According to Weenolsen (1988) loss can be characterized as anything that destroys some aspect of life or self. According to Worden (2002) grief can be characterized as the experience of someone who has lost an important relationship or even an attachment to another person. These concepts can be directly related to the loss of a parent. Losing a parent can be extraordinarily difficult due to the loss of support and characteristics which identify the position and role of a parent as being very special (Despelder & Strickland, 2005). The grieving processes can mean different changes for those within different roles. Older adults who lose their parents do not process or grieve as a child who has lost their parent. I feel that both of these specific roles and experiences are of greatest importance. Issues of culture also maintain consistent changes across societies in how one works through or expresses the loss of their loved ones. Support for children and adults is a very important part of the grieving process and should be connected to characteristics of who children and adults are within their roles and how they respond to such loss.
Due to modern technology only about 4 % of children experience the loss of a parent before the age of 18 yrs (Archer, 1999). In comparison, in the late 1700's to early 1800's many children were without parents, making life much more difficult for children (Fox & Quitt, 1980). One cannot discuss the loss of a parent to a child without discussing segments of attachment and other developmental theory. Attachment according to Davies (2004) is a special emotional relationship between two people. According to Archer (1999), Bowlby indicated that children are able to grieve and mourn when attachment processes become solidified around the age of six months to one year of age (Archer, 1999; Worden, 2002).
According to Weenolsen (1988) reactions related to grief and mourning begin within the early stages of infancy and learning when the child begins to understand their control over the environment, slowly gaining differentiation and losing their dependency. The mourning of this loss in dependency through the child's ability to gain control over their environment does manifest crying and seeking out behaviors that train the child to respond in this manner to gain access to their care giver (Weenolson, 1988). This instinctive response will be further utilized during future separations and loss (Weenolsen, 1988). Rando (1988) also claims that infants mourn when their nurturance is withdrawn and the mother (primarily) must assist in re-establishing the nurturing connection, thus reducing separation. These theoretical positions seem to be consistent with Attachment Theory in that it is the separation that initiates reactions. Furthermore, one could not understand or comprehend separation if one did not realize their own ability in controlling environmental circumstances in order to meet ones needs. It seems apparent that regarding reaction or understanding the meaning of death by children one would require sufficient cognitive ability.
The loss of a parent and the response is also due to what Bowlby characterizes as the loss of the child's "safe haven" or "secure base" to explore the world (Davies, 2004). One could hypothesize that this disruption of security would effect a child's exploration during toddler development, and at times hinder needed environmental interactions. According to Archer (1999) reactions by children during the mourning process due to the loss of a parent include; pining, preoccupation, yearning, seeking or calling. According to Littlewood (1992), Bowlby clarified that this reaction to loss as instinctive; and the seeking of the lost object (the parent) although fruitless, it is performed anyway. Although many reactions due to many types of circumstances are chosen by children as a response to emotional distress; these responses are considered specific to the loss of a parent (Archer, 1999). Furthermore, many of the emotional disturbances can bring with them depressive and anxious symptomatology; as well as sleep disturbances (Archer, 1999).
Children age 2 to 5 yrs. of age seem to ask many questions regarding the parental loss (Rando, 1988) They may display regressive behaviors, obsession over questions and circumstances, and may display anxiety and anger toward the deceased (Rando, 1988). There may also lay feelings of guilt and responsibility for the loss of the parental figure (Despelder & Strickland, 2005). Some of these reactions were clearly represented in my four year old son Jonathan who lost his grandmother this past year; he seemed to obsess over the funeral and what he had witnessed.
Ages 8 to 12 yrs. may feel helpless and experience reawakened feelings of childlessness (Rando, 1988). Children at this age may seek to repress such feelings, putting them at risk for complicated grief reactions (Rando, 1988). This would be consistent with Eric Erickson's stages of psycho-social development in regards to the stage of "industry vs. inferiority." According to Longress (2000) and Anderson, Carter & Lowe (1999) there is a push for the child to become "industrious" and confident during this stage of development. It seems clear that admitting ones childish and helpless feelings would be difficult during this period.
According to Worden (2002) when a death of a parent occurs in childhood or adolescents the child may not mourn effectively and this may create problems with depression and inabilities to maintain close relationships with others (p.159). According to Rando (1988) depression, denial and anger are feelings that seek to counter act the helplessness, dependency and powerlessness that adolescents are feeling. This response seems consistent when examining Erickson's psycho-social stages (Berger, 2001; Longress, 2000; Anderson et. al., 1999). During adolescents there is a pursuit to find ones "identity", and the parent is a role modeling figure who can assist with guiding and encouraging this process (Berger, 2001; Longress, 2000; Anderson et. al., 1999). It is understandable how an adolescent may feel powerless, helpless, dependent, and even angry due to the death of their parental figure.
