The paper aims at exploring grief as a natural occurrence in human beings which is part of real life. It also analyzes the symptoms of grief and special techniques that a therapist might use when treating those parents who are experiencing grief after the death of their child. The paper will explain how grief affects parents by identifying a number of negative consequences of grief that should be managed either professionally or clinically. The paper will also justify why grieving parents need the immediate treatment as a way of overcoming the loss of their child in order to resume normal life. There is a number of techniques that therapists should develop and practice when helping the grieved parents after losing their children. This is an important exercise since million of children die annually leaving their parents in grief and when not treated this may lead to depression, chronic illnesses, and death
According to Worden (2009), grief denotes the individual experience of loss. Grief that results from the death of a child is one of the most severe types, since the death of a child leaves many parents with shattered hope and an abrupt end to the dreams of existence into the future through their children. There is the need to distinguish grief from mourning, which is the process occurring after the loss. Grief, therefore, leads to mourning as a process in which an individual passes through several phases. Phase one is a period characterized by the lack of feeling that occurs immediately after the loss during which the parents may deny the loss, at least, for a brief period of time. The second phase involves yearning, where the parents may long for the dead child to return, and they may deny the permanency of loss due to anger. The third phase is the stage of disorganization and despair as the parents find it difficult to function normally in their environment. Stage four involves reorganizing behavior, where parents begin to pull life together to live the normal life (Worden, 2004).
According to Archer, (1998), grief is a cruel torment which makes other passions in life to disappear. He uses the word of King Solomon of the Bible that grief dries up the bones and makes them pale lean; makes one furrow–faced , to have dead looks, wrinkled brows, shriveled cheeks, and dry bodies. All these may bring the perverted temperament. According to the field of psychology, grief is a natural human reaction to loss, yet it produces mental suffering and afflicts physical health. Grief is a universal feature of the human existence regardless of culture, race, gender, or social class. The only difference is on how it is experienced that may vary from one person to another. It is usually experienced by all social animals after the loss of a loved one. The attachment theory explains that human beings and animals form the attachment and bonds with their loved ones, and when such bonds are broken, suffering and grief results (Worden, 2004).
The condition which results from the loss of a child by parents is an indication that a bond between the parents and their child is suddenly broken through death, leading to grief and subsequently to mourning. In the modern world, medical help has often been used to overcome depression which normally follows the losses that cause the serious torment. The origin of the professional help can be traced to the nineteenth century physician Benjamin Rush who recommended bleeding, purges and opium for grief. Later, psychiatry took over the treatment as a way of overcoming the prolonged grief that made people overcome the suffering that accompanies the mourning process (Archer, 1998). The field of psychiatry considers grief as a disorder that should be managed to avoid an exaggerated grief, which may lead to the severe depression. According to Rush, such prolonged grief being a mental disease if not managed may lead to death. The grief is usually displayed in the face of the person with features in the eyebrows and the mouth.
According to Freud, when a loved object ceases to exist a person becomes conscious of the loss, leading to the process of the withdrawal from the emotional attachment. This is usually painful and difficult. According to Borden (2009), there is the need for therapists to handle complicated mourning or chronic grief all of which are associated with depression, anxiety and sadness. Diagnosis and treatment for patients is necessary for their lives to be restored to normal. Therapists provide the social support needed to overcome the grief and to return to normal life. The modern world has experienced a remarkable development to the field of psychology making it possible for grief to be handled by professionals to reduce the loss that occurs with human beings in everyday life. There exist a number of techniques in the medical field that can be used to treat parents who have lost a child to make the mourning process a natural process that does not leave the parents unable to leave normal lives (Watson, 2005).
To help in managing grief that parents go through in the society, the grieving parents may seek healing from professionals who have a variety of techniques that can help those who are experiencing loss in their lives. The process of managing the mourning process involves understanding the loss and the process which follows the loss of a child. According to Worden (2009), the parents go through the stages of shock, awareness of loss, conservation-withdrawal, healing, and renewal. Therapeutic skills are the knowledge background that helps a counselor to treat parents who are going through mourning process in order to help them heal and resume the normal loss after the loss of a child (Archer, 1998).
