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Healing Children’s Grief:
Surviving a Parent’s
Death from Cancer
Grace Hyslop Christ
OXFORD UNIVERSITY PRESS
Healing
Children’s Grief
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Healing
Children’s Grief
Surviving a Parent’s
Death from Cancer
Grace Hyslop Christ
New York • Oxford
OXFORD UNIVERSITY PRESS
2000
Oxford University Press
Oxford New York
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Copyright © 2000 by Oxford University Press
Published by Oxford University Press, Inc.,
198 Madison Avenue, New York, New York, 10016
http://www.oup-usa.org
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Christ, Grace Hyslop.
Healing children’s grief : surviving a parent’s death from cancer / by Grace Hyslop Christ.
p. cm.
Includes bibliographical references.
ISBN 0-19-510590-7 (alk. paper) — ISBN 0-19-510591-5 (pbk. : alk. paper)
1. Grief in children. 2. Grief in adolescence. 3. Bereavement in children. 4.
Bereavement in adolescence. 5. Parents—Death—Psychological aspects. 6. Children and
death. 7. Teenagers and death. I. Title.
BF723.G75 C58 2000
155.9′37′083—dc21 99-015342
Printing (last digit): 987654321
Printed in the United States of America
on acid-free paper
This book is dedicated to the families of the parents who died.
Their stories are a legacy of healing they left for all of us.
This page intentionally left blank
Contents
List of Tables and Figures ix
Foreword xi
Acknowledgments xv
Introduction xvii
1. Mother and 3-Year-Old Daughter 1
Diagnosis and Treatment 1
Terminal Stage 2
Death and Family Rituals 3
Bereavement and Reconstitution 5
Cascade of Events 6
Conclusion 8
2. Childhood Bereavement Studies 11
Evolving Bereavement Models 11
Traumatic Stress 14
Studies of Bereaved Children 16
Traumatic and Anticipated Death and Divorce 21
Summary 21
3. Stages of the Illness and Child Development 24
Psychosocial Stages of Cancer 24
Contribution of Development 27
Summary 32
4. Study Sample, Intervention, Bereavement Model, Methodology 33
Sample 33
Intervention: Data Collection 34
Bereavement Outcome Model 37
Methods 42
5. Children 3–5 Years of Age: Themes 46
Developmental Themes of Preschool Children 46
Patterns of Responses in Preschool Children 48
Recommendations for Professionals and Caregivers 58
6. Children 3–5 Years of Age: Narrative 61
Mother and 4- and 7-Year-Old Daughters 61
7. Children 6–8 Years of Age: Themes 71
Developmental Themes of Early School-Age Children 71
vii
viii Contents
Patterns of Responses in Early School-Age Children 74
Recommendations for Professionals and Caregivers 89
8. Children 6–8 Years of Age: Narratives 92
Mother, 7-year-old son and 4-Year-Old Daughter 92
Father and 7- and 20-Year-Old Daughters 98
Outcomes 106
Discussion 108
9. Children 9–11 Years of Age: Themes 109
Developmental Themes of Later School-Age Children 109
Patterns of Responses in Later School-Age Children 112
Recommendations for Professionals and Caregivers 126
10. Children 9–11 Years of Age: Narratives 129
Father and 10-Year-Old Daughter 129
Mother and Three Children, Aged 7, 10, and 11 Years 138
Outcomes 146
Discussion 148
11. Children 12–14 Years of Age: Themes 150
Developmental Themes of Early Adolescence 150
Patterns of Responses in Early Adolescence 154
Recommendations for Professionals and Caregivers 166
12. Children 12–14 Years of Age: Narratives 170
Father, 12-year-old girl and 15-Year-Old Boy 170
Mother and 12-Year-Old Son 180
Outcomes 187
Discussion 190
13. Children 15–17 Years of Age: Themes 192
Developmental Themes of Middle Adolescence 192
Patterns of Responses in Middle Adolescence 195
Recommendations for Professionals and Caregivers 210
14. Children 15–17 Years of Age: Narratives 214
Father, 16- and 13-Year-Old Daughters and a 15-Year-Old Son 214
Mother and 16-Year-Old Daughter 224
Outcomes 230
Discussion 232
15. Conclusion 234
Mourning 235
Outcome 239
The Untold Stories 242
Combining Qualitative and Quantitative Approaches 243
Future Directions 243
Bibliography 245
Author Index 253
Subject Index 257
List of Tables and Figures
Table 2.1 Death, Divorce and Traumatic Stress: Differences and
Similarities 22
Table 4.1 Demographic Characteristics of Parents 35
Table 4.2 Children and Adolescents in This Sample 36
Table 4.3 Children’s Outcome by Gender of Child and of
Surviving Parent 42
Figure 4.1 Bereavement-Outcome Model 37
