Supporting Grieving Kids During The Holidays

The holidays are supposed to be a happy time for children, right?  Gifts, sugar-filled treats, being together with family.  But what happens when a special person is missing from those happy days?  Here are some tips on how to help children cope with the complexity of grief and the holidays.   

1. Talk about it.  Everyone knows that grief is the “elephant in the room” during the holidays.  Instead of walk around it, gather the family and discuss expectations.  What is being looked forward to?  Is anyone worried about anything?  What things happen during the holidays that remind the kids of that person?  Ask questions and listen.  

2. Decide how to honor the person.  This can be a tradition that happens year after year or can be something different each season.  Maybe it’s certain music, meals, or activities.  Maybe it’s putting out photos, reminiscing, or making gifts.  The kids may want to write the person a letter or make a special ornament in their honor. Choose what fits for your family this year, keeping in mind that it might be different for everyone.  

3. Share your feelings. So often, adults are concerned about making kids worry, or feel sadder if they share how they are really feeling.  “I shouldn’t cry in front of my kids” is a common refrain.  Unfortunately, when we don’t communicate how we feel, we miss an opportunity to give children permission to share their feelings.  A stoic parent non verbally communicates to their child that crying or feeling sad or angry (or any other of the hundred feelings that come with grief) isn’t necessary.  Allow yourself to verbalize how you are feeling, and take the opportunity to teach your child how about coping.  “I’m feeling sad today and missing dad.  Let’s go for a walk.  The fresh air helps me feel a bit better”.  

4. Take the pressure off.  This goes for you and the kids.  Allow yourself to say no to invitations, cooking, decorating, or any other activities that feel more stressful than joyous this year.  If you decide that the activity is important, look for the easiest way to accomplish it: print address labels for your cards, order side dishes from the deli, give gifts unwrapped, buy pre-made cookie dough.  Your emotional health is the most important thing and you will need reserves to guide your children through the season.  

5. Give permission to participate, or not.  Since not every family member is grieving in the same way, give permission to bow out.  Kids may not want to visit a grave, help cook a special meal, or hang a traditional ornament on the tree.  That’s OK.  Giving a child control over how to express their grief helps them feel more in control over the complex emotions that come when someone has died.  

How to tell a child their parent is going to die

Cara Allen, LCSW

I have worked as a therapist in an emergency department, an ICU, a cancer center, and private practice.  I have walked many caretakers, often the parent or parents, sometimes a trusted relative or friend, through the heartbreaking process of telling a child that their parent is going to die.  No one is prepared for this, and everyone feels lost. Here is what I recommend:

The truth is always best.

I don’t use the word always lightly.  However, in this case, it is.  Being direct and clear and honest in an age-appropriate way will lay a foundation of trust that will be helpful in the days, months, and years to come.  It is very likely that this conversation is more difficult and dramatic in your mind than it will be in reality.  

You will want to wait too long.  Don’t.  

Almost everything in you will want to avoid this conversation.  You will likely rationalize it by saying you don’t want to rob them of hope or make them sad before they need to be, or that they’re too young to understand or that they have a big game coming up or an important test, or a birthday or… In my 20 years in this field, I have never heard a child say “I wish they had waited longer to tell me, or I’m not glad I know”.  What they do say is “I wish I had known and I wish I had gotten to say or do certain things.”  These are moments that you can not replace for this child. Give them control during an uncontrollable event to make choices about what to say or do. It can dramatically change the course of their grieving process.  

If you are the parent who is dying, you can see the opportunity to help walk them through your death as one of the final gifts you give your child.  Tell them about your hopes and dreams for them.  Give them permission to live their life and be happy.  Let them know it’s ok to feel whatever it is they are feeling. 

What exactly do I say?

If you’re struggling to picture how this will look:

Be clear and direct: “John, you know mom has been sick.  The doctors told us today that she will not get better.  They don’t know exactly when, but mom is going to die.” *

Pause and ask what questions the child has.  

Answer the questions honestly.  It’s ok to say you don’t know.  Depending on age, maturity, and the situation, there may be many detailed questions or no questions at all.  

