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Grief in Children
Although there is no technically recognized diagnostic category of grief, many experts feel that developing criteria for a standardized clinical description will further our understanding of this process. While mourning and grieving overlap specific symptoms and criteria with recognized psychopathology categories such as depression and posttraumatic stress disorder, they do not always imply psychopathology.
Meaning of Grief
Grief is the process that occurs when someone or something important to them dies. While death is the most common cause of bereavement, actual bereavement can also result from a divorce, disaster, serious injury, or geographical relocation. Bereavement, grief, and grieving are all phrases that are frequently used interchangeably. However, in general, bereavement refers to the real emotion of loss.
Individual, individualized reactions to loss are characterized by grief or sadness, the subjective condition of mourning. Mourning, originally related to the psychological work of bereavement, has evolved into a phrase used in the literature and by the general public to characterize behaviors in response to loss (Le., to be "in mourning"). Social, cultural, political, family, and religious settings frequently define the character and particular behaviors connected with grief. Sitting shiva, awakening the deceased, celebrating feasts, picking clothing or washing the corpse, and wearing black or white are all examples from many cultures.
Often, the nature of the child's or family's suffering as a result of the loss lightens or displays a degree of alleviation in the changes (e.g., lessened pain) in such settings. In straightforward bereavement, children and families maintain social connections, reinvest in new relationships and activities, and eventually reenter life's rhythms. They adjust to a new, more meaningful life and do not suffer from persistent or incapacitating symptoms. Their coping mechanisms for dealing with sadness and bereavement are successful.
Complicated grief frequently entails tremendous loss (for example, the unexpected death of a sibling or the rapid abandonment of marriage and family by a parent). Disbelief is prevalent in such situations, and coping skills are severely tested. Complicated bereavement with traumatic sorrow combines trauma symptoms (such as extreme distress, fearfulness, shock, panic, and detachment) with great love for the lost object or person. Coping methods are being taxed.
Presentation of Grief
Loss affects children and families in several ways. All children face regular life loss events such as relocation, divorce, or the death of a pet. Even children's entertainment, such as films (e.g., The Lion King) or novels (e.g., the orphaned Harry Potter), confront sadness and loss regularly. Such events emphasize grieving problems and provide natural exposure to death and separation issues and teaching opportunities.
There may be an intimate, personal loss of a loved one in childhood. A child's most significant traumatic emotional loss is undoubtedly the death of a family member. Secondary losses and parallel stresses that arise from a family death (e.g., change in income, probable migration, change in routines, decreased physical and emotional availability of family members) add to the child's mourning reaction.
Children must also occasionally deal with bereavement due to their life-threatening or fatal disease. Grief responses can also develop in children with disabilities or medical trauma (for example, limb loss or paralysis). Open communication regarding the condition and its management between the kid, parents, and healthcare providers is sometimes required for the youngster to feel comfortable discussing worries, anxieties, and questions.
Developmental Considerations During Grief
Bereavement in children is strongly related to developmental stages and attempts to understand or master the notion and experience of death and loss. There has been debate in the psychoanalytic literature about how far children can understand death and grief; however, research in recent decades has shown that even very young children experience the powerful feelings of sadness, pain, anger, and loneliness that are commonly associated with bereavement.
Infants endure primordial separation distress when a caring carer withdraws physically and emotionally. Protest, sadness, and alienation are the traditional reactions to separation and loss. As item permanence evolves, the first notions of loss may be observed in games like "All Gone." Common loss indicators include irritability, lethargy, and failure to flourish in more severe cases.
Egocentric and prelogical thinking predominates in preschool-aged children. The youngster does not grasp time, place, measurement, or movement, and he or she does not understand cause and consequence. Magical thinking can drive the youngster to doubt both the source of the loss ("Did she die because I was mad at her?") and the permanence of death ("If I am perfect, maybe he will come back."). Death is felt in the present moment.
Preschoolers appear to be most concerned about the length of absence from a loved one that death entails, and they may regard death as a type of life under different conditions (e.g., separation, departure, or sleep). Bereavement symptoms manifest as erratic emotional swings in young children over short periods. This age group is characterized by asking the same questions repeatedly and unrelentingly in an attempt to master the finality of the loss.
Grief reactions include a broad spectrum of emotions, such as longing, grief, anger, guilt, and blame. Somatic complaints (e.g., stomachaches) and regression in previously gained developmental tasks (e.g., desire to sleep with parents, loss of bladder control) are common signs.
With an expanding understanding of the body's basic functioning, the school-aged youngster recognizes the permanence of death. School and learning issues may frequently arise due to concern about the loss. Anxiety, outward signs of sadness, and physical ailments such as stomachaches are more common in this age range than younger children. In adolescence, death becomes an abstract idea. As the teenager learns to think abstractly and symbolically, theological and philosophical aspects of death and grief become significant.
Teenagers grasp the body's various structures and functions, offering a physiological comprehension of the cause of mortality. Grief can cause despair, bitterness, fury, mood swings, and risk-taking behavior. Fascination with dramatic or romanticized death and suicide can manifest itself in both copycat behavior (e.g., cluster suicides) and competitive behavior ("He was my best friend.")
Assessment of Grief
Not every child needs substantial professional attention during or after a loss experience. On the other hand, common symptoms like melancholy, desire, and loneliness can be stressful to the youngster. Parents should provide enough aid and permit their children to seek such assistance. Children thrive in families when carers can satisfy the child's needs, enable open and honest dialogue about the loss, and give safety and consistency in life patterns.
Assessing the child's and family's premorbid functioning and the effect of family and community support gives clues to adjustment and emotional stability. The primary objective of identifying a kid at risk after a loss should be to prevent psychopathology and inappropriate mourning reactions.
Grief is the process of losing someone or something important to them and is characterized by grief or sadness. Bereavement is a complex process that affects children and families in various ways. In straightforward bereavement, children and families maintain social connections, reinvest in new relationships and activities, and eventually reenter life's rhythms.
Complicated bereavement with traumatic sorrow combines trauma symptoms with great love for the lost object or person. Pathological grieving is sometimes used to characterize a tough loss in which the bereaved individual suffers from protracted and significant emotional, social, and functional damage.
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