Clients who have lost a child may require counseling at any time during the grief process. The professional help may be sought at a period when the acute pain, disappointment, and confusion about how to react to the situation may he heightened. The clients may seek help after many months of suffering the loss, or even after years after the actual event. This becomes necessary when they finally realize their inability to deal with the problem on their own as they had imagined before. Some clients suffer in silence because they may have failed to get the chance to grieve because the effect of the loss may have initially overwhelmed them. During the counseling process, issues to be resolved in the life of a customer vary from one individual to another (Humphrey& Zimpfer, 1996). The individuals should, therefore, be handled in different ways that are best applicable to their conditions and situations.
Many clients do not understand the grieving process and this is in most cases mistaken to be a personal weakness. Awareness and education, therefore, determine the possibility of an individual to seek the help needed during the grieving process. Some individuals may only need a counselor to reassure them of the good outcome, while others may need to be rescued from the painful situation. The mental assessment of the client may he needed to determine the nature of their need for help. Generally, therapists use their skills to sooth the clients who are experiencing pain and experience the disoriented lives due to the loss of their loved ones. The healing process initiated by the therapists helps the grieving individuals to resume normal life patterns and to become productive as they had been before the loss (Neimeyer, 2011).
The therapy to grieving parents is aimed at making them see themselves a new and to make new choices on how to solve their current problems. The highly charged feeling and attitudes must be resolved before the normal grieving process is allowed to take place. The counseling session and the duration may vary depending on the degree of the problem facing the customer. The work of rebuilding the life will normally depend on a number of factors such as the personality of the client and his ability to cope with the problem. The therapist usually adopts listening and assessment to determine the need of the client from time to time and to respond to the more pressing needs of the client. The client is supported throughout the experience, and the professional judgment is usually used to ensure that the approach used by the counselor is the most appropriate to the needs of the client. The client is needed to guide the professional to their problem areas, depending on the view held by the client since the loss occurred (Archer, 1998). It is, therefore, important that the grieving parent is given an opportunity by the professional counselor to share their views about the loss of their child, to give the counselor room of understanding the problem and choose the best technique of handling the depression.
Parents who seek professional help may approach a counselor while question life, while others seek for the meaning of their life from the spiritual world, but others may withdraw from the normal way of reasoning. The pain of the grieving parents is often felt psychologically, spiritually, cognitively, emotionally and physically and a combination of number of these may also be found in some extreme cases. At times, the grief may be nagging and chronic and may last longer. The counseling, therefore, helps the client to benefit from the mutual experience between the client and the counselor as they both search for a more workable approach to solving the problem, at hand. The therapist-client relationship is a co-constructed approach which involves the application of knowledge and truth regarding the problem being faced by the client (Thompson, 2003).
The counseling process is broken down into three main stages of the early stages, middle and later stages at which the client works jointly with the counselor to solve the problem. The assessment, treatment and strategies are changed from time to time depending on the situation. To determine the best approach to take, a professional may set three main stages of solving the problem. The early counseling session is the stage at which the problem is so acute, the counselor analyzes the factors that contributed to the loss; contributions from the past losses if any, and the most appropriate interventions are sought. The middle counseling sessions are a stage during which the problem may be considered as being chronic and the issues to be analyzed include factors that may be contributing to the present level of problem; any contributions from the past; and the most appropriate interventions that can be used to solve the problem. The later stage of counseling sessions involves reinvesting and rebuilding the life of the client by analyzing factors contributing to the present loss; contributing from the past loss; and then appropriate interventions are sought (Gibson, 2010).
The assessments done at the early, middle and later stage help the therapists to decide on the most appropriate approach of solving the problem. The early sessions of counseling involve assessing the condition of the client and offering the encouragement to the client to narrate the whole problem. The client is also allowed to express all the emotions and to ask for the specific support. The therapist listens without judging the client since the acute grief being experienced may make the client to view everything in life as meaningless. The middle stage involves working to develop the approaches that are implemented to produce the most appropriate result for the grieving parents. During the final stage the client is assisted to build the strength needed, in life in order to live normally. These may include finding the meaning from the loss, developing a sense of belonging, being aware of the needed change, beginning to have fun and pleasure in everyday life, and setting new goals for the future. The goals to be set should be realistically attainable and simple (Ainsworth, 2000).