[...]... loyalty to their biological parent and retain a special and primary place for that parent when the surviving parent dates or plans to be married It was also hard for Rachel to accept Robert because she felt jealous sometimes She and Lisa had been a team” for four years, and now she had to share that special relationship When Rachel entered first grade, at age 6 she was a bright, highly verbal, engaging,... optimistic each time By now Rachel was 2 1/2 years old, and Joel and Lisa no longer talked hypothetically about Joel’s death Death had become a heart-wrenching certainty Terminal Stage Rachel was almost 3 years of age when Lisa visited the social worker on Joel’s hospital floor for advice about how to manage Rachel, who was reacting to Joel in a way that puzzled and upset both parents Several weeks earlier,... and planned a career that would give her maximum flexibility and time to bring up Rachel Dating was easy compared with thinking about a permanent relationship, which always made her anxious If one husband had died, it could happen again The trauma of an unexpected tragedy that occurs at such a young age is difficult to shake Cascade of Events Rachel’s relationship with Joel’s family became distant rather... provides important new information for the construction of theories about children’s adaptation to the traumatic experience of expected death from medical illness (and all that accompanies this in technological medicine and in specific family situations) The careful documentation of children’s adaptation to a parent’s death from cancer is also a model of research that can be extended to the consideration of... disturbed adolescents as arising from their early problems involving individuation and separation from the maternal figure (Masterson, 1972) In short, a developmental perspective, albeit primarily psychoanalytic, was an influential part of my understanding of mental health and mental illness The third important influence was my clinical work and research with cancer patients and their families at Memorial Sloan-Kettering... specialist after specialist Unhappily for everyone, Lisa and Robert finally separated when Rachel was 14 years old Although Rachel had resented Robert at first, she had become fond of him; in fact, she had adopted his surname in addition to Joel’s Robert had given her the stable family she had always thought she wanted When Lisa and Robert separated, Rachel was furious, feeling abandoned and rejected because... husband for myself It isn’t easy, but I need to date to find out what a person is like.” Rachel thought for a while, then said: “Don’t date at night Date when I am in school.” Rachel stopped talking easily about her father a year or two after his death When Lisa mentioned him, Rachel often adamantly announced that she did not want to talk about him As time went on, Lisa worked hard to complete an advanced... communicating was answering her questions about the illness and treatment as they were happening, rather than having to explain a sudden illness crisis that wasn’t attached to any concrete thing for her “I understand why parents are reluctant to tell their young children about a parent’s terminal illness The hardest part for me was realizing that I couldn’t protect Rachel from the pain of her father’s death. .. reconstitution that takes place after a parent’s death is not like putting Humpty Dumpty together again The surviving parent’s ministrations, preparation, love, support, and ability to understand and respond to the child’s despair are buffers that mitigate some of the ravages of the family tragedy and provide anchors that the child can use to construct a new Weltschauung, a view of the world that incorporates... adult patients (Abraham, 1927; Shafer, 1968; Volkan, 1981) Others added insights from the psychoanalysis of emotionally disturbed children (Freud, 1960; Furman, 1974) For example, Erna Furman observed that children as young as 3 years old had the capacity to mourn because they had attained object permanence (the ability to accept emotionally that they were separate from the parent and that the parent . Healing Children’s Grief: Surviving a Parent’s Death from Cancer Grace Hyslop Christ OXFORD UNIVERSITY PRESS Healing Children’s Grief This page intentionally left blank Healing Children’s. Aires Calcutta Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul Karachi Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Paris São Paulo Singapore Taipei Tokyo Toronto Warsaw and. Press. Library of Congress Cataloging-in-Publication Data Christ, Grace Hyslop. Healing children’s grief : surviving a parent’s death from cancer / by Grace Hyslop Christ. p. cm. Includes bibliographical
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