At a loss to explain

12th December 1997 at 00:00
The best way to help bereaved children is to tell them the truth, writes Victoria Neumark

Sarah was six when her mother died. Although it had been expected - her mother had fought a long, painful battle with cancer - the shock was great. Before her illness, Sarah's mother had been a lively, involved parent, always chatting to her children and the other adults in the playground. Now Sarah was being taken to school by her father and picked up by her aunt, both of whom were very low in spirit and neither of whom seemed to answer the little girl's questions.

One day, Sarah asked her teacher, "Where did my mummy go?'' Not wishing to interfere with the family's handling of the bereavement, the teacher avoided answering. Sarah became quieter and quieter. Perhaps to avoid painful memories, the family moved away when Sarah was eight. When she was 12, she was admitted to a hospital in-patient unit. She had been cutting her arms. At this point, she received some psychotherapy.

It took some time for Sarah to start trusting the therapist. When she did, she asked, in the same words she had used six years earlier, "Where did my mummy go?'' It transpired that, for whatever reason, her father and aunt had never told the little girl the cause of her mother's death. She had not seen the body nor gone to the funeral.

Deprived of any explanation, Sarah had pieced together her own, magical version of events. She knew her mother had been ill and in hospital, knew that she had been cut open to make her better. She also knew that she, Sarah, had been told to be quiet, because she might disturb the patient. So she decided that if she was very quiet, her mother might come back. After some years of this not working, and of no other explanation being offered, her misery and unresolved grief had turned inwards and she had begun the cutting, feeling that this might make her feel, in some sense, better, as it had been meant to make her mother better.

Benjamin was also six when his mother died. The youngest of five, he had been especially close to her. His family was insistent about involving the child in their grief because, as they said, "He feels it the most, he was with her all the time". Benjamin saw his mother's dead body and commented, "She can't cuddle me now". He went to the funeral, holding on to his married sister's hand.

Benjamin's father, who was often away on business, imported his own mother into the family, and she took over the role of the dead mother. She was a large, comfortable woman, who was not very assiduous in listening to her grandson read. One day, the teacher tackled her about this, and suggested she should help Benjamin with his school work. She replied: "My Benjamin has other work to do, remembering his dead mama."

The teacher felt this was morbid and was uncomfortable with signs of regression, such as Benjamin sucking his thumb. She felt he would benefit from a "clean slate".

However, as time passed, Benjamin changed. About a year after his mother had died, he was seen playing football. Two years after that, he started walking to school by himself. By the time he transferred to secondary school, only his kindness towards other children who were upset differentiated him from others in his class.

Two stories, two different ways of adapting to child bereavement. Clinical research shows that adults can best help bereaved children by telling them the truth, involving them in the family process of mourning, comforting them physically, and encouraging them to remember all the good things about the dead person and their relation to the living child.

It is much better to see the dead body than to spend decades wondering if the loved person is really dead, just as it is much better to ask all those difficult questions than to "cheer up''.

From the point of view of education, it is much easier for a child to go back to learning in school if he or she has true information about important life experiences. Children need to discuss what has happened with caring adults, not to start with a "clean slate'' as if the loved person had never lived. It is far more "morbid'' to pretend nothing has happened when the whole world has just collapsed.

There is a happy ending to the story of Sarah. At a family meeting, she demanded that her father tell her how her mother had died. Very reluctantly, he shared his account of her last few hours and explained how he had wanted to keep the evidence of so much pain from his young daughter. Sarah was able to accept this and stop blaming herself for her mother's death. She returned to school and made good progress.

For further information contact the Child Bereavement Trust, Harleyford Estate, Henley Road, Marlow, Buckinghamshire SL7 2DX. Telephone: 01628 488101

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