To decide when to apply the one or the other method rests with the analyst's skill and experience. Practical medicine is, and has always been an art, and the same is true of practical analysis. True art is creation, and creation is beyond all theories. That is why I say to any beginner: Learn your theories as well as you can, but put them aside when you touch the miracle of the living soul. Not theories, but your own creative individuality alone must decide. ~Carl Jung, Contributions to Analytical Psychology, Page 361

Tuesday, September 13, 2016

How Children Mourn

Notes on Grief

My notes ----------Taken from C. Lighter & N Hathaway - Giving Sorrow Words

Once a death occurs some people plummet into grief others become numbed thus  postponing  the pain. Some spend years submerged beneath the weight of sorrow, other balance precariously on the edge of anger.

Paradoxically the more ambivalent the relationship, the more difficult the mourning may be.

Beneath the sobbing or stoicism, the anger or acquiescence, the guilt or even gratitude, there lies a pattern.

Three phases of grief: avoidance, confrontation, and re-establishment  - T. Rando

4 Phases - numbing, yearning and search, disorganization and despair and finally reorganization. - J. Bowlby.

Kubler-Ross - denial and isolation, anger, bargaining, depression, and acceptance.

Like all defense mechanisms, the most common of all DM,  DENIAL keeps fear and anxiety at bay.

The defense of numbness anesthetizes the pain, allowing the Psych a little time to absorb the magnitude of what has happened. Numbness can come and go.

Using denial guards against the fear that if they stop denying what they feel, the lid will come off the emotional tornado.

Denial is born out of the desire to feel better fast, to be done with the pain. Puts the pain off until we can deal with it.

The main task at the beginning of mourning is to accept the reality of the death.
By giving sorrow words we start to accept what has happened and to release some of the pain.

Idealized portraits can be constructed in mourning as we play over and over again special moments even those at the time that was unremarkable.

Many people avoid the murkiness of their emotions and instead turn towards action. This only represses their grief. For no matter how hard you try it is impossible to ignore grief. One way or another it demands expression.

Fear is a natural component of grief, once you have experienced the death of a love one; you know the world is not a safe place

Those that are harsh with them attempt perfect 24hr care of the loved one, unconsciously hoping they can save the person, and they feel that nothing they do can ever be enough. They often want to avoid the feeling of guilt after the death. Guilt is not something you can utterly avoids. No matter how much self-sacrificing and saintly you are, when death occurs, you will be alive and your loved one is gone. If there are specific actions you can take now to reduce guilt later, do so. No one is superhuman; we do the best we can.
Adult siblings caring for a dying parent often exposes the rivalries of childhood. Some unable to cope with reality, with what is going on drop out entirely; others take charge. Grabbing the reins of responsibility in their own minds, becoming a tyrant in the minds of others.

The death of a parent shifts responsibilities to the child; the emotional underpinnings we have relied on our entire lives are gone. Unbuffered by parental protection (even if only symbolic) we feel the harsh winds of reality.

I spent my lifetime thinking I was somebody's child. But I was nobody's child.

I was angry with my Father for having shunned me when I was a child. It made me feel worthless and those entire feelings rose to the surface with a sudden and violence caused by his unexpected death. I needed his approval and never got it. His death removed the possibility that I ever would.

It is sad but also reassuring that the death of a parent can be an opportunity to do what we want without parental interference or disapproval. It can open the door to our own individuality by offering a form of freedom. I'm on my own now, what do I do? Or one could say I now don't have to worry about living up to someone else's expectation, no one is looking over my shoulder. (Although  you could have been ignoring your parents over the past 30 years.)

I could never please my Mother. She was so highly critical of me that when she died, I felt complete freedom to do what ever I wanted to do without harsh judgment. Her death allowed me the freedom to grow in self-confidence. In the presence of death we become more aware of life and then to seek it. The value of death is that it can inspire us to decide what are really matters in life and then to seek it.

My mind is scattered in a million different directions, emotionally, physically, and mentally. The pain was so severe. But I have come to realize that you cannot run from the pain.

Anger, guilt, relief and idealization.

Many people avoid painful memories and feelings by idealizing the deceased. In most cases, idealization is strong at first but then tapers off. People over idealize because it is unacceptable to them to feel ambivalent or negative feelings. But when it continues, it's a problem. Idealization creates a totally unrealistic image, a fantasy that prevents people from going on. They become stuck, immobilized by the fantasy and by guilt about their anger. They become depressed. They have difficulty connecting with other people because the more someone is idealized the more everyone is measured against them.
Many tend to discharge their emotions through work. Instead of mourning many will pull back from their powerful and frightening emotions but nevertheless they will feel them and redirect them into such maladies as headaches, backaches, insomnia, high blood pressure. Societal expectation reinforces this; "one must be strong, at the same time to provide emotional support to others. They must suppress their emotions. Many retreat into a conspiracy of silence. This is often what happens when people love each other so much they don't want o t hurt each other. In other worlds that stop communicating.
Much of personal anguish is the birth struggle to find the real self, the new self after a death. The new self is shaped by grief, they grow, and their values change. Experiencing death for the first time also allows for experiencing life. Paradoxically that grief can make one stronger. Once one survives this deadly wound, this insult to their lives, they stop sweating the small stuff. They are more direct. They know they have a right to being treated with respect. They believe in their own dignity. They become more forceful in a strange way, more powerful. Once you have survived the death of someone you feel you can survive anything.

