Grief in Children

This is a difficult topic for many of our clients as children grieve differently than adults. During this difficult time for families it can be especially challenging to figure out how to respond to a child who has experienced a significant loss. While adults can verbalize their feelings, children often express their feelings through behavior. This is often confusing to their parents who are often grieving themselves. Everybody experiences grief differently and hopefully this will be a helpful guide to assist with healing… 

Similar to adults, the first feeling many children experience when they lose a loved one is shock. When children first experience a loss they may appear to feel as if everything is fine. In fact, they may go on laughing and playing as normal. It is helpful to validate your child’s response by saying something like, “You may not be feeling anything right now… it may be difficult to understand how you are feeling… whatever you feel is okay”. This perceived lack of feelings is in fact a normal response, often followed by denial.  Your child may think that the person is going to come back. While this initial stage of denial is an important part of the healing process, it is essential to remember not to hide the truth about death or to reinforce their denial by saying something like “they will be home soon” or “they are sleeping.”

Children who have lost a loved one often become fearful and express many worries. They may be preoccupied with death and worry about whether they will die too, whether other loved ones will die, or who will take care of them. Understandably, they often feel insecure, confused, and overwhelmed. They may express these feelings through behaviors by becoming overly clingy, hyperactive, irritable, or experiencing somatic symptoms such as frequent stomachaches. Their eating and sleeping patterns may change. During this stage it is most helpful to comfort and assure your child by saying things like: “Even though the doctors could not make your brother better, most people live a long or healthy life.” Or “Even though I feel sad, I am going to be okay and I will take care of you.” You know your child best so trust that your continued emotional support and verbal reassurance will comfort them.

Your child may also display extreme behavior in response to the strong emotions they feel as they cope with their loss.  It is important to encourage your child to express their emotions while at the same time setting appropriate limits. Talk to your child about their feelings and validate their anger while reminding them that it is not okay to let out their anger by hurting themselves or other people.

Surprising enough, just like adults, many children feel guilty and blame themselves when someone they care about leaves or dies. They may believe that something they said (such as “I hate you”) or did (such as misbehaving) caused the death. They may also blame themselves for the sadness of those around them. For example, if they see a parent crying they may believe they are to blame.  This is a great burden for a child to bear. It is important for you to validate your child’s feelings while assuring them it is not their fault. You may choose to say something like, “Sometimes kids think the death is their fault. Do you ever feel like you did something to cause the death?” or “It is very sad that your brother died, but nothing you did or said caused him to die.” The more you are able to express warmth and acceptance of your child (both verbally and non-verbally), the more your child will feel loved and valued.  This will help them alleviate feelings of guilt and shame.

As children face the reality of their loss, they often express feelings of sadness. These feelings may come up months or years after the death and you may not realize right away that your child’s crying or becoming withdrawn is a result of the loss.  Again, it is a good idea to talk about this with your child.  Often parents are worried to bring up such topics for fear that they will open old wounds; however, chances are if you are thinking about it, so is your child. Furthermore, if you are hesitant or worried about bringing it up, chances are your child is struggling with the same worries.  Help model appropriate ways to initiate conversation about these difficult topics and provide an open and nurturing environment so that your child can feel comfortable discussing tough topics with you.  

While children never “get over” grief, the intensity of their feelings will decrease over time. As children enter the stage of the acceptance, they are able to accept the reality of the loss. At this point children are able to think, “my brother is gone, I miss him, but I am going to be okay”.

Each child grieves differently and will approach these stages at different times and orders. Overall, it is important to be supportive and understanding while never rushing your child to a place of acceptance. Be patient and take care of yourself so that you are able to express the warmth and support your child needs during this difficult process. 

Issues with your child waking too early?

Help, my child wakes up too early and is grumpy later in the day!

How can you keep your child from arising too early?  If your Preschool or School Age child wakes up before 5:00 AM here are some steps you can take to help you both sleep a little later!

Keep a consistent bedtime such as 8:00 PM. Consistent sleep schedules are very important.

Have a ‘calm down’ time before bed without TV or Videos.  Studies show that TV & Videos stimulates a child's brain, which will only keep them awake longer.  Instead use the time before bed as a special time where you can read with your child or listen to soft music.

Set an alarm to play soft music or nature sounds at an appropriate wake up time, such as 7:00 AM.

Tell your child to stay in bed with the light off until they hear the alarm. Instruct them that they may play quietly and read books in their bed but cannot leave unless they need to use the bathroom. 

Within a few weeks they should be able to retrain their bodies to stay asleep until their alarm goes off. Be patient, there are no quick fixes. It is normal to get upset when your child wakes you up too early. It will be challenging to shift their sleep schedule but stay consistent. If your child attempts to leave the room, send them back to bed.  Also, don’t forget about naps during the day; this will vary depending on your child, but here are some guidelines for both naps and nighttime sleep. 

Fun Family Activities: March in Chicago

We live in such an amazing city! Check out some of these fun family activities for the month of March.

