tailored to meet the needs of young children who cannot (or will not) talk about the loss of the loved one. We provide a comfortable, child-friendly environment with toys that will allow the child to process the death of the loved one through play. The therapy process allows the child to work through the loss of a loved one at the child’s pace without pressure or influence to grieve in a certain way. When the therapy process is over, the child has worked through the stages of grief in his or her own way and has achieved acceptance at an age- appropriate level.
If your child has experienced a loss, call (605) 275-0009 today to schedule an appointment to help your child to process that grief in a way that’s most helpful for them.