Debby Herbenick is a researcher of sexual behavior and is the director of the Center for Sexual Health Promotion at Indiana University. Her book Yes, Your Kid explores the growing trend amongst sexually active teenagers of engaging in choking, or sexual strangulation.
This is an important read for those of you who are parents of adolescents – although you may not want to read it.
And it is important for adolescents themselves, although it is not likely that many of them will read it either.
Herbenick calls the information “lifesaving.”
She wants kids, and parents to know that sexual strangulation is dangerous, even life threatening.
Evidently, many kids think their partners expect to be choked during sex.
But why?
The depiction of sexual strangulation in porn may have led some kids to try it. After all, all kids have access to porn at this point, and most have watched some.
And those same teens may have thought that choking is part of a normal sexual experience.
In fact, the rise of the use of sexual strangulation amongst older teens and college age kids has been meteoric. According to Herbenick, the number of teen girls between the ages of 12 and 17 who say that a partner has choked them during sex has risen to forty per cent. Two decades ago, sexual asphyxiation was unusual amongst any demographic, let alone young people.
The problem is that sexual strangulation can lead to unintentional unconsciousness or even death.
And some researchers, including Keisuke Kawata, a neuroscientist at Indiana University, thinks that each non-lethal episode can cause damage to the brain, similar to the ways that CTE‘s experienced by football players do.
It’s time to approach this issue with our teens.
It may be hard – but it is crucial.
Once your child is around 14, you can have a discussion about consent and its importance. And during that discussion, you can bring up the fact that lots of kids watch porn – but that not everything that happens in porn should happen in real life – just like the fact that not everything that happens in movies (chase scenes, shootings, dystopian disasters, etc.) should happen in reality.
You can talk with your kids about what they think their partners might want or expect and where these ideas come from.
This can lead to talking about how some things shown in porn are actually dangerous – and how porn does not show you that part.
Again, this is hard to talk about – but the time to start is now.
References
Yes, Your Kid, What parents need to know about today’s teens and sex, Debby Herbenick et al.
Peggy Orenstein, New York Times, The Teen Trend of Sexual Choking (4/12/2024)
In our 4 part series on loss, I talked about the little losses of everyday life, how children understand death, how to introduce the topic of death to children and what a child may feel when they lose a loved one. But something I did not talk about is the fact that, as hard as losing a loved one is for a child, they can also grow as a result of the experience.
This may come as a surprise.
But many people, including children and teens, not only manage to survive difficult losses, but they also grow as the result of their experience with loss.
Scientists who study trauma and loss have found that there can be a variety of positive psychological changes for some people following challenging life experiences.
Lawrence Calhoun and Richard Tedeschi called this “posttraumatic growth.” They mentioned the following positive changes as being prominent for many people:
· Greater appreciation of life
· Greater appreciation and strengthening of close relationships
· Increased compassion and altruism
· The identification of new possibilities or a purpose in life
· Greater awareness and utilization of personal strengths
· Enhanced spiritual development
· Creative growth
And, as it turns out, one crucial factor that allows people to turn a difficult event into one that promotes growth is the extent to which they explore their thoughts and feelings around that event.
Many people prefer “to look on the bright side’ and to not focus on the difficult things that happen to them. In fact, one young woman who sees me in therapy told me that when she hurt herself as a child, her mother used to say, “pretend that didn’t happen”.
However, Calhoun and Tedeschi found that the ability to acknowledge that the event has happened and to think about and process the painful feelings associated with the event are what allow some people to grow from their difficult experiences.[i]
Two other researchers, Todd Kashdan and Jennifer Kane, also studied this subject. Using a group of college students, they looked at how much people tend to avoid difficult and painful thoughts and feelings versus how much they are willing to allow them. In their study, the most frequently reported traumas amongst their subjects included the sudden death of a loved one, motor vehicle accidents, witnessing violence in the home, and natural disasters.
Kashdan and Kane found that the greater the distress the person experienced, the greater the posttraumatic growth that resulted from it—but only in those people who did not avoid their feelings, or who did so infrequently.
These findings support the benefits of encouraging children to experience and talk about their feelings following loss. It also supports the importance of having children and teens who are having difficulty experiencing or expressing their feelings get involved in some form of expressive psychotherapy, whether that be individual, group, or family therapy.
Another researcher, Jessica Koblenz specifically studied children who had lost a parent to find out what helps and what hinders them in their grief process. And she also found that there is growth from loss. One child in her study said they had a heightened sense of life and didn’t want to waste time or have regrets. Another said he had become more independent. Some mentioned that they learned to seek help from those who were able to provide it. Some found that exercise was a good method for coping with painful feelings, and others found humor helpful.
Teigan, a young woman I met through Winston’s Wish, told me that what happened to her after she lost her mother shaped what she wanted to do with her life. She described how one of her teachers at school called her every week after her mother died and provided her with much needed attention, support, and guidance. This teacher was an inspiration for Teigan, and she decided to become a grief counselor for children and teens so that she could help other students, just as her teacher had helped her. In the meantime, she was training to lead grief groups just like the one she had participated in herself.
For years, Calhoun and Tedeschi, studied the positive effects of trauma—including loss. They also found that some individuals who had suffered significant trauma experienced positive changes. These changes include improved relationships, new possibilities for life, a greater appreciation for life, a greater sense of personal strength, and increased spiritual development.
They also found some interesting contradictions. People they interviewed said things like “I am more vulnerable, yet stronger.” Individuals who experienced traumatic events tended to talk about their increased sense of vulnerability; however, these same people also reported an increased sense of their own capacities to survive and prevail.
