There are few words that can silence a group of people faster than the word "death." It is the last great American Taboo. This is an interesting American quirk. We will sit at a table full of people from all walks of life, of all ages and talk about our sex lives, our addiction histories, our dysfunctional families, even disclose our Botox regimens. We talk about things that take us way past the "need-to-know" line.
Yet, we hide our ill and dying in hospitals and hospices. What's particularly interesting about it to me is that our societal norms have been switched. We once tended to our dying plainly and openly in our parlors and bedrooms -- but sex, family and finances were all highly private matters. And what went on between us and our doctors stayed there. Now, we will talk about absolutely anything except the inevitability of loss and the one thing that affects absolutely everyone.
In a world where the pursuit of happiness is the Absolute Value, suffering, loss and grief are anomalies. In some circles, they are even considered a defect of character. I once heard a patient tell her child who had just lost his grandfather, "We just accept it and move on, dear. Tomorrow will be better." I could see she meant well, but it was clear her child was neither accepting it nor moving on. He was suffering and confused. Our children have not been untouched by this polar reversal in values.
A case in point:
Not too long ago, a client had the misfortune of attending the funeral of a friend, a young man with children. While all the grownups were inside, his oldest boy, a 10-year-old we'll call Kevin, was sitting on a bench outside by himself. My client sat next to him and held his hand. Kevin pulled it away sharply. She asked him how he was. He looked at her stonily, then down at the floor. "I got nothing to tell you. No one told me nothing."
As she found out later, his father had been sick for a while, but no one wanted to "worry" him by telling him about the visits back and forth to the doctors or how serious it was. No one told him about his father's imminent death. And when he finally died, his mother was so distraught that she was unable to be of much support.
Verbal First Aid For Children in Grief
Children, even those who are pre-verbal, are able to intuit that something is wrong when something is, in fact, wrong. They know someone is behaving differently: daddy doesn't smile as much, mommy needs to sleep all the time, grandpa doesn't come to visit with grandma or Aunt Rosa needs medicine to breathe. They hear the difference in our voices, sense the change in our body language, feel the alteration in our presence. They know. So, why do we hide it?
I believe it is for two reasons: One, because we worry about them. If the situation is dire and we are in pain, we don't want to impart anything that will give our children pain. Two, and perhaps more importantly, the topic scares us. We have not yet had the real conversation with ourselves.
The problem is that when there is a vacuum in a child's knowledge bank -- when there is the kind of ambiguity and dissonance that occurs when they see something amiss but there is no information forthcoming from the grown-ups -- they are counting on for guidance, so their imaginations fill in the blanks. And that can be much, much worse, far scarier than the truth, no matter how painful the truth is.
All of which is why we must talk to them.
Whenever I've presented this topic in seminars, this is inevitably the point at which I hear moans and see cringing. The hands raise, "But what do you say to a four-year old?" And, "How do you tell a kid his mother is sick?"
In Verbal First Aid, we answer these (and many other) questions in great depth and with a number of possible scenarios (and scripts). In this brief article, however, we can break it down to a few simple principles.
Presence: The first and most important principle is your presence and love. Start and end with that, always. You are their assurance, their resting place, their center, and their lead. Your rapport, understanding, and compassion -- even without words -- can hold a small heart and carry it tenderly through the most wrenching ordeal.
Honesty: The second principle is your simple honesty. If something is wrong, we can, indeed we must, say so. And with children, it is very important to say it in a way that is authoritative (not domineering, just assured and reassuring), calm, and clear. We want to truly keep it simple. If grandpa is sick, then that's what we say. If a child asks questions, we answer them without going off on tangents, providing information that is neither requested nor required and probably not even understood.
I remember a long time ago, I asked my parents "where babies came from." My mother turned to my father, who is a physician, and he started to talk to me about sperm, eggs and DNA. It was a short conversation, as I recall. Thus, simplicity is the cornerstone of helping a child deal with this kind of emotional upheaval.
Give Healing Time: After you've told the child what is happening or what has happened, you need to allow for time. That means we need to let the child ponder each response and see if he or she has any questions. Some children are innately curious and some children are sated with a more basic approach. In one family I know, there are two children. One asks "why" or "how" to almost everything. The other is satisfied with a statement of fact. Let your child express his or her concern, anxiety, confusion, curiosity or need in his or her own way.
Pacing: In Verbal First Aid, the way to do this is via a technique called "pacing." Think of a dance, in which one person leads and the other follows by waiting and watching for the small cues that guide them where the person wants to go -- that is the art of pacing. We move with the child, at his pace, letting his needs dictate how fast, how slow or how much of an explanation we offer. Explaining death or serious illness to a child must be an act of pacing or we run the risk of losing or confusing him. We only want to give him the information he asks for and actually needs at the moment.
One eight-year-boy I know recently lost a beloved grandfather. When his parents told him about the death, the child wanted to know if "grandpapa was okay now." He had been sick and uncomfortable for quite a while and the little boy knew that his grandfather was in pain because they had kept him with them in the home. So, they told him that, yes, he was okay now and that grandpa was no longer in pain.
Wisely, they waited a beat.
And then he asked, "So, he's with God?"
"Yes, he's with God," his mother answered. She wept openly, not just for herself but to let her child know it was okay to cry if he needed to do so. "His soul went to heaven."
"What about his body?" he asked.
"He doesn't need his body anymore so we're going to have a funeral."
The little boy waited, then turned and said, "Okay." He picked up a toy and went into the family room.
"I don't know:" While Verbal First Aid teaches us what to say, it also encourages and supports us in the silences, when there are no words, no explanations, and no simple understandings. For whenever we stand before death, we all stand together. No matter how old or young we are, we are absolutely equal in the Mystery of that finality. For this reason, it is important to remind yourself that you can also say, "I don't know, but I'm right here for you no matter what. I love you and I will take care of you."
One man confirmed this with me as he recalled the death of his grandmother when he was about five. "I asked some questions, and they answered some of them, but no one could really answer me when I asked 'why?' Now, I finally understand that."
Follow Judith Acosta, LISW, CHT on Twitter: www.twitter.com/VerbalFirstAid