Presentation on theme: "Death, Dying and the Child"— Presentation transcript:
1 Death, Dying and the Child 2007 Psyc 456Dusana Rybarova
2 Child’s reactions to loss of a parent Elisabeth Kubler-Ross: On Children and Death 0-6 months:Displays distress from loss by changing sleeping and eating habitsReacts to grief reactions of othersNeeds continuous loving care6 months to 2 yearsDoesn’t understand the permanence of the loss, will ask for the missing parentMay become angry because parent doesn’t come back, disinterest in play and foodClinging to caregivers and refusal to let them out of sightConstant loving care is the key
3 Child’s reactions to loss of a parent Elisabeth Kubler-Ross: On Children and Death 3 to 5 yearsAsks questions concerning absence of the parentAnger reaction to unfulfilled wish of parent’s returnMagical thinking, thoughts about life in the cemeteryClinging to favorite toysImportance of talking to the child and giving her/him loving attention5-9 yearsBeginnings of understanding of the finality of deathGrieving manifest in changes in behavior, school performance, anger reactionsImportant to have trusting relationship which allows the child to talk about their grief and distressAt age 9, with maturation of abstract thinking processes, most children have mature understanding of the concept of death
4 How to react http://www.med.umich.edu/1libr/aha/umgrief.pdf Is death like sleeping?Death is different from sleeping. When a person is dead, his or her body doesn't work anymore.children who are told that death is like sleeping may develop fears about falling asleep.Why did they die?the person's body couldn't fight the sickness any more. It stopped working.Explain that when most people get hurt they can get better and live a long, long time.Will you die? Will I die?Let your child know that most people live for a very long time.Children also need to know who will take care of them if a parent or guardian dies.Did I do or think something bad to cause the death?Reassure your children that saying and wishing things do not cause a death to happen.
5 How to react http://www.med.umich.edu/1libr/aha/umgrief.pdf Will they come back?"Forever" is a hard concept for young children to understand.Young children may need to be told several times that the person won't be back ever.Is she cold? What will he eat?Young children may think the dead body still has feelings and walks and talks under the ground.explain that the body doesn't work anymore. It can't breathe, walk, talk or eat anymore.Why did God let this happen?Answer questions related to God and your faith according to your own beliefs.It is best to avoid suggesting God "took" someone to be with him, or that "only the good die young".Some children may fear that God will take them away too. They may try to be "bad" so that they won't die, also.
6 Child SuicideIncrease in suicide in children between 5 and 14 years of ageChild suicide is influenced by immature understanding of death:Death understood as a transient and reversible stateDeath as a vehicle to a happy reunion with the deceased or as a gateway to a happier situationInability to understand multiple dimensions of a situation
7 Erik Erikson’s model of life-span development Stage 1: Trust vs MistrustInfancyCounts on caretakers to meet her/his basic physiological, social and belonging needsBased on that experience develops understanding of the world as a predictable placeLong-term unpredictable separation may lead to anxious, emotionally defensive reactionsStage 2: Autonomy vs ShameToddlerLearns what he/she can control (preference of food, preference of toys, excretory functions)Belittling a child’s efforts can lead to feelings of shame, self-doubt and a lasting sense of inferiority
8 Erik Erikson’s model of life-span development Stage 3: Initiative vs GuiltEarly childhood 3-6 yearsExplores environment, initiates new activities, takes on new challengesLack of encouragement may lead to self-negation, guilt, resentment and unworthinessStage 4: Industry vs Inferiority6 years to adolescenceLearns to function in adult-like world, compares itself to the standard or othersIf the child does not learn strategies to overcome life’s challenges and crises, it can in most extreme cases result in self-destructive, suicidal behavior
9 Humanistic perspective Each human being is unique and child’s reaction to loss depends on their unique personal experience, which goes beyond the child/parent bond and stages of cognitive developmentTo understand child’s grief their individual experience, environmental, familial and cultural background needs to be taken into accountQuestioning of stage theories of development as a key to understanding children’s concepts of death and grief reactions
10 The Dying ChildTerminally ill children as young as 3 years old come to know that they are dying, and that death is a final and irreversible processChildren may not be able to talk about death but express their understanding of their approaching death in their behaviorFear of wasting time, wanting to have things done right awayDislike of talking about the futureAbsorption with death and diseaseSetting up a distance from others but acts of anger and silence
