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Featured this Month:

Adolescence and the Grief Process
Monday, June 01, 2015 by Cynthia Waderlow MSE, LCSW
As a grief therapist in the LOSS Program for Children and Youth, I have the privilege to reflect on the active and diverse grief processes that teens have shared with me after experiencing a suicide loss.  The skills that teens bring to the grief experience are unpredictable based on age, and what each individual does with grief reflects various levels of engagement with a painful, yet often enriching process.  The seven or so years that comprise the adolescent period offer quite a range in observable development.  And we may have noticed how developmentally different one 14 year old can look from another, and  the difference in cognitive and expressive capacities often found between boys and girls who are of the same age.  The ranges in emotional maturity and identity processes may not be completely resolved by the time teenagers become adults, but there are some bottom-line, integrative and representational capacities that that we expect adolescents to demonstrate that also have implications for their grief processes.  The abstract thinking which made its debut between ages 9 and 12, is now a shining feature of adolescent expression in relationships, academics and further skill mastery and perspectives on social and moral dilemmas.  Depending on where teens are focusing their developmental energy, we will see some areas of cognition getting practice over others. Some individuals will have a tendency to stick with a more concrete way of approaching daily life, while others will find symbolism and interpretive thinking more gratifying. The outspoken opinions that we hear from some teens are products of their developing minds and world views.  With their evolving cognitive skills, they have begun to take ethical positions on the basis of what is perceived as right and wrong, fair and unfair, and to interpret their relationships and experiences.  Despite differences in preferred cognitive styles, normally developing teens are struggling to form an identity or self-image, to integrate some guiding values, hallmarks of the developmental tasks toward which the teens’ more advanced cognitive skills are applied. Abstract thinking skills are also features which play so prominently in making meaning of a profound loss.

Valente and Sellers, clinicians, who have written about helping adolescent survivors of suicide loss, comment on the unique challenges faced by teens responding to a suicide loss:

“Without a firmly established identity or self-image, the adolescent struggles to cope with the stigma, rejection and disillusionment that accompany a suicidal death… The adolescent, like the adult, desperately struggles to understand the course of events of the suicide but is limited by lack of exposure to death, by developmental status, and by immature cognitive skills.  Thus, adolescents are particularly vulnerable to feelings of guilt and inadequacy (p. 167-168).”

But identity figures into the grief process even more as adolescents interpret and create meaning from a loved one’s suicide. As identity is forming, we come to know ourselves partly through reflections that we receive about ourselves from significant others.  Relationships are greatly influential in how we see ourselves and develop a world view, and the teen’s relationship with the deceased person may be scrutinized during years of grief work: “How did my deceased sibling or parent see me?  Did I disappoint my deceased parent? Have I been abandoned?   How do I deal with the conflict that my loved one and I were experiencing prior to the suicide?  How will I deal with the differing visions that my deceased parent and I had for my future, our differing views about my friends, religion, race, educational goals?”

The message from a suicide is one of despair.  It bears upon a bereaved adolescent’s capacity for empathy, as well as his or her understanding of mental illness and the role of impaired thinking, as opposed to choice, regarding the act that ended the loved one’s life.  After a suicide loss teens may experience their first existential thoughts about suffering, endurance, addiction and dealing with failure and loss of hope.   When the deceased person clearly had an influence on the values and identity of the grieving teen everything that had been offered may now be questioned.  How can I be angry at a person I have loved, who is now gone? How do I reconcile the paradox of my deceased loved one’s life affirming values and her later suicide?  Such questions that rise to an adolescent’s consciousness are not always welcome.  Teens may grapple with articulating the conflicts that arise as they begin to interpret the suicide of their loved one.  And awareness of the conflicts may be transient, which is fitting for the adolescent developmental time frame.  Like children, teens may address grief intermittently, with limited tolerance for the emotional and cognitive demands of the grief process, and the need for those demands to be balanced with many other developmental challenges confronting them.   

