By Ken Doka, Ph. D.

 

You never expect to bury a child—no matter what the child’s age. Children, it is believed, should outlive their parents. You expect to watch your children grow and develop, marry and have children of their own, before you pass from their lives.

Whenever a child dies, you lose not only that child but also your assumptive world—your beliefs about what the world should be like. It is little wonder then that the death of a child at any age complicates grief. It is a most difficult loss.

This article cannot offer words to explain such a loss. No article could. Perhaps though, this article can extend 3 offerings. First, in its description of the grieving process, it may offer validation—that is, a sense that reactions and responses that emerge after the death of a child are shared by other parents as they struggle with their loss. Second, it may offer suggestions on how to deal with situations and issues that may arise as you grieve. Finally, this article offers hope.

Catherine Sanders, a mother who had just returned to school, lost her 15-year-old son in a water skiing accident as she watched from the beach. After the death, she changed her major to psychology and focused on the study of grief—in many ways to help her understand her own grief. Eventually receiving a doctorate, Sanders later contributed much to understanding the ways that parents cope with the death of a child.

In her studies, Sanders talked about the varied phases of grief that many parents experienced as they dealt with loss. She was sensitive to the individuality of grief—acknowledging that her research might explain the types of reactions that many parents have, but also recognizing the individual choices that parents have as they respond and adapt to loss.

1. Your grief experience

Sense of shock

Many parents, Sanders found, experienced a deep sense of shock when their child died. This is understandable because, even in cases where the child has a disease, you never truly expect your child to die before you.

In the days immediately after the death of your child:

• Everything may seem to be a haze or a bad dream.
• It is common at times to deny or to disbelieve the loss.
• Everything may seem confusing or unreal.
• You may feel that you go through the motions, never fully conscious of what occurred—or quite believing the horrific reality.

One of the values of the funeral is that it offers opportunities to slowly face that terrible truth.

Awareness of loss

Sanders labelled the next phase as awareness of loss. Now that the shock is beginning to fade, you are likely to experience grief intensely. Grief, after all, is the natural and normal response to loss. This experience of grief will affect you at every level—physically, emotionally, cognitively, socially and spiritually.

The physical level

Physically, grief can make you feel unwell. You may experience a range of aches and pains—headaches, backaches, muscular pain, digestive difficulties or exhaustion. Sometimes the pain may even be symbolic of the loss. Studies of mothers, for example, who experienced the death of newborns found that many of them complained of upper arm pain—the muscles that would normally be used to hug or cradle a child. Other parents described their loss as a feeling of emptiness that felt like “a hole in the heart.”

While physical reactions to loss are common, it is essential that you monitor your health carefully in the period following the death of your child. This is a stressful, vulnerable time. In tense times good self-care is critical.

Monitor the ways the death has affected your own lifestyle and habits:

• Are you eating and sleeping well?
• Are you getting adequate exercise?
• Are you taking any prescribed medications in the proper way?
• Are you overusing any prescriptions or over-the-counter medications?
• Has alcohol become a way to cope with the loss?
• Are you doing things to reduce the obvious stress?
  • listening to music
  • exercising
  • other pleasurable activities

If problematic physical reactions continue, have them evaluated by a physician. It is important to let the physician know of your recent loss.

The emotional level

Naturally, emotions are part of grief as well. You may experience intense feelings as you cope with the loss of your child. There may be periods of deep sadness, intense yearning and even moments of profound loneliness.

Anger

You may be unprepared for the anger you may feel—shocked that your temper seems to run so short. Anger is a natural response to loss, a feeling that arises to having someone so important disappear from your life. You may direct that anger:

• at those you feel are responsible or un-supportive.
• at those closest to you.
• with the person who died.
• with God for allowing your loss.
• at other children seemingly engaged in destructive acts or negative behaviours.

While anger is a normal reaction as you grieve, it can be problematic if it turns into blaming or drives others away and thus deprives you of support—separating you from those you most need in your journey with grief.

