A Psychological View of a Child’s Loss of a Mother to Breast Cancer

From ages five to nine, a child’s notion of death is personified and the child will often avoid discussion of the topic. Children of this age have trouble separating the “deed from the doer” and will often believe that death is a punishment for his or her own deeds or thoughts. Sometimes, the child may not understand that death is permanent and continue to grow with the concept that the parent that has died will be back somehow.

At ages nine or ten, the child begins to understand that death is inevitable and affects all people including himself or herself. All of the above factors lead children to experience what is called a “cascade” of significant life changes in how they view the world and all areas of their development are impacted in both the present and the future. Helping a child who has lost a parent to breast cancer stretches the abilities of even the most experienced and skilled therapist.

Tasks During the Grief Process:

Task 1: To accept the reality of the loss. Like adults, children must learn to believe that the dead are actually dead and will not return to life before the child can deal with the emotional impact of the loss. Young children may believe that the parent is away on vacation or asleep and will wake up someday.

Task 2: To experience the pain or emotional aspects of the loss. Children need to approach this task in a way that does not exceed their coping skills. They may “act out” with aberrant behaviors. It is important to address the feelings of responsibility that children may experience, and they may even have ambivalent feelings that need to be addressed.

Task 3: To adjust to an environment in which the deceased is missing. The mother is frequently the child’s caretaker and primary confidante. As aspect of mourning is for the child to adjust to not being cared for the way his mother has cared for him. And as girls grow older, they understand that they no longer have a mother to talk about bodily changes during puberty.

Task 4: To relocate the dead person within one’s life and find ways to memorialize. The child or teen must learn how to transform the connection to the deceased parent and view the relationship differently, rather than separate from the dead parent. They can learn that the parent is “not dead in my heart.” According to researchers, there are many variables that predict how children handle the loss of a parent, particularly a mother. The following represents a discussion of these important predictors of adjustment, with an emphasis on the loss of a mother:

Type of Death: When a mother dies of cancer, the death is not sudden or unexpected. Often the family and children are aware of the apparent signs of the illness. The children may begin to separate prior to death if the mother has a prolonged stay in the hospital. And where families that lose a family member to a trauma may become more cohesive after the death, this is often not the case after an extended illness. There are significant stressors on the entire family during the time of illness.

Funeral Preparation: Children who were not prepared for a funeral by being told what to expect were more likely to show disturbed behaviors such as poor self-concept and poor functioning two years after the death of a parent. They also appear to have greater difficulty talking about the dead parent.

Gender of the Parent: While the death of the father brings many stressors: the death itself, the economic impact on the family and other often dramatic changes, the death of the mother has a set of stressors that can have the greatest impact on the family when the mother has been the primary caregiver. Children who lose their mothers tend to experience high levels of anxiety, lower concept of self, and higher levels of tension in the home due to such things as worry about the safety of the surviving parent.

Pre-death Relationship: Another important variable that is predictive of the impact of grief is the pre-death relationship of the child with the deceased parent. This would include attachment and the level of conflict between the child and the deceased parent prior to death. The emotions encompassing attachment or conflict can have great effects during life, and may generate significant distress upon death.

Discipline: Setting limits with children is difficult and even more challenging when one feels sorry for the child who is grieving. Disciplinary problems often begin prior to death when the healthy father is struggling with the stress of his terminally ill wife and mother to his children. Some fathers become over-controlling in an effort to control a situation that feels beyond control. Other fathers may become over indulgent due to a sense of guilt or sometimes because he is depressed, withdrawn and depleted from the death of the spouse.

Gender of the Child: Girls tend to show more anxiety than boys two years after the death of a parent. They tend to worry about the safety of the surviving parent, and are more sensitive to family conflict almost immediately after the death of the parent. Girls tend to idealize the deceased parent and keep objects that belonged to the dead parent. Girls also tend to experience more physical problems. Boys are more likely to evaluate their own conduct as worse than their friends and they are more likely to have academic problems.

Gender Match: Girls who lost a mother may be more likely to identify with the deceased mother. They tend to view themselves as more mature; however, they tend to experience more emotional and behavioral problems within one year after the death. Interestingly, after two years, girls tend to display behaviors that they believe would be pleasing to their mother. Boys who lost a mother felt more fear about the safety of the surviving parent in the first year after death and reported more health problems. These responses seem to subside after year two.

For teens that lose their mother, there is a sense of loss of the person who organized the household, provided opportunities to participate in sports and other peer activities, and helped with homework. They deeply miss these relationships, and sometimes resented having to assume some of those duties and responsibilities within the family. For older teens, boys sometimes tested limits and displaced anger upon the surviving parent.

In summary, the cascading effect of the death of a parent is displayed most within one to two years after death, and the developmental impact of those effects can be life long depending on the severity of the impact and appropriate psychological intervention.

References:

Christ, G.H. (2000) healing children’s grief: Surviving a parent’s death from cancer.
Clark, D., Pynoos, R. & Gobel, A. (1994) Mechanisms and processes of adolescent bereavement.
Haggerty, R. Garmezy, N., Rutter, M. & Sherrod, L., Stress, risk and resilience in children and adolescents: Process mechanisms and interventions (pp. 100-146)
Nagy, M.H. (1948) The child’s theories concerning death. Journal of Genetic Psychology, 73, 3-27.
Nagy, M.H. (1959) The child’s view of death. In H. Feifel, The meaning of death.
Worden, J.W. (1991) Grief counseling and grief therapy: A handbook for the mental health professional.
Worden, J.W. (1996) Children and grief: When a parent dies.

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