Nature of Grief Caused by Death of a Child
The death of a child is known to cause the severe grief regardless of age of the dead child, and it is made worse by the unique strong bond that often exist between the parents and the children which is a long lasting bond, even when the dead child is an adult. The death of a child indirectly means the loss of dreams which the parents had in the child, as well as the aspirations and hopes for the future. Parents usually need the continuity of their lives through children and, therefore, when a child dies, parents suddenly feel taken back by losing some vital part of their life (Aiken, 2000). The sudden inability of the parents to continue caring and nurturing for their children, where the parents had invested emotions and resources makes their grief more intense. The parents are also faced with challenges in their relationship because death of a child may weaken the bond which existed between parents. The family may also experience grief due to the feeling of being incomplete because many parents expect to have children at their homes that are expected to outlive them. Death, therefore, creates the severe desperation in the entire home (Borden, 2009)
When a child dies, the relationship between the parents is placed under a special form of stress because the normal support, reassurance and the intimacy of the relationship may be lost or threatened. Children in many cultures serve as an adhesive element in many marriages and the dead of a child eliminates such bonds. Anger is also one of the normal aspects of the mourning processes that may be directed at the spouse as a result of the frustration resulting from the death of a child. Each parent may experience the pain of seeing the other suffering and feeling unable to help. Each may grieve in a different way and at a different pace. This may create tension and misunderstanding. The spouse or a child in the family may remind the parent of the dead child, and this also may cause more pain within the family since no more comfort may be found (Archer, 1998).
Treatment for the Loss of a Child
The death of a child can be handled positively with the help of professionals in a way that reduce the pain of losing the child and to help restore the relationship between the couples. A counselor may help the parents to pay attention to each other and to take time to listen, to share and to have fun together. Social behaviors like the need to continue to hug and touch each other, and also to renew other aspects of the relationship. Each of the parents may be helped to appreciate the need to cultivate patience and to allow space in the relationship, and to understand that the spouse is not the only source of healing. The professional help may help parents to become more loving and patient with each other. When the death of a child is managed well, it may draw the family together in warmth and tenderness. Death of an infant before and soon after the birth is also a source of the profound grief, since the society may not regard it as a loss and as a misfortune of the parents from which parents can quickly recover. The parents should be allowed go through the normal mourning process so that they overcome the emotions which accompany such loss (Thompson, 2003).
The Task of Mourning and Grief Counseling
Professional counselors help grieving parents in overcoming the loss by helping them parents to accept the reality and confront the fact that the child is dead in a way that helps the parents to overcome the initial denial or avoidance to be replaced with the realization of loss. This initial acceptance is a big step towards the beginning of the healing process by accepting the inevitable. Therapists may subject the parents to experience the pain of grief and to accept cooperating and working with the counselor to overcome the pain which may be displaying itself through the self-defeating behaviors alone. This is useful in making the process of grieving useful for the parents because the normal mourning must be allowed to take place, so that the emotions are released, and the healing process is given a chance (Rosof, 1994)
The support of counselors also enables the parents to adjust to the new environment away from their home. This may be difficult because the child that they loved may not be easily forgotten because the items that the child used would still be seen around and may make the parents to assume that the child is still around (Aiken, 2000). The parents are made to fulfill the roles that the child used to occupy in their lives in order to come back to normal. This transition may require a counselor to ensure that the new arrangement at home does not work against the feeling of the parents. The assistance also enables the parents top withdraw of the emotional energy from the dead child and to reinvest in another relationship and to develop the interest in other activities. This is aimed at helping the parents to channel their attention and efforts towards new activities and interests as a way of living normally (Murray, 2003)
A counselor also helps the mourning parents to admit the agony of loss when handling the memory of the dead child for life to go on normally. The parents are made to know that the pain they display is normal and should be managed before their life returns to normal. A therapist may also encourage the grieving parents to express sorrow, hostility and guilt outwardly and to be able to mourn openly, which is more beneficial than if sorrow is not expressed openly. This solves the emotional problems that if handled may lead to the acute depression and the prolonged suffering. The realistic approach to life is allowed so that the healing comes normally (Neimeyer, 2011).