Guilt

Sometimes the anger can be directed inward—at yourself. Guilt, too, is a very common response to grief. As a parent, it is easy to place unrealistic expectations upon yourself—to believe that you should have somehow protected your child from death. Margaret Mile and Alice Demi researched the kinds of guilt reactions that parents had following the death of a child. They found these reactions to be both powerful and complex.

• There may be role guilt—a sense that you might have been a better, more caring, more responsible parent.
• There is also death causation guilt—a feeling that you had some role in the death. This is very common when a child dies of a genetic disease. Yet, it is experienced in many other circumstances as well, such as a child dying in a car accident while running an errand for a parent.
• In survivor guilt you may feel guilty that you are still alive—a reaction often common not only in parents but also in siblings.
• You even may feel a moral guilt that this loss is some form of cosmic punishment for something you had done or not done.
• Then there is what Miles and Demi called grief guilt—feeling guilty that you are doing too poorly, or too well, in your grief.

You cannot control these guilt feelings. Guilt does not have to have a rational basis to be experienced as real, but sometimes it does help to move outside of yourself—to ask yourself if others would see you as guilty.

Anxiety and fear

You may have increased anxiety and fears. When a child dies it is easy to feel that the world is an unsafe place where anything can happen. It may be very difficult to let surviving children engage in the normal activities of life. It is easy to become too overprotective.

Jealousy

You may even feel jealous of others who still have their children. These feelings of jealousy are normal but they can be disturbing. You may find you even have less patience with those who share the normal problems inherent in raising children—bad behaviour, poor grades or other factors that now seem to you as almost meaningless complaints. You may even feel a sense of being different, perhaps even a sense of shame, a feeling that other parents now see you in some other ways than they did before your loss.

Other reactions and feelings

There may be other momentary reactions and feelings. If your child suffered with a disease or injuries, you may experience a sense of relief that the pain or discomfort has now ended. At other times, you may feel a renewed appreciation of the role your child played in your life. These emotions are normal, too, the natural result of time together.

There is no order to these feelings. It is not unusual to experience many, even conflicting, emotions as you grieve. One grief therapist described it as “a hive of affect”—that is, many complex, even ambivalent, emotions buzzing around inside you. That, too, is part of the experience of grief.

However, feelings and emotions are only part of the grief experience.

The cognitive level

Grief also influences the ways you think.

• You may find it difficult to focus or concentrate.
• You may seem forgetful and find yourself easily distracted.
• You may constantly think about your loss—constantly going over painful details in your mind and wondering if it could have turned out differently.

It is not unusual to have experiences like these. Louis LaGrand, a writer, called them extraordinary experiences, where you have an incident that evokes the child.

• This may be a momentary feeling where you sense the deceased child’s presence.
• Or perhaps you may even seem to see, smell, feel or even hear your child.
• Dreams of your child may be common.
• There may even be times when another event or some comment evokes a sense of your child.

Many parents find such un-explainable events comforting once assured that they are not uncommon.

The social level

Your behaviours also may be different.

• You may cry a great deal, weeping at your loss uncontrollably.
• Or you may be confused that you cannot even seem to cry.
• You may find yourself less patient or more prone to anger.
• Or, you may be more lethargic and apathetic.
• You even may withdraw—seeking lots of time alone that was not typical of you before the loss.
• Or, you may constantly seek the activity and company of others as a way to distract you from your grief.
• Some may avoid reminders of the child who died. It simply may be too painful to view photographs or watch activities that bring your child to mind.
• Others may seek these reminders and find the memories they evoke comforting.
• You may even find it important to engage in activities that affirm your child.

Charles, for example, found it important to be active in creating a scholarship fund, funded by a charity basketball game that perpetuated the memory of his late son.

The spiritual level

Grief may often affect you spiritually. Some may find great strength in beliefs. They are what sustain you as you struggle with your loss and your grief. You may find your spirituality deepen—attending worship, praying or reading scripture even more frequently than you did in the past.

