How to help children deal with grief
Over the past year, grief and loss have become an unwelcome and consistent presence in our lives because of the global Covid-19 pandemic. Where previously we would experience grief every now and then, it has never been as unrelenting as the grief Covid-19 has brought into our realities and of those around us.We have all either experienced the loss of a loved one (or loved ones) or know people who have lost loved ones. Some of us have lost friends, colleagues or relatives – in this most unexpected way. The unfortunate, and most difficult, part about the Covid-19 pandemic has been its unpredictability in the way that it travels and the way that it takes away what it chooses. Not only have people lost their lives, but many have lost their livelihoods, their income streams, homes, support systems, special occasions, and freedom in the Covid-19 lockdown. As a result, many people have struggled with their mental health and sense of well-being because of the ongoing pandemic.What is grief?Grief is “the natural reaction to loss”, something which is “both a universal and a personal experience”, according to the Mayo Clinic. Essentially, people who have lost something, whether it is a person or something of value in their lives, can experience a grief reaction. While there are many ways of trying to explain and categorise grief, it is important to remember that grief differs from person-to-person. However, there are ways to understand what they are going through. This applies to individuals of all ages, whether children, adolescents, adults or the elderly.Understanding what grief looks likeWhile many researchers have looked into helping us understand grief, the Kübler-Ross Model of grief is a useful way of helping us understand what grief looks and feels like. Elizabeth Kübler-Ross was a psychiatrist who worked with terminally ill patients, in whom she noticed common stages they experienced as they were reaching the end of their lives. She found that these stages were similar in individuals who were grieving the loss of a loved one. While she outlines five specific stages, it is important to note that these stages do not necessarily happen sequentially, not everyone will experience all of these stages and there is no set duration in which one must experience a particular stage. The model of grief is purely a guide, which outlines common thoughts, feelings and behaviours that a grieving individual may experience.As opposed to outlining each step in so much detail, it could be summarised as follows:The model explains that initially one may experience a profound sense of shock and denial, following the news that a known or loved one has passed away (“this cannot be true”). This is often followed by feelings of anger (“why did this have to happen?”, sadness (“how will I go on?”) and a need to make the pain stop (“If my loved one comes back, I promise to…”). Eventually and ideally, many people may reach a point of acceptance – accepting that one has to continue knowing that their loved one is not coming back.Grief in childrenSince the Covid-19 pandemic reached our shores, it is also important to understand how children display and deal with grief. Children have not only lost people who they loved, they also lost their freedom (e.g. no playdates or visits), their support systems (friends and relatives), activities they used to enjoy over the weekends and going to school.When going through grief, children may show many changes in their behaviour such as increased sadness and withdrawal, not wanting to be alone and clinginess, regressive behaviours (e.g. not wanting to sleep alone anymore), changes in appetite, loss of interest in activities they used to enjoy and a loss of concentration or focus. Some children may become irritable or aggressive, while others may become more withdrawn and quieter. Caregivers will be able to spot grief in a child even if symptoms are not this overt. The subtle signs are usually more common in children and it may be empowering for parents to get to know these, too. Supporting a grieving childAs a parent or caring adult, you will get a sense when your child is struggling with loss – usually through changes in their behaviour. There are various ways in which a caring adult can support a grieving child:Try to get a sense of what they are thinking and how they are feeling by asking them questions about the losses they have experienced. This can be an indicator into what are they struggling with the most.Let them know that they are safe talking to you about it and that you will try your best to be there for them.Allow children to deal with grief in their own way. Some children don’t mind speaking while others prefer to deal with it in other ways, like by drawing, writing or through movement, however, is comfortable for them. Most important is to guide and be present in the journey they prefer.Many parents or caregivers often wonder about what information is “too much”, when speaking about grief or loss with children. Remember to:Be honest, but in a way which is appropriate for the child’s age and emotional maturity. For example, determine whether it is necessary to point out details around the loss which are unnecessary or too detailed for the child to know.Keep it simple and straightforward, sticking to appropriate facts and acknowledging the reality of the loss.Explain that the person is no longer here and outline how you will cope as a family by providing a sense of safety and stability.With that said, we want to also assist children in reaching a stage of acceptance. By doing the things above you are helping them along with the grieving process, however, also get them to speak about what life means and looks like without their loved one – what the new reality is. You can also do some activities together which can help with this, such as:Planting something in memorial of your loved one (e.g. asking the child to choose the plant or tree and involving them in the process).Praying together if this forms a part of your beliefs.Visiting the graveside together and leaving flowers and anything else the child would like to leave.Looking at photos together or creating a memory book of your loved one.Understand that like an adult a child will also go through various stages so allow them to go through these without judgment or criticism. Some children may display increased anger while others may feel withdrawn and sad. Allow them to feel what they need to feel by validating their experiences, but also coming up with a solution on what could possibly help them feel better. Tap into their interests and things they usually enjoy, ask them to help you around the house, get them involved in new routines and come up with new activities together. More than anything, it is important to model that it is okay to grieve, rather than hiding one of the most common reactions we go through as human beings.Book your spot on the Integrating Home, Work, and Play Series workshop.Reabetsoe Buys is a counselling psychologist who has experience in employee wellness, higher education and private practice. She believes that through mental health education and access to resources, individuals in our society will be able to tackle mental health challenges and support others better.