Allow any emotions.  It is normal to have a very wide range of responses.  This could mean tears, anger, shock, or even a blank look.  Tell them directly it is ok to feel whatever they are feeling.  Those feelings might change, or stay the same.  It’s OK to show whatever feeling you are having as well.  

Tell them they can ask anything, at any time.  The door is always open. 

Let them know it is not a secret, and suggest people (a trusted relative, friend or counselor) who they may choose to speak with.

Think of this conversation as the first of many, not one where you need to cover absolutely everything.  Wait a day (or less depending on the situation) and if the child does not bring it up, ask them if they have any other questions about what will happen.  Give choices about attending doctors’ appointments, seeing the person, attending services, etc.  Suggest ways to communicate, like writing a letter, making a music playlist for the person to listen to, or drawing a picture if appropriate.  

*Children age 5 and younger may not yet be able to grasp the permanence of death.  Let them know that death means the body stops working and that people who are dead can’t do things living people do like walk or talk and that it means they are not coming home.  Stay away from comparing it to being asleep (this can be scary since the child sleeps every night) and know that they may continue to ask when mom is coming home or act like nothing is different.  

This age group also may experience magical thinking that can lead them to believe that if they are very good or bad that it will influence the situation.  Some may even believe that something they did wrong could be causing mom to die.  Reassure them directly that this is not the case.  “It’s no one’s fault.  Nothing any of us did caused this and nothing any of us can do will change it.”

Anticipatory Grief

Anticipatory Grief

Cara Allen, LCSW

Often loved ones of patients at the end stages of illness begin to mourn the physical and emotional losses of the relationship before the death occurs.  Called anticipatory grief, this process is natural, yet can also feel distressing. There may have been a long term illness, like cancer or Alzheimers, but a shorter course disease may also elicit feelings of anticipatory grief.  

Understanding anticipatory grief can help us to navigate through it and embrace the opportunities it presents. 

For many, the process of anticipatory grief begins with significant changes in the relationship with the person who is dying.  No longer being able to enjoy activities together, talk in the way you used to, or a shift to patient and caretaker changes the dynamic of the relationship and these losses trigger grief.

The surviving person may begin to imagine the dying process and what life may be like after the person has died.  It is common to have daydream type experiences that may be about the funeral service, what the house will feel like without the person and even ponderings of what future relationships may be like.  Often, these thoughts come with feelings of guilt and confusion, with beliefs that remaining present, positive, and appreciative of the person still being alive is the only “right” thing to do.  

While the complexities of anticipatory grief are often most prominent for adults, children can certainly experience grief prior to a loved one’s death.  Watching changes in the person and to the relationship can bring on feelings of anger, anxiety, depression, emotional numbness, or fear.  

By acknowledging these anticipatory feelings and that death is on the horizon, there is an opportunity to prepare, say the things you may regret not saying, and to help the children in their life do the same.  Having permission to say goodbye is an opportunity to be embraced, and one that helps bring closure for the dying person, and a healthy start to the grief process for those surviving. 

Parenting While Grieving

Cara Allen, LCSW

It is said that parenting is the world’s hardest job.  What should be said is that parenting while grieving is the world’s hardest job.  Simply put, while you are pushed to your emotional edge, you are entrusted to guide a young person through their own grief.  It doesn’t get much more challenging than that. 

Wells Need Water

There are a lot of ways to describe the phenomenon of a parent’s tendency to put their child’s needs before their own.  I like the analogy of the well.  If you allow your internal well to go dry, you have no water to offer your child.  Take a moment to contemplate what this means in your life.  What fills your well of emotional and physical well being? Exercise, sleep, eating well, talking openly, professional support, etc.  Once you have an answer, do it.  A well with at least a little water will help you meet your child’s needs as they grieve.  

Share the Load

Acknowledging the struggle to family and friends may feel like admitting that you don’t have it all together or know all the answers.  But you don’t.  None of us do.  Allowing others to lend physical and emotional support to your children provides a new perspective and shows an additional way to cope.  The aunt or friend or neighbor may have just the words, actions, or advice that your child is craving at that moment.  