Others may find their spirituality threatened. This is not uncommon when a child dies. It is easy to feel the death of your child is not the way it should be or you may feel abandoned by your faith. You may struggle with anger at God and doubts about your prior beliefs. You may find it difficult to connect with your previous beliefs and obtain little comfort at this time from your faith. You may find yourself searching for some way to make sense of this unfathomable loss.

The roller coaster

During this phase, the experience of grief may often be described as a roller coaster—full of ups and intense downs, highs and lows. On some days, you may feel that you are doing well—only to plunge into a deepened sense of grief. Some of these low periods are unsurprising—you may expect holidays and other events such as birthdays to be difficult. However, there is no true predictability. Sometimes little events—seeing a child who looks or dresses similarly, clicking past your child’s favoured television show, hearing a song, seeing your child’s friends on the street or even seeing a favoured toy or game, may evoke intense grief.

Grief conservation and withdrawal

There is no timetable to this intense period of loss. However, over time, the intensity of emotions begins to lessen. You may be forced back—by the demands of family or work—into living life now even as you still cope with your loss. The world around you may seem less patient now with your grief. You may feel that you are putting on a mask as you go through the motions of living.

Sanders called this phase of grief conservation and withdrawal. In many ways, it is one of the longest and most difficult times in your grieving process. While the grief continues, perhaps at a lower level of intensity, there is often diminished social support. Your family and friends may underestimate or fail to understand your continued grief and need for support. Yet this is often a time, when as one colleague whose daughter died noted, “you have to cope with the continued presence of the absence.”

In this period, it may seem to take all your energy just to cope with the demands of life. Physically, you may feel fatigued and seem to need even more sleep as you cope with the ongoing demands of life and your grief. It is critical to pay attention to your health in this period as the continued stresses of grief can weaken your immune system and make you more vulnerable to illness.

Choices in grief

One of Sanders’ critical points was that you have choices in grief. Some people may continue their life seemingly without ever leaving this phase. I remember one mother whose only child died. She said that while her son was alive the world was in colour—using the metaphor of a television show in colour. She thanked me as she terminated therapy—indicating that I had allowed her to put the TV back on in her life—only now it was black and white. I suggested, “we could bring back the colour.” She objected. That, she thought, would be a betrayal of her son.

As Sanders indicated in both her research and her life—you can choose to move forward, to live a meaningful life despite the loss. Perhaps you will even be able to find a meaning that makes your life a tribute to your child. In Sanders’ research, many parents experienced this turning point in their grief as they:

• began to re-engage in activities.
• recognized the needs of their other children.
• became involved in activities that were a homage to the child who died.

Such parents, Sanders noted, reached the phase of renewal.

Renewal

Renewal can be best described as learning to live—despite the loss. As one therapist described it, you have an empty space in your heart—but you have now learned how to live with that empty space. For most, over time, the roller coaster begins to slow down—the bad days are less frequent, less intense and do not tend to last as long. As the pain ebbs, you may find that your energy levels and previous abilities seem to return. Grief becomes less disabling. Often you begin to function at a level similar to the one prior to the loss. In this period, you still may experience some down times especially at anniversaries, birthdays or other special events. You will never lose your connection or memories of the child who died.

Sanders’ insights may offer some very general type of road map, but it is important to remember that there is no single, right way to experience grief nor does grief have a timetable. Your experience of grief is what it is. It comes from who you are. After all, you cannot compare your loss to the losses of others, or your reactions or responses to those of others. Differing experiences of grief have little to do with how much you have loved or cared about your child. Each child, every relationship, even the circumstances of the loss, are unique. Your grief will be different as well.

2. Your journey with grief

The power of ritual

The first thing you will have to do when your child dies is to plan the funeral. You may likely be in shock throughout this process. A sense of unreality may permeate the event since you never expect to plan such an event for your own child. Nonetheless, the funeral can be seen as one of the first stops as you journey with grief.

