Loss and Grief Response in Children

The grief reaction is seen in everyone who has experienced a loss, but the reactions and the intensity of these reactions are different for each individual during the grief process. These differences observed individually also vary by culture. Various rituals, commemoration ceremonies, and cemetery visits performed after the loss prepare the individual for the irreversibility of the loss. In the event of loss, the most common symptoms include a crying reaction, clinging more to the person nearby in young children, loss of appetite, sleep problems (nightmares, dreams about the loss), bedwetting, worrying about the safety of loved ones, and physical complaints (such as abdominal pain and nausea).

In older children and adolescents, feelings of guilt, anger, blaming others, thinking that the world is an untrustworthy place, concentration and memory problems, lack of interest in the environment, withdrawal, pretending to be cheerful to suppress feelings, feeling of loneliness, and suicidal thoughts may be observed.

Loss and the Mourning Process

The first reaction after a loss is shock and denial . Children have difficulty accepting and believing the loss they have experienced. They may ask questions about the lost person: “Will he come again? Where did he go? Let him come back from where he lies?” The individual experiences intense anger due to the feeling of being prevented from not being able to reach the person/object he wants or not being able to do what he wants . He may get angry with the lost person and think that he has abandoned him. The child begins to question in order to cope with the loss and make sense of the events. In this stage, called bargaining , the child constantly accounts for the loss in his mind (“If I had not been there at that hour, these things would not have happened”, “If I had called the ambulance in time, he would not have died”, “If I had been a good boy, my grandfather would not have died”, etc.). While young children tend to blame themselves during this stage, reactions such as blaming someone else or blaming God may be observed in older children/adolescents. After this stage, intense depression may accompany the feeling of helplessness. They may exhibit hostile attitudes towards their surroundings or may exhibit completely introverted reactions. Depressive symptoms in children usually occur with the expression of anger. After a while, it becomes clear that the loss experienced will not come back and the child begins to accept the situation . It is very important to support children at this stage, when they are taking steps towards putting their lives in order.

These feelings experienced after loss are quite normal, understandable and expected. The steps that need to be taken for a healthy mourning process are exactly in this direction. However, in some cases, individuals/families do not/cannot mourn at all after the loss. They continue their lives as if nothing happened. In some cases, mourning never ends, and even after years have passed, the individual still thinks about the person/position/object they lost and cannot forget. Extreme feelings of guilt and worthlessness may also accompany suicidal thoughts.

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In children, unlike adults, the loss experienced is symbolized through “play.” In this respect, it is very important not to interrupt or intervene while the child is playing.

Explaining Loss to Children

After a sudden loss, it is very important to make the child feel that you are with them. The loss of a loved and valued person should be explained by one of the parents (the person closest to the child if they are not alive). During this time, being in an environment where the child feels safe (such as their own home, living room) is very critical in supporting the child regarding the loss. It is not appropriate to make statements such as “they went on a long journey, became an angel, fell into a deep sleep” for the lost person. Such statements, which will create an anxiety reaction especially in young children, can become the trigger for other problems. Instead, it should be stated that the loved one “died, is no longer alive”; it should be explained that death is the end of life and is an irreversible situation. It should be explained to the child that the deceased person is no longer alive : “The person you loved can no longer walk, eat, sleep, or come to us”.

Cemetery visits can be made starting from primary school, but the child’s level of readiness is very important here. Since the child witnessing this moment during the burial can create another type of trauma, it is recommended to visit later, when the people nearby and the environment are relatively calm.

Therapeutic Support During the Mourning Process

Since prolonged grief, as well as grief that has not been experienced at all, has a detrimental effect on an individual’s functionality, it is essential to get support from a professional in such cases. In some cases, children may exhibit symptoms of anxiety, depression, and anger. If these symptoms are observed, the aim is to get support from a psychologist/psychiatrist to help the child cope with the symptoms and the loss.

In addition to the loss of the child, it is very important to work with the family member who is accompanying this loss. Explaining the reactions observed after the loss and discussing parental attitudes is another goal of psychotherapy.

Especially for young children, play therapy or cognitive behavioral therapy is among the most commonly used therapy methods. The aim is to provide the child with the opportunity to express their feelings after the loss, to commemorate the loved one, and to guide the child in this process in order to collect unspoken/unfinished words/memories.

When necessary, medical treatment is also used to alleviate symptoms.