Another experience often reported by trauma survivors was a need to talk with other people about the traumatic events, which tended to deepen some of their personal relationships. Some also found themselves becoming more comfortable with intimacy and having a greater sense of compassion for others who experienced life difficulties.[i]
In my clinical practice, a teenager whose father had died at the beginning of Covid said to me, “My dad’s death gave me a different perspective. I used to think that if a friendship ended or someone died, all the time you put into that relationship was wasted. Now I think that it was valuable. I would rather have had my dad for the time I had him rather than some other dad who was around longer.”
This young woman gained a new perspective and came to a new appreciation of the relationships in her life. She came to understand the importance of the person that her father was despite her lifelong frustration with having had an older dad. And she also recognized that relationships are important in their own right, even if they end prematurely.
Calhoun and Tedeschi also found that some people who faced trauma were more likely to become engaged with fundamental existential questions about death and the purpose of life. A commonly reported change was for the individual to value the smaller things in life more and to also consider the religious, spiritual, and existential components of life. A common theme for many people in this study was that after a traumatic event, philosophies of life can became more fully developed, satisfying, and meaningful.[ii]
Researchers such as Calhoun and Tedeschi have found that growth can occur not despite adversity but because of it.
It is true that they looked predominantly at adults, but interestingly, very similar findings have been found in research on bereaved children.
In a study of what helps and hinders children and adolescents who lose a parent, Jessica Koblenz found multiple areas of growth in many of the children she interviewed.[iii]
Seventy-three percent of the participants in her study felt that navigating and understanding death at an early age made them grow up faster.
And it is interesting to think about whether “growing up faster” is a form of growth or a toll that is paid by children who have experienced early loss. I suspect that some children might consider it a form or growth, some might feel it was a toll they paid, and some might feel that it is both.
Some children in Koblenz’s study said they responded to loss by embracing life. One said, “I have a heightened sense of life, not wasting time, and not having regrets.” According to some grief theorists, this renewed sense of life is an adaptive form of meaning-making following loss.[iv]
Many of the children Koblenz interviewed said that support helped them to get through their loss. This finding is important because traditional psychological and psychiatric views of bereavement have minimized the role of relationships and support from others in coping with loss. However, more recently, evidence has shown that relational support plays a crucial role in a child’s ability to cope after a loss and may actually improve and intensify some existing relationships.
Interestingly, participants in Koblenz’s study stated that their most helpful source of support were other mourning children who could relate with their exact position.
Koblenz also found that becoming self-reliant was a coping strategy that some of the participants in her study utilized. In her study, kids said that they began to rely more on themselves once they decided that they could no longer depend on others. For some, it was easier to express they “were strong” and “could handle it alone” than to acknowledge their loneliness.[v]
Koblenz says that the sentiment of “needing to be strong” was expressed by many participants and reflected their inability to convey vulnerability. As one participant said of her childhood loss, “Everyone always said, ‘You’re so strong.’ No one ever said, ‘It’s okay if you’re not.’” From this Koblenz concluded that applauding children’s ability to handle their grief alone may make it difficult for them to feel they can be completely open and show their vulnerable selves. But some participants were able to find a balance of healthy independence while still reaching out to others in times when they needed help.[vi]
[i] Lawrence G. Calhoun and Richard G. Tedeschi, “The Foundations of Posttraumatic Growth: An Expanded Framework,” in Handbook of Posttraumatic Growth: Research and Practice, ed. Calhoun and Tedeschi (New Jersey: Lawrence Erlbaum, 2006), 3–23.
[ii] Richard G. Tedeschi and Lawrence G. Calhoun, “Posttraumatic Growth: A New Perspective on Psychotraumatology,” Psychiatric Times 21, no. 4 (April 1, 2004).
[iii] Jessica Koblenz, “Growing from Grief: Qualitative Experiences of Parental Loss,” Omega 73, no. 3 (March 2015): 203–230.
Just after October 7 we posted on how to talk with children about what was happening in Israel and Gaza.
Since then the situation has changed considerably and children will be curious about what is going on: Why do people have such different opinions? Why are students protesting on college campuses? Why are people arguing? What is really happening in Gaza and in Israel? And why?
These are difficult questions to answer.
People ARE arguing; people ARE divided; people ARE suffering; people ARE starving.
How do we explain all of this to children?
Well, if you’ve been reading this blog long enough, you know that I always advise starting with the truth – and providing it at a level that is in keeping with your child’s age and stage of development.
No matter how you feel about the situation in Gaza and Israel, you can talk about what is going on. You can provide your children with a little history and you can try to explain why people have such strong feelings right now.
You may feel that you would like to protect your children from events in the world like these which are troubling or painful.
But if you do not talk about these events with them at home, they will hear about them elsewhere – whether at school, online, or from their neighborhood friends. And without your guidance, they will be left alone to wonder about what is going on, or they will rely on sources which may be less reliable than you are.
Here are my suggestions:
1. Bring up the topic with your children – no matter how old they are. Ask them what they’ve heard about it.
2. Show them on a map where Israel and Gaza are if they don’t already know.
3. Give your children a little history about what has happened in this area of the world over time, and how many people have wanted this small piece of land.
4. Tell the truth about what is happening now. Talk about what is actually happening in Gaza and Israel right now.
Be factual.
4. Explain that people have very strong feelings about what is happening based on their views. Tell them that many people are taking sides.