Funeral and memorial services are powerful, therapeutic events for many reasons. They are a “rite of passage”—a dignified way that people move on from the death to rejoin the world of the living. More than that though, funerals play many roles for surviving family. They provide a sense of structure and support in a highly stressful time. Funerals also provide a safe venue for the physical and emotional expression of grief, because the ritual contains that grief and guides its expression. They offer a chance for family, friends and the larger community to come together in support. Funeral rituals provoke memories that help you find meaning in the life of the person mourners are remembering. In addition, funerals allow you to draw upon your own spiritual beliefs to find comfort even in this difficult time.

Personalized services

There may be things you can do within the funeral that may assist you in your journey with grief. Funeral rituals are especially therapeutic when they are personal. Your funeral director and clergy can assist in making the funeral more meaningful.

Things to consider:

• Exhibit photographic images of your child. Such displays not only evoke memories they reaffirm that your child had a life but also remind you that your child touched the lives of others.
• Are there readings, poems, music or hymns that have special meaning?
• Is there an opportunity for others to participate in the readings or music?
• Is there an opportunity for a eulogy—for a member of the family or a friend to say some words about the child who died?
• If your child was older, perhaps friends can play a role—serving symbolically as pallbearers or ushers, maybe even doing readings, perhaps from scripture or poetry, that have significance to the child.
• Perhaps you can involve your child's school glee club, band or choir in a musical performance.

Other public rituals

Even beyond the funeral there may be opportunities for rituals that memorialize and remember your child. For example, you may wish to have a memorial service or mass at the anniversary of the death. You can also arrange other events. One father whose son died in high school has a charity athletic event each year in his son’s memory. The money raised supports a scholarship fund in honour of his son.

Private family rituals

These can be as simple as lighting a candle on the anniversary of the death. One family places a significant toy—such as a video game system—under the Christmas tree as a gift from the child to the family. Another family purchases a wrapped gift for the child that is donated to a children’s shelter. Both small rituals give voice to feelings of loss that might otherwise remain silent. Both offer permission for family members to share both their memories and grief.

Coping with your loss

While everyone’s experience of grief is different, J. William Worden, a grief therapist, speaks of common tasks or issues that individuals need to address as they cope with loss. The word “tasks” is interesting. Just as with any set of tasks, some people find some tasks easier than others. Each person does their tasks in their own way.

Engaging in any set of tasks can be difficult and tiring. Grief is no different. Just as you need time off from any work, so you need respite from the tasks of grief. You need not feel guilty if there are times you find enjoyment in an activity or seem removed temporarily from your loss. These times when you are a bit removed from grief are both necessary and natural. They are part of the cycle—the roller coaster of ups and downs—that is so much part of grief.

Acknowledging the reality of your loss

When your child dies, regardless of the circumstances or age, it may seem unreal—a nightmare from which you wish to wake. You never expect your child to die before you. It takes time to adjust to the new, tragic reality. You still may find yourself going to your child’s room or buying the child’s favourite breakfast cereal.

In the beginning, the shock of the loss may insulate you from the new reality of what has happened and is still happening. But slowly that reality begins to emerge—eroding that shock and initial denial. The funeral ritual itself is a reminder, a reaffirmation, of your loss, as are the sympathy cards and condolence calls. As you talk about your loss and grief with others, perhaps even in a bereavement support group, the reality of the loss begins to be felt.

Most people, over time, acknowledge the death. Gradually you will no longer expect your child to return. The reality of the loss slowly seeps into your consciousness. Bit by bit, your behaviours adjust to the new reality. You no longer look in the room to see whether the child returned. Your hand no longer reaches in the grocery store for the once requested item.

Exploring and expressing your emotions

As indicated earlier, grief is often a time that you may struggle with many difficult and complicated emotions. There are few emotions that you may not experience as part of grief. The first step in dealing with your feelings is to acknowledge them. They are a natural part of the process of grief. You really have little control over this experience of feelings. Recognizing your feelings is the first step in dealing with them.

