Monday, November 4, 2013

Grief and Loss of a Child


Grief and Loss of a Child


Written by Dr. Dino Zuccarini, C.Psych.

Parent’s Grief Process in the Aftermath of Loss of a Child

Parents vary in terms of how they deal with loss—most parents will cycle through a wide range of emotional reactions.

All parents face profound painful feelings and absorbing experiences of grief when a child dies. There can also be intense shock, confusion, and even denial about the loss. There is no loss more devastating than the loss of a child. This loss leaves parents disoriented and disorganized. Hopeless despair can immobilize parents from dealing with the tasks of everyday life, connecting to each other or other children. In hopeless, despair states, parents can experience existential distress---finding life to be meaningless and purposeless.

Parents will also vary in terms of how long the grieving process takes. Some parents will move toward sadness and grieving the loss, trying to make sense of the loss and what life will be like with the loss of their beloved one. They will reach out and connect to others (i.e., their partner, support systems), memorialize the loss of the loved one (e.g., scrapbook, rituals), and re-organize themselves and create a new sense of family identity with the remaining children---although the loss will continue to be felt, the intensity of the emotions will lift. Some parents, on the other hand, will hold onto grief for longer than others---remaining disoriented and disorganized in the aftermath of the loss---not being able to make sense of the loss in the present and the meaning of the loss in terms of the future. Some parents will be over-consumed by guilt and self-blame--feeling that they didn’t do enough to protect or care for their child, and even possibly feel shame and a sense of inadequacy and failure. Many parents will have an increased sense of fear about the surviving children, and a deep sense of isolation and loneliness in feeling disconnected from others who they feel may not understand their experience.

Others may experience intense anger at themselves, their spouse, hospital staff or whomever as a reaction to the loss of a loved one, and even resentment toward those who have children---while experiencing deep sadness and deep fears underneath. Some will enter into a state of numbing, withdrawal to escape the pain, and even turn to other maladaptive soothing behaviours, such as increased alcohol or substance use. Being stuck in guilt, shame, anger and resentment, or numbing withdrawal can prolong the grieving process and block a parent, couple and family from re-building a renewed sense of hope for the future and reshaping a new family identity in the aftermath of the loss of a beloved child.

Parents might express and deal with emotions differently---which will affect the grief process and how parents will journey through this difficult period. Parents who are able to express themselves and journey through this painful experience together can help assuage each other’s distress, make sense of the loss together, deal with the changes to the family, and re-build a sense of hope and future for themselves and remaining family members. A renewed sense of family identity can be created while holding onto the loving memories of the lost child.  Parents must re-define their family identity together. Parents who are emotionally isolated or withdrawn block the necessary engagement to deal with emotional distress and to engage in this meaning-making process that allows the couple and family to re-organize their sense of family identity and future in the aftermath of a loss.

The hardest part is when partners are in different places emotionally and cannot be present for each other (e.g., one is disorganized and the other sad). It is important to be able to reach out to other family members at this time as well for emotional and practical support in dealing with everyday tasks.

Strategies to cope with the loss of a child

1.  Express your emotions and needs to supporting, caring others. It is important to authentically express the wide range of emotions and reactions that are experienced in the aftermath of loss to maintain an emotional connection. It is important that parents take turns expressing their feelings, acknowledging each other’s emotional reactions and listening to what each parent might need. For example, Sara might be feeling hopeless, despair. It is important that she express her needs to her partner, Paul. She may need contact-comfort (e.g., a hug) or verbal reassurance from him (i.e., that the family and the rest of the children will be okay and that they will get through this together). Expressing needs for support and care when distressed is important in sustaining the connection and taking care and soothing each other’s emotional distress.

2.    Reach out for support and care. Isolation increases emotional distress. Ask loving family members and caring friends for practical support for tasks (e.g., helping with other children, home tasks etc.). This allows parents to deal with their emotions and other tasks related to the loss.

3.    Prepare yourself to deal with questions about the loss. Telling the outside world about the loss of a child can bring up emotions. Find a way to tell your story in a way that is comfortable for you (i.e., the amount of details that you feel comfortable sharing). If you feel others are asking too many questions, it is okay to let them know your limits (i.e., I only feel comfortable sharing this amount of information).

4.    Healing takes time. Expect strong emotional responses for a sustained period of time and accept differences in how you are reacting to the loss. It is important to acknowledge emotions and accept that the intensity of these emotions will diminish over time. In the midst of painful emotions associated with loss, parents might benefit from reminding themselves that these emotions shall pass over time. It is important to accept that there will be moments in which you are both experiencing different reactions and will differ in your grieving process. Talk about your child and use his or her name---avoiding names does not allow you to come in touch with your feelings. Eventually, parents will be able to talk about their child with less of a reaction.

5.    Ensure all family members emotional needs are addressed, including other children. If there are other children in the home, it is important to ask them about their sadness and help them along with their grief. Children can feel a wide range of emotions and have several needs at this time for contact-comfort, reassurance and physical affection.

6.    Don’t make any big decisions in the immediate future (i.e., doing anything with clothing or toys of your loss child, returning to work, moving, making big changes to family routine and structure). During the initial phases of grief, the disorganization and disorientation may lead parents to make decisions that may not be beneficial for themselves or their family in the long run. Take time to deal with your child’s personal items.