5. But avoid dichotomous thinking yourself.
Try not to put the issues in terms of right and wrong or good and bad. Let your children know that people in Gaza are suffering AND people in Israel are suffering.
Tell them that students on college campuses are demonstrating as a way of expressing their opinions.
Tell them about your own experience. Have you had strong feelings? Have you had differences of opinions with friends? Have you found that it is difficult to talk with others about this situation and that conversations that started out calmly have turned into arguments? Let your children know that it is sometimes difficult to remember to be respectful of the other person’s feelings when you have strong feelings about something you are talking about – but that it is important to try.
6. Be curious about your children’s point of view. Ask them what they think.
7. Talk to your children about what solutions they have for the situation. What would they do if they had the power to change the situation in Gaza and Israel? What are some ways they can think of to talk about the situation without getting into arguments? And what are some things they can do if they do get into an argument with someone to de-escalate the situation?
This is a difficult and painful time. Many of us feel quite helpless.
And research has shown that one of the hardest things for children as well as adults is just this – to feel helpless.
Something that can help with this feeling is taking action in a productive way. Perhaps you can ask your children if they would like to contribute money to a charity which will aid people in Gaza or Israel – or both. Let them earn money by doing some jobs around the house or garden. And then let them sit with you as you make the contribution with their money.
Or ask them if they would like to learn more about what is going on – or the historical roots of what is going on – and then help them do some research.
We need to do the difficult thing and talk with our children about all of this.
If we have any hope for future generations, it’s time to start talking with children about how people can disagree, how people can be angry, how people can want to retaliate against one another, and ALSO how people can try to be respectful of each other’s opinions, and how people can wait to talk about things until they are not so angry. We can talk about how differences – even differences between nations and peoples – can be worked out through negotiations rather than war. We can explain to our children that everyone suffers when there is conflict and war – and that we need to learn other ways to resolve our difficulties with one another.
*******
For more help on how to talk to children about this and other scary subjects, check out Dr. Abigail Gerwitz’s book, When the World Feels Like a Scary Place: Essential Conversations for Anxious Parents and Worried Kids –
George Bonanno, one of the leading researchers on resilience, defines resilience as the ability to maintain relatively stable and healthy levels of psychological and physical functioning in the face of adversity. He says that resilient individuals may still be upset and disturbed by a loss or a very difficult event but that their upset is short lived and that after a few days or weeks they are able to go back to functioning in their usual way.
And he states that this is not as rare as we once thought.
He says, “many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function.
Unfortunately, because much of psychology’s knowledge about how people cope with loss or trauma has come from people who sought treatment, theorists have often viewed resilience as either rare or pathological.
Bonanno says that among adults, only 10 – 15% of bereaved individuals experience chronic distress or prolonged grief after a loss. This is a much lower number than we might expect!
He talks about some people as “hardy”, that is, they are able to withstand difficult events and move on.
While he has mainly studied adults, perhaps we can also think about this in terms of teens and children.
Bonanno says that people who seem to be hardy are usually committed to finding meaningful purpose in life, they possess the belief that one can influence one’s surroundings and the outcome of events and also the belief that one can learn and grow from both positive and negative events in life. He also says that people who are hardy are likely to be more confident and able to use active coping strategies as well as social support from the people around them.
Another attribute which has been found amongst people who prove to be resilient is the trait of self enhancement. Interestingly, people who think well of themselves, and perhaps even exaggerate their positive attributes, often do better under difficult circumstances. This has been found to be particularly true following severe loss.
Research has been done on people who were near the World Trade Center on 9/11 in New York City as well as on Bosnian civilians who lived in Sarajevo after the Balkan civil war. In both cases, people who were high on the self enhancement scale were rated by mental health professionals as being better adjusted than those who were not as likely to engage in self enhancement.
People who are full of themselves, people who are what some of us might consider over confident may sometimes be annoying to be around – but it turns out that this trait can have benefits when it comes to weathering adversity!
Other researchers have found that certain pre-existing characteristics help people to weather adversity. For example, one study done during the pandemic found that people who have a sense of being able to affect others and their environment (called self-efficacy) are more likely to return to normal functioning after a significant loss. The team summarized the findings of their study saying that a high degree of self-efficacy served as a protective factor against depression and grief among the bereaved individuals who lost their loved ones due to Covid.[i]
In his review of the professional literature on this subject, another researcher found that individuals who were characterized as having what is called openness, who have a tendency to accept new experiences, who feel less nervous through disappointments, and who believe in themselves, also fare far better following loss.
Similarly, individuals who are agreeable, those with conscientiousness traits, those who exercise their abilities and recognize their limitations, and those who set realistic goals all tend to have increased ability to persevere and persist in challenging situations.
In an interesting study on children and teens, it was found that those who have a tendency to ruminate and reflect on their experiences are both negatively and positively affected by this tendency when they are faced with an adverse event. As it turns out, while rumination on negative events can lead to depression, it can also facilitate processing, integration and making meaning out of the negative things that happen to us.
And one last way that people who seem to be resilient are observed to cope with adversity is through the use of positive emotion and laughter. Often the use of positive emotions after loss and other difficult experiences has been seen as a sign of an unhealthy level of denial. However, in recent years, research has shown that positive emotions can reduce levels of distress following difficult events and it is thought that their use need not necessarily be seen as unhealthy.
It seems that those cultures which have a tradition of telling jokes and funny stories about the deceased at a wake or funeral were on to something important years before the social scientists!
