Grieving Children: Helping Your Child Deal With Loss

WebMD Live Events Transcript

Event Date: 08/03/2000.

How should you explain death to children? How can you better understand and help your child deal with grief? Join Charles A. Corr, PhD, to discuss the unique ways children handle loss and how to prepare yourself to guide them through it.

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.

Moderator: Welcome to The Informed Caregiver program on WebMD! Our guest today is Charles A. Corr, PhD, and the topic is "Grieving Children: Helping Your Child Deal With Loss".

Welcome, Dr. Corr! It's a pleasure to be speaking with you today. First off, please tell us a bit about your background.

Dr. Corr: I'm a person who has taught courses on death and dying since 1975, and children and death since 1977. I've been interested in issues relating to children and adolescents, and I try to write and help other people write and get published in this area.

Moderator: What does death mean to a child, and is it important to view loss from the perspective of a child rather than trying to impose an adult view on children?

Dr. Corr: It's very important to try and understand a child's view of things -- his or her understanding of death or bereavement. What does death mean to a child? You'd really have to ask the child. Sometimes young children think of death as sleep, and so they ask do dead people eat chocolate cake? What do they do when they're buried or gone to heaven. Sometimes they think of it as travel. But of course, in sleep and travel, there's the possibility of return, and that's not the same as death. You have to ask the individual child what he or she is thinking about, and how they understand a concept like death.

e_knowlton_excite: What is a good age to start talking about death?

Dr. Corr: I would start talking with children about death whenever they show interest in the subject -- not dependent on a certain age. For example, I wouldn't say don't talk to children under age three or five. Watch the child's experience -- if they come across a pet that dies, or when they wonder what it's like when you say you're going to a funeral. It might be that some child needs to know something about death, such as if a grandparent is ill and dying and you need to prepare the child. Think about what the child wants to know, but also what the child needs to know. I would not pay special attention to the child's age.

yingeleh_webmd: My son's grandmother died recently after a long bout with cancer. Is it appropriate to answer all of his questions about how she died?

Dr. Corr: Oh, yes, it's always appropriate to answer a child's questions. You might think about what you say, and that might relate to what happened or what the child needs to know, but I would always try to answer a child's question. Otherwise, the child learns you aren't the person to whom questions can be put, and you can't be trusted to be helpful.

yingeleh_webmd: We are not a religious family, but I sometimes think it would be best if I told him about religious views of death just because it might comfort him. Is this wrong?

Dr. Corr: I would share with a child whatever my values were -- whatever framework I use to make meaning out of life and death. It's also fine to tell children that other people might have other values or beliefs that they use to understand death, but I wouldn't just tell a child a story about a belief that I didn't accept or have confidence in just to comfort the child.

Moderator: Are there certain aspects of loss children can handle a lot better than adults?

Dr. Corr: Good question. I think sometimes children do handle some kinds of loss better than adults because they don't have our life experiences, so they don't see the larger framework or the larger term, and just ask questions about right now. So in that sense, children who questions lots of things about life also question things about death. But this just reminds us of your opening question, that we should always try to look at things from the perspective of the child.

Moderator: Do you feel most parents are unprepared to deal with their grieving child?

Dr. Corr: No, not necessarily. I think sometimes in our society, we want to push off questions about death, particularly we want to put off addressing those in the company of children. We find them uncomfortable, or we're not sure what to say, so sometimes people try to push death out of the mainstream of life. That's not good. Death is a part of life. But I do not think that all adults in our society are poorly prepared or unwilling to help children deal with death. Many are willing to, they just need to be encouraged to do so. And perhaps guided. There are lots of resources. There are books for adults to help children with death. There are books for children that focus on death-related topics. In many places there are support groups for grieving children. We have resources, and we can help, we just need to do it.

wabe_grb_webmd: Does the way a person died affect the child's grieving process?

Dr. Corr: Yes, it can. Deaths that are off time, or occur very suddenly or quickly, or sometimes the result of long, drawn out dying process -- almost for everyone, those kinds of death are difficult to deal with. Deaths that involve personal agency, such as suicide or homicide, can be particularly difficult for survivors. So yes, the manner of death can be very important to a grieving child.