11 The Dying ChildStages:Initial awareness of the seriousness of the illnessLearning names of various drugs and medical procedures, perceives that he/she is seriously ill but will get betterLearns the purpose of various medical procedures and perceives that she is always ill but will get betterAfter series of relapses he perceives that he wil never get betterAfter numerous relapses and remissions understands that he/she is dying (often associated with leaning about death of a peer with the same disease)
12 Feelings of a Dying Child Fear and anxietySeparation from parents and other family membersIncreasing anxiety of medical proceduresIncreased anxiety because of feelings of fear and anxiety in their family membersAngerLoss of self-control and independenceOften results in developmental regress to an emotional level at which they are no loner independentSome children overcompensate by refusal of help from family and hospital personnelSadnessGrieving loss of what they had before the illness (decline in contact with friends, absence from social and other activities, pain, discomfort, decreasing mobility, alterations in body image etc.)Loneliness and IsolationBecause of mutual presence of the approaching death, there may be no opportunity for parents and the dying child to truly share their concerns and fears and provide comfort, security, and reassuranceChildren’s feelings about death sometimes become masked and repressed
13 Feelings of a dying child Often marked by mutual pretense of the approaching deathChildren may want to maintain the pretense that they are feeling well because they are afraid of being abandoned or rejected‘ To let children talk about death, about their fears and feelings, their hopes and despairs, their certainties and uncertainties, their love, and hate, means we are allowing them to talk about life, their life, and we are providing them with the only possible help: the presence of another human being until the end.’Spiritual needsProminent in the lives of dying childrenA positive image of what lies beyond deathReassurance that they will be rememberedIndividual differencesSome children are resilient and playful even when their life is ending
14 Three stages of bereavement in the young child dealing with death of a parent ProtestAnger and fear aimed at reattachment to the lost parentDespairSadness, distance, unresponsivenessMay result in psychosomatic symptoms (headaches, enuresis,…) or psychological problems (school phobia, depression, poor school performance)Slowly processing the lossDetachmentMoves from depression to increased activity and openness to new relationships
15 Reactions and Grief Strategies Regression to an earlier developmental stageIf denied the opportunity to openly grieve a lost parent, the child is likely to remain frozen in the regressionWith time and nurturance the regression will subsideHyperactivityIncreased activity to get attentionEmotional outburstsAngry outbursts and irritability as symptoms of griefOverprotectiveness of the surviving parentPreoccupation with the remaining parent’s potential deathConstructing the deceased parentLocating, experiencing and reaching out to the deceased parent, waking memories of the parent, cherishing objects shared by the child and the dead parent
16 The Death of a SiblingBereaved siblings show significantly higher levels of behavior problems and significantly lower social competence than normal children throughout the bereavement periodSiblings can tolerate and accept less parental attention and more anxiety if they know what is happening with the dying siblingThe anxiety level of a children informed about terminal illness and loss was found to be significantly lower than that of uninformed childrenBereaved children need explanations, comfort, and supportPretense and avoidance can be frightening to anyone in a stressful and painful setting, especially a childIf children are involved in grieving of the family, it helps them to learn coping strategies they can rely on in dealing with future losses
17 When a Pet DiesFor many children loss of a pet is their first experience with deathReactions to death of a pet across ages:Preschool children appear to miss the animal more as a playmateSchool-age children express profound grief over the death of a pet, but usually for a short-time and adapt quickly to the changeOlder children and adolescents tend to have the most profound experiences with the loss of a pet, possibly because of their adult understanding of the death as final, permanent, inevitable, and irrevocableThrough this experience children can learn that ‘death is a natural part of the life process, that death is permanent and painful, that the grieving process itself is tolerable and doesn’t last forever, and that feelings of guilt, sadness, and anger following death are common and can be overcome.’ (Levinson, 1972)
Your consent to our cookies if you continue to use this website.