So loss and exposure to difficult events may be very painful, they may be difficult and recovery may be lengthy – but there ARE ways to cope, and many, in fact most people are resilient in the face of loss and adverse events.
References:
Bonanno, George. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? The American Psychologist, Jan. 2004. P. 20.
Bonanno, George. The Other Side of Sadness.
Lawrence G. Calhoun and Richard G. Tedeschi, Handbook of Posttraumatic Growth: Research and Practice (London: Routledge, 2014).
Todd B. Kashdan and Jennifer Q. Kane, “Post-Traumatic Distress and the Presence of Post-Traumatic Growth and Meaning in Life: Experiential Avoidance as a Moderator,” Personality and Individual Differences 50, no. 1 (January 2011): 84–89, https://doi.org/10.1016/j.paid.2010.08.028.
Jessica Koblenz, “Growing from Grief: Qualitative Experiences of Parental Loss,” Omega 73, no. 3 (2016): 203–230.
“Be a room parent!” my son said. “I’ll get to see you, Mommy!”
With a nerf gun to my head, I took on the responsibility.
I figured this would help me keep an ear to the ground as they say. First of all, I could learn which of the teachers wanted to cut and run mid-year and I could support them every way I could. Second, I could spy on my son and see exactly how he was behaving at school!
But what did this job entail?
I had no idea.
As it turns out, it entailed countless meetings that could have been emails. And also having to send out countless emails that could have been skipped altogether.
Additionally, I had to attend all the grade level events.
And don’t get me wrong, seeing my son at his school interacting with his peers has been amazing.
But since August (when the school year started) I’ve had to chaperone several field trips. On one they gave me five kids to keep track of, and two of them had the same name. Why would they do that, you ask? Well why not? At least, I had one less name to memorize.
Afterwards, I took the extra step of texting all the parents pictures of their children on the field trip.
And throughout my time as room parent I’ve gotten to know the other students in my son’s class, met some parents, and regularly shown my support for the teachers. I’ve also volunteered at lunch a number of times.
Long before I became a parent I dreamed of participating in my future children’s school. And this fulfilled that dream. And, as a result of my involvement, my face has become more familiar around the school. The children and staff know me. An added bonus has been being able to infuse a little diversity into the mostly homogenous place we send our son to school.
Then, finally, the school year was three quarters over and the annual field day was upon us. Of course, room parents were required to be there. But I didn’t plan ahead and couldn’t make it. However, I was able to cajole my husband into going in my place.
For context, let me just say it was February and my son had been in this class since August and this would be the FIRST time my husband would be in our son’s classroom.
But back to field day – my husband went, he took on the role of getting the students from activity to activity, something he is far better at than I would have been. And in each of their events he encouraged the kids and assisted the teachers. When the two hour stint was over he and I met for a nice lunch.
That afternoon our son excitedly came home from school. His backpack was strangely full. And when I looked inside, what did I find? Not one but twenty-seven HANDWRITTEN NOTES, LETTERS AND PICTURES from his classmates. Each and every one thanking my husband for volunteering.
You would have thought he had given each child a pony.
I am willing to wager that despite my having been in that classroom or on those field trips or at lunch at least eight times this year, most of the students in the class don’t know my name.
But in each and every letter, my husband is addressed as “Dr. Misra”. He isn’t referred to as my son’s “dad” or as “Mr. Amit” – but “Doctor”. And the funny part is that my husband likes to tell people he’s a “water meter reader” instead of a physician…but we couldn’t expect our son to keep up the same pretenses.
And one of the handwritten notes included animation!!
All had ten dollar vocabulary words like “encouragement” and “persevere.”
Meanwhile, as of today?
I haven’t received so much as a thank you post-it.
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Tejal Misra resides in Arizona with her family. She has recently authored and published a children’s book that offers a unique perspective on the festival of Diwali through the eyes of Sita. If you’re interested in acquiring a copy of the book, see the link below:
Part of this post is excerpted from my forthcoming book, How Children Grieve: What Adults Miss and What They Can Do to Help
Previously in this series I talked about the little losses of everyday life, about ambiguous loss and about how to talk to children about death. But eventually, most children suffer an actual loss when a loved one dies.
This is just so painful – both for the child – and for the adults who love the child and want to understand what she is feeling.
And there is so much to understand.
Behind childhood grief is a world of feelings and beliefs, shaped and colored by the child’s age and stage of development but also by the child’s personality, the degree of closeness she had with the person who died, her particular family circumstances, her culture AND by the way her parents feel about this loss in particular and about loss in general.
The problem in understanding what your child feels about her loss is that it is often difficult for her to put this into words. And lacking an explanation, adults who try to help a grieving child often look at the child’s behavior – and when they look at the child’s behavior, they form ideas of what the child is feeling and how they are affected based just on external impressions.
And in doing so, they can miss a lot.
They can miss what is going on in the child’s inner world; they can miss what the child truly feels about the loss; they can miss what the child understands about the loss; they can miss the child’s misconceptions about death and loss in general; they can miss the child’s fantasies about this loss in particular and what role the child believes she played in causing the loss to happen.
And it is important not to miss these things.
When a child loses someone they love, the child doesn’t stop loving that person. The child may not even really believe that person is gone. The child may start searching for them everywhere they go, and each night they may see their lost loved one in their dreams.
When a child loses a beloved person, their love for that person becomes a one-sided equation. It is an unreciprocated, lonely kind of love that involves powerful feelings of missing their lost loved one.