Be Honest - It’s OK to not be OK

The desire to protect kids from our adult emotions is universal, and unfortunately, not doing the kids any favors.  While we don’t want to overdo it and make our children feel like they need to parent us, it is very healthy to model that grief can come with big feelings of sadness, anger, frustration, fear, etc.  The trick here is to allow the emotion and then talk with your child about how you deal with it.  For example:  After crying during breakfast, say, “I’m really missing your dad this morning.  It feels good to cry for a bit, then I think I’ll go for a walk outside before I go to work.”  Modeling healthy coping helps your child learn ways to cope when big emotions come up for them.  

Teachable Moments Abound

Yes.  This will change them.  AND accepting that and using it is the best you can do.  Unfortunately, we can not change the situation.  What we can do is help our children learn how to express their emotions in a healthy way.  We know that bottling up feelings can lead to a lifetime of negative coping and emotional disconnection.  Teaching children the words to describe what they are feeling, and giving them permission to express themselves lays the foundation for a healthy emotional future.  

It Won’t Be Perfect

Because there is no such thing as perfect grieving.  It will be messy and complicated and confusing and many other things for you and your child.  What we know is that being loved and cared for and having our basic needs met in childhood is the foundation for a healthy and happy life.  When in doubt, focus on the love you have for your child.  It’s what will matter more than absolutely anything.  

Talking with kids about community crisis

Cara Allen, LCSW

A community crisis can mean different things.  It might be an accident, homicide, or suicide that impacts a community, or a larger scale event like a shooting or terrorist attack.  Certainly, the current pandemic qualifies as a community crisis.  While the scale may be larger, and the grief shared and more widespread, as individuals we still grieve in our own ways.  

For those guiding children and young adults through community crisis, some things to keep in mind:

• Let them hear the truth from you.  

  • While the instinct is often to shield children from crisis, hearing directly from you, their trusted adult, is better than hearing rumors or random news reports.  Build their trust by being brave enough to bring it up first.

• Ask questions and listen to their fears and worries. 

  • There is no question too big or too small when it comes to processing a community crisis.  Your child’s concerns may be different than yours, so it’s important to not assume and instead to ask questions.  

• Don’t force your child to talk. 

  • They may not be affected by what is going on, or it may be more beneficial for them to process in other ways. Open the door for conversation, but then leave it and revisit in the days to come if they don’t want to engage.  Since we know kids process through play, suggest a walk or something physical to do together. This might get the conversation started naturally.  

• Model your own positive methods of reflection, communication and coping

  • It might be allowing them to overhear a conversation with a friend about how you are feeling or sharing with them directly how you are coping. 

  • Kids learn by watching and will likely model your behaviors.  If you’re sharing how you are doing openly, chances are they will as well

More than anything, in times of crisis children and young adults need love and reassurance that they will be helped through this time.  It doesn’t mean that nothing bad will happen, just that they will have support to cope with it. As difficult as these moments in life are, they do build resiliency and, handled in an open way, the foundation of coping with life’s challenges that may come down the road. 

Processing grief through play: why it’s okay to let your kids play it out During COVID-19

Cara Allen, LCSW

As a clinical social worker who has worked extensively in bereavement for the past 20 years, I can tell you – there’s no right way to do this. As we watch the COVID-19 crisis unfold across the world and within our own communities, we are all grieving, stressed and feeling isolated from the ones we love. You are not alone and there is no one right way to process your pain as an individual, a family, or a child.

We do know that kids process grief through play. Researchers have identified play as beneficial to kids who have experienced the loss of a loved one. At Experience Camps for Grieving Children, we bring together hundreds of kids across the country each year for one week of free summer camp. Kids who have lost a loved one get the regular sleepaway summer camp experience combined with specific lessons and activities to help them learn how to deal with their feelings of grief, stress, and loss. For many of them, the relationships they make and the encounters they have playing sports, engaging in arts and crafts, and experiencing campfire comradery are the most healing.