Play with a purpose

What exactly is play therapy?  As adults who are familiar with ‘talk therapy’, play therapy may be a difficult thing to understand and appreciate.

I am not going to lie, it took me awhile to buy into it. I remember sitting in my first play therapy class thinking it was all a little too strange. “The healing power of play?” At the time, I thought ‘play’ was just a way to trick kids into talking.  But there my teacher was, talking about play as if it had a power of its own. Weird.

Since those days I have developed my own understanding and appreciation of the word ‘play’ in play therapy.

It is most important to understand that children relate differently than adults. While we, as adults, depend on language and rational thinking, children relate through play and enactment. Since their verbalization is limited, play is their initial, natural language.

In order to communicate effectively with children we must speak their language, the language of play. Play therapy operates from the assumption that children are not ready to confront their problems or traumatic history directly.  Instead, children have the ability to project and reconstruct their problems and interpersonal issues in a narrative, metaphor form. They can also work toward a resolution within this narrative metaphor and symbolic communication. Play therapy becomes an effective tool to address children’s presenting concerns. The right therapist has the right tools- a carefully selected tool box with toys, activities and objects.  Given the right tools for play, children will actually choose what they need to work on in therapy. It is quite amazing!

It may look like we are ‘just playing’, but through play therapy children are able to express and master feelings related to their problems and experiences.  They are able to learn more through ‘doing’ rather than talking.  They are also able to re-experience, rework and remediate developmental disruptions from earlier stages of development that they may have missed.

While in session we depend heavily on the language of play, however we also utilize ‘words’ to build upon the limited verbal understanding that children have.  As the therapist guides the child in play therapy, the therapist is able to provide observations, reflections about the child’s feelings (statements not questions), and interpretations to help children make sense of confusing life circumstances such as a parent’s divorce, grief & loss, adjustment issues, trauma, etc.  In addition, the therapist is able to explain patterns, conflicts, and new perspectives to parents as means to develop a deeper understanding of their child’s struggles as well as their strengths. 

Although I was once hesitant to understand and appreciate this medium of therapy, now as a clinician I couldn’t imagine my practice without this invaluable medium to reach and assist children.  If you are curious as to whether or not your child may benefit from play therapy, please contact us as we would be happy to answer any questions you may have.  

Teenage Woes

It’s hard to be a teenager!   

A parent recently asked me “how do I build my teenager up when so many things around her are bringing her down?”.  While this teen is a bright, kind-hearted girl with a great group of friends, she has been experiencing difficulty lately.  She is an over achiever who, like many teenagers, worries about how others view her.   

The hardest part about being an over-achievier, as most of us know, is that we are often our own worst enemies.  The same is true for kids!  With this young girl we initially worked to explore the expectations she had for herself.  As it turns out, those expectations far exceeded those that were possible.  This young girl was carrying around the weight of the world!  While working to define more realistic expectations we gave her permission to ‘let go’ of many of the worries and even guilt she was carrying around.  Once she realized that her expectations were unrealistic we were also able to normalize her feelings of being overwhelmed and, at times, feelings of being a failure.

Which lead to our second focus - her anxiety about failure.  We began working to re-define how she viewed ‘failure’ as this seemed to be one of her biggest worries.  In re-defining this word and what ‘failure’ meant to her we were able to take away much of the power ‘failure’ had over her.   This teen was able to put words to some of the negative self-talk she had been engaging in for months!  In doing so she was able to shift not only the way she viewed herself, but also the manner in which she viewed others.  

Her parents always assumed that their daughter knew they were proud of her, when in reality she had been beating herself up and holding in her negative feelings for fear that she would disappoint them. 

This parent’s question is very similar to questions that are raised to us by other parents- and the answer is always the same “build them up at home!”  You cannot control the never-ending stream of information and interactions that are thrown at your children.  In fact, as difficult as it is for adults to “log out” this difficulty is multiplied for teens who use technology as their primary method of communication!  Interactions with peers are no longer limited to school or outings - Facebook, twitter, iphones, websites, apps  (the list goes on and on.) have forever changed the manner in which kids interact at the world.  Often exposing them to adult issues and situations at a much younger age.  It is increasingly more difficult to be a teen.  In turn,  the demands of parenting are also magnified and becoming increasing more challenging.  You can try to limit the information that is fed to your children, but we all know that in this technological world it is difficult to control the information that is being not only fed to your children, but also swarming about your children (think gossip on speed).  What you can do is build your kids up when they are home with you.  Strengthen their confidence, their self-worth and the manner in which they view themselves.  Affirm them in a variety of ways so that even when they feel that the world is against them, they have a safe place to return at home.

Focus on the positive and praise them often! :)  It sounds simple, but this can be a challenging task.  Especially when your teenager is shutting you out or pushing you away.  Don’t give up and keep working to find new ways to reach them.  A little secret- even if you don’t see the results right away, even if you didn’t receive any feedback, and even though you won’t be receiving a “thank you” keep doing it because your children are listening- especially when it seems like they aren’t.  You are laying a foundation that your children can fall back on later when they need it.  