Relationships between siblings are always complicated and ambivalent. Identification between siblings are strong and so too the rivalry. Siblings have to deal with guilt and anger that goes way back.

I felt so helpless, at the death, as I felt so ultimately excluded.

There is usually a mixture of love, anger, guilt and sorrow. (Mad, Sad, Bad, Glad) The difficulty is in resolving these emotions.

How children Mourn.

They respond to the death of the chief caregiver just as they do to other separations, they cry and show distress, a reaction that diminishes when someone whom they trust takes over the responsibility for their care. The initial response is protest, hoping the parent will return. When this doesn't happen they may sink into despair, losing interests in everything around them. If they continue to be deprived of nurturing they shift from despair to detachment. The parent must anticipate the children needs.
The grief of children is colored by fear. The world is now seen as an insecure place. They fear further abandonment; they may worry about their own demise. In response to these fears the child, particularly younger then 5 will respond by clinging, and being very demanding, often they regress.

Children often feel guilty because, egocentric little creatures that they are readily conclude that Mommy isn't returning because of something they did. They use magically thinking. They remember their negative thoughts (I wish you were dead) and they may conclude that there wish many have caused their death. It is their fault. They bear these thoughts silently. Children have to spread it over time. They grieve intermittently and often invisibly. As they grow, in each new developmental stage can revive their grief and caste it into a different light. The process of identifying with and thinking about the deceased undergoes many shifts over the course of their lifetime. The child who is not told and left to figure it out on their own, to grieve in isolation, without the support of family members. Not telling spares the child no pain; the children know that something is wrong.

Young children are frequently told lies and evasions, sometime purposely, by adults whose own fear of death makes them instinctively repress all thoughts and feelings. Children who withdraw need to know that their feelings including fear, anger, and guilt are perfectly acceptable to you. They are afraid of their own reaction, motivated by fear of losing control. When the child's world is so thoroughly threatened, shutting down their emotions may be the only solution. In families in which the adult subscribes to repression, children likewise feel compelled to hide their sorrow, they are emotionally abandoned. They are grieving in a situation that recognizes neither their feelings nor the facts.

To help a child express their feelings the parent or someone else must be able to express their own. A child takes their cue from their parent. How can the child identify their own feelings if the parent cannot either? And are willing to be vulnerable enough. They instead go on doing all those things that keep the peace, doing all those things that please the parent.

But that initial compliance later turns into rebelliousness, acting out. Beneath the tough exterior there lies a broken heart and a guilty conscious. Acting out has its roots in anger, guilt and fear. That the child may be unable to express in other ways. It is important not to hide your own fears.

Bereavement in Childhood is a catastrophic experience, a threat to their basic survival. Even a brief separation from their primary love object activates anxiety and a dreadful anticipation of deprivation of the most basic needs. It is simply emotional shock of the deepest kind.

The immediate response is pervasive denial that the event has occurred at all. Detachment, actually leaving the scene psychologically removes them from the reality of the loss. As the children attempts and always fails, extreme feelings of helplessness, hopelessness and unworthiness become pervasive. If the child cannot integrate the loss, long lasting and persistent behavioral changes may occur.

Young children at this time are attempting to separate and gain control of their own thoughts and body.  During this time their thoughts take on a magical quality. They often believe that their thoughts influence outside events. This is a boundary issue. What is mine, what is yours and what is ours. The two basic instincts, love and hate are felt intensely. If the child hates by wishing the parent to go away, when they do, the child is left wondering whether it was his influence that made them go away. This then is where guilt comes from. Ones hate drove the parent away leaving the child believing he is bad and responsible for this.

When the loved one does not return they often reason that the love one does not wish to, do not wish to be with them. They feel unworthy and that the parent does not care for them. There is of course a sense of abandonment. They become convinced that it was their own misdeeds or evil thoughts or misbehavior that caused such a catastrophe, hence guilt and the start of OCD, and pleasing behaviors. The child is concerned with who is to blame for the abandonment and their conclusion is that they are. There is a sense of culpability in the death of the parent, which of course gives rise to hopelessness, anxiety, feelings of badness and hence being unlovable. In the child mind, their abandonment is proof that they are unworthy of love and care and they may actively seek punishment (masochism) as a way of atonement. Self-identity, self-esteem goes down.

 The developmental stage of initiative versus guilt is interfered with.  Their former security in the world is lost and the world becomes a hostile and unpredictable place. In future any losses many trigger the original loss, with regression occurring. It is the memories of these early losses, and its accompanied bewilderment, confusion and anxiety that return. Any aggression is now viewed as dangerous, destructive therefore they respond by attempting to control their emotions and impulses in a very rigid manner. Often the lost parent is idealized and the child will retreat into a world of fantasy that only included the child and the dead parent.

Mourning is the most intense process the people go through. Grief is complex and primal. The only way through is expressing their feelings. If one faces their grief they will be able to make room in their heart for hope and happiness. If you suppress it sticks around forever. No matter how much time has passed it can always spring to life at any moment. A death in childhood is the hardest blow of all.

To grieve one must experience not just sorrow and loss, but anger and guilt. The future is a blank to most people, before they can move ahead they must look back, they must grieve.


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