Amanda N. Howard, M.A.
Practicum Trainee (2021-2022)
“My child is grieving, but she isn’t going through each stage like in the book I read. Should I be worried?” Caregivers frequently ask me this question, or a variation of it, when their child has experienced the death of someone in their life. This question usually stems from a misunderstanding of grief and a misapplication of an outdated and inaccurate theory of grief.
You may have heard about the five stages of grief, a model popularized by the 1969 book On Death and Dying by psychiatrist Elisabeth Kübler-Ross. However, the model was not originally intended to describe the process of grieving the death of a loved one. In fact, the five stages are based on Kübler-Ross’ work with terminally ill patients who were coming to terms with their owndeath. She found that patients often went through five stages as they coped with their mortality: denial, anger, bargaining, depression, and acceptance. It is important to note that these observations were purely anecdotal and were based on her own conversations with some of her patients.
Since the publication of On Death and Dying, numerous experts have rejected the stage theory of grief due to a lack of empirical support. The model, and similar models that use ‘stages’ or ‘phases' of grieving, is also criticized for its over-simplification of a complex process, and its implication that everyone goes through the same stages in the same order.
More recently, grief experts have provided support for different frameworks for understanding grief. One of the most well-known and widely accepted theories by leading grief experts is the dual process model. Introduced by Schut and Stroebe (1999), the dual process model states that grieving individuals experience two types of stressors: loss-oriented (recognizing the loss by looking at photos, crying, etc.) and restoration-orientated (adjusting to life without the deceased person, such as through new bedtime rituals, custody arrangements, etc.). When confronted with loss-oriented stressors, individuals tend to ruminate on the death and events surrounding the death, often causing feelings of sadness, anxiety, and anger. When experiencing restoration-oriented stressors, the grieving person tends to confront the death by trying to restore a sense of normalcy through distraction, such as playing video games. The dual process model emphasizes that grieving individuals switch back-and-forth between processes as they cope with daily life (Schut & Stroebe, 1999).
The dual process model can be applied to childhood grief after the death of a family member, pet, or a friend. However, children experience grief in other situations as well. Research shows that children can experience symptoms of grief after being separated from a parent, such as in the case of divorce, parent incarceration, placement in foster care, or the parent or child being hospitalized, and there can be detrimental long-term effects if the grief is not properly addressed (Ferow, 2019).
Regardless of which theory of grief you support, there are many ways you can help your child as they deal with grief and bereavement. Here are just a few things you can do:
· Address your own grief. Your child learns from you and how you respond to different situations. Ensure that you can regulate your own emotions in order to best support your child and model healthy coping methods.
· Learn about childhood grief. Consult trusted resources to educate yourself on childhood grief and better understand what your child is going through. Knowing what to expect can help you be patient and understanding as your child experiences new thoughts, feelings, and behaviors associated with their grief.
· Teach them about death and grief. Normalizing your child’s grief can help them feel less alone. Teach them that many children their age experience grief and that their reactions to the death are normal and common.
· Validate their feelings and teach them strategies to deal with big emotions. Encourage your child to share their feelings with you if they are able and ready to do so. Practice calming or relaxation strategies as a way to cope with their emotions.
· Maintain daily routines. Children benefit from structure and stability, especially when dealing with grief. As much as possible, continue the same daily activities and routines to give your child a sense of comfort and demonstrate that life does go on.
· Seek professional counseling. If you’re concerned that your child’s grief is significantly impacting their daily life or if the death was traumatic, consult a licensed provider trained in empirically supported treatments for grief and traumatic grief. Traumatic grief may occur after a sudden and unexpected death (e.g., suicide, violence, accidents) or after an anticipated death due to medical illness.
References:
Ehmke, R. (n.d.). Helping children deal with grief. Child Mind Institute. https://childmind.org/article/helping-children-deal-grief/
Ferow, A. (2019). Childhood Grief and Loss. European Journal of Educational Sciences.
National Child Traumatic Stress Network. (2005). The courage to remember: Childhood traumatic grief curriculum guide. https://www.nctsn.org/sites/default/files/resources//the_courage_to_remember.pdf
Ross-Kubler, E. (1969). On death and dying. Routledge.
Schut, M., & Stroebe, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death studies, 23(3), 197-224.