Explore your feelings

• What are the circumstances and times that trigger these emotions?
• How are you dealing with these feelings?
• Are holding yourself responsible for things or events you simply could not and cannot control?

Sometimes when you really examine difficult emotions, they fade like the mist. As you struggle with your emotions, draw from your own spiritual strengths. Learn to forgive yourself.

Coping with grief emotions

While you cannot control what you feel, you can control how you cope with your grief reactions. There are constructive and destructive ways to deal with emotions. Think, for example, of anger.

Constructive ways to deal with anger may include:

• exercising
• punching a pillow
• screaming at an empty chair
• fantasizing
• directing your anger to enact change—for instance, getting involved with an organization that actively fights against what may have caused your child's death

There also are destructive ways to deal with anger—lashing out at those around you, driving others away, and limiting your support. These should be avoided or minimized.

Fear and anxiety offer another example. The death of your child may make the world feel unsafe. Nevertheless, your fear and anxiety can be activated as a force for change. A constructive way to deal with anxiety after a child is killed crossing the street to school would be to lobby for a crossing guard, as opposed to requesting all children stay within view every minute of their walk to school—inhibiting their own development and emerging independence.

Unfinished business

You may have left some unfinished business. You may regret something you did or said, or something left unsaid or undone. Once you recognize the unfinished business, you may find a way to complete this unfinished act. Some may share a final comment with an empty chair or at graveside, others may write a note in a journal or a letter to their child, or complete a small ritual.

Holidays, birthday and special occasions

Yet certain days, such as holidays, birthdays and special occasions such as anniversaries, or even the anniversary of the death, are generally hard. You need not drift unaware into these emotionally difficult times. Prepare for them. Think of where you would like to be, what you would wish to be doing and whom you would wish to be with on these difficult days.

Seek help when you need it

Sometimes you may be able to do this exploration on your own. Taking time to work through your feelings or writing in a journal about them can be helpful. Other times it may be helpful to examine your emotions with a close friend or confidant, within a support group, or perhaps with a counsellor or your clergy.

Adjusting to the new reality of life without your child

When your child dies, your life changes. These changes can be both profound and subtle. Your house may seem strangely quiet. You may find activities that once had meaning—cooking perhaps or watching television—no longer have the same significance. You may miss the activities that you shared with your child. If your child was older and had a spouse or children, relationships with in-laws and grandchildren also may be affected.

The death of a child may create “secondary losses” or other things that have now changed. You may find relationships with other parents are no longer the same in the wake of your child’s death. You may miss the fact that your child’s friends no longer come into your home.

Name the changes

One of the critical tasks of grief, then, is adjusting to a life without your child—a life that is now changed. It helps to name those changes. This does 2 things:

• It validates—reminding you of the many ways that life has changed.
• It allows you to problem solve—to figure out what you can have control of and which changes you may simply have to accept.

Assess the changes

You may wish to assess what changes are causing the most difficulties. What can you do about them? These questions allow you to assess the situations, times and events that are challenging for you. Only then can you decide how to adapt to these changes in the way that is best for you.

Assess your own strengths and weaknesses:

• How have you adapted to change and loss in the past?
• What did you do well?
• What are some of the problematic ways you have coped in the past that you might now want to avoid?
• Who can you count on to help?

Get help when you need it

If your family is not functioning well after the death of your child, you may need to draw upon your extended family—or perhaps even your faith community, friends or professionals.

If you have other children, how well you function will have a major influence on how they cope with the loss. Your surviving children need what every child needs—love, support, consistency and structure. If the intensity of your grief is impairing your ability to meet those needs, draw upon the strengths of others. Perhaps consider having a family member move in with you for a while to help.

Stress

Recognize, too, that change adds stress to your life. Taking good care of yourself, getting enough nutritious food, adequate sleep and sufficient exercise, as well as doing whatever you can to manage stress, prepares you to cope more effectively with a now changed world.

Give yourself the gift of time. In the stressful time, you may not always think clearly. Try to make interim solutions, rather than final ones. It might be better, for example, to put your child’s toys and belongings away—if that is what you wish to do—rather than to immediately dispose of them or give them away. Later, you may be more attentive to the items you wish to retain.

