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Featured this Month:

When Teens Grieve a Sibling’s Suicide
Sunday, January 01, 2017 by Cynthia Waderlow MSE, LCSW & Deborah Major, PhD, LCSW
Family systems are often initially paralyzed by the suicide death of a child, with parents being the primary focus of grief support, as suicide grief literature has identified the loss of a child as among the most devastating for parents.   A 2005 study on sibling suicide bereavement for children who are still at home identify these children and adolescents as “the forgotten bereaved,” where  “necessary help is impeded due to the extraordinary experience leaving siblings outside the circle of friends and parental grief community”  (Dyregrov  &  Dyregrov, 2005).   The study recognizes the devastation of parents who have lost a child, as well as a period of emotional absence that may diminish previous patterns of attunement to surviving children.  We have spoken with teens who perceived themselves as having engaged in grief work “by myself.”  Not infrequently, grieving teens will reject the support of parents and family members.  What are the grief needs of teens under such disrupted circumstances?  What are the unique issues of those experiencing sibling suicide loss?   
     
We recognize both risk and resilience in these young people engaged in the process of becoming their own persons while in the midst of profound family tragedy.    Parents may underestimate the levels of their children’s grief, not only because the grief expression looks so different from their own experience, but because adolescents, have a tendency to minimize their grief in the presence of their parents (Bank & Kahn, 1975).  A study of adolescent sibling grief observed that adolescents did not discuss personal matters with their parents after a sibling’s loss for up to a year (Balk, 1983).   Children may feel the need to protect their grieving parents from caregiving tasks and responsibilities before addressing their own pain(Jaques, 2000).   Our work with youth suggests that for individuation purposes, some teens interpret the process as intensely private and boundaried, and emphasize a sense of not needing their parents as they confront the great work of mastering loss.   For various reasons, teens may prefer to process the loss of a sibling in isolation, a possible characteristic of adolescent grief that may heighten the potential for either risk or resilience as teens deal with the pain of their loss and the questions it generates.        

The grief process will be shaped by where teens are in the developmental process.  Commensurate with the developmental surge in cognitive skills, teens begin to create a meaningful narrative about the suicide. This is an intense introspective process, varying with the cognitive and emotional capacity of each young person.    We notice that if the teen can direct expression outward to a journal, or art, or through speaking to another person, this outward expression externalizes grief, while raising consciousness of thoughts and feelings.   One teen mourned her sister’s suicide under the silent depth of a pool, using the discipline of repetition, breath and the resistance of water to move through her thoughts and feelings.   Others have used homework, technology, excessive activity or socialization to distance from grieving because grief feels too unsafe, or the tasks of grieving appear to conflict with the mastery of other developmental tasks.  Because adolescent grief can resemble that of children and adults, teens may process aspects of grief with abstract thinking abilities similar to their parents, or with shorter attention spans like their younger siblings, where grief is experienced in spurts. 
The immaturity that is associated with adolescence can affect judgment regarding ways to cope, and can contribute to denial or distortions about the loss, as well as an inability to find appropriate and reliable support.  Developmental limitations, which may include immature coping, can be present at the same time the teen is showing a greater capacity for forming ideas and opinions about their experiential world, and can be an indicator of the risk and protective factors in their grief process.

There are some features unique to adolescent grief of a sibling’s suicide.   Relational aspects of sibship, such as rivalry, modeling of positive or negative behaviors, gender, birth order, birth spacing and the teen’s observations of parents’ perceptions of individual siblings have implications for how adolescents interpret the sibling relationship, the meaning of the suicide and their role within the family.  Siblings can have powerful influences on self-perception, and exploration around this becomes part of the grief process. Was it a validating relationship?  Did the teen feel criticized or less important than the sibling who died?  Had either sibling taken a protector or caretaking role?  Was there anger, or estrangement?  If the sibling who died had a history of troubling behaviors or mental illness, was the surviving child idealized or valued more favorably? Other issues may include survivor guilt and feeling the need to restitute the loss for parents.  Some surviving siblings will attempt to replace the role that the deceased brother or sister played in the family (Bank & Kahn, 1975).  In sifting through these layers, teens will need to explore and challenge potentially distorted perceptions that increase the pain of bereavement.  The conflicts, jealousies and rivalries that may have been part of the teen’s relationship with the deceased sibling will need attention in the grief process, so that feelings of guilt, remorse or responsibility for the sibling’s suicide can be addressed.
  