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How to help children cope with distress
If children are distracted from talking about fear and anxiety, they often become preoccupied and feel alone with their worries. Educational psychologist, Junior June Manala explains how caregivers can help children navigate distress.What are the signs of distress to look out for in a child?Parents and primary caregivers are the most important people in children’s lives in the early dependent years. It follows that stressful relationship environments are deeply felt by all children. Unfortunately, emotional distress is not often talked about. Yet, babies and toddlers, like other children, are highly attuned to shifts in their caregivers’ emotional states, verbal tone, facial expression, and movement. Infants and young children are immensely affected by stressful situations, and if the stress is chronic, it can impact their developing brain neural connections. Toxic stress can change a baby’s brain chemistry and their overall development trajectory. (Graham Music, Sue Gerhardt,)Manifestation of distress in infants and young children may include but is not limited to (especially when these occur out of the ordinary or suddenly):CryingRefusal to feedLack of eye contactHiccuppingPositingScreeching soundsClinginessPale or reddish skin pallorEczemaRespiratory problemsSleeping problemsAngerAt times too much activity in the arms and legs of a newborn is an indication of distress. In this case, gathering the infant together and wrapping them up nicely and speaking softly to them can have a calming effect.Adolescents grieve loss just like adults and may hide their vulnerability by isolating themselves or turning outward for peer group support more than usual. However, teenagers may engage in risky behaviour to mask or numb emotions. Amazingly too, neuroscientists e.g., Dan Siegel, 2013 writes that adolescence is a period of major brain growth that can enhance creative thinking if adults can engage and listen.If we consider behaviours as the language of children that need to be translated into words, then we are well on the way to teaching our children to connect their feelings-in-the-body with their behaviour. This helps soothe, calm, or relax the central nervous system that is operating in a fight or flight or freeze mode.What are some of the causes of distress?Many responsible parents take particularly good care of their children’s practical needs such as feeding, grooming, etc., but what often gets neglected is attention to emotional needs. As a result of the emotional neglect and unmet attachment needs, distress will arise.Examples of some of the causes are:Unrealistic demands of children beyond their age and capability. Infants do not understand death but respond to loss and separation of a loved one by protesting it. Some young children might search for the person in their usual places.Children aged 7-8 years old may not understand the permanence of death and regard the deceased as sleeping. Seeing the loved one in a coffin and attending a burial leaves the child with worries as to how the loved one will “get out” of the box when there is so much heavy soil over them.In many African cultures’ children are protected from seeing corpses. They may come to understand death as an emotionally charged situation, where main caregivers are preoccupied in their grief, which can be overwhelming for children. This leaves memories and experiences that are not processed since adults often find it hard to speak to children about death.The vast body of knowledge by neuroscientists Antonio Damasio, Jaak Panksepp, Allan Shore among others, indicates we can intentionally build our children’s brains and resilience to toxic stress from pregnancy through the first two and half years by attending to feelings, naming them, and allowing for their expression. The way we hold our children, look at them, speak to them and respond to their inborn natural attachment needs is learned and stored in our children’s brains.What can I do to reduce the risk of distress in our home?Parents need to remind themselves that they want the best for their children and that parenting is hard especially when faced with a pandemic which brings sudden change and the loss of loved ones.The idea of “good enough” parenting is quite freeing. Parents might need to be reminded of self-care, which is what they need to recharge their emotional cups. Another reminder is that there is no such thing as perfect parenting. This helps to reduce some of the pressure parents face.Thoughtfulness and intention to be a good parent is a given for many parents and includes paying attention to the following:Noticing your response is the first step towards being emotionally available to yourself and creating moments for self-care to refill your emotional energy.Having a support system helps in generating a blanket of warmth and care in difficult times.Being calm helps you transmit the same calmness to your children.Maintaining consistency in caregiving routines such as feeding and bedtimes.Asking for help and cooperation from your children such as tidying and putting away things in the home.Avoiding activities that are likely to heighten stress and anxiety i.e., long hours of watching and listening to violent movies or long periods on social