When a child has experienced a significant loss, such as the death of a parent, grandparent or other close family member, that child’s caregiver has a significant responsibility in helping the child to mourn in a healthy way. In my last essay, I wrote about some strategies that parents or caregivers can use with their children in the midst and immediate aftermath of this kind of family loss.

Grieving, however, is not a quick process, and children need support over time to help them process and adjust to a death. Grieving cannot be completed in a healthy way unless the child has space to express his or her feelings about their loss, and for many children that self-expression happens through imaginative play.

Several years ago, before I started incorporating play materials into my practice, I provided the children that I worked with in therapy with musical instruments only. Over time, I discovered that I would be a play therapist whether I wanted to be one or not — all of my small percussion instruments quickly became characters in the various dramatic enactments that my child clients created. One time, a six-year- old child lined up every small percussion instrument in my office — maracas, jingle bells, egg shakers, mallets, etc. — behind a box-shaped drum called a slit drum and announced that this was the funeral procession that was leading up to the burial of the red maraca’s father. I assisted him, per his instruction, in moving the procession of guests toward the imaginary cemetery, located under the piano bench.

This child was working on his feelings about his own father’s death in a very direct, concrete way, but a child’s means of working through feelings of grief through play can be variable, depending on the types of feelings that the child is coping with inside. Caregivers might also witness anger or aggression in a child’s play, where the characters will yell or behave violently toward each other. Play is the way that children express what is happening in their psyche. Often it is a good idea to find a play therapist to help your child work through their feelings with play.

If, as a parent or caregiver, there are opportunities to observe a child at play, healing and restorative themes can also be witnessed. I once worked with a seven-year- old girl whose mother had died in the hospital. When I arrived at her home for our visit, she had gathered every single doll she owned around the bed and explained to me that this was a hospital, and each of these children were here to be treated. She listed their diagnoses one by one, ranging from a broken arm to cancer (the disease that had killed her mother). She then told me that one of those dolls wanted to sing a lullaby to another, and asked me to play the guitar. She began to improvise words and a melody, speaking through the dolls (and, metaphorically, to herself) about why it was going to be okay and how she could be soothed.

A very important task of grieving, once the myriad feelings have been expressed and worked on through therapy, play, the arts, or all three, is to relocate the deceased person and find a way to establish a new relationship with him or her. For many adults and children alike, this means finding ways to connect to memories and feel a sense of the deceased person’s presence. Often we find that connection in religious institutions or at a burial or memorial site, but it is helpful to have other ways to remember and connect to that important person. A variety of art projects or ways of connecting to nature can help children to memorialize the person they have lost, and the final product can be kept as a keepsake and memory of that person’s love.

As a closing thought, it is important for parents and caregivers to remember that a child’s experience of grief can be an ongoing process that changes over time. In addition to changes in intensity as certain feeling states or life adjustments are worked through, a child will be faced with the task of renegotiating the meaning of his or her loss again and again as he or she grows and must address the impact of missing the important person during important life milestones. Imagine, for instance, a ten-year-old who loses her mother. Even if that child completed a healthy grieving process in the couple of years immediately following her mother’s death, she will doubtless revisit its meaning and the corresponding pain when she reaches major life milestones such as puberty, her first romantic attachment, graduation from high school, etc.

Loss is a part of life that is always difficult, but with attention and attunement it is possible for parents and caregivers to make a child’s grieving process one that is ultimately meaningful and healing.

Meghan is a licensed creative arts therapist and a board-certified music therapist with over ten years of experience working with children, adolescents and adults. At her private practice in Brooklyn, she incorporates Depth Psychology, Vocal Psychotherapy and In-Depth Music Therapy to work with children and adults struggling with loss in their lives and with those who are looking for a creative way to understand themselves. Her style of therapy is client-led, and focuses on self- expression through music and/or the creative process. She can be reached at: meghan@brooklynletters.com or by phone at 646-450-1644. Learn more about music psychotherapy at http://MeghanHinman.com

Most parents hope that they will never have to see their young children exposed to the pain of loss. But we live in a world where life is finite, and many families with young children are faced with the difficulty of coping with the death of someone close. Parents and other caregivers often struggle with how to address and support a child’s grieving process, which is especially difficult and complex when the parents are having their own painful experience of grief at the same time.