Moderator: Would you say those are instances when you shouldn't tell the child exactly how the person died?

Dr. Corr: Well, you might tell the child something about the death, but perhaps not every difficult detail. The rule here is that whatever you say should be reliable; it should be something you won't have to take back, but honesty doesn't mean you have to be candid about every detail of a death. Again, what does the child want to know, and what does the child need to know?

eelz_webmd: We just got a goldfish which my daughter loves but which I doubt will live very long (judging from my experience with having goldfish). Is there a way I can prepare her for its death?

Dr. Corr: Most animals have shorter life spans than human beings so, often, living with a pet can teach us something about its life and needs and responsibility, but also living with a pet can teach us about loss, death, sadness, and coping. I think it's good for children to have contact with pets and to deal with those issues.

melissa4418_msn: My three-year-old was there when her great-grandmother died. She brings up her death in general not the event all the time. She says "I'm sad bubby died" when she is upset for any reason, including being told no. How should I respond? I just say "I'm sad, too," at this point?

Dr. Corr: "I'm sad, too," is a good answer. It shows that we've had losses also, not just the child. But you might explore that further. You might ask, "Why are you sad," or "What about this makes you sad?" You could also say, "What is it about the present experience that makes you think of the sadness you had with your grandmother's death?" Someone once said, "We are all born with the ability to change, but we have to learn to cope with loss." So, use these opportunities as moments in which to help teach your daughter how to cope with loss.

yingeleh_webmd: How should I respond to my son's questions about his own mortality in light of his grandmother's death?

Dr. Corr: I think in two ways. First, you have to be honest. "We are mortal creatures; at some point we will all die." That can be difficult. Second, you want to speak about hope also. "We hope that will not happen for a very long time. We will try to do whatever we can to make possible a long life." So I would join honesty and hope in response.

Moderator: Is there a grieving process most children go through?

Dr. Corr: I don't believe in stage theories of grief or mourning, particularly not stage theories that were developed not from children and not from bereavement, but from dying. Now, having said that, children react to loss; that's what grief is. It would be surprising if they didn't react to an important loss in their life. Second, children try to deal with both the loss and their reactions, for example, with the loss of a grandparent and their anger that grandparent died. Dealing with is coping, or mourning. So is there a process in the sense that children experience grief?' They express and try to cope with loss of grief, yes. And they will do all of this on the basis of what has happened, what they understand about what has happened, and what they have learned about coping, and finally whatever help they get from the people around them.

Moderator: When there is more than one child involved, would you recommend encouraging the children to help each other through the process?

Dr. Corr: Yes, I think shared experiences can be the basis for lots of mutual help. Shared experience is really the basis for all the support groups in our society. So yes, I would encourage children who have experienced similar losses to try and help each other if they're willing.

eelz_webmd: How do you deal with a child's anger when she or he loses a loved one?

Dr. Corr: Anger is a perfectly normal response to loss. It says, "I've been hurt and I want to turn that outward at someone or something." The real question is not the anger, but how the anger is managed, or how we help the child cope with his or her anger. So, we might encourage them to pound a pillow rather than beat his little sister. For an adolescent, we might encourage sports activities rather than fights at school. It's not being angry, it's what we do with the anger that is important here.

chapman_2_webmd: Do you have any advice for friends of people who had parents die?

Dr. Corr: Well, we're all the children of some parents, so in a sense, all of us could be affected by the death of parent, just as to a parent, no matter how old the child is, the child is still my son or daughter. Friends could recognize the importance of a parent's death for a person at any age. That is perhaps even more significant for a younger child or an adolescent; for a younger child, because the parent is so crucial to taking care of the child, nourishing him, cleaning him or her, providing food, etc.; for an adolescent, because even though there is a normal developmental process in adolescence of separating from parents and developing one's own personal identity, still if we take away the parent, that process is complicated. So death can complicate lives in general, and it can complicate normal development in children and adolescents. Friends should try to be available for anyone who has experienced the death of a parent. Being available often means just being present and listening. Sometimes it's uncomfortable -- be there anyhow.

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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