media. Create spaces for play or talking or storytelling that soothes rather than arouses anxiety.What are the key things I should do to help?Remembering that you are bigger, stronger, and wiser than your child will help you to find your calm. This is contrary to complaints that young children or infants are controlling and manipulating their parents. Remember that infants and young children’s brains are not yet sufficiently developed to “control”.Love your children for who they are not for how they behave and encourage them to come to you when they are distressed.This is our step-by-step way to comfort a child.Take in your child’s emotions as if you are in their shoes (empathy) rather than being dismissive of their emotional pain.Find your calm and lend your calm to the child (co-regulate through your face and eye contact), use a soft voice and smooth movements to soothe a fearful or upset child. Holding or gentle touching helps to soothe. Children prefer bodily contact.When you are sure that you have the child’s attention, find the words to help them find their own words to speak about how they are feeling.As an example, let’s say Mpho is moving from one activity to another without really thinking about what he is doing and why. This is an example of nervous emotional energy expressed as restlessness or hyperactivity. Supposing mum were to gently say, “Mpho, come here,” and held him kindly, lowering her voice and directing kind eyes to him saying, “I can see that you are telling me that you are unhappy inside.” If mum pauses and allows him to really take this in, over time, he learns to connect how nervousness or fear shows in his body. It is likely that mum will notice relaxation in Mpho and he might be able to respond positively in words. Mum will have succeeded in noticing the distress, understanding the language of his behaviour and translating the behaviour into words. This process is co-regulation and soothing for Mpho.When should I, as a parent, seek help for my child?When distress disrupts the normal functioning of the child and the family it is a call for help, particularly when the caregivers have tried everything without success. It will then be time to seek professional assistance.For babies and young children under five, help can be sought from parent-infant psychotherapists such on Gauteng Association for Infant Mental Health South Africa (GAIMHSA); Ububele African Psychotherapy and Training Centre; Grow Great runs Flourish prenatal and postnatal programmesFor children and adolescents, telephonic help is available from Lifeline or the South African Depression and Anxiety Group. Public schools have school-based support teams that can assist children. Some universities offer counselling services to communities at minimum costs or for free.Private practitioners such as clinical social workers, counsellors and psychologists are available at a cost. Junior Manala offers play therapy, parent infant and under Fives psychotherapy, Strubenvalley Assessment and Therapy Centre.
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Man To Man: There Is No Shame In Having Mental Health Difficulties
Clinical Psychologist and Artivist Mthetho Tshemese aka The Village Shrink speaks openly about his Mental Health challenges, including battling depression "If, as a Xhosa man, I can break the mould in seeking mental health support and can accept the very real benefits of being in therapy, I think you can too." Today he guides us through some of the things that may be holding us back from better mental health, and the things that can help us rise.Firstly, you may not know that you need help You might not even recognise that you may be having mental health difficulties. If we look at depression as an example, many of us don’t know what it feels like. And more than that, our masculinity can even mask depression. Before I could even consider that I was struggling with depression, all I knew was that I felt aggression and irritation. But there are also other signs we can watch out for. Watch your sleeping patterns. Are you sleeping too much? Too little? How is your energy? Depression can be quite immobilising at times. How are you coping with day-to-day challenges? Are you feeling overwhelmed? How have you been feeling over the last month? These are questions we must ask ourselves. We've got to be both vigilant and reflective because too many of us fall into the patriarchal trap of not allowing ourselves to be human, to be vulnerable, or to understand our own emotions. You may see it as a weakness That patriarchal trap I’m talking about is the way we’ve been stripped of our humanity. I often say “men are not born, men are made”. When we are raised as boys, we are conditioned, engineered, and socialised; made ready to perform the functions expected of us as men. And often that means to be the provider, to be the protector, to be strong. We normally don’t even see a doctor until we are heavily symptomatic, never mind a mental health practitioner. We see mental health difficulties as a vulnerability, as a weakness, and so we don’t allow ourselves to acknowledge it. But I’m here to tell you that mental health is mental wealth. So here are a few more questions you can ask yourself right now. What do you do when life’s pressures and stressors overwhelm you? Do you have