As parents who are now full-time caregivers, remote workers, teaching assistants and more – all within four small walls – it’s important to remember that we are all struggling with these new roles and responsibilities, and that your kids are too. As we change our daily routines and practice social distancing, don’t forget to give your kids unstructured time to play. To support kids during this difficult time, whether they’ve lost someone specifically as a result of COVID-19 or are processing new feelings and experiences based on news reports and changes to our daily routines, giving them the time and space to work through their new emotions and the permission to do so, is healthy.

Kids not only benefit from opportunities to express their own grief, they learn by watching you manage your own.  It’s healthy for kids to hear that you are also affected by what is going on, and how you are managing it.  As parents we try to protect our kids, but the more open you can be about your own emotions and sharing ways you cope with them, the better they can learn from you.

Include them in the ways you have found to cope:  take a walk together (practicing smart social distancing), dance it out in the living room, connect with friends and family online. The ways you cope with stress and feelings of isolation will benefit your kid as well. Don’t forget to talk to them through it – “when I am nervous I…” or “I get sad when I watch the news and it helps when I…” to help them learn for future situations.

Remember, kids need love and connection most of all.  If you’re one of the many feeling overwhelmed and just able to focus on the basics of home life right now, that’s OK.  Focus on the love.  It’s something that you can supply no matter how busy, sad or scared you are.

 Cara Allen is Chief Clinical Officer for Experience Camps and has a private psychotherapy practice in San Diego, CA.  She holds both an MSW and a Master of Management degree, is a licensed clinical social worker, and has worked extensively in bereavement for the past 20 years. Cara provides clinical supervision to aspiring therapists and has been a part of Experience Camps since 2014.

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How to find purpose after someone we love dies →

Molly Giorgio, PsyD

After someone we love dies, it can feel like we are just wandering aimlessly for a bit, a ship without a rudder. The everyday things that we are used to doing might feel like they are too much or returning to normal is just not an option anymore. We have entered a “new normal”. 

A way to integrate your grief into your new normal is to find purpose and meaning. It might feel hard after someone we love dies but it can be so helpful in creating this new normal.  Finding purpose and meaning has been linked to overall better well-being. In Man’s Search for Meaning, Viktor Frankl states that we “find purpose in work, in love and in courage during difficult times.” If you think about your own life, what areas (work, love or in courage) could you deepen or find meaning in? 

This could mean that we rediscover an old hobby we loved doing with our person, or we begin volunteering with a group that is connected to our person in some way. Or it could be strengthening our spiritual connections and beliefs and finding a community of support. This could also mean drawing on our own courage to take it day by day. 

Although we cannot change the fact that our person has died, we can choose to move forward by creating new purpose and meaning and still allow ourselves to grieve. 

Back to the Basics 

Sometimes finding purpose can be as simple as making a daily to-do list to help you through the day. This could mean getting out of bed, making the bed, taking a shower, brushing your teeth, having breakfast, etc. Sometimes when we are lost in our grief, these daily tasks can seem overwhelming but it is important to remember that each item on your to-do list that you cross off is a win. Maybe the purpose of the day is to take the dog for a walk or to organize the linen closet. Whatever it is, finding meaning in the basics of your daily life will help you kick start your new normal. 

Purpose through Connection 

Did your loved one really like a sports team? Or did your loved one die from an illness or an experience that other people have died from? Or did your loved one really like to cook or work in the yard? Things that your loved one is connected to can also be a great way to stay connected to your person and also give back to the community or continue on traditions in your loved one’s honor. Sometimes that means volunteering with an organization that somehow connects to your person or it could mean learning how to cook your person’s favorite foods and trying new recipes every week. 

Meaning Making 

How are you making sense of your loved one’s death? How we understand and make sense of our experiences is called meaning making. Meaning making has been shown to help people have more gratitude, feel like they have more wisdom, and also move forward with their new normal. A way to make meaning of your experiences is to begin journaling about it, talking with friends and family who you feel are understanding and loving, seeking therapy from a professional, engaging with a spiritual community you connect with. We can find purpose after the death of a loved one through allowing ourselves to process and make sense of what happened. Some key questions to ask are: what is this teaching me? What can I learn from this situation? How can I honor my grief feelings? What do I want the rest of my life to look like? 

