Loss and grief for children and adolescents
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Loss and Grief for Children and Adolescents. Graham Martin OAM, MD, FRANZCP, DPM [email protected] Personal reflections. Death and Children in 2007. Children may experience meaningful loss through death of Grandparents, Parents or Siblings Animals

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Loss and grief for children and adolescents

Loss and Grief for Children and Adolescents

Graham Martin OAM, MD, FRANZCP, DPM

[email protected]



Death and children in 2007
Death and Children in 2007

Children may experience meaningful loss through death of

  • Grandparents, Parents or Siblings

  • Animals

  • Death on Television though the News, or more likely through programs is more frequent, but may have less impact.


Acute loss syndrome
Acute Loss Syndrome

  • Psychological and Somatic Symptoms

  • May appear immediately, or delayed

  • May be exaggerated or apparently absent

  • May appear to be a distorted aspect of one part of the syndrome

  • Is amenable to support, care, but needs to run its course


Symptoms
Symptoms

  • Somatic Distress - often in waves

  • A sense of unreality, with increased emotional distancing

  • Often an intense preoccupation with the image of the dead

  • Feelings of responsibility or guilt

  • Disconcerting loss of warmth in relationship, with irritability or anger

  • Changes in patterns of conduct

  • Traits of the deceased may appear in the behaviour of the child


Death of a mother
Death of a mother

  • Universally accepted as more traumatic

  • Shock, disbelief, denial may be followed by episodes of panic

  • Regression

  • Compensation

  • Clinging to a mother substitute


Death of a father
Death of a father

  • All the previous symptoms may occur

  • Death of a father may be more difficult for a boy


Death of a sibling
Death of a sibling

  • Regret or Guilt may be prominent

  • Profiting from extra parental attention

  • Struggling with the reaction of parents

  • A ‘replacement’ child can have special problems


Grieving in infancy
Grieving in Infancy

  • During the first 2 years there may be no true understanding of death

  • However, stages of loss (Bowlby, 1958) may appear:

    • Protest

    • Despair

    • Detachment

  • There may be later problems with attachment, or an inability to trust that others will ‘always’ be there


From age 3
From age 3

  • May have more comprehension

  • May be able to discuss the death

  • May act out fears and fantasies

  • May not have concept of death as final; this may lead to anxieties over sleep

  • Separation anxiety is common, and dependency may be strong

  • Grief work through play


From about age 6
From about age 6

  • May accept that death is final

  • May have resulting fears around own finiteness

  • Personification of Death

  • Grief work more verbal


From about age 10
From about age 10

  • More emotionally mature with an understanding of the finiteness of death

  • Most of the intellectual tools to understand death and its context

  • Delayed or distorted reactions can occur


Distorted grief reactions
Distorted grief reactions

  • Overactivity with no sense of loss

  • Taking on traits of the deceased

  • A psychosomatic disorder

  • Alteration of relationships with friends and siblings

  • Hostility to certain people (eg professionals)

  • Withdrawal

  • Problems at school

  • Aggressive acting out

  • Depression with agitation


The funeral
The Funeral

  • Whatever our core religious beliefs, some ceremony is necessary for us to celebrate a life and acknowledge the passing

  • All children should be present and take part in the mourning as far as they can


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