S Supporting Young People Coping with As the importance of emotional literacy is better established in schools as a u p p prerequisite for improving achievement, the PSHE and Citizenship curriculum is o r increasingly used to offer young people opportunities to express and manage their tin Grief, Loss and Death g feelings. This book, by two experienced and talented authors, has been derived Y o from their research and practical work with teenagers. The aim is to provide A u k n o students aged 11 to 18 with an opportunity to: L g o u P B c e o • understand about grief, loss, and death k p k y le c • recognise, manage and express the range of feelings associated with grief, D C u Deborah Weymont & Tina Rae o D u p loss and death c in y k g k • learn more about the afterlife beliefs, death rituals and funeral customs of w c B it u major world religions o h L o G k r A • promote mental health and resilience. ie f , L o Most important is the emphasis on the development of emotional literacy skills and s s specifi cally the development of an emotional vocabulary, empathy, tolerance, and a n d resilience. The focus on death and loss and the process of grieving is central to the D e course. The way in which the supporting materials are illustrated and designed for a t h easy differentiation is also a key feature. Facilitator notes, copiable activities and all resources are provided for the twelve sessions, which can be delivered to either the whole class or to smaller groups of D students. e b o Deborah Weymont is a teacher and art therapist based in Bristol. r a h W Tina Rae is a Senior Educational Psychologist based in Hillingdon. e y m o n t & You may also be interested in: T in a Remembering R a Providing support for children aged 7 to 13 e who have experienced loss and bereavement Lorna Nelson and Tina Rae ISBN: 1-9043-1542-9 11 to 18 year olds Printable worksheets CD-ROM www.luckyduck.co.uk grief loss death_COVER.indd 1 17/5/06 14:33:02 Supporting Young People Coping with Grief, Loss and Death A Lucky Duck Book grief loss death_INNER.indd 1 18/5/06 15:04:19 grief loss death_INNER.indd 2 18/5/06 15:04:20 Supporting Young People Coping with Grief, Loss and Death Deborah Weymont & Tina Rae grief loss death_INNER.indd 3 18/5/06 15:04:20 © Deborah Weymont and Tina Rae 2006 First published 2006 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. Rights to copy pages marked as handouts, certificates or overhead foils are extended to the purchaser of the publication for his/her use. The right of the author to be identified as Author of this work has been asserted by him/her in accordance with the Copyright, Design and Patents Act 1988. Paul Chapman Publishing A SAGE Publications Company 1 Oliver’s Yard 55 City Road London EC1Y 1SP SAGE Publications Inc. 2455 Teller Road Thousand Oaks, California 91320 SAGE Publications India Pvt Ltd. B-42, Panchsheel Enclave Post Box 4109 New Delhi 110 017 www.luckyduck.co.uk Commissioning Editor: Barbara Maines Editorial Team: Mel Maines, Sarah Lynch, Wendy Ogden Designer: Jess Wright Illustrations by: Deborah Weymont and Mark Ruffle A catalogue record for this book is available from the British Library Library of Congress Control Number 2005907010 ISBN10 1-4129-1311-X ISBN13 978-1-4129-1311-9 ISBN10 1-4129-1312-8 (pbk) ISBN13 978-4129-1312-6 (pbk) Printed on paper from sustainable resources Printed in Great Britain by The Cromwell Press Ltd, Trowbridge, Wiltshire grief loss death_INNER.indd 4 18/5/06 15:04:20 Contents Psychological Effects of Loss and Bereavement .....................................................1 Death ...................................................................................................................4 Emotional Literacy and Mental Health ..................................................................6 How to Use the Programme – Notes for Facilitators .............................................7 Session 1: Understanding Loss ...........................................................................13 Session 2: Divorce and Separation ......................................................................19 Session 3: Belonging ..........................................................................................27 Session 4: A Matter of Life and Death ................................................................39 Session 5: Facts and Figures ...............................................................................47 Session 6: Beliefs and Customs ...........................................................................63 Session 7: Feelings and Thoughts .......................................................................91 Session 8: Questions and Answers ....................................................................97 Session 9: The Grief Cycle .................................................................................105 Session 10: Support and Communication .........................................................113 Session 11: Remembering and Celebrating .......................................................123 Session 12: Review ...........................................................................................129 References ........................................................................................................133 grief loss death_INNER.indd 5 18/5/06 15:04:21 How to use the CD-ROM The CD-ROM contains PDF files, labelled ‘Worksheets.pdf’ which consists of worksheets for each lesson in this resource. You will need Acrobat Reader version 3 or higher to view and print these resources. To photocopy the worksheets directly from this book, align the edge of the page to be copied against the leading edge of the copier glass (usually indicated by an arrow). All CD-Rom content is contained within the ebook grief loss death_INNER.indd 6 18/5/06 15:04:21 Psychological Effects of Loss and Bereavement When children or adults experience a significant loss, separation or bereavement they grieve. Grieving helps us to adapt to change and move on with our lives. If we do not grieve, we run the risk of carrying unresolved emotional issues into other parts of our lives. In order to understand loss, separation and bereavement and the process of grief, it is necessary to understand how we form attachments and how our emotional wellbeing is dependent on the quality of our significant relationships. Bowlby’s attachment theory Bowlby’s attachment theory is based on the notion that humans are driven to connect to others, and that as babies we are ‘programmed’ to bond emotionally with our ‘primary care-giver(s)’. These are usually our parents. This bond is made through ordinary parenting behaviour which includes being fed, nurtured, held, protected