Why Counsel children and adolescents in grief and loss?

Children need opportunities to process grief and loss.

In the past, it was always believed that children weren’t aware of what was happening in the family. They would not be allowed to go to the funerals of dead family members because they “would be too distressed about it”. The departed family member would never be discussed. Children would often form faulty beliefs that they had been responsible for the death of their family member. Even now, it is hard for grieving family members to attend to the needs of the children in the family. Frequently, children benefit from talking to an outsider who can focus on them and their needs.
Below is the story of “Anna”. As with all my blogs, I never use real names and usually use a composite of several clients, removing anything that could identify the clients. I also print people’s stories only with permission. In this case, Anna asked me to print her story with just her name changed.
When I was 11, my year group were taught to perform CPR. We were told our actions would mean the difference between life and death for someone we loved. I took that very seriously. A year later, at the age of 12, I was visiting my grandparents when my grandmother collapsed. She had no pulse or respirations. I worked on resuscitating her for what seemed like hours, but was probably no more than fifteen minutes. When the paramedics arrived, they took over and I went and sat in the back room while my family gathered around the stretcher as my grandmother was wheeled out to the ambulance. Nothing was said to me. My brother and I went home and my parents and grandfather went to the hospital. Later they returned and said my grandmother had died. What I did was never discussed. My brother made a passing comment about not knowing how to perform CPR, but no one ever talked about what I did. My mother told me my grandmother would have been happier to have died, rather than become an invalid, but this did not help me. All my mother did was reinforce the faulty belief I had about my part in my grandmother’s death. I was devastated and full of guilt. When we learned CPR we were told all we had to do was perform CPR and the person would live. I believed I had killed my grandmother because I must have done something wrong or she would not have died. I also believed that if I told my family what I did they would reject me. My grandmother’s death was never discussed and I never had the opportunity to talk to anyone about my belief and be reassured that it was not true. We forget as adults that children think differently and will often hide the things they most fear, and that often children form faulty beliefs about their culpability in events. It is so important children are given a safe place to talk so that those faulty beliefs can be expressed and corrected.
When I grew up I became a nurse and used to dread the call to attend a cardiac arrest, something that, working in Intensive Care and Coronary Care, I had to do frequently. Eventually I was working in Aged Care and one of my residents choked on a sandwich. I found myself in the same situation as when I was 12. I worked on this woman, but despite my efforts she died. This time, there was someone to talk to about it, as my employer was serious about debriefing people. I realised that I still carried the guilt of my grandmother’s death into every resuscitation event, fearing that I would kill those people too. Every time there was a cardiac arrest, my brain went into fight or flight mode and there was nothing I could do to stop it.

It was many years before I heard the statistics of how few people are successfully resuscitated. I persisted in the belief I had killed my grandmother until that moment in the CPR refresher course when I heard those statistics and was finally able to realise I needed counselling to shift the belief that I had killed my grandmother.
All the years I tormented myself with guilt could have been prevented if my family had talked about what had happened, instead of never mentioning my grandmother or the events around her death again. Or, if my parents had not felt able to talk about her death, if they had sent me to a counsellor or to a grief and loss group. My parents were not bad people. Their behaviour was due to their inability to deal in a healthy way with loss.

We live in a society that discourages openness about death. Frequently in families the death of a loved one is never discussed. Children will often report that it is like the person they loved never existed. It is heartbreaking when children feel distress that their family never talks about the person who has died. Those children never get a chance to properly grieve for their dead loved one and learn an unhealthy way to grieve that will impact on their grieving as an adult. Children are also impacted in other ways by their feelings. Anna internalised her guilt so no one thought there was anything wrong, but many children act out their feelings and are seen as being naughty. The pain is never properly resolved and continues to cause problems into adulthood.
My aim in counselling children is to give them the chance to talk about what has happened. To teach them that it is okay to feel a great range of emotions, it is okay to talk about how they feel and to show them that they can reach out to others for support. It is also an opportunity for the child to express those common false beliefs he or she holds about being responsible for what has happened to them or others. In this way, the child can grow into a healthy adult.

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