All this missing can feel different for each child. It can feel like pain. Or it can feel like confusion. It can feel like an ongoing emptiness. It can feel like an ache in the pit of the stomach or a headache that never ends. Some children stop eating. Some start eating too much to fill that emptiness.
Most children can’t bear the feeling for long, and they take breaks from it by returning to play and school activities. This could make it seem like the child is no longer grieving. But, in fact, it does not mean the pain, the emptiness, the yearning, or most of all, the loving has stopped.
For example, Chloe was four years old when her grandmother died. She had been close to her grandmother, seeing her at least once almost every week of her life. After being told that her grandmother had died, Chloe went off to the family room. Her parents observed her playing quietly with her dolls, and they were relieved. They felt that she had taken the news very well and saw her as returning to her normal activities.
Several weeks later, when Chloe began to have trouble at bedtime, refusing to go to sleep without one parent or the other lying down with her, they did not link this to her experience of her grandmother’s death. They felt that she was being “clingy” without good reason.
What the parents missed was that her behavior at bedtime was a communication to them.
The truth was that Chloe was very frightened. She had been told that her Nana had “gone to sleep forever and was now with God in Heaven,” so she was afraid to go to sleep, fearing that she would never wake up and that she would go to be with God in Heaven.
When Chloe went to play with her dolls after being told the news of her grandmother’s death, she had played a game of putting her dolls to bed and having them go to sleep and then go to Heaven. She played this over and over, trying to work out both how someone could sleep forever and where Heaven was.
In addition to becoming frightened to go to sleep for fear that she too would sleep forever, Chloe was feeling more fearful of separations in general. She began to have tantrums each morning when it was time to go to preschool and when either her mother or her father left the house. She also had powerful feelings of missing her Nana and didn’t understand why she couldn’t still go to Nana’s house to visit. AND she was worried that others in her life might go away and not come back. Of course, her solution to this was to not let anyone she loved out of her sight!
Chloe’s parents had not thought to wonder how Chloe would understand the words they said to her about her grandmother’s death. They had four children altogether, and Chloe was the third. They were happy with Chloe’s adaptation to the news of her grandmother’s death and very caught up with their own grief, the reactions of their other three children and the funeral arrangements.
Chloe’s story is just one example of how a child might react to loss.
In How Children Grieve, I tell many other stories about children’s grief. And I take an in-depth look at the internal world of the child in order to help caregivers better understand the nuances of feeling and fantasy a child may experience when confronted by loss. I discuss how unique each child’s understanding and reaction to loss are and how strongly they are shaped by her personality, family circumstance, age, stage of development, and culture. I talk about losses of all kinds, including losses due to death, abandonment, deployment, divorce, and immigration.
Following a loss, adults sometimes forget that young children who have never lost a loved one before may not know what death really is. For example, one little boy I saw in therapy lost his father when he was three. His grandfather told him that his daddy had gone “up there” and the grandfather pointed to the sky.
This little boy, who I will call Teddy, accepted this explanation — but then he started to regress. He became fearful of separations, he would not take a bath and his speech became babyish.
His grandmother brought him in to see me and in the first session, Teddy sat down in front of my doll house, took the daddy doll out and threw him behind the house. When I asked, “what happened to the daddy?”, he retrieved the doll and said, “The daddy’s on the roof”.
This is what he had understood when his grandfather had told him that “Daddy’s up there”.
He thought daddy now lived on the roof of their house.
Young children know so little about the world. Everything is new — and this includes the concept of death. It is common for them to believe that when someone dies, they have just gone to live somewhere else and that they can come back.
Older children may understand that death is permanent, but they often believe that if a death occurs, it is someone’s fault. This can lead them to blame others -or themselves – if someone they love dies or leaves permanently.
One little boy I saw in treatment was convinced that his parents had gotten a divorce and his father had gone to live abroad because he was not lovable enough. He told me in no uncertain terms that if only he had been better at soccer and a few other things, his father would have stayed.
When someone dies, children under the age five or six need frequent reminders about what has really happened. They need to be told that the person who died cannot come back, even if they might have wanted to. Fantasy is so powerful at this age that it can quickly replace a reality that is poorly understood (as well as being unwanted).
Children under the age of five or six need death to be explained to them in a concrete way, including the facts that when a person or animal dies, it cannot see or hear or breathe or feel anymore.
And when a child between the ages of six and ten loses someone, they need a slightly more nuanced explanation of what has happened. They need to know the truth and they need to be told face to face, soon after the loss has occurred. They need to be told some details about the sort of illness or the event that caused the death. They also need to be reminded that the death was no one’s fault (if this is true).
Teenagers may seem like they don’t need much help following a loss. After all, they understand what death is, and they manage a great many feelings on their own already.
But whatever age a child is — from infancy through young adulthood, support is needed following a loss due to death.
When a teenager retreats to her room following a loss, when she looks at her phone when you try to talk to her about her feelings or about what is going on in the family, this is NOT an indication that she does not need your help.
Like kids of all ages, teenagers may feel uncomfortable talking about their feelings and they may feel awkward when feelings are talked about with them.
But don’t give up. Keep asking how your teen is doing, keep checking in on how they are feeling and keep letting them know how you are doing and feeling.
There is a great deal to understand about children’s understanding of death and their feelings following the loss of a loved one. If you are interested in learning more, check out my new book:
For children of all ages, there will be grief and there will be mourning if they were close to the person who died.
But this grief may not take the form that adults expect.
Some children will show signs of sadness, much like an adult would. But others may not.