Making Space for the New 

Allowing for new interests and activities, new work endeavors, new relationships, new experiences is so important in finding purpose after loss. We have to find ways to make room for these new things in our lives because they can bring new meaning, new purpose and new positive experiences. If we get stuck in how things “were” then we are not integrating our grief into our new normal. Finding ways to be open to the future will help you feel more like yourself. Making space for the new while also honoring our feelings of loss and grief and being able to feel both is a sign of processing the grief and finding purpose. 

Molly Giorgio received her PsyD from William James College in Boston, where she was a clinical psychologist. She taught previously at the University of Hartford, now leads her own practice in Windsor, and serves as a clinical director at Experience Camps.

When goodbye wasn't an option

Cara Allen, LCSW

Sometimes we get to say goodbye.  And sometimes we don’t. While there is no “better” or “worse” when death is sudden or anticipated, it is certainly different.  

When saying goodbye isn’t possible, as is the case with unanticipated, sudden, or the death of someone estranged, many people struggle with a layer of trauma, unresolved emotions, regrets, or a sense of unfinished business.  

While we can’t change the circumstances, we can acknowledge the unique challenges sudden grief presents, and do a few things to help get through.  

Managing shock and disbelief

Depending on the relationship, daily life may have changed in a moment.  If this is the case, feeling profound shock and disbelief is both appropriate and overwhelming.  While there are likely many tasks that seem necessary, taking time to allow emotions is important.  A 20-minute walk, a long shower, some basic grounding (naming all the things that are the color blue that you can see) and breathing (5 seconds in and 5 seconds out) exercises can help. Try having a mantra to repeat to yourself.  Something like “I can do this” can be enough to get you through the acute time in grief.   

Self blame and guilt

Sudden death can be incredibly complicated.  Accidents, suicide, overdoses, sudden health issues, and violent deaths are all complicated in their own right.  It is so common to struggle with self-blame and guilt. Thoughts of “if only” or “what if” are natural and a part of the grief process.  The key here is allowing these contemplations without getting caught in them. While there is no specific time frame, if you hear yourself saying “I should have” to the point that it feels out of balance with other grief emotions, it may be time to seek professional support to process those feelings.  

Trauma

Sudden death often registers as a trauma.  It might be that you were present when the death occurred, or can’t shake the memory of the moment you were informed.  You might be fixated on the details that were shared with you, or many other scenarios that are traumatic in the wake of sudden death.  Post Traumatic Stress Disorder may be diagnosed if you are struggling for over one month having flashbacks, recurrent and intrusive memories or dreams, and are working to avoid distressing memories or reminders of the event.  You might be disinterested in your normal activities, feel distant from others, feel irritable, or hyper-vigilant. While not a comprehensive list, these symptoms should be addressed by your health care provider. The good news is that PTSD is treatable.  

Seeking purpose and connection

While sudden death can cause many layers of grief, sometimes very complicated, it can also cause us to seek connection with others who can relate to our situation.  Consider connecting with organizations that support survivors of suicide, homicide, addiction, and many others. Humans seek answers to questions, and “why?” can be one of the biggest questions with sudden deaths.  While we may never have a direct answer, we can seek to answer the question by looking for purpose. Being a part of supporting others, and helping further awareness can bring peace, if not answers.

How to know when your child needs more help →

Dan Wolfson, PsyD and Jenna Wolfson, LCSW

We deeply believe that grief is a normative process and that all people- children and adults- have the capacity to lead healthy and fulfilling lives after loss. But experiencing the death of a loved one is also a significant stressor and will, of course, affect children in a number of ways.  

It isn’t always easy to see how grief is impacting a child, and they might not have the language themselves to verbally acknowledge the ways they are struggling.  Below are a few indicators that it might be a good idea to provide your child with additional sources of support such as a therapist, guidance counselor, or peer-based grief group.  

