Decreasing the Risk of Complicated Bereavement and Future Psychiatric Disorders in Children

Journal of Child and Adolescent Psychiatric Nursing,  Apr-Jun 2005  by Kirwin, Kathleen M,  Hamrin, Vanya

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The researchers went on to form a principal factor that they identified as "emotional distress". Children with the highest distress scores were doing poorly in school, experienced more problems with peers for having a dead parent, were more preoccupied with thoughts of their dead parent, and had more health problems.

Geis et al. (1998) found that the loss of a parent affects children in many ways. There are changes in both the family life and in the daily routine. Other adults may provide for basic survival needs. Such a major loss leaves the children with an emotional void and creates a sense of fear about a once-secure world. The children's immediate reactions to the death of a parent may appear brief, when in fact the parent's death continues to influence the child's life in each new developmental stage. see Table 3 for a list of how to help children cope with bereavement at each developmental stage.

The Psychological Tasks of Grieving

There have been numerous contributors to the evolutionary process of grief work. Theresa Rando (1984) states that Lindermann (1944) offered three tasks for working through the grief process. These tasks are as follows:

1. Emancipation from the bondage of the deceased. According to psychoanalytic terms, when a person loves someone, he or she becomes emotionally bonded to that person. This is called cathexis. Within this emotional bond, the individual invests his or her psychic and emotional energies in the loved one. When this loved one dies, the one left behind has to withdraw his or her energies as a result of the death. The person who lives develops new, altered attachments in the form of memories.

2. Readjustment to the environment in which the deceased is missing. The person who is grieving develops a new view of the world without the loved one. The person will need to redefine his or her roles and skills to incorporate the functions the deceased performed. There are many distressing feelings that happen with these adjustments. The loss of a loved one affects the individual in many ways: emotionally, somatically, socially, and financially.

3. Formation of new relationships. The emotional energy that is displaced from the relationship with the deceased is reinvested to someone new or something else (Rando, 1984, pp. 18-19).

Processing grief is difficult work and requires strenuous effort on the part of the bereaved individual. In our society, we have unrealistic expectations and often have inappropriate responses to the grievers' normal responses to their loss. This will often make the grief work even more difficult than it needs to be. The work involves not only grieving the loss of the loved one but the losses of all that made their relationship, with the hopes, dreams, fantasies, and unfinished expectations that the person had for the deceased (Rando, 1984). see Table 4 for the next theorists that added to stages or phases of grief.

In Baker, Sedney, & Gross (1992), Heiney, Dunaway, & Webster (1995), Steen (1998), and Worden (1996), there are normal tasks or phases of grieving. In Baker et al. (1992), the grief process is seen as a series of tasks that must be accomplished over time (see Table 5). The concepts of the tasks are based on Bowlby's stages. The early tasks are during the initial stage of numbness, the middle phase tasks take place during the time of yearning and despair, and the late tasks are those that must be dealt with during the final period of reorganization.