Some children may express their feelings readily and ask lots of questions. Others may not show many feelings and the adults around them may wonder whether they are grieving or not.
All children will pop in and out of grief — sometimes seeming sad or angry or irritable and other times going about their usual activities including playing and seeming completely unphased.
But whatever the child’s age, clinical experience and research show that a strong relational environment is one of the most important factors in helping the child to process their grief, tolerate their sad, confused, or angry feelings, and come out the other side.
Adults can help a grieving child by understanding the many forms the child’s grief may take, by tolerating their child’s feelings and by talking about how the child feels, whatever those feelings may be.
This task is complicated, however, because often, when a child is in mourning, the parent will also be in mourning. If a grandparent has died, the parent is grieving the loss of their parent or their parent-in-law. If a sibling has died, the parent will be in mourning for their child. And even if it is a close family friend who has died, the parent will also be affected.
This makes it more difficult for a parent to be available to a child. They may need to bring in help for a brief period of time — and have others provide the support their child needs.
Death is hard to accept for all of us. We all need a great deal of help and support when we lose someone we love — and this is all the more true for children and teenagers.
In this series we have talked about the little losses of everyday life and we have talked about the unacknowledged losses in life, called “ambiguous losses”. Today we are going to talk about how to help your children learn about the biggest losses of all: the ones due to death. Part of this post is excerpted from my forthcoming book, How Children Grieve: What Adults Miss and What They Can Do to Help.
And please weigh in on this subject – leave a comment!
For a child, losing a loved one is scary—because it makes death real.
For a child, death itself is scary—because what is death, anyway?
For a child, losing a loved one is excruciating—because the pain of not having the loved one is so terrible and the capacity for bearing pain is so small.
For a child, missing a loved one is possibly the hugest part of loss.
For a child, losing a loved one is confusing—because it is hard to understand why this person had to die.
For a child, losing a loved one stirs up guilt—because the child imagines that she could have prevented her loved one from dying if only she had behaved differently.
And for each child, grief is experienced, felt, and expressed differently.
Each child goes through her own particular feelings at her own rate.
We hate to think about our children suffering.
We prefer to think we can protect them.
Sometimes we even try to shield them.
But the sad fact is that many kids suffer losses due to death during their childhoods. Whether it is the loss of a grandparent, the loss of a teacher, the loss of a public figure, the loss of a friend, or the most grievous loss of all, the death of a sibling or parent.
So how do we prepare our children for the possibility of any of these?
This is something we have been talking about in our parenting group. And many of the parents have acknowledged that in the confusion of everyday life, it is hard to get to this topic.
One of the mothers realized that she really did not want to talk about death with her children – and another seconded this, saying that growing up, death and loss had just not been talked about in her family and she didn’t know how to start.
It is important for us as parents to acknowledge – to ourselves – that it is not possible to protect children from loss – and that we do need to get ourselves to talk about it. Because, if we don’t, how are our children going to know that it’s an OK thing to talk about? And how are they going to be prepared when someone they know and love dies?
In our society, death is kept at a distance.
People who are dying are often in the hospital, in a continuous care community or in a residential hospice. Children are not accustomed to being around those who are dying and most children have never seen someone who has died.
This makes death strange. And foreign.
But as parents, we know well that death IS a part of life – and we need to introduce our children to this knowledge.
But how to start?
The best way is to talk about loss and death early…and often.
It should not be a one time conversation.
Parents can start when children are as young as 2 or 3. The conversation can begin when the child sees a dead bug or a dead animal. The parent can bring it up or the child can bring it up. Either way, start talking about it. Children are super-curious about these things. They want to know what happened and why.
And talking about death when it has happened to something or someone distant from the child is helpful.
Explain what death is.
You can talk about it in a very concrete way: for example, you can say that when something dies, it stops breathing and moving. It cannot eat or sleep anymore and its body will decompose and go back into the earth.
Your child will have questions, of course. They may want to know what and who can can die. They will want to know if you will die or if they themselves will die.
This is when the conversation gets more difficult.
But children can and want to know the truth.
And yes, they may worry about dying once they have learned about it. They may have a period of time when they worry about you dying. They may have nights when they think about death before they go to sleep. They may have periods when they can’t get to sleep because they are thinking about it.
But this is ok.
It is normal.
It is part of childhood to learn about death, and to worry about death.
And the best thing a parent can do is to not leave the child all alone with these thoughts and feelings – but to stick in there and to be available to talk about them.
As children progress through development, the conversation can become more sophisticated: “What causes people to die?” “What role does illness play in death?” “What is cancer?” “Why can’t all cancers be cured?” “Is there life after death?” “Where do our spirits go when we die?” “Why can’t we live forever?”
Each of these questions can be entertained. All you have to do is to answer to the best of your ability. AND maintain an attitude that says “we can keep talking about this.”
In adolescence the questions can become fully existential: “What is the purpose of life if we are all going to die anyway?” “How do I make my life meaningful knowing that I’m eventually going to die?” “What is the best use of time, knowing that our time is limited?” “Is there really such a thing as heaven?” “If there is a god, why does he/she let people suffer and die?”
And the best answer to these questions is not an answer, it is a question that you put back to your teenager: “what do you think?”
This is a conversation.
And if your teen is motivated, if they are really interested, you can refer them to the philosophers. You can talk to them about spiritual beliefs. You can suggest they talk to your priest or rabbi or imam. And to their friends. And again, you can keep the conversation going.
Death is hard for all of us to understand. Often, we just try to avoid thinking about it. But, for many of us, including for many children, the knowledge of death lends more meaning to life, and to the value of each day and each moment.