The reaching questions that may be generated by adolescents following a sudden, profound loss are similar to those of adults. They are the kinds of critical questions on which the meaning of the suicide and evolving identity issues are constructed.     But without considerable life experience and the maturity that supports measured, balanced perspective- taking, adolescents are in need of guidance and sounding boards as they wrestle with meaning making.  Grief counselors are skilled in facilitating balanced memories and perspectives as grief unfolds.   Teens need to have their own feelings and interpretations as they grieve an important loss, but a mature, supportive listener may help a grieving teen to test the conclusions that become the story of loss. We need to encourage evolution in the stories that teens tell themselves about the suicide and the person who died. We need to help them understand mental illness and the ways that loved ones can be changed by it.  We need them to realize that suicidal action is not a reflection of character, not an expression of rejection toward those loved by the person who died.  And teens are benefitted by conversations that allow them to safely differentiate themselves from a deceased parent.  With support, they may safely disagree, and adopt different perspectives from the prevailing influence of the now deceased parent or caregiver.  This is normal developmental work that can still occur without the living presence of the deceased.  In this context, feelings of guilt and inadequacy are made conscious, but are less likely to flourish as a result of limited ways to think about the loved one’s suicide.
 
Social development is another pressing area of a teen’s personal growth.  Adolescents need frequent opportunities to re-charge among friends, school and sports activities.  They need the assurance that part of life will continue to feel almost normal, that they can blend in and feel accepted. Acceptance stems from the valuable positive reflections that teens receive from peers.  Although there may be safety in a healthy peer group, teens are less likely to share intimate details about their grief experience with friends.  Much of adolescent grief regarding family loss is done in private or with selected confidants outside the immediate family.

Esther Shapiro, a noted scholar in grief as a family process, emphasizes that all “ grieving children make sense of overwhelming experience with the tools of the developmental moment, weaving together a web of associations and meanings that represent their best capacity at the time to face and master the event  (1994, p.149).”  Let us protect and respond to each child’s moment as they reconstruct loss, self and future over time.
   
Valente, S.M. & Sellers, J.R. (1986). Helping adolescent survivors of suicide.  In C.A. Corr & J.N. McNeil (Eds.), Adolescence and death. New York: Springer Publishing Company.
Shapiro, E. R. (1994).  Grief as a family process. New York: The Guilford Press.




Archives:

Adolescence and the Grief Process
Monday, June 01, 2015 by Cynthia Waderlow MSE, LCSW
As a grief therapist in the LOSS Program for Children and Youth, I have the privilege to reflect on the active and diverse grief processes that teens have shared with me after experiencing a suicide loss.  The skills that teens bring to the grief experience are unpredictable based on age, and what each individual does with grief reflects various levels of engagement with a painful, yet often enriching process.  The seven or so years that comprise the adolescent period offer quite a range in observable development.  And we may have noticed how developmentally different one 14 year old can look from another, and  the difference in cognitive and expressive capacities often found between boys and girls who are of the same age.  The ranges in emotional maturity and identity processes may not be completely resolved by the time teenagers become adults, but there are some bottom-line, integrative and representational capacities that that we expect adolescents to demonstrate that also have implications for their grief processes.  The abstract thinking which made its debut between ages 9 and 12, is now a shining feature of adolescent expression in relationships, academics and further skill mastery and perspectives on social and moral dilemmas.  Depending on where teens are focusing their developmental energy, we will see some areas of cognition getting practice over others. Some individuals will have a tendency to stick with a more concrete way of approaching daily life, while others will find symbolism and interpretive thinking more gratifying. The outspoken opinions that we hear from some teens are products of their developing minds and world views.  With their evolving cognitive skills, they have begun to take ethical positions on the basis of what is perceived as right and wrong, fair and unfair, and to interpret their relationships and experiences.  Despite differences in preferred cognitive styles, normally developing teens are struggling to form an identity or self-image, to integrate some guiding values, hallmarks of the developmental tasks toward which the teens’ more advanced cognitive skills are applied. Abstract thinking skills are also features which play so prominently in making meaning of a profound loss.

Valente and Sellers, clinicians, who have written about helping adolescent survivors of suicide loss, comment on the unique challenges faced by teens responding to a suicide loss:

“Without a firmly established identity or self-image, the adolescent struggles to cope with the stigma, rejection and disillusionment that accompany a suicidal death… The adolescent, like the adult, desperately struggles to understand the course of events of the suicide but is limited by lack of exposure to death, by developmental status, and by immature cognitive skills.  Thus, adolescents are particularly vulnerable to feelings of guilt and inadequacy (p. 167-168).”