Remembering your child

The end of grief is not the end of memory. Words like closure actually have little significance in grief. Even in death, you always retain a bond with your child that time or death can never break.

The bond with your child continues in:

• the memories
• in the legacies that are left
• in the spiritual connections and experiences that you have

You may even carry an “inner representation” of your child. This means that when a child dies at a young age, you are constantly aware of the age the child would be now. You may note to yourself that this is the year your child would graduate from school, have a Bar Mitzvah or join Little League. This inner representation is natural—another example of the bond you retain with your child.

Memories

Memories are natural, even unavoidable. Think how often a sight or a place, even a taste or a smell, will evoke a remembrance long forgotten. You can no more control what you remember than what you feel. In fact, as the pain of your loss eases, your memories become more vivid and less painful. This is often one of the first positive signs in your journey with grief.

Memories, too, are often comforting. They remind you of the person who died—bringing the individual closer if even fleetingly. They are an affirmation of the life and love shared.

Painful memories

Memories, though, can be a double-edged sword. Some memories may be painful—reminding you of tough and troubling times or difficult relationships. Then, too, you can be obsessed by certain memories, reviewing time and again the illness, the death or even actions or words that you regretted or other actions you wished you had done or words you wished you had said. Yet, these painful memories also need to be confronted. Only when you fully explore them can we truly understand them and find ways to release these problematic recollections.

Engage in activities

It may be helpful to engage in activities that allow you to continue this bond with your child. Scrapbook, photo albums, special events and rituals, even remembrances such as scholarships or contributions in your child’s name are natural and helpful ways to reaffirm the child’s continued presence in your life.

Rebuilding faith

In difficult situations, it is natural to look to your faith, your beliefs and your philosophy of life to find some answers, to find meaning. Sometimes your faith can do that—offer comfort, or at least a sense of support and presence that sustains you in your grief.

When faith is shattered

In other cases, the death of a child can shatter your most cherished beliefs—however deeply held. You may find it hard to believe there is any meaning to the universe or any point in life. The circumstances of the death or the extent of suffering may make it hard to believe in a benevolent God. You may feel lonely and abandoned. Your faith may seem to offer little comfort.

Share your struggles

One of the tasks of mourning, then, is to rebuild faith or philosophies that have been challenged by our loss. One of the biggest mistakes you can make during this period is to isolate yourself from your beliefs. You need, instead, to share your struggles within your faith community. This is a time to identify those within your faith communities who can journey with you, who are comfortable in hearing your conflicts and sharing their own.

While you may have to look hard to search out and find those people, you may be surprised at how supportive faith leaders can be in the face of your doubt and uncertainty. They may even share in your anger or disappointment with God and be a comforting presence during your faith struggle.

Find a spiritual discipline

Prayer, meditation, ritual, and readings are all ways to connect with your faith traditions. Each spiritual tradition and every philosophy has encountered death and loss. Each has writings that speak to that encounter. Maintain your own spiritual discipline whatever that is.

Explore the struggles of others

Finally, you may find value in reading about the struggles of others. Rabbi Harold Kushner wrote “Why Do Bad Things Happen to Good People” as he struggled with the death of his young son. C.S. Lewis explored his faith struggles after his wife died in “A Grief Observed.” These writings not only remind us that such moments are natural and normal valleys in the journeys of both faith and grief, they offer insight, suggestions on how to best cope and hope.

3. Grieving as a family

Your grief, your spouse’s grief

The loss of a child will affect you and your spouse deeply—but perhaps differently. Every person, after all, grieves in his or her own way. You cannot and should not compare your loss to those of others or your reactions or responses to those of others. Differing experiences of grief have little to do with how much you loved or cared about your child.

Terry Martin, a psychologist at Hood College, and I have written about what we have called a continuum of different grieving styles.