Stick in there. It’s not easy. But being available and willing to talk about loss and death is one of the best things we can do for our children.
In the first installment of this series I told you about my forthcoming book, How Children Grieve: What Adults Miss and How They Can Help, and I offered some ideas about the small losses of everyday life which children experience. I talked about these small losses and how important is it for parents to try to tolerate their children’s sadness when they experience them.
In this installment I am going to talk about another kind of loss – the kind of loss kids can suffer without it necessarily being recognized, called “ambiguous loss”.
Ambiguous loss is loss that may not involve death. It is the loss that happens slowly, or the loss that occurs when something otherwise considered good is happening.
This kind of loss can involve a grandmother who is slowly losing her memory. It can involve missing a sibling who has gone away to camp or to college. It can involve a parent who has gotten a new job and has to work longer hours. It can even involve someone who is still present but who seems psychologically absent because they are depressed. Or it can involve the loss of someone who is not available because they are in mourning themselves, such as a father whose own father has died.
Pauline Boss coined this term as a result of her own childhood experience – and she wrote about it in her book, Ambiguous Loss, Learning to Live With Unresolved Grief.
Boss grew up with a father who had emigrated from Switzerland. As a child, she noticed a pervasive sadness about him, but she did not understand where it came from. She felt that her father was absent sometimes when he was actually present. No one in her family talked about this. Only later in her life did she realize that her father’s sadness originated from having left his homeland and his family and that, as a sensitive child, she had picked up on his powerful missing feelings.
In the course of her research on the subject, Boss studied two types of families: one type being families in which the fathers were too busy working to take an active part in raising their children and the other type being the families of fighter pilots who were missing in action. In the first kind of family, she noted that the fathers were psychologically absent from their children’s lives but physically present. In the other type of family, the fathers were psychologically present but physically absent. She saw that each type of family lived in a kind of limbo where their losses were not really named but where there was sorrow and grief anyway.
It is Pauline Boss who defined ambiguous loss as a situation of unclear loss in which it is not known if a loved one is dead or alive, absent or present.
And she has pointed out that ambiguous loss is stressful and produces anxiety that blocks coping and understanding.
We can extend the concept of ambiguous loss to describe the experience of most children and adults over the time of the Covid-19 pandemic, just as Pauline Boss did in her later book, The Myth of Closure: Ambiguous Loss in a Time of Pandemic and Change.
Ambiguous loss was ubiquitous from 2020 to 2022. Even those of us who did not lose loved ones to illness lost other things during this time, including our normal way of life, our sense of safety, and our freedom to go where we pleased. And for the times of quarantine, we all lost our ability to be with friends and family, to go into school or work, and to go about our daily lives as we had previously.
For children who were born during this time, or for those who were small, opportunities to socialize with other babies and small children were lost. Opportunities to attend playgroups and pre-school were lost. For those who were older, the school experience was drastically different, and in many cases, not sufficient to promote age appropriate learning or socialzation.
These are losses which we are beginning to name but which we don’t yet know enough about.
Even without a pandemic, ambiguous loss happens all the time. For example, ambiguous loss occurs when a teenager gets ready to go to college and then leaves. The teenager loses her childhood home and the proximity of her parents. The parents lose the everyday presence of their child. Siblings lose the presence of that sister or brother in the house.
Going to college is supposed to be a happy event. The teen is going there to study, to meet others, to learn how to be independent and to find out where their interests lie. But there are also many losses involved in this “happy” event.
Ambiguous loss also occurs as couples decide to separate and then move into different apartments or houses.
No one has died, but a way of life has ended.
Ambiguous loss occurs when a child “graduates” from preschool to kindergarten or from middle school to high school. These kids are usually happy, they are excited, but they may also be anxious or sad. They are leaving behind the familiarity of the old building, the usual classmates, the well known routine.
And what about kids whose families decide to move to a “nicer” house or to a safer neighborhood? Or even those kids who must emigrate from their homes to move to a safer location within their country because their town is under attack? Or those who must move to another country because their country is at war?
For the adults involved, these moves make sense. For the children, this sort of move may feel unwanted, scary, even devastating.
Ambiguous loss is a sort of loss which is much subtler than loss due to death. But it is still painful, and it is still felt by children and adults alike. These losses are not always acknowledged—and unacknowledged losses are harder for people to process.
As Pauline Boss says, “Ambiguous loss is always stressful and often tormenting.”
In the decades following Boss’s original research, she treated the families of Alzheimer’s patients, families whose loved ones had died in natural disasters but whose bodies had never been recovered, and the families of those lost on 9/11. She said that for these families, their losses existed without any conclusion or resolution. She talked about the grief in these families as often being “frozen.”
And similarly, the grief of many children who have had a sibling leave for camp or college or the military, or who have left a home for a supposedly better or safer home may end up with certain of their feelings about the experience left unacknowledged and frozen.
We need to take the trouble to try to recognize children’s otherwise unacknowledged losses, to speak about them with the child and to support the child’s feelings about the loss, whatever these feelings may be. In other words, we need to bring these things up – even if our children are not talking about them. We can initiate the conversation, we can talk about similar losses we have experienced, we can talk about our own feelings … and then we can see what the child does with this and follow their lead. Do they seem to need to talk more? Or do they seem satisfied?
