LISA CLARK: Thank you for joining us for this webcast. I'm Lisa Clark. When there is a death in the family, everyone takes an emotional hit. But the impact can be especially intense on children, who not only have to deal with the immediate loss of someone they love, but they are also vulnerable to many fears which may never occur to an adult. For the next few minutes we'll take a look at how you can help a child who has been devastated by loss, whether it is your own child or someone that you care about.
Joining our discussion this evening is Benyamin Cirlin. He is a clinical social worker and the executive director for the Center of Loss and Renewal in New York City. He is also the coordinator of bereavement services at Jacob Perlo Hospice of the Beth Israel Medical Center. Welcome, Benyamin. Also joining us is Patty Donovan-Duff. She is a registered nurse, and she is the director of the Bereavement Center of Westchester, where she has also done a lot of hospice care. Thank you so much for being with us as well, Patty.
LISA CLARK: I have a recent example of a child dealing with grief. I had a good friend who passed away a year ago, and he left behind his wife and his 6-year-old son. Now, this child was very much included in the process. It was a long term illness, and he was aware of what was going on and participated at the funeral. The issue for him now seems to be dealing with the fear, which he expresses in many different ways, that he's going to be left by his mother now. Is that very common?
PATTY DONOVAN-DUFF, RN: Oh, yes. In the children that we work with, that comes out universally, the worry that the other parent is going to die. In the groups that we run simultaneously, the adults are talking about the same thing. They're worried that something's going to happen to them, too. When we put the two experiences together, we have found that-- children are very selfish by nature, and certainly in their grieving they are selfish also-- they are really mostly concerned with "What would happen to me if that parent died?" It's not the sadness about losing the Mom-- that's there as well-- but it's more, "Where would I go?" So we encourage the parents, actually, to approach that subject with the children, maybe saying, "You know, Mommy's probably going to live for a long, long, long, long time, but just in case you wanted to know, you would probably go with Aunt Sarah if something happens." That's all they want to hear, and they want to be able to say, "Not Aunt Sarah, Aunt Beth." They can't really --
LISA CLARK: Verbalize?
PATTY DONOVAN-DUFF, RN: Right. Of course, that makes us very sad. They just really want to know what's going to happen to them.
R. BENYAMIN CIRLIN, CSW: One of the things that happens when a death occurs is that death no longer remains a rumor. It's a reality.
LISA CLARK: They're faced with the reality.
R. BENYAMIN CIRLIN, CSW: Adults as well as kids have to deal with that.
LISA CLARK: How able are children-- I guess this is very dependent on the age and the mindset of the child-- to accept the permanence of death, that that person isn't coming back?
R. BENYAMIN CIRLIN, CSW: Correct me if I'm wrong, Patty, but I think pretty much it's not until a child is 9 or 10 do they have the cognitive capabilities to really understand the permanence of death. Children who are 2, 3, 4 really think that death is not permanent, that the person is going to come back. It's really into the latency years when kids begin to see that this really is forever.
LISA CLARK: We've talked a little bit about the grief and the fear that sometimes attends a child at this time. What other ways may they express anxiety about what has happened? Anger?
R. BENYAMIN CIRLIN, CSW: You'll have kids engaging in regressive behaviors. A young child might have been toilet trained, but then you'll see following the death that they'll start bedwetting, that kind of thing. Kids become much more clingy. Anger gets expressed at school in biting and fighting and all kinds of irritability. You have a lot of fears at nighttime around sleeping.
LISA CLARK: Well, I'd like to thank both of you, Benyamin and Patty, for being with us and for your insight into helping children grieve. It's a very important process for all of us, but especially, I think, for children, because they have to deal with this for their entire emotional lives. Thank you again. Thank all of you for joining us. I'm Lisa Clark.