and communicated with. These primary attachments allow us to survive. They also provide the foundation for our longer term mental health and ability to form relationships. If a primary attachment is strong, the child will feel confident, secure and loved. Once established, a child will be able to make a healthy separation from the primary caregiver and will relate well to other people, i.e. they will themselves make healthy attachments. If a primary attachment is insecure a child will become anxious and feel insecure. Difficulties may arise both when separating from the primary caregiver and in developing trusting relationships. When a primary attachment is broken (by bereavement or other means) during early childhood, the pain of the loss can literally feel ‘life-threatening’. The child will be in terrible emotional pain which may express itself physically. A period of mourning and grieving will be necessary and recovery may only be partial. The loss will literally shape the child’s psychological development. There is now consensus that many mental health problems presented by adults often stem from unresolved childhood losses and the breaking of these primary attachment bonds. (Black 1978, Bowlby 1979). The biochemistry of attachment and loss Bowlby’s theories are both confirmed and clarified by current developments in our understanding of the brain, which shows that there is a biochemical dimension to attachment and loss. Primary attachments are rooted in brain and body chemistry (Sunderland M. 2003). When we are intimate, loving and playful, natural opioid like chemicals in the brain and hormones in the body are released. These are drug-like in the way they motivate us to want to be with the person who makes us feel like this. Even thinking about and remembering people with whom we have a primary attachment has a biochemical dimension. When we lose someone to whom we are deeply attached we experience a withdrawal from these positive brain states. Our anxiety level may rise, as will the levels of stress hormones in our bodies, and we may feel depressed. Depending on circumstances, this change in biochemistry can also generate the release of chemicals which make us feel angry or hostile. As Sunderland states, in the light of these biochemical facts it is not surprising to learn that: ‘Seventy per cent of men in prison suffered a broken attachment in childhood,’(NACRO). ‘The biggest group of children who are excluded from school for bad behaviour before the age of nine are the group who have suffered a bereavement,’ (Home Office Statistics 2001). (quoted in Sunderland 2003) 1 grief loss death_INNER.indd 1 18/5/06 15:04:21 Similarly: ...‘parental bereavement may put an individual at greater risk of social exclusion and mental health difficulties,’ (Ribbens McCarthy, 2005, p68). Encouragingly, it seems that biochemical distress can be reduced through being comforted and by being encouraged to stay calm. When a child who experiences a major loss is comforted, natural brain opioids will be released. Remaining calm allows biochemical distress to subside. It is therefore vital that children who experience a major loss are both physically comforted and enabled to remain in a calm state. While our capacity for strong primary attachment is at its greatest, and is indeed essential in infancy, we now know that strong attachments can be made at any point in our lives. For example, when we fall in love and when we become parents the same chemicals and hormones help us to form new attachments. Positive warm relationships at any age can therefore help build a healthy brain and improve our emotional wellbeing – literally, our mental health. Thus it is that when a child, or adult, is grieving, it will be contact with and connection to caring people that will provide both comfort and the potential for recovery. Additionally, the chance to remember the person, and to talk about them, will be useful in terms of being able to make a healthy ‘separation’ and ‘move on’. Loss There are many different types of loss and a wide variation in the ways in which individuals experience and respond to loss. Feelings of loss will be experienced in a bereavement but also in relation to events such as the birth of a sibling, divorce, moving house, losing a toy and so on. It is important for adults to recognise that even small losses for children and adolescents can become quite significant and can also impact on how they later respond to bigger or more significant losses. For children and younger adolescents the experience of loss can be quite different to that of an adult. This is because they have less experience on which to draw when making sense of what has happened to them. They are more likely to feel overwhelmed by their feelings. Also, because children have less control over their circumstances and environment they are generally dependent on the adults around them to notice when they are grieving a loss. A wide range of behaviours or responses to loss have been identified, as follows: Cognitive • regression to previous level of skills • loss of skills • reluctance to communicate • difficulties in communicating • confusion over what has happened • difficulties in sequencing (order and time) • being unable to make up your mind about things • inability to concentrate or attend • loss of memory • decrease in reasoning skills • decrease in academic output/functioning. 2 grief loss death_INNER.indd 2 18/5/06 15:04:21 Psychological • obsessional behaviours • loss of concentration • loss of attention • personality changes • increase in nightmares or scary dreams • fear that the event will recur • concerns for others within the family or social context. Emotional • the need to be looked after by others • feelings of sadness • feelings of depression and anxiety • guilt, anger and shame • mood swings • concerns and worries about losing someone else or something else that is valuable and important to the individual. Behavioural • clinging behaviours • regression to more babyish behaviours • obsessive and repetitive talking • aggression and disobedience • decrease in ability to self control or discipline • abuse of alcohol or drugs • reluctance to attend school • withdrawal • being disorganised • feeling and being distant from others • feeling or being unpredictable or irritable • physical symptoms • lying or stealing. Physical • experiencing headaches • experiencing stomachaches • experiencing shock • experiencing constriction of the throat • disturbed sleep • feeling tired and listless • loss of appetite • loss of control physically • avoidance of others and social contexts • unable to cope with established and regular routines (home and school). 3 grief loss death_INNER.indd 3 18/5/06 15:04:22