Adolescents should be in the process of individuating, distinguishing themselves from parents while remaining a functional part of the family.  During this developmental phase they are challenged with forming an identity, becoming competent in chosen areas, building a capacity for nuanced ways of thinking, learning to value intimacy and tolerance for difference and forming a world view. In this process lies the potential for resilience after a life-changing loss such as a sibling suicide. These developmental tasks are central to the grief work of representing the self in the pain of loss and creating a meaningful perception of the deceased sibling and his or her experience leading to the suicide.  We observe that some teens  use the use the existential questions  invoked by grief to actualize their individuation processes, leading to provisional narratives  that may depart from what parents are saying about the suicide.  These explanations can evolve over a lifetime as the young person develops socially and emotionally.   The adolescent’s past history of coping with disappointment, frustration, failure and other losses can be an indicator of his or her ability to navigate their grief process.  

Each family and loss is unique, and this brief article can only speak generally about how an adolescent might process grief when a sister or brother dies by suicide. We always recommend supports, such as a trusted adult friend outside the immediate family, individual counseling or a teen grief group such as offered by The LOSS Program for Children and Youth.  We wish to offer teens a place to explore grief safely, hold the vulnerable feelings that can be an extraordinary challenge for those leaving childhood understandings behind, and use new levels of consciousness to create meaning through loss.  In addition to the necessary help with coping, the goal is to offer teens support for a private, authentic exploration of their relationship with the sibling who died, and to facilitate growth in identity formation and self-compassion.   
References

Balk, D. (1983). Effects of sibling death on teenagers.  Journal of School Health, 53, 14-18.
Bank, S., & Kahn, M.D. (1975). Sisterhood-brotherhood is powerful: Sibling sub-systems and family therapy.  Family Process, 14, 311-337.
Dyregrov, K., & Dyregrov, A. (2005). Siblings after suicide—“The forgotten bereaved.” Suicide and Life-threatening Behavior, 35(6), 714-724.
Jaques, J.D. (2000). Surviving suicide: The impact on the family. The Family Journal: Counseling and Therapy for Couples and Families, 8(4), 376-379.

Reprinted from October 2013 edition of the Obelisk.


Archives:

When Teens Grieve a Sibling’s Suicide
Sunday, January 01, 2017 by Cynthia Waderlow MSE, LCSW & Deborah Major, PhD, LCSW
Family systems are often initially paralyzed by the suicide death of a child, with parents being the primary focus of grief support, as suicide grief literature has identified the loss of a child as among the most devastating for parents.   A 2005 study on sibling suicide bereavement for children who are still at home identify these children and adolescents as “the forgotten bereaved,” where  “necessary help is impeded due to the extraordinary experience leaving siblings outside the circle of friends and parental grief community”  (Dyregrov  &  Dyregrov, 2005).   The study recognizes the devastation of parents who have lost a child, as well as a period of emotional absence that may diminish previous patterns of attunement to surviving children.  We have spoken with teens who perceived themselves as having engaged in grief work “by myself.”  Not infrequently, grieving teens will reject the support of parents and family members.  What are the grief needs of teens under such disrupted circumstances?  What are the unique issues of those experiencing sibling suicide loss?   
     
We recognize both risk and resilience in these young people engaged in the process of becoming their own persons while in the midst of profound family tragedy.    Parents may underestimate the levels of their children’s grief, not only because the grief expression looks so different from their own experience, but because adolescents, have a tendency to minimize their grief in the presence of their parents (Bank & Kahn, 1975).  A study of adolescent sibling grief observed that adolescents did not discuss personal matters with their parents after a sibling’s loss for up to a year (Balk, 1983).   Children may feel the need to protect their grieving parents from caregiving tasks and responsibilities before addressing their own pain(Jaques, 2000).   Our work with youth suggests that for individuation purposes, some teens interpret the process as intensely private and boundaried, and emphasize a sense of not needing their parents as they confront the great work of mastering loss.   For various reasons, teens may prefer to process the loss of a sibling in isolation, a possible characteristic of adolescent grief that may heighten the potential for either risk or resilience as teens deal with the pain of their loss and the questions it generates.        