any healthy coping mechanisms? For example, I journal, or I write a poem, I may go to the studio and record a song, or I read, or sleep. What can you do to bring yourself back into balance? You may not even be sure what mental health really is Mental health is not the absence of stress or struggle. The World Health Organization gives us a good description of what mental health looks like, and I’ll give you a brief overview of it now. There are three components to mental health: the first is to pursue your potential, the second is to build the skills to deal with day-to-day challenges, and the third is your contribution to the community in a way that works for you.Let’s break those down. Look inwards The first component is to pursue your potential, and by that I mean your true potential. Not what you were raised to be, but who you want to be. There may not have been much room for negotiation between the two before today, so now I compel you to ask yourself: how much of who you are right now, or who you think you are, is actually a consequence of what you were raised to be? I've come to the conclusion that many of us men are living a very unconscious life, where we conform to expectations without really engaging our own self. So ask yourself, “Wait a minute, is my life even what I want it to be?” For our own mental health, we must learn to enjoy our lives in a meaningful way. Find purpose outside of what is expected of you. Explore what could make you happy, and take it one small step at a time. Build your own toolbox of healthy coping mechanisms There will always be a certain amount of stress that comes with modern day life, and that’s why the second component of mental health is to build the skills to deal with day-to-day challenges. And here’s where I come in with a warning for you: be wary of the things you might be doing to numb your pain. There is no judgement here, and often our behaviours are unconscious, but I urge you to start observing how you are managing conflict and handling stress. It can help to look at which desires we’re financing most. Are we buying things like alcohol to numb our pain? We all need to build our own toolboxes of healthy coping mechanisms – and I say “build” because we don’t just wake up with these skills. That’s why it’s always a good plan of action to see a therapist; they are the ones who can really help us build those skills. It also helps to be more pragmatic about how we can incorporate mental health into our lives. Just as you might dedicate some time towards being outdoors, pursuing your hobbies, or being physically active, you also need to dedicate some time towards your mental health. Even if that’s just one day a month. That’s just 12 days a year – you can do that, right? That one day a month is your time to access mental health care. Sit with a therapist who can help you clear your head and shift your perspectives, who can help you connect with the little boy you once were and find a healthy way to give him the things he needed but didn’t get growing up. This is the space where you can give that little boy the psychological hug he needs, where you can find out how to forgive yourself, where you can learn what you need to let go of, what you need to reward yourself for, and to honour how far you have come. Keep the conversation going in your community The third component of mental health is community. And one of the most powerful ways we can contribute to our community is to be there for each other. Especially as men, we need to create the language and the safe space to have these important conversations. You might be asking, “How do you expect us to be able to communicate and create a language for our feelings when we were not encouraged to talk about vulnerability?” And this is when I say, “If, as a Xhosa man, I can break the mould in seeking mental health support and can accept the very real benefits of being in therapy, I think you can too.” Too many of us suffer in silence. We need to break the stigma. We need to have open conversations and create safe spaces in our friendships. When we meet, we must check in with each other. Take the time to share our stories and listen to each other. We must listen when someone says they’re feeling overwhelmed or “not okay”. We must pay attention when someone starts isolating themselves. And we must recognise the courage it takes when someone tells us they are not okay. Because that is courage. It is not weakness. And I will say it again: there is no shame in experiencing mental health difficulties. These conversations we have with each other can be a powerful mental health resource in a country very clearly lacking. Be kind to yourself In all this, learn to be kind to yourself. Looking back, I can see how horrible I had been to myself, so I too am learning self-compassion. I'm learning to practice gratitude. And regardless of the situation, I’m learning to always look for something good, even if it's a simple lesson or a new way of looking at things. So from man to man, I say be courageous in your vulnerability. Be intentional in your pursuit of purpose, and be deliberate about investing in your own mental health. "From man to man, I say be courageous in your vulnerability. Be intentional in your pursuit of purpose, and be deliberate about investing in your own mental health."