Social isolation / Withdrawing from preferred activities

Have you noticed your child spending more time alone in their room? Have they stopped going to soccer practice or dance?  When kids become socially isolated or withdrawn, it is possible that they are feeling a greater sense of loneliness or disconnection from their peers.  When a child has had a significant death loss, they are often acutely aware that they are the only person in their classroom or group of friends that have had this type of experience. Social isolation can also be a symptom of depression and is something that we want to be aware of and monitor. 

Mood shift

Have you noticed a shift in your child’s mood? Has your child had less patience with siblings, homework or chores? A shorter fuse? A steady stream of tears? It is extremely important to notice and tune in to how your child seems to be feeling.  We know that throughout a child’s development, it is normal for children to feel sad, irritated, or down from time to time. However, if there seems to be a consistently low mood or chronic irritability, we want to pay close attention. While an irritable or angry mood might seem like a bad attitude or disrespect, this might be representative that a child is struggling with expressing their thoughts and feelings in an adaptive way.  While grief and depression are different experiences, the emotional distress of loss coupled with environmental changes or a feeling of social disconnection can certainly contribute to depression presenting concurrently with grief.

Behavioral changes

Has your child been struggling with nightmares? Difficulty falling asleep each night?  Stopped eating the foods they love or eating significantly more or less than usual? Eating and sleeping are two key indicators of a child’s overall functioning. It is possible that there is increased anxiety or worry that might be intruding on your child’s sleep, or impacting their appetite.  In cases of more extreme behaviors, such as school refusal, getting into fights, substance use, or self-injurious behaviors, we recommend consulting a professional immediately.  

So what do I do?

If you are noticing any of the behaviors above, you are already on the right track by being attuned to your child and noticing what is going on in their life.  Seeking professional support will be helpful in assessing the picture further in order to come up with a plan that will best meet the needs of your family.  

Speaking with your child’s school counselor can be a helpful first step.  In addition to potentially offering more therapeutic support in school, they can help identify resources in your local community.

It can also be incredibly useful for children to connect with other kids their age who have had a shared experience. A peer grief group (or camp!) can provide this type of environment where kids feel socially connected, as it is a structured place where children can talk, play, and engage in activities that can help them feel a sense of community again. 

The bottom line here is to recognize that sometimes providing care for your child means taking a team approach. This team will look different for every family, but simply by reaching out for support and guidance, you are showing your child that you see them, see their emotions, and that you care.

Talking with kids about death in the news

Honored to be asked by Lantern to write about talking with kids about death in the news. You can read the article here:

https://www.lantern.co/articles/talking-with-kids-about-death-in-the-news

Why Blue Doors?

Cara Allen, LCSW

What’s in a name? I’m so glad you asked!

If you’ve ever tried to name something (a child, a business, a car, a pet) you know how difficult it is to find that just-right combination. I contemplated “of course you want to come to me for therapy” and “the center for you’ll be glad you chose this practice” but those didn’t roll off the tongue. “I promise you’ll feel better” and “come on, take the leap” just didn’t fit right either. All joking aside, it’s really a difficult project to name something that matters.

I chose Blue Doors. Here’s what it means:

In life, I picture us as always in a room with many different doors. Sometimes we get to choose which door we walk through, and sometimes we don’t. Regardless, once we step through that new door, another room is there with a whole new set of doors. We keep going: choosing some and not others. Entering joyful rooms, neutral rooms, or rooms full of despair. These doors symbolize all of our life transitions, large and small. The sequence of doors creates our life story, our individuality, and our strength. It’s a process that goes on throughout our entire lives.

In my work with clients, we learn together what these doors have been, what has brought them to this moment in life, and where they would like to go next. We work to explore the current room, understand it a bit more, and make decisions that may influence what doors present themselves next. It’s a process of learning what we can control, what we can’t, and how we view where we currently are.

But why BLUE doors, you ask? That’s the easy part. I like the color blue. It’s also soothing and broad, reminiscent of laying on the grass and cloud gazing in the sky. It’s endless possibilities, individual interpretations, and a dependable constant.