A parent’s feelings about death often transfer to his child. Treating death as part of life may ease the child’s confusion and fear.
A child’s age, emotional development, environment, and experience with death influence his or her idea of death. Early experiences may involve a family member, friend, or pet. An early lesson in understanding is that with death, the functioning of inanimate objects (toy, clock, watch) and once-living things (flower, leaf) stops. It’s final.
Babies have no concept of death, seeking only consistent routine in their care. From eight months, infants develop what Piaget calls “object permanence.” They develop a “mental image” of the deceased and a sense of “missing them.” Parents can reassure them by keeping routines consistent (www.medicine.yale.edu/childstudy).
Toddlers, for whom death is temporary, may ask “When will my mother be home?” They learn irreversibility with the death of a pet. When a relative dies, don’t say the person has “gone to sleep,” “went to heaven,” or “Jesus took her.” The child might become afraid of sleep, or get puzzled about an abstract heaven, or be angry at Jesus. Avoid describing death in terms such as “lost” or “gone away,” which can cause misunderstanding. Young children take things literally.
In early childhood, children fail to grasp causality. Hence, “It’s my fault. I was mad at my mother once and I told her I wish she would die and then she died” (quoted by Salek and Ginsburg). Before age 9, they may feel guilt or shame, seeing sickness as punishment for something they thought or did. Salek and Ginsburg, in their work “Children’s Developmental Stages: Concepts of Death and Responses,” have explored characteristic grief responses across the stages of childhood.
At school age, death is seen as final, but happens only to the old and infirm; children can escape it by keeping healthy. Death is personified as an angel, skeleton, or ghost. This stage heralds the fear of ghosts, ghouls, and evil spirits. Older children become curious about the physical process of death and what happens after. Their main sources of anxiety are fear of the unknown, loss of control, and separation from family and friends. There is a strong tendency toward denial.
They may act out their anger and sadness or be unable to concentrate at school. Others act jocular or indifferent, withdrawing and hiding their feelings. There may be shock, depression, changes in eating and sleeping patterns, and regression. They might fantasize about how they would have prevented death to gain control over the situation. Unable to verbalize feelings, they might playact through video games, war games, or other activities.
Adolescents may say, “My friends can’t relate to what it’s like losing a dad.” For preteens and teens, death is viewed abstractly and subjectively. They think themselves immortal. They pose philosophical questions (“What is the meaning of life?” “What is my special mission?”). Death may be romanticized as beautiful and tragic. Due to TV and the movies, loss from death becomes easier to deal with.
Early teens hide feelings to avoid differing from their peer group. Expressing sadness is weakness, so they appear removed and indifferent. Teens display uncharacteristic expressions of grief (anger outbursts, irritability, bullying). They exhibit physical symptoms, moodiness, changes in sleeping and eating patterns, indifference toward schoolwork, or isolation from peers. They worry about practical issues (how will the household survive without the deceased, or how will they be taken care of?). They have questions on religious and cultural beliefs about death.
What children need most to have their fear assuaged is support—someone to listen and reassure them. Their lack of understanding of death affects their ability to process what happened and cope with their feelings. In “How Children Understand Death and What You Should Say,” healthychildren.org suggests what to do to help your children:
Remind them that not everyone who gets sick dies.
Reassure them of your health.
Let them know how many people care for them.
Encourage them to do things to reduce anxiety. They may not want to talk or think about the deceased because it is painful.
Take care of yourself. Make sure you have support.
Your children watch you closely. When they see you’re okay, they become more comfortable.
——————
Dr. Ruben Encarnacion is a clinical psychologist and professor of Leadership and Human Resources at the Ateneo Graduate School of Business.