In regards to meaning, Fiorini & Mullen ( Article ) clarify that it is very important to characterize the meanings of grief and loss through a developmental lens. According to Worden (2002), Murry Bowen clarified that one must understand the role and position of the dying parent within the family system, and the level of adaptive abilities of family members during and after the loss of a parent. I feel, as a social worker it is important with this information to better understand what this systemic loss means to the developing child within the family system. To many children the loss of a parent means a loss of stability, security, nurturing, and affection (Despelder & Strickland, 2005). According to Worden (2002) there are needed cognitive processes and concepts that must be developed before grief can be fully understood by children. The factors are as follows;
1. Understanding time; and what forever means
2. Transformation process
3. Irreversibility concept
4. Causation
5. Concrete Operations
According to Worden (2002)
Figure 1.1
According to Archer (2002) children before the age of 5yrs. believe that death is reversible. Many young children up to this point maintain a figurative representation within their minds of the lost parent and do not completely understand the permanency of the circumstance until cognitive maturation takes place (Despelder & Strickland, 2005; Rando, 1988). This would validate findings by Piaget in regards to object permanence and development of the cognitive processes of children (Berger, 2001). According to Archer (2002), Speece and Brent indicated that children from the age of 5 to 7yrs. of age begin to understand the irreversibility of death. Furthermore, according to Archer (2002) children less than 7 to 8 yrs. of age however, represented a lack of understanding regarding the word "death." This is consistent with Piaget according to Archer (2002) and Berger (2001), that in order to understand such a concept as death and irreversibility, ones conceptual thought must be sufficiently developed.
Up to the age of 9 yrs. of age however, most children attribute the death of their parent to outside forces, such as God and other (Carey, 1985). According to Rando (1988) although children 8 to 12 yrs. of age may have a more clear perception of what death is and understand the irreversibility of the process, they may also refuse to accept it.
Adolescent understanding and meaning regarding the death of a parent can be characterized as one of frightening shock and in-depth spiritual examinations. The adolescent is capable of these processes due to what Piaget termed the Formal Operating Stage of development (Longress, 2000; Berger, 2001). A questioning of spirituality and ones mortality can also be associated with Erickson's stages of development in regards to adolescents finding and understanding their social and human identities within this stage (Longress, 2000; Berger, 2001; Anderson et. al., 1999).
According to Littlewood (1992) it was indicated by studies from Anderson (1949), Bunch (1971) and Birtchnell (1975) that adults who lose parents react with tendencies to
have increases regarding:
1. Suicide ideation
2. Rates of suicide
3. Rates of clinical depression
According to Littlewood (1992)
Figure 1.2
Reactions and feelings related to the loss of a parent as an adult differ according to ones age (Rando, 1988). Adults in their twenties and thirties continue to view their parents as significant support structures, and losing them my feel as if one has been robbed. Feelings of childishness and regression is common and should not be repressed or ignored (Rando, 1988). One may find themselves utilizing their attachments to others such as children, friends, etc. in order to work through the grieving process (Rando, 1988). According to Rando (1988) it should be understood that the emotional nature of the relationship between the adult and parent will effect how the adult works through the grieving process. With this information one could hypothesize that the more an adult is undifferentiated in their identity in regards to the emotional parental relationship; the more difficulty they will have with separation (McGoldrick, 1998). This also would be consistent with Attachment Theory and the reactions associated with separation in regards to utilizing other constructed attachments in the absence of the parental primary (Davies, 2004). According to Littlewood (1992) a study by Sanders (1980) regarding grieving scales indicated that parents who lose their parents reacted high in two areas:
1. Increased death anxiety
2. Loss of control
According to Littlewood (1992)
Figure 1.3
According to Littlewood (1992) the increased anxiety is the result of the adult child feeling as if the are next in the generational line to experience death. The loss of control represents the loss of an important and unique relationship between the adult child and parent that sustained significant support features for the child (Littlewood, 1992; Despelder, 2005). From a gender prospective, it is believed according to Porter & Stone (1995) woman seem to indicate greater problems within the realm of relationships after a significant loss; men report greater work related problems through out the grieving process.
The meaning of losing our parents can different for many adults depending on the importance of the adult child / parent relationship (Rando, 1988). The parent has been the most significant and most influential force within the lives of their children; to lose this special relationship, is to lose a great deal in regards to support, the past and childhood connections, and an interpretation of circumstances within the world (Rando, 1988). These changes according to Rando (1988) & Despelder (2005) may place an adult in the position and process of no longer viewing themselves as a child; thus called the "developmental push." According to Despelder (2005), Rando (1988) & Littlewood (1992), the loss of the mother is usually more severe for adults than the loss of a father. This information is based on two primary factors:
1. The mother is usually the most nurturing
2. The mother is usually the last parent to experience death
Despelder (2005), Rando (1988) & Littlewood (1992) Figure 1.4
Losing a parent within adulthood also means "not having a home" to go back to which can leave a person feeling alone and frightened (Rando, 1988).
