Grieving the Death of a Child Presented by Dora Parys, LCSW Little Stars Pediatric Program, Eugene, OR [email_address] This presentation was inspired by The Initiative for Pediatric Palliative Care Curriculum (IPPC), Newton, MA: Education Development Center, 2003.Referenced and reprinted with permission from IPPC, 2008.

Suffering “ A state of severe distress that occurs on a biological, psychological, spiritual and/or socio-cultural level, and that is associated with events that threaten the sense of intactness of the person. Suffering…..poses the existential challenge of the loss of meaning and purpose.” Browning, 2004

“ A state of severe distress that occurs on a biological, psychological, spiritual and/or socio-cultural level, and that is associated with events that threaten the sense of intactness of the person. Suffering…..poses the existential challenge of the loss of meaning and purpose.”

Browning, 2004

Bereavement “ The overall experience of family members and friends in anticipating the death of a loved one, and in living through and adjusting to life beyond that death.” Parkes, 2001

“ The overall experience of family members and friends in anticipating the death of a loved one, and in living through and adjusting to life beyond that death.”

Parkes, 2001

Traditional Grief Theories Grief is a universal process that people go through in similar ways Mourning is private and focused on expression of pain and sadness Grief stages and tasks Grieving involves the “working through” grief Focus on letting go of attachment ties Mourning leads to full resolution and withdrawal of energy Hagman, 2001

Grief is a universal process that people go through in similar ways

Mourning is private and focused on expression of pain and sadness

Grief stages and tasks

Grieving involves the “working through” grief

Focus on letting go of attachment ties

Mourning leads to full resolution and withdrawal of energy

Hagman, 2001

New Focus In Grief Theories Bereavement response is unique influenced by social and cultural context No anticipated end point in grieving Continued exploration of attachment and adoptive role of maintaining a continuing bond Grief as a form of communication within social system Focus on cognitive and meaning-making process in mourning Hagman, 2001

Bereavement response is unique influenced by social and cultural context

No anticipated end point in grieving

Continued exploration of attachment and adoptive role of maintaining a continuing bond

Grief as a form of communication within social system

Focus on cognitive and meaning-making process in mourning

Hagman, 2001

Bereaved Parents’ Experience of The Continuing Bond Sense of the child’s presence Seeing, hearing, smelling, touching, or talking to the child Belief in the child’s continuing active influence on thoughts or events Incorporation of the characteristics or virtues of the child into the self Klass et al., 1996

Sense of the child’s presence

Seeing, hearing, smelling, touching, or talking to the child

Belief in the child’s continuing active influence on thoughts or events

Incorporation of the characteristics or virtues of the child into the self

Klass et al., 1996

Bereaved Parents’ Web of Meaning Mourning process for bereaved parents occurs within a web of mutually interdependent and constantly interacting bonds and meanings: How the universe works Place and power of the self Bond with the child Bond with transcendent reality Meaning of the parent’s life Meaning of the child’s death Community/family membership Klass, 1999

Mourning process for bereaved parents occurs within a web of mutually interdependent and constantly interacting bonds and meanings:

How the universe works

Place and power of the self

Bond with the child

Bond with transcendent reality

Meaning of the parent’s life

Meaning of the child’s death

Community/family membership

Klass, 1999

Meaning Making and Rituals Memories Creating and acknowledging meaningful places or events Creating or continuing rituals to celebrate child’s life Visiting favorite family places Visiting the cemetery/significance of urn placement Community work, activism Attention to objects that symbolize child’s life Community acknowledgment of child’s life

Memories

Creating and acknowledging meaningful places or events

Creating or continuing rituals to celebrate child’s life

Visiting favorite family places

Visiting the cemetery/significance of urn placement

Community work, activism

Attention to objects that symbolize child’s life

Community acknowledgment of child’s life

REFERENCES Browning D.M. 2004. Fragments of Love: Explorations in the Ethnography of Suffering and Professional Caregiving. In: Living With Dying: A Textbook in End-of-Life Care for Social Work , J. Berzoff, P. Silverman (eds.). New York: Columbia University Press. Hagman, G. 2001. Beyond Decathexis: Towards a New Psychoanalytic Understanding and treatment of Mourning. In Meaning Reconstruction and the Experience of Loss, Neimeyer, R.A. (ed.). Washington, DC: American Psychological Association. Klass, D., Silverman, P.R. and Nickman, S.L. (eds). 1996. Continuing Bonds: New Understandings of Grief. London: Taylor and Francis. Klass, D. T.1999. The Spiritual Lives of Bereaved Parents. Philadelphia: Brunner/Mazel. Parkes C.M. 2002. Bereavement: Studies of Grief in Adult Life . London.: Routledge.

Browning D.M. 2004. Fragments of Love: Explorations in the Ethnography of Suffering and Professional Caregiving. In: Living With Dying: A Textbook in End-of-Life Care for Social Work , J. Berzoff, P. Silverman (eds.). New York: Columbia University Press.

Hagman, G. 2001. Beyond Decathexis: Towards a New Psychoanalytic Understanding and treatment of Mourning. In Meaning Reconstruction and the Experience of Loss, Neimeyer, R.A. (ed.). Washington, DC: American Psychological Association.

Klass, D., Silverman, P.R. and Nickman, S.L. (eds). 1996. Continuing Bonds: New Understandings of Grief. London: Taylor and Francis.

Klass, D. T.1999. The Spiritual Lives of Bereaved Parents. Philadelphia: Brunner/Mazel.

Parkes C.M. 2002. Bereavement: Studies of Grief in Adult Life . London.: Routledge.