Intense grief reaction

Children who have had Reactive Attachment Disorder and been successfully treated will still continue to have grief and loss issues. This an area of sensitivity and will be more evident when the child is under stress. At these times increasing the amount of reassurance, affection, and physical contact can be very helpful. Providing the child with more certainty and consistency are two other helpful strategies. Finally, verbalizing for the child what may be creating emotional conflicts can also help. But, primarily, it will be increasing affection and security-enhancing interventions that will be most effective. Good to hear from you. Best wishes,

Hi Dimasmom and Dr. Art: Grief and loss and the fear of it seem to be big issues. Sometimes when my children have fears of what will heppen in the future in a given situation it can be emotional and they do not know what to do. For example my daugher fears that she will not get the classes she wants when she puts in her request for schedule change. To her this matters quite a bit. What I do is try to have her "talk" about what is on her mind about the uncertainty. Then we talk about how it could go and many of the various options of how it could go. Then we talk about what the "trend" or history has been in similar situations and what did she think about that. We talk about what steps we would take towards betterment if an option came up that she did not prefer, etc. This seems to calm her. It is interesting as she feels calmer on one fear then another one will be verbalized then another and so on. It may be a long talk but that it okay. I have to really concentrate on not overreacting to her fears or dismissing them as they are real to her. Her inexperience in life in general and her detailed type of thinking is what seems to bring the fears on. Correct if if I am wrong on this, Dr. Art. In the case of my daughter she was fearing the "loss" of a school schedule that she would like and fearing having to go through a semester with a difficult or displeasing schedule. She is sensative, choleric and a wonderful daughter. Dr. Art do you have some pointers for parents to help their children talk out their fears? Also, do you have some pointers on the most helpful responses as our children become verbal about their fears? Thank you I very much appreciate your help. Warm regards,

When talking about fears, loss, and grief there are several things parents can to do help their children. Don't start out by trying to "make them feel better." When you try to convince your child that there is nothing to fear you imply the child's feelings are not valid. Begin talking with your child by exploring what your thinks and feels. Using acceptance of the feelings and curiosity about what the child thinks and feels, what the child is afraid of, what the child thinks may happen, etc. you allow your child to feel understood and you authenically understand your child. This is vital. Don't rush into fixing the problem. You need to be sure you understand the meaing of the fear. For example, "Oh, you're afraid of the dark because you think a bad person will come along and get you." Once you have a clear view of what your child's fears are about, you can use empathy to normalize the fear or behavior. "Oh, I can really understand why you cry so much when we say goodnight. You're thinking that you'll be left alone...that's pretty scary." Then you can talk about strategies to effectively manage the fear and provide reassurance.

Hi Dr.Art: I very much appreciate your directives. Helps immensely. I like the way that your directive included what occurs in the child as you wrote in your answer: "Once you have a clear view of what your child's fears are about, you can use empathy to normalize the fear or behavior." Thank you very much for increasing my understanding of "why" empathy is important. Very helpful advise. Best regards,

Thanks so much Art and Sabra. Fortunately my son did well at accepting my guidance to talk about his feelings. He was only able to identify sad on his own. I added in a few other, more complex emotions like abandonment since he's ready to move past the 4 basic emotions. We've tentatively planned a dinner with his TSS for a few weeks from now. I've done this in the past when he was struggling with the loss of a teacher at the end of the school year, and it helped a lot. Plus we're in a very rural town, and the reality is that he will still see his TSS periodically. At least for my son, processing his feelings, plus something to look forward to seems to help a lot. It's just so heart breaking to see my son bottom out after a pretty good summer. For the most part, I was convincing myself that he's just a regular kid who really doesn't need the extra supports. He really does well when his needs are met. It's when they are not, that his issues become apparent. He has another loss coming up that I am holding off on sharing with him just yet. His outpatient OT for the past year, is now going to be totally school based, so we can no longer work with her. She's wonderful, and despite the 2 1/2 drive to OT, he loves going. I'm not sure if we can even get in a farewell session, although she's so wonderful that we can probably do the dinner thing with her too. I'm just going to wait until he settles into the new school year to drop that bomb. Thanks for the support!

Dimasmom, I'm intrigued by your story. How old is your son? How long have you been working on the abandonment issues with him? Just starting off at our home, it would be nice to hear your story. Thanks, Jane

Hi Janeliz, and thanks Sabra for tipping me off about this post, for some reason I wasn't automatically notified via email? My son was 3 yrs 9 months old when we adopted him. He will turn 10 in a few weeks. He spent the first almost 4 years of his life in a Russian orphanage. Then we wisked him off to what might as well have been another planet. He adjusted well initially, then with the loss of his Ukranian babysitter, started to show intense grief. By the time my son turned 5 he was becoming violent and difficult to manage. Several therapists later, we started working with Art. My son was almost 8 by then. In less than 1 year, he fully resolved his attachment disorder. I think this gave him enough stability to face the bigger abandoment issues of loss of birthmom. My son showed grief for his birthmother on and off most of last year. This is not a bad thing. It's just part of life as an adoptee. For my son to move forward in his life, he has to come to terms with the loss of his birthmom. I am part way through reading "Primal Wound" which talks about the innate love for a birthmom. I definately see this in my son. He has likely never seen her and yet he aches for her. In a discussion of wishes and dreams at camp this summer my son shared that his wish was to have a picture of his birthparents. Things are more complicated with my son. The resolved attachment disorder leaves some scar tissue behind. He is much more sensitive to loss issues than the typical kid and likely more so than the typical adoptee. He also has bipolar disorder which is responding well to medications - but leaves him more sensitive to the normal everyday ups and downs in life. I hold my breath as our next big loss is on the horizon. A dear friend of mine is very close to death. She is loosing her battle with cancer. She probably won't make it through the night. I shared this with my son today, when I got back from the hospital. We are very close with the entire family and I know my son is already struggling with this. He spent the entire time I was gone, just laying in bed or on the sofa. I was able to perk him up and get him engaged in activities once I got home, but know he will struggle immensly with Kelly's death. Loss is just a part of the adoption picture that differentiates our families from those formed by birth. We cannot deny the impact loss has on us or on our children. We just need to support and guide and permit our children to grieve. It's essential to their well being. Dimasmom