Cyberbullying

Cyberbullying

Bullying as we know it is much more complex and has taken new forms.  What used to involve a face-to-face interaction between two or more peers has now transformed into a much more complex issue.  Kids who might not have otherwise said something cruel to another child in the hallways will instead turn to other outlets such as the internet, cell phones, or social media.  Often times kids (as well as adults) seem to gain a false sense of courage by becoming ‘invisible’ behind the computer screen responding with unfiltered and often reactive rants. Kids used to be safe from bullies at home, but through the Internet bullies have access to victims 24/7.

As a therapist I hear many accounts of cyber bullying from children of all ages and backgrounds – from young elementary school children through high school age children. Many of the stories are heart breaking.  It’s hard to ignore the effects this chronic stress has on children’s lives.  Often the bully’s own insecurities and desire to ‘fit in’ cloud their ability to think rationally. 

The internet and technology has introduced a variety of outlets that make kids vulnerable for bullying.  Additionally, the internet has posed new challenges to most parents who likely have not had experience with cyber bullying and often feel at a loss over how to deal with the unique challenges this presents.

So how do you respond to cyber bullying?

1.     Listen and stay calm. Remember, it took a lot of courage for your child to come to you – praise them for that.  As disturbing as the online posting may be to read, it is crucial that you don’t overreact.

2.     Acknowledge their hurt; the pain they feel is very real.  Don’t downplay their feelings or lecture them about “sticks and stones.” Take a deep breath, support, and comfort your child. Assure them that they are loved and that the cruel words written/spoken by others do not and cannot define who they are as a person.

3.     You know your child better than anyone - be aware of how the bullying may be affecting your child. Have they become depressed? Are they suffering from low-self esteem? Are they overly sensitive or misdirecting anger at other family members? Have their grades dropped? Chronic stress can affect your child’s brain and nervous system, which can in turn make learning difficult.

4.     Make your home a safe, comfortable place for your child to return to each day.  You may need to enforce ‘phone/internet free’ times each day to force your child to disconnect.  Suggested times to do this are at mealtimes, homework times and especially bedtime.  There is no need for your child to have their cell phone with them during the hours they are supposed to be sleeping.  This will encourage your child to get a good night sleep and have a fresh start to each day. 

5.     It can be helpful to inform your child’s school so that the school social worker can keep an eye out for in-school bullying and for how your child is handling things.

6.     Block the user who is harassing your child.

7.     Assess if your child is at risk. If a threat has been made against your child consider contacting the local authorities. 

To find more information about cyber bullying please check out the video by Wiredsafety linked below:

http://www.youtube.com/watch?v=T38-9OCDrP4&feature=player_embedded#!

Childhood Depression

Is your child suffering from depression?

Depression looks very different in children than most parents expect.  When we hear the word ‘depression’ the words that usually come to mind are- sadness, crying,  and hopelessness. However, as with many health concerns, symptoms of depression vary from person to person.  This is especially true with children. 

When a child is struggling with depression the symptoms appear in a variety of different ways:

Emotionally:

-       Your child may display chronic sadness and melancholy

-       Often times, however, the sadness and hurt is expressed through anger and emotional outbursts.

-       You may notice that they no longer experience pleasure in activities or interactions with others as they used to.  This can sometimes look like boredom, or apathy.

-       Rather than overt feelings of sadness (crying or hopelessness) your child may start to isolate more and become more withdrawn.

-       Your child may be experiencing interpersonal problems and difficulty relating with others

-       Your child may not feel ‘good enough’ and may demonstrate a negative image of themselves/low self esteem

Physically:

-       You may notice changes in their eating patterns (more or less)

-       You may also notice changes in their sleep patterns (more or less)

-       They may be more irritable and agitated.

-       Your child may present more lethargic and lack energy or motivation to do things. You may find that they are no longer completing tasks such as homework or chores.

-       They may lack interest in their hygiene or the manner in which they present themselves.

Behaviorally:

-       They may not be able to focus or articulate clear thoughts as easily.

-       They may be getting in trouble at school more.  Either because they are fidgeting, unable to sit still, engaging in more reckless/risky behaviors or acting out.

-       Difficulty making or maintaining friendships

-       Your child may engage in harmful behaviors and self-injuring (such as cutting themselves, pinching, picking at nails, hitting, etc)

-       As noted above, isolating themselves or withdrawing from family/friends.

You know your child better than anyone else! Listen to your instincts.  Marked changes in your child’s behaviors indicate that something is going on.   Children often don’t understand or can’t find the words to explain what is going on with them.  Or they might not even know something is wrong.  Your kids rely on you to assist them with understanding and navigating through not only life, but their own bodies and cues. Ask questions - it’s ok to pry and be concerned about your childrenJ  Lastly,  if you suspect your child is struggling with depression consult with a professional who will support you in helping your child.