It seems clear that the death of a parent and its meaning can be commonly stated as a process that will force the adult child to redefine themselves, their roles, and expectations for their lives and the lives of their family of procreation.
According to Irish, Lundquist and Nelsen (1993) how cultures react and define meaning of death and loss of a parent varies. When examining the behaviors and perceptional meanings of death in various societies of the world, differences are evident between collectivistic / naturalistic cultures and individualistic / modernized cultures (Kalish, 1977). One primary difference that can be identified is the blame and reasons for ones death across cultures. Within modern societies death can be attributed to internal body failures due to poor nutrition and health maintenance (Kalish, 1977). Within our modernized society we may blame the person or parent for creating internal processes that led to their own deaths; like smoking, poor eating habits, etc. (Kalish, 1977). Within other cultures, especially isolated societies external agents would be to blame for the death of a parent, such as evil spirits or magic (Kalish, 1977).
Other grief differences across cultures include examples of muted grief, excessive grief, somatization, and excessive grief (Irish et. al., 1993). According to Irish et. al., (1993) in Bali if one does not remain emotionally calm and mute their grief process after the death of a parent or any loved one, sorcery and magic may place a person vulnerable to harm. Irish et. al., (1993) indicates Wikan's (1988) investigation of Egyptian culture expressed excessive grief through constant suffering and bereavement over an extended period of time. According to Oltjenbruns (1998) a study comparing scores upon the Grief Experience Inventory between Mexican students and Anglo students expressed that Mexican student's results expressed much higher somatization scores, thus indicating that Mexican culture seems to express greater amounts of somatization due to loss. Violent grief and rage seem to be expressed across most cultures; the initiation of this rage or violence seems to be connected to external circumstances; such as other cultures or other people who caused the death of a loved one (Irish et. al., 1993; Kalish, 1977; Archer, 1999).
According to Rando (1977) if children do not resolve their grief; complications can develop, such as; psychosomatic illness, psychological disturbances, adjustment disorders and behavior issues (p. 1999). One strategy according to Rando (1977) is for a therapist to facilitate the withdrawal of attachment from the deceased and make attempts to redirect the emotional energies in another primary figure in the child's life. This process of course would include identifying primary support structures that assist in sustaining the child's emotional, psychological, and social well being (Littlewood, 1992). Support structures could be identified as either formal or informal processes (Littlewood, 1992). It seems to be important to utilize professional support to assist a child as well as family before, during and after the death of a significant loved one, such as a parent (Littlewood, 1992). During these processes it would also be useful according to Littlewood (1992) to utilize informal supports; such as family members and others to assist with reducing psychological and emotional distress within the child or adults. It would seem that a therapist would be obligated to assess the roles, expectations and culture of the family and children before initiating any informal or formal interventions.
According to Rando (1977) children may at times act as if they are playing death games or acting out the funeral activities; however this is their way of coping and taking a break from their grief. Because children also have difficulty expressing their feelings, thoughts, and memories of the lost parent, it is important that a therapist assist with facilitating emotional expression (Rando, 1977; Despelder, 2005). Ways of gaining a child's attention and assisting them with expressing this emotion is to utilize book readings by authors who have written stories that relate to childhood grief (Despelder, 2005). Other strategies a therapist could utilize is art therapy and support group interventions to express emotional and psychological processes (Despelder, 2005).
Processes and supports for adults who have lost their parents and others are important processes that will assist adults through the grieving process. When assisting adults in coping with the loss of their parent it is important to understand that there are gender differences in coping with loss (Archer, 1999). According to Archer (1999) women tend to utilize greater emotional expression and emotional components to cope with the loss of a parent. Men it is believed, utilize problem solving strategies throughout their grieving process (Archer, 1999). According to Gallagher, Lovett, Hanley-Dunn, & Thompson (1989) woman seem to utilize cognitive process in order to work through the grieving process, where as men were indicated as utilizing "keeping busy" types of activities. One could hypothesize that a therapist would have to develop therapeutic interventions that would utilize these innate way's of coping according to one's layered identity, such as with gender. With this knowledge, Worden (2002) clarifies that a counselor should primarily seek goals that facilitate acknowledging the reality of the loss, to help the person with expressed and latent affect, to assist with problems related to readjustment and to assist the person with remembering the deceased while feeling good about moving on within their own lives (p. 52).
In concluding, one must understand that with the loss of a parent, the roles and expectations of those left behind will have dramatic effect upon them and the ways in which a social workers must intervene. It becomes apparent that through out the grieving process for children or adults primary considerations must be applied. Gaining better understandings of child and adult reactions and meanings of parental loss, examining the information through a cultural and gender perspective and utilizing coping and support processes to assist the bereaved is of great importance.
________________________________________________________
References
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