Some parents will want to return to work soon to restore some sense of normalcy in their lives, while some will return too early without having  healed enough and completed their grieving process---with dire consequences on their family and work life. Making big changes creates further disruption and emotional distress that may block the grieving process from unfolding. Other children will require structure and routine to hold them emotionally through the turmoil of loss---routine and structure allows for a sense of normalcy and provides children with a sense of safety and security.

7.    Rituals and Honouring Memories of the Child. It is important to make sense of the loss and to create a narrative about the beloved child---the meaning of the child to the family and the positive experiences of love, joy and connection that were experienced in the relationship with the child. Creating a scrapbook or ritual to construct this narrative will allow parents to hold onto the positive and loving memories of the child. Involve children, if appropriate developmentally, in this process. Also, plan on how you are going to deal with birthdays and the anniversary of your child’s death. Planning ahead of time can minimize distress. Creating a ritual around these dates can be helpful to deal with the emotions associated with the loss and remind parents and other children of the positive joy and loving memories of their beloved one.

8.    Join a support group. Isolation makes emotional distress harder. Being able to share your feelings, and learn from others who have experienced the loss of a child can make the healing journey less isolated.

9.  Consult a psychologist.  Psychologists can support you to understand your own, your partner’s and other family members’ emotional reactions to loss. Some parents, couples and children will need extra support to move through a grieving process. Couple and family problems can emerge when the residue of unprocessed grief persists. Depression, anxiety, traumatic stress, child emotional, learning and behavioural difficulties can also ensue when grief and the emotional residue of loss is


What types of programs does the Centre provide to parents who have experienced the death of a child?

CFIR has several services that can support parents in dealing with the impact of loss of a child on the individual parent, the couple relationship and the family (i.e., other children and family relationships).

The Grief and Loss Service offers psychotherapy services to individual parents to support them through the devastating and intense emotional experiences in the aftermath of significant losses of loved ones, such as the loss of a child. Psychologists who are part of this service are experienced in supporting individual parents to deal with the different, and sometime complex, emotional reactions experienced in association with the loss of a child (see grief process below). Individual parents will vary in how they will deal with their own emotional reactions and how they will respond to their spouses or other children’s emotional reactions to the loss. Over time, and as the grieving process unfolds, most parents can expect that their emotional distress will lighten---although the loss of a child can continue to trigger emotional reactions upon reminder of the loss in future years. Loss of a child can be extremely disorienting, especially since a parent’s sense of self and family identity was so closely tied to the child who has died. For some parents, the emotional reactions and distress will seriously affect their ability to return to work and affect their sense of connection to their partner and/or other children. Some parents will have complex grief reactions that will be accompanied by symptoms of traumatic stress, depression and anxiety that are unremitting over time and that affect their capacity to function in their relationships at home or at work. One’s sense of self and the future can be shattered when the hopes and wishes held for a child and one’s sense of self and family identity is altered as a result of the death of a child. CFIR psychologists accompany individuals through their grieving process and support them to cope with losses and minimize the devastating impact of loss of a child on emotional well-being, relationships and occupational functioning.

Psychologists in the Child and Family Psychology Service can support parents to address the emotional needs of other children in the family to adapt to these circumstances. Children grieve deeply as adults do---and sometimes they are blocked by their inability to put words to their complex emotional experiences. Helping children make sense of loss is a challenge to parents undergoing their own grief process, yet other children in the family will need more support than ever to make sense of the loss of a sibling. Losses of a sibling can create deep sadness and fears about future losses, create a sense of unpredictability, and increase insecurities that require increased parental emotional attention to their children. Psychologists in this service support children through their own grief process and support parents to deal with their children’s emotions and the impact of the loss on the entire family system. Children will deal with grief in developmentally appropriate ways---a psychologist can help you to understand how your child’s grief process varies depending on their stage of development and the types of strategies that should be used for connecting to them emotionally. Sustaining a healthy emotional connection with a partner and other children is important in supporting all members to grieve, make sense of the loss, and re-build a new sense of family identity and future in the aftermath of the loss of one member of the family.

The Relationship Service provides services to individuals and couples who are experiencing relationship difficulties. The loss of a child can have an impact on a couple’s emotional connection with each other. For some couples, each parent will be able to express their grief and respond to the other with nurturance, warmth, care and support that will decrease the emotional distress of loss. A parent’s connection to the other parent and their other children can be an antidote against the painful emotional distress associated with loss.  Connecting with a partner and children at a time of loss can buffer us from the distress of these painful emotions. The loving responsiveness and the accessibility of partners to each other’s emotions and the deeper meanings associated with the loss of a child helps each partner cope better with the intense emotional experiences in the aftermath of loss. When one partner shuts down, or withdraws by numbing and emotionally withdrawing to deal with their painful emotions, the other partner can feel rejected and abandoned during a critical moment of need for connection, support and care. Emotional distancing can create relationship distress and have a negative impact on the couples attachment bond. CFIR psychologists support couples to deal with loss together in a manner that deepens each partner’s capacity to express their emotions and needs to each other in the aftermath of loss, and to enhance each partner’s responsiveness to the other’s emotional reactions during this painful experience of loss.  

Read more about our Depression, Mood & Grief Treatment Service.