Grief, Loss, and Healing After Burn Trauma: Helping Children
Megan Bronson APRN, BC and Samantha Price MHDL, NCC, LPC
MANY PEOPLE THINK OF THE PROCESS OF GRIEF AS THE PROCESS THAT WE GO THROUGH WHEN SOMEONE DIES. ACTUALLY, THE GRIEVING PROCESS HAPPENS WHEN WE EXPERIENCE ANY LOSS OR MAJOR LIFE CHANGE. TH E LENGTH OF TIME IT TAKES TO GRIEVE AND THE INTENSITY OF THE GRIEF WILL BE DIRECTLY RELATED TO THE SEVERITY OF THE LOSSES AND HOW MUCH THEY AFFECT OUR DAY TO DAY LIVING. THIS HOLDS TRUE FOR CHILDREN AS WELL. WE HOPE THAT THE FOLLOWING INFO RMATION WILL HELP YOU IN HELPING THE SPECIAL CHILDREN IN YOUR LIFE TO RECLAIM LIFE AND CHILDHOOD WHEN THEIR LIVES HAVE BEEN AFFECTED BY BURN TRAUMA.
Burn trauma is fraught with loss and is unique for each family depending on who or what was lost and the circumstances of that family. These losses can include loss of a beloved family member; loss a family member’s ability to function and support the family in the way that he or she did before the burn injury; loss of pre-burn appearance; loss of body parts; loss of pets, home, possessions, family relationships; loss of lifestyle; the many losses related to divorce, and so on.
The statements “Children are resilient” and “It is good they won’t remember this time” are both urban legends that probably developed to help adults feel better. There is some truth in both statements; however, the reality is that children are very good at walling off loss and trauma while appearing to be fine. They are able to go to school, play with friends, and be involved in activities, etc., while a part of them carries the pain of the loss outside of conscious awareness. They may not have clear memories but they do carry emotional and body memory of the loss and trauma.
Nine-year-old Laurin made this point in a most touching way in the following drawings, which she drew after the death of her baby sister:
Another child expressed her feelings related to major loss in this drawing:
Children do grieve and feel deeply about loss. They are able to move through grief and to reclaim life and their right to be a child when the loss is clearly acknowledged, their feelings are treated as normal and expected, and their grief is supported in appropriate ways over time.
PRINCIPLES FOR SUPPORTING GRIEF
The following are basic principles to keep in mind when working with and supporting oneself or another in the grieving process. It is important to consider the developmental stage of children and to give information in an age-appropriate way that they can understand and handle. These principles create a safe container for the healing process of grief.
- The truth, spoken with care and compassion, catalyzes the emotional healing process.
- Withholding or distorting truth complicates grief and feeds denial.
- Therefore, support compassionate truth-telling.
- People, including children, are doing the best they can with the tools they have to work with.
- Acceptance is more helpful than judgment.
- Therefore, avoid judgment.
- There may be differing values, and even spiritual beliefs, within the same family.
- Many families will have different values and belief systems than yours.
- Recognize, respect, and honor difference. Children may be angry with God after loss and this anger needs to be allowed expression. God can handle our anger.
- Facilitating saying good-bye supports closure and facilitates healing later on.
- Interfering with the process of saying good-bye blocks healing in individuals and families.
- Give children opportunities to say good-bye.
- Feelings are neither right nor wrong, good or bad—neither are they necessarily logical.
- Feelings need to be heard respectfully and without judgment. Listen to understand.
- Feelings do not need to be interpreted or analyzed and they do not need to be fixed.
- Show respect for and honor feelings.
HOW TO HELP YOUR CHILD
- Give your child opportunities to express his or her feelings creatively or through play.
- If a death has occurred, provide opportunities for the child to say good-bye.
- Consider the developmental stage and needs of your child as you discuss the loss.
- Provide opportunities for your child to talk about, ask questions about, and express his or her feelings about the loss.
- Reassure your child that a wide range of feelings about a loss, including anger, sadness, guilt, longing and missing, and even emotional numbness for a time, are normal.
- Listen, listen, listen—with an open heart and mind—listen
- Maintain daily activities and routines as much as possible.
- Touch reassures and helps—use opportunities such as reading a book or watching television to provide physical contact with your child.
- Give your child extra attention—be patient with regressive behaviors
- Involve your child’s school in his or her reentry to school after loss. (The Journey Back resource developed by the Phoenix Society is currently being modified for children returning to school after the death of a loved one.)
- Encourage your child to participate in a bereavement group for children (provided by local hospice agencies, Gilda’s Clubs, etc.)
- Enroll your child, or your family, in a bereavement camp.
- Protect your child’s privacy if they don’t want to talk about the loss, especially with others.
- Encourage ways to remember, such as sharing stories, making memory books or boxes, planting a tree or a garden, drawing a picture, etc.
- Have age-appropriate books about loss available to read to your child or for he or she to read on his own.
WHEN TO BE CONCERNED ABOUT YOUR CHILD OR TEEN AND SEEK PROFESSIONAL HELP
The following behaviors are common after loss. It is when these behaviors persist for months after the loss that they are considered red flags and indicate the need for professional assessment and intervention.
- Anxiety that limits the child’s ability to function, such as school phobia, fear of separation from caregivers, fear of further loss, fear that he or she will also die
- Persistent difficulty talking about a person who has died or preoccupation with the loss.
- Regressive behavior, such as thumb sucking, whining, clinging, bed wetting, going backwards in toilet training
- Hyperactivity, aggression, destructive outbursts, risk-taking behavior, rebellious behavior
- Avoidance of friends and social activities • School difficulties (could present as failing grades, difficulty concentrating and following directions, or overachievement and perfectionism)
- Persistent self-blame and guilt
- Wanting to take care of everyone else, but not wanting to be cared for
- Physical complaints, such as headaches or stomachaches
- Frequent accidents, developing symptoms of the deceased person’s illness
- In teens, substance abuse, sexual promiscuity, or other self-destructive behaviors; expressing a desire to die
- Prolonged inability to cry or to express or experience longing for the person who died
- Sleep and eating disturbance
Kids grieve too and can handle loss and change when their healing process is supported over time. The grief of children will likely reemerge at each developmental stage. Supporting the child’s grief as he or she grows and develops through the teen years helps to keep them developmentally on track. Remember that the journey of grief is challenging and sometimes painful, however it is how adults and children heal and adjust after loss and major life change. Healing is grief’s purpose and function. Healing and recovery after loss are ultimately about reclaiming life and hope.
RESOURCES FOR SUPPORTING CHILDREN THROUGH GRIEF
www.dougy.org A national grief center for children since 1983. A National Directory of Grief Resources on their website can help you locate a children’s grief group in your area. Also offers many books for kids and teens after loss.
http://www.compassionbooks.com The world’s largest mail order service with resources on grief and loss for children and adults. Also offers many books for kids and teens.
http://www.selfesteemshop.com An excellent source of books for children about loss, trauma, and self-esteem.
Worden, J.W. (1996). Children and Grief: When a Parent Dies. New York: The Guilford Press.
Monahon, C. (1993). Children & Trauma: A Parent’s Guide to Helping Children Heal. New York: Lexington Books.
Bronson, M. (2002). Helping the Traumatized Child to Reclaim Life. Burn Support News, Summer Edition. Grand Rapids, Michigan: The Phoenix Society for Burn Survivors, Inc.
This story is an excerpt from The Phoenix Society’s® Burn Support News, Winter Edition 2007. Burn Support News is a tri-annual publication that contains articles on the emotional, psychological, and social aspects of burn recovery. All Rights Reserved.