Intuitive griever:

• You may experience grief as waves of emotions—loneliness, sadness, anger and guilt.
• Your expressions of grief will mirror these feelings. You may find yourself crying, perhaps even uncontrollably at times.
• Your emotions are vivid colours—easy for others to see. When you are angry or sad, others will quickly know.

Instrumental griever:

• Your feelings tend to be more muted.
• Like pastels, these feelings are not as clearly accessible to others, perhaps even to yourself.
• Your grief is experienced more in your thoughts or perhaps physically.
• You may find it easier to express your grief in what you do, for instance in artwork.

Blended griever:

Naturally, some people are more in the middle of this continuum—you may find that your grieving style blends traits from both. Others, often at great difficulty, may try to act in ways different from their inclinations. For example, one person may hide his or her own emotions and tears to spare a partner.

No "right way" to grieve

The point of this should reaffirm that there is no one, right way to grieve. You and your spouse may have different ways of dealing with your grief. That should not be a problem unless you make it one. There are, however, a few points to keep in mind as you cope with any differences in the ways that you grieve.

1. Recognize and respect that you may grieve in different ways.

This does not mean that one of you has a problem or loved the child less. It simply reaffirms that you are different. These differences can be strengths. For instance, while one spouse may become fatigued while grieving, the other may find solace in keeping active and be able to assume a more active role with children.

2. You may have to take responsibility to meet your own needs.

The way you find it helpful to deal with grief may not be helpful to your spouse. While you may find a support group helpful, your spouse may not.

3. Communicate your concerns.

The dimensions of how you grieve may affect every aspect of your relationship—including your ability to relate to one another, your ways of supporting each other, even your level of intimacy. It is important to talk about the ways that you cope as individuals, as a couple and as a family.

The divorce myth

The death of a child is a stressful event. As such it certainly can add tension to the marital relationship. However there is a destructive myth that many, if not most couples, inevitably divorce after the death of a child. This myth is simply not true. The divorce rate in couples that have experienced a death is no higher than the rate in the general population. A child may have died, but the love that you shared for that child remains. The same skills—open communication, understanding and mutual respect—that saw you through other relational crises can see you through this one as well.

Brothers and sisters

You may have other children. They too will grieve and, like adults, their grief may come out in many different ways—physically, emotionally, cognitively, behaviourally and spiritually. Some reactions such as sadness or crying you will recognize as grief. Others, such as changes in behaviour, acting out behaviours, even changes in interests or grades may not be immediately acknowledged as manifestations of grief.

Be attentive

As parents, it is important that you are attentive to the ways that your other children may be dealing with the loss. Again careful observation and open communication are essential. If any of the children begin to behave in ways that are destructive to themselves or others, counseling may be very helpful.

Even, perhaps especially, in loss, children need love, caring attention and structure. Studies have shown that the best predictor of children’s outcome in grief is how well the family continues to function. Sometimes the best thing you can do for your children is to make sure you have the help you need to work well as a family. That help may mean counselling or perhaps even other relatives or friends who can assist with your children as you cope with your loss.

Beware of idealization

There is another issue that siblings may experience when a brother or sister dies. It is natural and easy to idealize the child who has died. You hear so many times advice “to remember only the good things.” The danger of idealization is that it may make any surviving children think that they can never reach the standard, or be loved as much, as the child who died. Even as you honour the child who has died, be sensitive to the ongoing needs of your other children.

Grief and others

Your child’s death will affect not only your spouse and children but also other relatives and friends.

• Your parents have lost a grandchild.
• Your siblings grieve the death of a niece or nephew.
• Neighbours, coaches, teachers and friends all experience that loss.

Their own ways of dealing with that loss may influence their own abilities to offer support to you. Some may be extremely supportive—sharing their own stories of your child and their grief. Others may find it too painful and withdraw.

Insensitive remarks

Still, others may trouble you with insensitive remarks. “Be thankful you have other children.” “You are young, you can have another child.” Erin Linn, in a wonderful book entitled “I Know Just How You Feel: Avoiding the Cliches of Grief,” wisely suggests asking yourself 3 questions when such thoughtless comments trouble you.