Anyone who has lost someone close has learned that grieving is a process that takes time, and necessitates difficult tasks. We have to accept the reality of our loss, experience the pain and other emotional aspects of the loss, adjust to an environment in which the deceased is missing and, eventually, find a new way to relate to the deceased person. Children need to work through these stages just as adults do, but a child’s experience of these tasks will be different depending on their cognitive and emotional development. Death is a taboo subject in our culture, and talking to children about death can be extremely frightening for parents. But when a death has occurred or is imminent, it’s vital to speak openly with children, allow them to ask questions, and give developmentally appropriate answers.

How do parents identify developmentally appropriate answers? Well, some of it is about knowing your child. But it also helps to understand what happens in typical emotional and cognitive development. For instance, most children under five years old haven’t grasped the concepts of permanence and irreversibility– that means that you may need to repeat “Grandma has died, and she won’t ever come back” many times, over a period of months, before your child can understand what that means. Many children under five years old are also prone what is called “magical thinking,” ascribing meaning and/or causality based on fantasy. This could take the form of a thought like, “I told my teddy bear that I hate my mommy, and that made my mommy die,” or “something bad happened to Grandpa because I wouldn’t give him a hug.”

Children who are 5 to 7 years old are most vulnerable to the negative effects of grief, because they are mature enough to understand the concept of death, but they haven’t yet developed the ego or social skills to cope easily with the resulting emotional experience of grief. The most common emotions experienced by grieving children include sadness, anxiety, guilt, and anger– and these emotions may emerge immediately after a death, or not until 1-2 years later. Children may worry about their personal safety or the safety of other family members, they may worry about abandonment, and they may experience teasing from peers.

So what can help a child to get through a grief experience most effectively? The answer is support, nurturance, and continuity. Especially after the death of a parent, bereaved children rely strongly on their surviving parent, and are greatly affected by the functioning of that parent. Participation in grieving rituals– such as attendance at funerals, and even help with planning– is extremely helpful in leading children to understand and adjust to a death. Children also adjust better after a death in the family if they have had to cope with fewer daily life changes, so trying to maintain routines can be of vital assistance.

The most important thing that a parent can do for a child who is grieving is to really tune in to what the child is thinking, feeling, and experiencing. A child who has experienced a loss needs extra security and validation, which comes from feeling understood and heard during the grieving process, especially by the child’s parent. This can be challenging when the parent is also experiencing his or her own grieving process, and other family members as well as grief counselors can help. That most important piece, though, is the parent-child love and attachment, and its ability to prevail and sustain even in the midst of grief and tragedy.

In my years of working with children who have experienced loss, I’ve watched kids and parents alike struggle with the complex and intense emotional processes of grief. It’s truly a process that can only be moved “through,” and not avoided, walked around, or hurdled over. But in healing grief, and in walking that difficult road together, kids and parents can form even stronger ties to each other, and approach life with true appreciation for what can be felt, shared, and experienced.

In a future post, I will write more about how children can adjust to grief over time, how families can help their children to develop and nurture an ongoing relationship with someone who has deceased, and how grief counseling and music and play therapy can help children who are coping with complicated grief.

Meghan is a licensed creative arts therapist and a board-certified music therapist with over ten years of experience working with babies, children, adolescents and adults. At her private practice in Brooklyn, she incorporates Depth Psychology, Vocal Psychotherapy and In-Depth Music Therapy to work with children and adults struggling with loss in their lives and with those who are looking for a creative way to understand themselves. Her style of therapy is client-led, and focuses on self-expression through music and/or the creative process. She can be reached at: meghan@brooklynlearning.com or by phone at 646-450-1644. www.brooklynlearning.com