Grief: Helping Your Child Deal With Loss (cont.)

eelz_webmd: At what point should we question whether the child is so upset by a death that she or he might need counseling?

Dr. Corr: Usually the touchstone for a child who might need counseling is everyday activities. So you might ask, how is the child sleeping? Is the child eating? Is the child engaged in normal childhood activities, play, school? Do you notice over a period of time regressive behaviors, bedwetting, thumb sucking, etc.? You could always refer to a professional who has some competence in grief and loss to evaluate the child to assess him or her. You could always consider a children's support group.

Moderator: Have there been any studies about whether boys react differently than girls?

Dr. Corr: Well, there are different ways of experiencing and expressing one's grief. Some express grief openly, they cry in public. Others keep their grief inside themselves. It depends on a lot of things, culture especially, but also personality, past experiences, so girls in our society might tend to react more often in externalized behavior or expressive grieving, and boys might tend to turn to problem solving or what is called instrumental grieving, taking actions to do something about a situation. But I think we ought to be very cautious about imposing gender-based stereotypes on real live children and adolescents. So again, I would look at, talk to, be involved with, the individual child above all.

eelz_webmd: My daughter had a twin sister who died at birth. She knows about this and has started asking questions about what happened to her sister (she's four now). How can I explain this?

Dr. Corr: I would tell her the truth. I would be honest and trustworthy. How much to tell her depends again on what she wants to know, and maybe on what she needs to know. I would certainly say that we loved the child who died, and we love you. And I would make great effort not to make her some kind of replacement for the dead child.

eelz_webmd: Do all the images of death in the media affect how a child views death?

Dr. Corr: Sure. They couldn't help but do that. Basically children learn about death from their own experiences, a dead animal in the woods, for example, and from what family members tell them, and from messages from our society, especially the media. Lots of children know that sometimes the messages they get from the media are distorted. All of our college students remember the cartoon, Road Runner. In that cartoon, the Road Runner is chased by Wylie Coyote, and he suffers repeated catastrophes. Boulders fall on him, explosions blow him up, but he experiences instant resurrection, and there is never any grief, no tears, so the message seems to be, "Don't worry about death, it's not real, see, you can overcome it." That's not a good message for real life. Children are taught lots of lessons, not always good ones, by the media.

Moderator: How do you explain to a child that death is permanent, and that in real life people aren't immortal superheroes?

Dr. Corr: Permanence, finality, those are difficult concepts. You can quite appreciate, if you think about from a child's point of view, you can quite appreciate it would be hard to grasp that permanent means forever, not a while or a long time, but forever. It may be that very young children are unable to understand that, that they do not yet have the cognitive capacity to grasp such a difficult and sometimes abstract notion. So I would just try to explain permanence to them -- compare it with other things that have ended, and expect to come back to this discussion again and again as the child grows and develops.

Moderator: Do children often blame themselves?

Dr. Corr: Yes. Children often think that there is always someone responsible for whatever happens, and they often view the world in an egocentric way, that they are at the center of everything that happens. So it's quite common for children to think that maybe somebody died because of something I did or I said, and we sometimes unwittingly encourage this. We say things like "You'll be the death of me," and then if I die a couple of weeks later, a child might think ,"See, it was something I did." So it's very important to explore with children concerns about blame, blaming themselves or some one else, and to show them that they are not to blame when that's true.

eelz_webmd: Is it common for a child to begin to fear death right after the death of a loved one? How should this child be comforted?

Dr. Corr: Yes, it is common. A typical child's concern is first, "Did I cause it?" but secondly, "Could it happen to me?" If it happened to someone else, father, brother sister, could it happen to me. We should discuss that with children. For example, for an older child, when a younger brother or sister dies of SIDS, "that's not going to happen to you; you're older, or beyond the time when that occurs." Or we might say, "Yes, we're going to be careful. We'll watch out about cars in the street, etc." So yes, "Could it happen to me?" is a very common child concern, and it should be diffused by addressing it correctly.

zanita9er_webmd: What about children over nine-years old. Do they also blame themselves?

Dr. Corr: It's not a matter of age, not a matter of children under nine don't, but over nine do. It's a matter of feeling responsible. It's a matter of thinking this terrible thing happened because someone was responsible and if I can't find someone else, then I might think I was the one responsible. So children at any age, and some adults, too, might think they were responsible for a difficult, sad, tragic event like death.

eelz_webmd: What effect do you think all the school shootings have on children's image of death? How can children get support for the deaths of friends and come to grips with people their own age dying?

Dr. Corr: There are probably several elements here. First, people my own age dying. Yes, whenever I can identify with the deceased, my age, gender, etc., then it's threatening for me. Second, terrible events have occurred in recent years in some American schools. Deaths that would be difficult in any circumstances, shootings, homicide, things of that sort, and worst of all, they occurred in what should be a safe place, school. So again, the possibility of a strong concern or reaction to that ought to be explored. But one other element -- it may be that part of the problem here is the media, that so much attention is given to very isolated events. Really, children are much safer in school than they would be in the bus on the way to school. Motor vehicle accidents are a leading cause of death for everyone. So we need to keep some perspective or some proportion on these deaths without at all diminishing their real horror and difficulty.

Moderator: Thank you so much, Dr. Corr. We've covered a lot. Is there anything else you'd like to add?

Dr. Corr: This is an important subject to address, and it deserves attention.

The opinions expressed herein are those of the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

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