Grief is a deep sadness caused by a loss. Grief and loss is at the core of all adoption work. All members of the permanency triad (birth family, adoptive family and adoptee) are impacted by grief and loss. Goals for working with individuals with grief are to identify it, to diminish it and to work with what is left.
Six types of loss are identified when dealing with adoptees: of relationships, of objects of comfort, of secure or familiar environment, of self, of familiar habits and routines and of skills, competencies and abilities. Children express their grief and loss through their behaviors. This kind of behavior differs with the child’s developmental stage.
Much of the loss experienced by foster and adopted children is ambiguous grief, which is difficult to resolve because so much is unknown. This is unresolved loss, not the kind that occurs with a death but another type of separation. For a child in foster care, this loss comes with many unanswerable questions. Why did I have to leave? Will I be able to go home? These are just two of many questions. An adopted child may have a different set of questions. Is my birth family out there somewhere? Will I ever get to see my birth family again? Do they think of me? Ambiguous loss causes the child to wonder if she will ever have the answers, if she will always feel as if something is missing.
In 1969, Elizabeth Kubler-Ross delineated the five stages of grief.
She postulated that everyone cycled through these stages. She considered them a cycle of adjustment to the death of a loved one. The list was not meant to be a complete description of the grieving process as everyone is an individual and moves uniquely through grief.
Because children process facts differently, Maria Trozzi defined the stages of grief for children.
- understanding (what happened and why)
- commemorating (formally or informally)
- moving on (shifting of attachment not a severing)
The behaviors exhibited during these stages depend on the age of a child. She believes that adult caregivers have three important tasks in helping children grieve: to foster open and honest relationships; to provide a safe and secure space for children to mourn; and to be role models of healthy mourning.
During the pre-school stage, children are less verbal so their expressions of grief are primarily physical. The behaviors can include: excessive activity, fear, self-blame (someone must be responsible), crying (expression of painful feelings) and clinging (fear of abandonment).
With the onset of the latent developmental stage, new behaviors emerge. The new expressions include: changes in eating and sleeping, distraught or pre-occupied, decline in school performance, anger or lack of control and withdrawing or being unwilling to connect.
Adolescents struggling with grief bring a new dimension to typical teen-age behaviors and difficulties. Among the issues are: depression, running away, drug and alcohol use, risk taking, self-harm and suicidal thoughts.
Triggers throughout life can bring back early grief and loss. These triggers are: shame or guilt, abandonment or rejection, control, identity, intimacy or attachment, loss and grief. Any of these emotions can cause a reoccurrence of prior grief and loss.
Certain myths get in the way of a child’s grieving process. One is that children do not grieve. Children most definitely grieve their losses. A flip side of this is that children should be shielded from their losses. Children need to be given information according to their developmental level. When children are not given important information, they will fill in the details, which are often worse than the truth.
The death of a loved one is not the only loss that can be experienced by a child. A child placed in foster care loses his neighborhood, his school, his home, his room, his toys, his family. He loses all that is familiar to him.
Another myth is that children quickly get over a loss. Every child is unique and all grieve differently. Because children’s brains perceive information differently than adults, their grieving process is different. This may make it seem as if the child has moved past the loss when in reality he has not. Children grieve in spurts.
Talking is not the only way to help a child process the feelings associated with grief. According to a survey conducted by the National Alliance for Grieving Children, 41% of respondents indicated that talking about the loss is helpful. In contrast, 59% responded that spending time with friends and family is helpful, 49% said that listening to music is helpful, 46% preferred to stay busy, 42% found attending a support group helpful.
Allow the grieving child to be the expert on his grief and to teach the adults in his life about his process. Do not assume all children grieve the same or that their grief process mimics an adult’s.