The downward spiral of hope: Complex Grieving in Children

Hurricane Katrina taught us alot about the grieving process in children. Unless the situation was a dramatic event, such as discovering the body of a parent who committed suicide or being a war refugee child, children’s symptoms are often overlooked. But unexpected deaths by natural causes, accidents, or motor vehicle accidents can cause acting out, depression, insomnia, and anxiety. Children may be sad one moment and then seem fine an hour later. This is because children experience grief differently than adults and we expect them to respond to trauma in the same manner. Unlike adults, children do not sit and emote how the trauma has impacted their life.

Complex grieving is different from uncomplicated grieving in the fact that the child does not move through the normal stages of grief. They remain stuck. PTSD symptoms are also present, such as avoidance of reminders of the deceased, emotional numbness,nightmares, excessive irritability, excessive loneliness, and hopelessness. Because of the varying emotional awareness of their parents, these children may become very depressed and hopeless before anyone is aware of their plight. It is very important that these children receive therapy. A combination of therapies may be the most successful with these children to address the PTSD symptoms and the grief. Play therapy is an ideal choice because children naturally play in their environment. However, truama based- cognitive behavioral therapy is also a good choice because it is proven to be an effective treatment for trauma. Depending on the whether the symptoms seem to be more truama based or not will determine whether TB-CBT will be the primary therapy with Play Therapy augmenting this treatment. In any case, no one child presents in just the same manner, so it is important to draft a treatment plan specific to the child.

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Author: Evelyn Wenzel,MSW,LCSW,CAP

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