Suicide Grief in Children and Adolescents - Canadian Association For Suicide Prevention

Trying to navigate the path of grief after a death by suicide is tremendously complex to say the least. It is like desperately trying to untangle a knotted ball of string that has woven in upon itself – as soon as one thread is pulled another tightens.

This path can be especially confusing and frightening for children and teens who do not yet have the intellectual ability, the coping skills, and life experience to assist them in this process.

One of the most helpful things for a child or teen at this point is the presence of caring and compassionate adults who can listen and support without judgment. Adults who will allow them to grieve in the way that they want to, not how anyone else thinks they should. Teens will tell you there should be “no shoulds”.

Research suggests that child and adolescent bereavement can be internalized as a traumatic event. A trauma response can be considered an even stronger possibility if the child witnessed the suicide, found the body and/or was exposed to emergency personnel attending at the scene of the death. Until the death is ruled a suicide the police operate under the assumption that it might have been a homicide. This in and of itself is incredibly frightening for adults so one can easily understand how confusing and scary this might be when viewed through the eyes of a child or teen.

Telling Children about a Death by Suicide

One of the most difficult decisions that adults face is what to tell the children about a death that has occurred as a result of suicide. Discussing death with a child can be heart-wrenching in and of itself without the added layer of explaining suicide.

Finding an age appropriate response to the truth of the cause of death is the direction that most experts will advocate: there is no need to go into the details of the death but speaking in broad terms in child friendly language is important. There are two primary reasons why honesty, although difficult, is required. Children thrive when they are raised in an environment where they can trust the adults they interact with.

When children are not told the truth of the nature of the death it can have long lasting impacts. Most children are quite intuitive and will feel the disconnect between what they are told and what is really happening, this can further destabilize them at an already volatile time. If a child is not told of the suicide and finds out later they will “re-grieve”, they will cycle back through their grief experience and relive it all over again as they reshape their view of the deceased and those who did not tell them the truth.

Suicide Grief in Children

Children grieve in what is called “grief spurts”, they rapidly cycle through their grief and it may be apparent for only minutes at a time. The child may feel for a moment and then quite happy a short time later. They tend to grieve physically with bursts of excess energy.

The child’s response to death is very much age dependent and individualized, previous loss can also play a role in a child’s understanding of what has occurred. Young children (5 and under) are concrete in their thought processes and will not likely understand the permanence of death until they become older.

Children will express their grief through behavior. Some will act out, some will withdraw, some will become anxious in their attachments fearing something else bad might happen. It is normal to see regression in children who are bereaved (i.e. tantrums in children who are well beyond the “terrible twos)

Unfortunately, many children who lose a loved one are teased and some are seriously bullied. When the death is a result of suicide children too suffer under the stigma of the cause of death. Other parents may create a distance between their own children and the bereaved child. Teachers, too, who are so important in a child’s life, can have negative reactions. In this respect the child can be further marginalized and left without community support at a time when it is most crucial. It is important to teach the bereaved child how to respond if bullying occurs.

Typically the child will work through their feelings about the death through play and art. It can be useful to provide them with a number of outlets to work through their grief. Children are often very physical in their grief so keeping them active can be beneficial. Many care providers might find this difficult as adults tend to see a decrease in their energy while children become more energetic. In these circumstances it is worth considering having a trusted adult or teen to take the role of “playmate”.

A child may express the desire to die as well. This can be very alarming for many adults. Often what the child means is that they want to see their loved one again to be reunited, but it doesn’t mean that they truly want to die. As mentioned, young children don’t fully understand the permanence of death. Of course, if the child acts in ways that indicate something further than a passing desire to reunite with their loved one, medical intervention should be sought.

The child will come to a period where they will attempt to re-organize their life in response to the family changes, and again one might see this primarily in shifts in play. Control issues will often surface in response to their lack of control over the death. It is important to provide the child with as much control over their life as is reasonable for their age.

In our experience, in order to make sense of the death children will try to understand a causal factor. This search often leads them to some distorted thinking about their own role in the suicide. Such thoughts might manifest as: “if I had been a “good” boy/girl Mommy would not have died”, “Daddy died because I didn’t want to go to the movies with him”, etc. Many children, like adults, feel guilt over things they did or didn’t do and what they did or didn’t say.

As the child moves through the developmental levels they will come to understand the death differently and will cycle back and appear to grieve all over as the impact of the loss hits them at deeper and broader levels.

The impact of bereavement of death due to suicide can hit on a multiplicity of levels. Academics can be affected, behaviours can change, psychosomatic issues can manifest, social engagement can shift. It is important to remember that child development, childhood bereavement and exposure to trauma all come together in a very complex relationship where each impacts the other.

Suicide Grief in Adolescents

Along with many of the factors listed above, grief for teens has an added complexity as a result of their stage of development. Adolescents want to fit in with their peer group, this is how they further develop their sense of self. Yet, when death directly impacts their life they are instantaneously different than their peers. When the death is of a peer (classmate or teammate) there is the added component of teens facing their own mortality at a time when, developmentally, they still feel invincible.

The majority of bereaved teens express a sense of isolation and loneliness that seems to be even more pervasive when the death was by suicide. The longer term impact of this experience appears to be a lack of trust in relationships, an overarching sense that they will be abandoned by whomever they connect with. As teens move through adolescence they may develop grieving patterns similar to adults (i.e decreased energy). Often, teens will keep and wear an article of clothing of the deceased. This can cause adults some concern but it is normal.

Teens appear to be exposed to potentially more triggering environments than children. Films viewed or books read at school, activities in drama class and even the use of the term “suicides” as an exercise in gym class can be very difficult for these teens to deal with. Added to that they can feel even more isolated if they publicly react and more closed off if they say nothing.

Helping teens to find a voice to express their experience can be difficult. For teens especially the ability to be surrounded by others their age who have had a similar tragedy touch their life can be very beneficial to their healing process.

PDF

Guide to Talking to Children When Someone Dies by Suicide (MHCC)

Supporting Children and Youth to Grieve After Suicide Loss Kit (CMHA PEI)

Surviving Suicide Loss and Suicide Survivor Support Groups

For more information on suicide, surviving suicide loss and suicide survivor support groups we would encourage you to search the Support Services Directory to find groups in your area and any of the other following websites:

American Foundation for Suicide Prevention

International Association for Suicide Prevention

Centre for Suicide Prevention

Suicide Prevention Resource Centre

American Association of Suicidology