Counselors are also instrumental in enabling the parents to understand the severe grief reactions associated with the loss, which may be mistaken by other family members. Such reactions may strain the family relationships further since a number of them may be negative; such as restlessness, agitation and anger. The awareness created between the parents and other family members may promote the mutual understanding and harmony at home. The professional help also assists the parents to come to terms with anger which may be directed towards the dead child for the disappointment, all of which if not managed may lead to the inability to maintain normal patterns of activity and normal life (Murray, 2003)
Symptoms to Be Assessed on Parents Who Have Lost a Child
A number of behavioral patterns may be observed from the parents as the symptoms to be used to offer the professional and medical help. The behaviors may include when parents continue to experience some dramatic memories and flashbacks and still do those things as if the child is still alive or around. When the couple is feeling emotionally numb and does not experience any pain in an abnormal way as if they have failed to acknowledge that the loss occurred. The parents may feel overwhelmed with life until they are unable to perform their normal activities, or when they no longer have the interest in their normal life. When parents are still crying uncontrollably and the grief appears devastating for them and moving them to the point of nervousness. When one or both parents are isolating themselves from friends and family and evading some social circumstances because they feel pain of seeing people who have children, or when they feel embarrassed because they were negligent to the point of loss of their child (Rosof, 1994)
When parents continue to feel temperamental, bad-tempered and angry, distrustful, or scared, and when the parents have the difficulty in having or falling asleep, sleeping too much and experiencing nightmares. This happens when the parents still feel guilty that they were unable to solve the problem which lead to the death of the child or prevent the disaster that has caused the death of the child. When the parents develop the feelings of fear and a sense of doom about the future (Thompson, 2003)
Special Techniques that Therapists May Use in Treating the Grieving Parents
Counselors may use a number of clinical interventions to help their clients to go through the phases of grief and loss.
Empathy; this helps the parents to overcome loss, grief or death. They are encouraged to express words which reflect what they feel. Through empathy, the counselor takes the position of the grieving parents and feels their pain without being judgmental. The therapist may encourage the parents to write down their thoughts concerning what happened, or they are being instructed to write to the dead child, especially the thoughts that had not expressed when the child was still alive (Perry, 2008).This technique is meant to let the feelings to flow and it helps the parents to release the emotions and to connect with the dead kid emotionally. When a therapist supports the expression of feelings naturally it becomes possible to assess the condition of the mourner using an outlet such as physical activity and writing letters. These may reveal some hidden feelings, which in spoken words or interviewing skills may not reveal easily (Ainsworth, 2000).
Use of rituals; the therapist may also use rituals for the dead child such as encouraging the parents to light a candle at the meal time in the memory of the loved one and to pause to recall the later one to keep them close. The parents may be encouraged to create a memory area at their home for the dead kid. A table may be arranged with a photograph, prized possession, an award created for their lost child among other things. The parents may also be allowed to be alone some time and to concentrate on their thoughts, feelings, memories, hopes and dreams. The technique to be used to help parents to overcome the loss of a new born child involves allowing the parents see the new born and to do some certain rituals like naming, taking photos and to allow the siblings and grandparents to take part in the process. The friends can also acknowledge the loss by giving assuring words and gestures. This technique allows the parents to overcome the grief in the normal way (Neimeyer, 2011).
The parents may also grieve by doing something that the child would have enjoyed so as to remember the one who died in a special way. This means to create a satisfaction that cannot end with the death of the child. The process may also include engaging the soul through meditation and prayer. The parents may worship with the congregation or do it in their own way. The spiritual connection of the dead and the living ones may at times defy the understanding. The parents may be encouraged to rearrange their homes and houses so that it reflects the reality that the child is longer around them (Gibson, 2010)
The client may also be treated by helping them to remember the good feelings by associating the previous good experience with the dead child. The client may be asked to think and visualize the valued relationship and the time they had with the child, the present good feeling which is created, is used to overcome the grief experience since the felt presence enables the client to enjoy good feelings. To achieve this, the client should be instructed to remember some special qualities of the relationship which the parents had with the child and to remember the love, comfort, stability, companionship and any other experience they used to have. The feeling created is used to experience the good feeling which the client previously had and helps in relieving the pain. This is useful during the stage of grief (Rando, 1998).
A counselor may help the parents to mark the end of the mourning process, to help the client to leave the mourning period behind. This technique should be adopted as a sign of a complete break from the mourning period. This is achieved by designing a set of events that should bring a new routine at home. The therapist may use a group mural to deal with the loss. A counselor may act as a guide in saying goodbye to the lost child. They may also evaluate the degree of depression, guilt or excessive anger. The gradual or sudden onset of illness or weight gain are also the signs that help may still be needed (Humphrey& Zimpfer, 1996).