In reading Pauline Bosses books and in thinking about the concept of ambiguous loss I have come to appreciate some of the ambiguous losses that I experienced early in my own life: the strange absence of grandparents who didn’t live so far away but who almost never came to visit, the sudden disappearance of the old red chair in the basement which was my favorite place to curl up, my father’s slow retreat into work and long naps, my mother’s strange helplessness after my father’s early death. None of these were discussed – or even mentioned. But I reflect on them at the ripe age of 69, realizing that I would have been better off if they could have been talked about and if my feelings about them could have been elicited and acknowledged.
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In Part 3 of this series, I will talk about children and death.
Everywhere you look, someone is either writing or podcasting about how you should be raising your children. You should be more gentle; you should be less gentle. Your children need to develop an understanding of feelings; your children are overprotected and unprepared. Whether you are reading Sarah Ockwell-Smith or Johthan Haidt, you will find that you are doing it all wrong.
What’s a parent to do?
Well, if you ask me, it’s not one or the other. Sometimes children need limits and sometimes they need help understanding their own feelings and the feelings of others.
We don’t want to over protect our children so they are unprepared for what life is really like nor do we want to overexpose them to disappointment and difficulty.
So, again, what’s a parent to do?
Well, I would like to start with just one subject. And that is the subject of loss.
Children – all children – experience losses and disappointments in their lives and we do not need to protect them from these or from the feelings that result from these.
But we do need to prepare them and to help them when these losses happen.
We need to prepare them for both the little losses and the big losses so that as they mature, they will be able to handle what comes their way.
We don’t like to think about it, but children suffer losses all the time. And they need to be able to manage when these losses occur.
A friend doesn’t show up at school because she’s sick. Another friend moves away over the summer. A beloved stuffed animal is left behind on a trip. A promised adventure to the amusement park is cancelled due to rain.
These are small losses, but losses all the same.
So, do we go out and buy a new stuffed animal right away? Do we call the teacher and tell her how sad our child is that her friend is out sick? Do we try to introduce our sad child to other kids as soon as we find out her friend is moving? Do we substitute a trip to an indoor trampoline park instead of the amusement park?
You might be tempted to do one of these things.
But how about holding off?
Our job, as parents, is not to protect our children from experiencing loss, nor from the feelings accompanying loss.
What we need to do is to help our children with their losses, whether big or small, and we need to start early.
We need to convey that yes, it is sad to lose a stuffed animal or to miss a friend or to lose a much hoped for day at the amusement park – but we also need to convey that these losses can be survived.
Little losses are the best place to begin – because they lay the groundwork for dealing with bigger losses which will certainly come along at some point.
We should try to avoid giving our children the impression that life is always good.
Because it isn’t.
And we want our children to be able to feel what they feel when life isn’t good, and to be able to talk about it (if they want), and eventually to be able to move on.
The problem is that often these small losses are not spoken about.
For the obvious ones like the loss of the stuffed animal, parents are often tempted to make the sadness go away by replacing the lost toy.
But why not let your child feel sad for a while?
Part of the problem with this is that for parents, it can be hard to tolerate a child’s sad feelings. It is painful for us.
But try to take a moment. This is our job – we just have to try to allow the sadness and to show that WE can survive it ourselves.
If we can tolerate our child’s sadness, this will help them to tolerate their own sadness.
And a missed friend or a missed day of fun?
Let’s also let them be sad. Let’s try not to “make it all better”. Let’s talk about how sad and hard these things are. Let’s share times when we suffered in the same way. And let’s tolerate our children’s sadness and disappointment – and let them know that these things will happen from time to time in their lives.
And what about less obvious losses? The ones that we might not notice but which children are suffering with?
They are what Pauline Boss calls “ambiguous losses” and I will talk about these in Part 2 of this series.
The other day one of the mothers I work with told me that while she was playing with her son, she picked up her phone to look at a text. He told her to put her phone down. He knew that her attention to the text was taking her away from him.
And how old is he?
Two.
This little boy is two years old and he already feels like he has to compete with Mommy’s phone for her attention.
Imagine what a five year old feels. Or a ten year old.
No wonder kids want their own phones. And no wonder they’re wanting them earlier and earlier.
It’s hard to buck this trend.
Kids are asking for phones early in their lives. But if you want to be able to put off their phone ownership, or, if once they own one, you want to be able to limit their usage, the first thing you really need to do is to be more aware of your own phone usage – especially in the presence of your children.
One thing that I find particularly worrisome is the way that some parents use their phones when feeding their babies. Parents may think it doesn’t matter. What does a newborn notice? If you use your phone while nursing or, while bottle feeding, perhaps you feel like it doesn’t matter.
But, like with the two year old I mentioned, and like with the five year old or the ten year old, it’s more about what you aren’t doing than what you are doing.
With a newborn, what you aren’t doing is looking into their eyes, being present with them, feeling their soft skin, smoothing their little bits of hair.
And what you aren’t doing is necessary for building connection and attachment – theirs and yours.
So, will they remember that you were on your phone while feeding them? No. But will it affect them that you weren’t as present as you might have been, that they missed that face to face, direct eye contact that can sometimes occur with feeding? Yes, I think it will.
And I do not say this to induce your guilt. I just say this to encourage all parents – including the parents of newborns and young babies – to limit your phone time to times when your baby or child or teen is not with you – or when they are napping or sleeping or when you absolutely have to take a call or a text.
And if you do absolutely have to do one of these things in the presence of your toddler or your older child, explain why you are doing it.
This will make it much easier later when and if you decide to put limits on your child’s screen usage – and it will also be better for your relationship with you child – and theirs with you.
Thoughtful Parenting 