The grief process will be shaped by where teens are in the developmental process.  Commensurate with the developmental surge in cognitive skills, teens begin to create a meaningful narrative about the suicide. This is an intense introspective process, varying with the cognitive and emotional capacity of each young person.    We notice that if the teen can direct expression outward to a journal, or art, or through speaking to another person, this outward expression externalizes grief, while raising consciousness of thoughts and feelings.   One teen mourned her sister’s suicide under the silent depth of a pool, using the discipline of repetition, breath and the resistance of water to move through her thoughts and feelings.   Others have used homework, technology, excessive activity or socialization to distance from grieving because grief feels too unsafe, or the tasks of grieving appear to conflict with the mastery of other developmental tasks.  Because adolescent grief can resemble that of children and adults, teens may process aspects of grief with abstract thinking abilities similar to their parents, or with shorter attention spans like their younger siblings, where grief is experienced in spurts. 
The immaturity that is associated with adolescence can affect judgment regarding ways to cope, and can contribute to denial or distortions about the loss, as well as an inability to find appropriate and reliable support.  Developmental limitations, which may include immature coping, can be present at the same time the teen is showing a greater capacity for forming ideas and opinions about their experiential world, and can be an indicator of the risk and protective factors in their grief process.

There are some features unique to adolescent grief of a sibling’s suicide.   Relational aspects of sibship, such as rivalry, modeling of positive or negative behaviors, gender, birth order, birth spacing and the teen’s observations of parents’ perceptions of individual siblings have implications for how adolescents interpret the sibling relationship, the meaning of the suicide and their role within the family.  Siblings can have powerful influences on self-perception, and exploration around this becomes part of the grief process. Was it a validating relationship?  Did the teen feel criticized or less important than the sibling who died?  Had either sibling taken a protector or caretaking role?  Was there anger, or estrangement?  If the sibling who died had a history of troubling behaviors or mental illness, was the surviving child idealized or valued more favorably? Other issues may include survivor guilt and feeling the need to restitute the loss for parents.  Some surviving siblings will attempt to replace the role that the deceased brother or sister played in the family (Bank & Kahn, 1975).  In sifting through these layers, teens will need to explore and challenge potentially distorted perceptions that increase the pain of bereavement.  The conflicts, jealousies and rivalries that may have been part of the teen’s relationship with the deceased sibling will need attention in the grief process, so that feelings of guilt, remorse or responsibility for the sibling’s suicide can be addressed.
  
Adolescents should be in the process of individuating, distinguishing themselves from parents while remaining a functional part of the family.  During this developmental phase they are challenged with forming an identity, becoming competent in chosen areas, building a capacity for nuanced ways of thinking, learning to value intimacy and tolerance for difference and forming a world view. In this process lies the potential for resilience after a life-changing loss such as a sibling suicide. These developmental tasks are central to the grief work of representing the self in the pain of loss and creating a meaningful perception of the deceased sibling and his or her experience leading to the suicide.  We observe that some teens  use the use the existential questions  invoked by grief to actualize their individuation processes, leading to provisional narratives  that may depart from what parents are saying about the suicide.  These explanations can evolve over a lifetime as the young person develops socially and emotionally.   The adolescent’s past history of coping with disappointment, frustration, failure and other losses can be an indicator of his or her ability to navigate their grief process.  

Each family and loss is unique, and this brief article can only speak generally about how an adolescent might process grief when a sister or brother dies by suicide. We always recommend supports, such as a trusted adult friend outside the immediate family, individual counseling or a teen grief group such as offered by The LOSS Program for Children and Youth.  We wish to offer teens a place to explore grief safely, hold the vulnerable feelings that can be an extraordinary challenge for those leaving childhood understandings behind, and use new levels of consciousness to create meaning through loss.  In addition to the necessary help with coping, the goal is to offer teens support for a private, authentic exploration of their relationship with the sibling who died, and to facilitate growth in identity formation and self-compassion.   
References

Balk, D. (1983). Effects of sibling death on teenagers.  Journal of School Health, 53, 14-18.
Bank, S., & Kahn, M.D. (1975). Sisterhood-brotherhood is powerful: Sibling sub-systems and family therapy.  Family Process, 14, 311-337.
Dyregrov, K., & Dyregrov, A. (2005). Siblings after suicide—“The forgotten bereaved.” Suicide and Life-threatening Behavior, 35(6), 714-724.
Jaques, J.D. (2000). Surviving suicide: The impact on the family. The Family Journal: Counseling and Therapy for Couples and Families, 8(4), 376-379.

Reprinted from October 2013 edition of the Obelisk.