Interpersonal skill; this is another skill especially used at the beginning of the interview for the good interaction process. This should have warmth and hospitality and to foster friendship. The counselor may advise the parents on the good physical care that may also be used to avoid the serious problems of grieving (Perry, 2008).This may include ensuring that they maintain a good balanced diet and paying attention to drinking fluids, engaging into regular exercises and resting when tired. They should also be helped to avoid drugs and tranquilizes that only offer the temporary relief (Morgan, 1984). The promotion of forgiveness in case the death was as a result of neglect or absence of the parents. Encouraging the parents to be busy and engage in other worthy activities like studies and volunteer work in order to find meaning for their lives as they emerge from the loss of a child. A therapist may also help the parents to face the reality of the loss of the child by directing parents to read religious books that deal with the related loss. The parents should be encouraged to talk about the death of the child as a process of releasing tension and bitterness (Thompson, 2003)
Evocative language; this is another therapeutic technique, in which the counselors use tough words that evoke feelings, for example, the counselor may use the expression your son died instead of you lost your son. This type of language helps the parents to face the reality of the issue and to stimulate some painful feelings that should be felt before the healing process begins. The counselor should also speak in past tense when referring to the dead at any time when addressing the parents. This approach is helpful for making the parents to go through the natural stage of healing, to talk about the parent as the ways of appreciation that the child lived and died, and that it is a past occurrence that should be put in the past so that the parents may move on (Humphrey& Zimpfer, 1996).
The mourner may be asked to bring large photos of the child who died to the counseling sessions. This helps the counselor to immediately understand the loss and to focus on talking about the child of the mourning parents. Other symbols may include letters or videotapes of the deceased or articles that belonged to the deceased. Once a clearer sense is established about the dead child, the counselor may offer more appropriate methods to help the parents out of the depression. Drawing pictures of the deceased that reflect the feelings and experiences can also be useful. However, this technique may work the best with grieving children, but may also be used in treating adults. Drawings are not easily made defensive as talking and if used by the patient; they help in facilitating feelings and may identify certain conflicts that the mourner may not be aware of. They also help to heighten the awareness of what the person lost and to identify the person in the mourning process (Gibson, 2010).
The counselor may also use letters by encouraging the parents to write a letter addressed to their dead child, by expressing all their feelings and emotions to the deceased. The parents may be instructed to write a farewell letter to their child by translating their feelings into a language and constructing a consistent narrative of the events which enables some thoughts and feelings to be harmonized in a way that can help in resolving the painful experiences. The parents may also write poetry; the parents may use it to express their feelings (Neimeyer, 2011).
The cognitive re-constructing may be used because thoughts influence on feelings. It involves converting thoughts into the self-talk which includes the words of assurance and the words that inspire confidence in the grieving parents that they can overcome the sadness and all negative emotions. This approach helps in using the words that help the grieving parents to develop some positive feelings and attitudes for overcoming their conditions (Thompson, 2003). The counselor may also create a group among the counseled ones over a number of the related problems. The group members come together for the social and emotional support and learn from each other in the process of interaction with each other. The group may have the same people over a period of time or may evolve that emotional support; and it is offered for all the group members. The group may be open ended in which people join and leave or may be a closed ended group in which only a number of people may belong to the group until the end of the desired period. The group members are made to cultivate trust and mutual understanding and to meet for the certain amount of time. The people are motivated to take active roles in the group activities (Worden, 2009).
Loss is an integral part of everyday life, it is not something that happens as people are living, but loss is life itself. Death and other forms of loss usually occur and cause grief that should be managed with the help of a professional counselor so that after the loss people may still have normal lives. The parents who are recovering from a loss of a child should be handled professionally to develop strength in overcoming not only at present but also in the future. This kind of loss may recur in the lives of a couple, hence, the need for the skills and techniques by all professionals. The grief which is the pain that results after the loss should help in boosting the relationship between the family members. The couple which is smarting from the loss of a child should be helped by a professional to find the meaning, security and purpose after the loss. The human condition after the loss is passive. Therefore, people should be helped to overcome their grief. The grieving individuals should be helped to overcome the state of hopelessness and to foster the growth and self actualization. Counseling or therapy should be based on the solid theoretical understanding of the human personality and behavior rather than the techniques only. The counselor should seek the history of the grief that the parents are going through before choosing the best technique for his therapy.