When a child dies, how do we stop the pain?

THE EDITOR: In a conference room in Atlanta a few days ago, the young doctoral student from Singapore asked the first question: What do you call a woman/man whose spouse has died? A widow/widower. OK. Now what do you call children whose parents have died? Orphans. The third question was: What is the name given to parents whose child/children have died? There was no answer.

She went on to discuss the trajectory of parental bereavement in that Asian country, the first study done of its kind and I thought, Singapore?

That country is often cited as a high-income economy with a good reputation and strong global growth but there is the recognition and only recently, that more attention, money and policies needed to be put in place for workers who have lost loved ones, especially their children, and to combat mental health issues such as depression which was directly related to one’s grief and loss.

The Child Bereavement Support group was soon established to “work with the medical and care professions to provide sensitive and compassionate care to bereaved families.”

Over the last few weeks in Trinidad, many parents have lost their children to chronic illness, accidents and senseless acts of violence: the family tragedy in Toco; the young woman fleeing an abusive relationship; the young man gunned down in Laventille; the car accidents of young men falling asleep at the wheel; the deaths by suicide and drowning; and the list goes on.

It is estimated that for every death, 137 people (immediate and extended family, friends) are grieving the loss and the number is higher when a student has died, as his/her peers also grieve a death which they consider to be incomprehensible. “How can a young person die? That’s not the ‘natural’ order of things, is it?”

In the aftermath of these local deaths, the families were reported by the newspapers to be in a state of shock, rage, disbelief, horror and grief, unable to believe that the sudden loss had occurred. What is not reported at all is what happens after this initial loss, the plunge into a tunnel of darkness that life does not prepare us for, until it happens.

The period of mourning begins – the words left unsaid, the awkwardness of colleagues and friends who don’t quite know what to say and do, the relationships between parents which may begin to unravel as blame and anger sets in, the loneliness, withdrawal and pain.

How do we stop the pain and the brokenness? How do I continue without the presence of my loved one? When there should be five at the dinner table, now there’s four. Do I forget him? How can I stop loving her?

We grieve because we have loved. Parents who have lost their children are most vulnerable – we expect our children to bury us, not to bury them.

Complicated grief is a mental health disorder where there is a constant rumination about the circumstances of the death, especially if the death was sudden and unexpected, or violent. Without intervention, complicated grief can lead to severe depression, substance abuse such as alcohol abuse, post-traumatic stress disorder and even suicide.

One mother who lost her daughter to suicide admitted that she neglected her other children and was unable to resume her “normal” life; she did not want to be joyful and was preoccupied with thoughts of death. Her devoted husband was unable to understand her pain and became withdrawn and isolated from his family. The younger boy, aged 12, asked me, “Doesn’t Mummy know that she has two other children to live for? Why can’t she be happy? Doesn’t she love us too?”

In this country, support is needed for parents who have lost children despite how old the child may have been. The pain that surrounds shattered dreams is no less, whatever the age. A Child Bereavement Support group can be started by bereaved mothers and fathers.

Community support can be given, through providing breakfast and lunch in the aftermath of a loss, or helping with the other children to take them to school or with homework; religious groups if the family allows for prayer rituals; being present even if for silent support; listening without offering advice and only if asked; offering to help for as long as you can.

Grief does not go away when a child dies. However, it can be managed and the families can be supported. Let us rally around those people who have lost their loved ones.

DR MARGARET NAKHID-CHATOOR

clinical and educational psychologist

president (TT Association of Psychologists)