"Learning to 'move on' after loss is more about finding peace than establishing closure."

Delivering News of a Violent Death To Children:

The Helping Professional as Educator/Coach

 

- Should children be shielded from pain and suffering?
- How much do they really need to know when their loved one has died or is dying from a violent death?

As a grief counselor at a medical center I often met with adults in the ER, ICU, or Pediatric ICU who were grappling with these sorts of compelling questions. More recently, I have worked in hospice settings where numerous parents and grandparents struggled with whether or not to include their children and grandchildren in honest conversations around dying and death.

I have come to believe that it is often best for children if they are told the truth--even after a violent death. However, I do have one caveat: information should be properly distilled and carefully paced. Early on, as the adults are grappling with the news of a violent death, our work is to empower these parents, grandparents, and others to consider how best to be inclusive, truthful, and supportive with their children.

The primary role of the helping professional is often to be an educator and coach. The following case example will explain the terms distilling, pacing, and coaching.

- Mary was faced with having to tell her eight-year-old son that his father died.  She first chose appropriate language so that her son would have the most “necessary” information. Then she listened carefully to her son’s reaction in order to know how to effectively pace the conversation. Finally, she found someone she could collaborate with for the long and difficult road ahead.

- Mary had found her husband at home--dead from a self-inflicted gunshot wound. As she recovered from her own shock and disbelief, she realized how grateful she was that her son was not with her, and that he would be spared the trauma of finding his dead father. Initially, as she formulated her plan of action, she had hoped to hide the suicide story from her son.  She realized, however, that if she weren't the one to tell him, he’d eventually hear about it at school or on the news. Unsure as to how to proceed, she called some friends for help.  Eventually, she was referred to me.  By the time we talked, Mary was ready to tell her son that his father had killed himself but had no idea how to begin. I coached her over the phone, and that evening her conversation with the boy went something like this:

- “Daddy died. That means that his body totally stopped working.  He died from suicide.  A suicide is when someone makes his body stop working.”  She paused and asked the boy, “What more would you like to know?”

First, Mary distilled the story of her husband’s death by explaining the suicide story in the simplest language: “Daddy made his body stop working.”  Then she paced the conversation by letting her son choose what he wanted to do next.

If her son didn’t want to ask any more questions and indicated that he wanted to end the conversation, I suggested that she sit a little while longer with him and that they make a list together of the safest grown-ups he could turn to if he had questions later.  I also told her to prepare for two more questions from her son that were likely to come up sooner or later: How and Why.

How did it happen? If he asks how, I told Mary to use the least overwhelming language possible.  She told me later that when he did ask, she told her son that his daddy made his body stop working with a gun. Of course the entire story was much more graphic than that, but Mary wisely used the least overwhelming, yet truthful, explanation she could think of.  This is what we mean by distilling.

Why did it happen? I suggested to Mary that if she didn’t know why her husband took his life, it would be perfectly fine for her to tell her son that she simply didn’t know why he did it.  However, if she felt that it was the result of a mental illness, even a young child is able to understand that mental illness can cause great emotional pain, which might sometimes leads to suicide.  I also advised Mary to tell her child about alternatives to suicide--such as seeking professional counseling, receiving group support, taking medication, and hospitalization.

Knowing that the story of his father’s suicide was likely to be deeply challenging for the rest of his life, it was troubling and painful for Mary to tell her son the truth, Nevertheless, by being honest with her son:  by distilling the story to its least overwhelming truth, by patiently pacing their conversations, and by seeking out a knowledgeable coach,  she was able to establish herself as an invaluable resource for her son in the months and years to come.

Mary showed great courage as she grappled with an enormous parenting challenge. Especially when a death is violent, however, some parents can be much more resistant to dealing truthfully with what has happened.  In the following vignette, Jane is unable to admit, even to herself, that her children might have been traumatized--despite their direct exposure to their father’s violent death.

Jane was seeking counseling for her nine and ten year-old boys, both seriously acting-out in school and facing expulsion.  As I took a family history during my initial parent interview, I learned from Jane how on one fateful morning three years earlier, the boys heard the sound of a gunshot coming from the basement. They ran downstairs to find their father bleeding-out on the floor, a pistol in his hand.

Jane admitted during the interview that her husband had killed himself, but that neither she nor anyone else had ever talked to the boys about their father’s death. Furthermore, she insisted that the boys did not know it to have been a suicide--despite what they had seen that day.  The terms she set for my working with her boys included a promise never to refer to their father’s death as a suicide. She also told me that she believed that the death of their father had absolutely nothing to do with their behavioral problems in school--and referred to any suggestion to the contrary as “psycho-babble.”  Finally, she said that she believed that there was no need for any therapist who worked with her sons to ever bring up their father’s death at all--that she'd only mentioned the suicide to me because I'd asked about her family history.

It is easy to dismiss someone who presents as irrationally as Jane did. However, in the face of distortion and denial as powerful as Jane’s, try to remember three essential therapeutic principles:  patience, persistence, and compassion. By keeping these principles in the forefront of your work, you’re more likely to be an effective educator/coach--even when a parent’s interpretation of events seems unrealistic and counter-productive.

First, be patient.  Often deep denial like Jane’s is grounded in some serious emotional wound that has generated fear and distrust.  So before you even begin to meet with her sons, work to establish a trusting relationship with Jane. This will require time and patience, with no guarantee of success.

Be persistentGently inform Jane of how you understand childhood trauma.  For instance:  1. Children who are directly exposed to violent deaths may become traumatized.  2.  Childhood traumatic responses may reveal themselves behaviorally over time.

Be compassionate.  Always keep your heart open. Remember that parental resistance is usually motivated by deep love for the children.  This is probably the case with Jane.

After a violent death and in the midst of their own grief, parents are often handed the double-whammy of having to figure out how, when--and even whether-or-not--to inform the young people in their families. Too often they are unprepared for the challenges thrust upon them. Your role as the educator/coach can make a critical difference in the lives of these children and their families.

 

Guest blogger Robert Zucker, LCSW, FT, is a nationally known grief educator, author and counselor. He is author of The Journey Through Grief and Loss: Helping Yourself and Your Child When Grief Is Shared (St. Martin’s Press) and was one our keynote speakers at the 2012 NAGC conference in Orlando. Rob invites you to visit his website at www.robertzucker.com.