1. “Why did it hurt?” Almost always the answer is that such comments invalidate your grief.
2. “Why did the person say it?” However careless the comment, most times, the other person simply does not know what to say. This question allows you to acknowledge that, however clumsy it may seem to you, the comment was meant to support.
3. “What should I have said?”
   1. For example, the response to, “You are young, you can have another child,” may be something like “I do not know what the future might hold—right now I am deeply mourning Tanya.”
   2. A response to “Be thankful you have other children,” might be, “I am—they are a great comfort but I still miss Robbie terribly.”
   3. While it may be too late to respond to the comment, such an answer both prepares and empowers you for the future.

4. Using resources

Books

As you grieve, you need not grieve alone. There are many resources to assist you in your grief. Books can be useful in a number of ways. They can reassure you that your reactions are natural. Books can offer suggestions for coping and sustain hope.

Support groups

Support groups are another resource that offers much. When a child dies, it is easy to feel alone and isolated. People may not know what to say. They may even avoid you. The normal interactions, once centred on your child, now cease. Support groups offer an opportunity to be with other parents who have experienced the death of a child. Here is a safe place to share feelings, reactions and memories and to exchange strategies in coping with that loss. Support groups also offer hope as you see other parents who have lived with their losses and found strength in reaching out to others.

Counselling

Counselling is another source of help. The death of a child is inherently complicated. It may be especially helpful when you require more personal attention and assistance than might be available within a group. If you are engaging in self-destructive behaviours such as using excessive alcohol or drugs, or failing to function in critical roles at work and home, it is best to seek professional assistance.

Additional resources

• Often your funeral home or local hospice will have information about self-help groups and local grief counsellors.
• Some funeral homes may even have grief libraries or aftercare services such as bereavement support groups or informational lectures.
• The Compassionate Friends is a national support group for parents who have experienced the death of a child. Many of their local chapters also may have sibling programs. Local chapters may also be a source of referral to counsellors that members found effective.
• The Association for Death Education and Counselling also can provide the names of certified grief counsellora within your area.

As with other professionals, you may need to try a few groups or counselors in order to find the resource with which you are most comfortable and the one that best meets your needs.

5. Transforming loss

You had no choice about your child’s death. You have no choice about your grief. That grief is the result of the attachment and love you felt for your child.

You do have choices within your grief. You could choose to live your life in perpetually mourning for your child. Or, as difficult as it is and may seem to you right now, you can choose to live a now different life—but to live it fully, keeping alive the memories of your child and lessons that, however long or short your child’s life was, you gleaned from your child. Living your life in that way will be a tribute to your child.

About the author

Dr. Kenneth J. Doka is a professor of gerontology at the Graduate School of The College of New Rochelle and senior consultant to the Hospice Foundation of America. A prolific author, Dr. Doka’s has written 24 books, published over 100 articles and book chapters and is editor of a journal and newsletter on the topics of death and grief.

Dr. Doka was elected president of the Association for Death Education and Counseling in 1993. In 1995 he was elected to the board of directors of the International Work Group on Dying, Death and Bereavement and served as chair from 1997-1999. The Association for Death Education and Counseling presented him with an award for Outstanding Contributions in the Field of Death Education in 1998. In 2000 Scott and White presented him an award for Outstanding Contributions to Thanatology and Hospice. His Alma Mater, Concordia College, presented him with their first Distinguished Alumnus Award. In 2006 Dr. Doka was grandfathered in as a Mental Health Counselor under New York state’s first licensure of counselors.

Dr. Doka has keynoted conferences throughout North America as well as Europe, Asia, Australia and New Zealand. He participates in the annual Hospice Foundation of America Teleconference and has appeared on CNN and Nightline. In addition he has served as a consultant to medical, nursing, funeral service and hospice organizations as well as businesses and educational and social service agencies. Dr. Doka is an ordained Lutheran minister.