But identity figures into the grief process even more as adolescents interpret and create meaning from a loved one’s suicide. As identity is forming, we come to know ourselves partly through reflections that we receive about ourselves from significant others.  Relationships are greatly influential in how we see ourselves and develop a world view, and the teen’s relationship with the deceased person may be scrutinized during years of grief work: “How did my deceased sibling or parent see me?  Did I disappoint my deceased parent? Have I been abandoned?   How do I deal with the conflict that my loved one and I were experiencing prior to the suicide?  How will I deal with the differing visions that my deceased parent and I had for my future, our differing views about my friends, religion, race, educational goals?”

The message from a suicide is one of despair.  It bears upon a bereaved adolescent’s capacity for empathy, as well as his or her understanding of mental illness and the role of impaired thinking, as opposed to choice, regarding the act that ended the loved one’s life.  After a suicide loss teens may experience their first existential thoughts about suffering, endurance, addiction and dealing with failure and loss of hope.   When the deceased person clearly had an influence on the values and identity of the grieving teen everything that had been offered may now be questioned.  How can I be angry at a person I have loved, who is now gone? How do I reconcile the paradox of my deceased loved one’s life affirming values and her later suicide?  Such questions that rise to an adolescent’s consciousness are not always welcome.  Teens may grapple with articulating the conflicts that arise as they begin to interpret the suicide of their loved one.  And awareness of the conflicts may be transient, which is fitting for the adolescent developmental time frame.  Like children, teens may address grief intermittently, with limited tolerance for the emotional and cognitive demands of the grief process, and the need for those demands to be balanced with many other developmental challenges confronting them.   

The reaching questions that may be generated by adolescents following a sudden, profound loss are similar to those of adults. They are the kinds of critical questions on which the meaning of the suicide and evolving identity issues are constructed.     But without considerable life experience and the maturity that supports measured, balanced perspective- taking, adolescents are in need of guidance and sounding boards as they wrestle with meaning making.  Grief counselors are skilled in facilitating balanced memories and perspectives as grief unfolds.   Teens need to have their own feelings and interpretations as they grieve an important loss, but a mature, supportive listener may help a grieving teen to test the conclusions that become the story of loss. We need to encourage evolution in the stories that teens tell themselves about the suicide and the person who died. We need to help them understand mental illness and the ways that loved ones can be changed by it.  We need them to realize that suicidal action is not a reflection of character, not an expression of rejection toward those loved by the person who died.  And teens are benefitted by conversations that allow them to safely differentiate themselves from a deceased parent.  With support, they may safely disagree, and adopt different perspectives from the prevailing influence of the now deceased parent or caregiver.  This is normal developmental work that can still occur without the living presence of the deceased.  In this context, feelings of guilt and inadequacy are made conscious, but are less likely to flourish as a result of limited ways to think about the loved one’s suicide.
 
Social development is another pressing area of a teen’s personal growth.  Adolescents need frequent opportunities to re-charge among friends, school and sports activities.  They need the assurance that part of life will continue to feel almost normal, that they can blend in and feel accepted. Acceptance stems from the valuable positive reflections that teens receive from peers.  Although there may be safety in a healthy peer group, teens are less likely to share intimate details about their grief experience with friends.  Much of adolescent grief regarding family loss is done in private or with selected confidants outside the immediate family.

Esther Shapiro, a noted scholar in grief as a family process, emphasizes that all “ grieving children make sense of overwhelming experience with the tools of the developmental moment, weaving together a web of associations and meanings that represent their best capacity at the time to face and master the event  (1994, p.149).”  Let us protect and respond to each child’s moment as they reconstruct loss, self and future over time.
   
Valente, S.M. & Sellers, J.R. (1986). Helping adolescent survivors of suicide.  In C.A. Corr & J.N. McNeil (Eds.), Adolescence and death. New York: Springer Publishing Company.
Shapiro, E. R. (1994).  Grief as a family process. New York: The Guilford Press.