Adolescent Loss

By the Irish Childhood Bereavement Network  Adolescence is a time of huge change. These years are marked by rapid physical, cognitive, emotional and social transition. Teenagers are looking for increased autonomy from family and home, for greater independence, and for new experiences. They are developing their personal value system while progressively forming their unique identity. Adolescents struggle with the paradoxes of their lives: striving for closeness yet fearing intimacy; lacking in autonomy yet expected to act maturely. The most frequent deaths experienced by adolescents are those of parents, siblings or peers. Bereavement forces them to rethink their world; how they view themselves, others, and life as a whole, and can evoke an intense grief response. The response will depend on their age, the nature of the death, their relationship with the deceased, each individual personality, how the family grieves, and the changes the death creates within the family. There is a marked difference in the grieving styles of Early (12-14 years) and Late (15-18 years). Early Adolescence

• In early adolescence, cognitive change is in initial development of formal operational abilities.
• Psychological change involves the withdrawal of emotional investment in the parent.
• Social change highlights the importance of peer relationships for teenagers.
• Puberty causes biological change.

This combination of factors makes adolescence a very complex transitional age.

• Due to formal operational thinking and a changing need for information, early teens may show a diminished interest in, and an active avoidance of information about, a parent or sibling’s illness or treatment.
• The change in their emotional relationship with parents is complicated by a parent’s serious illness. They are caught in the need to distance and the longing for closeness.
• They want privacy as they develop their own identity.
• Younger teens may talk with friends more readily than with their parents. This need changes in late adolescence.
• They do not like to be seen as different as they fear being rejected by their peers. Some friends may shy away.
• Avoidance of feelings is common at this stage.
• They experience muted anticipatory grief.

Typical reactions:

• Drop in school grades.
• Sleep problems.
• Anger.
• Sadness.
• Withdrawal from discussions about the parent’s condition.

Behaviours to watch out for:

• Oppositional.
• Argumentative.
• Demanding behaviour.
• At times of intense anxiety, teenagers may want to co-sleep with a parent. If this extends over a longer time span it can indicate more serious problems.
• Extra demand of chores at home may interfere with their time with friends, which can cause resentment.
• They can become highly anxious and preoccupied with how to manage their emotions. An attempt to hold emotions in and not show upset is common.
• They need a final communication with the parent or sibling who is dying.
• Adolescents who are informed and prepared for a death can feel more in control of what is happening, which can help in grieving afterwards.
• Adolescents like to be part of the funeral planning and rituals, and have a need for such inclusion.
• Many have definite opinions about how they want to engage in these rituals.
• Some feel oppressed by the crowds at the funeral and long for time with a parent.
• Adolescents often cry alone as they do not want to upset a parent, and if they see the parent upset they will often leave the room.
• If the loss is of a parent, the adolescent has to develop a new relationship with their dead parent in their memory, while negotiating a new relationship with the surviving parent.
• Adolescent’s mourning is generally episodic, often triggered by specific events such as birthdays or anniversaries.
• They may show resistance to talking as they are more preoccupied by school and peers.
• They often talk with adults other than their parents about their experience of loss.
• Parents often find it difficult to enter their teen’s experience of loss.
• Such teens may be more angry and tearful about difficulties in school or homework than about the death.
• Some may be more expressive – these tend to come from families that foster open communication of emotions.
• Reminders such as birthdays and holidays are important.
• The surviving parent’s mourning can feel threatening to many adolescents because the parent appears more distraught than they had previously seen.
• Wearing a dead parent’s clothes is not uncommon as a way of identifying with them.
• Bereaved teenagers often discuss talking with their dead parent, dreaming about them, and feeling the parent’s presence.
• It is important for them to express the specific meaning this loss has for them. For example, a father may have been a mentor and friend who promoted independence. Others mourn the loss of a confidante.
• They require help in setting limits on potentially destructive regressive behaviours, acting out aggressively, or with drugs and sex.

Late Adolescence (15-18 years)

• Mourning takes place in a more adult manner.
• A complex mourning process, teens automatically think about and integrate their past relationship to the parent who has died, what the parent expected of them, and how they might live up to those expectations.
• More advanced cognitive abilities means more painful grief, as this age group can understand the enduring consequences of the loss.
• Anticipatory mourning is experienced first, followed by more persistent and prolonged periods of mourning after the death.
• At this stage, they have the ability to see the situation from another person’s perspective.
• They develop deeper personal relationships
• They are in the process of planning for their own future.

Gender differences:

• Girls emphasise the change in relationship with their mothers. Boys are usually engaged in more fully separating from both parents.
• For girls, a parent’s death interferes profoundly with their developmental task of changing their relationship with the surviving parent. Rather than only withdrawing emotional investment from the relationship, they now have to renegotiate their relationship with the deceased parent and the surviving partner.

Reactions in bereaved adolescents may include:

• Masking their fears with rebellion, by acting out their protest at what has happened.
• Exaggerating their maturity in order to mask an inability to cope.
• Being moody, negative and rebellious, and feeling life has become very unfair.
• Using drugs or drink to numb the pain.
• Expressing blame at anyone they feel might be responsible for the death.
• Become disconnected; dropping out of activities or losing enthusiasm for them.
• Feeling powerless over what has occurred and trying to find some meaning from it.
• Struggling to prepare for what now feels like an uncertain future.
• Feeling different from their peers.
• Not always wanting to talk.
• Using sport as a release.
• Looking for excuses to try, such as watching sad movies or read books on loss.

How you can help:

• Be present for them.
• Listen to them – and hear what is not being said.
• Give the teen time to unfold their struggles.
• Is there another adult who can support them? Teens may want to protect a parent from their pain, and talk to someone else.
• Be patient; don’t react to their responses to loss.

Adolescents need extra help if they:

• Deny the death has occurred.
• Suffer panic, anxiety or fear which interferes with their day-to-day life.
• Suffer physical ailments that continue without identifiable medical cause(s).
• Have prolonged feelings of guilt or responsibility for the death.
• Have chronic depression.
• Display chronic anger or hostility.
• Display behaviour that is reckless and life-endangering to self or others.
• Demonstrate prolonged changes in personality, personal appearance and/or behaviour.
• Withdraw consistently from friends, family members or prior interests.
• Show prolonged changes in sleeping patterns.
• Have continuing problems with eating (such as overeating, under-eating or binging).
• Abuse drugs or alcohol.
• Are sexually promiscuous.
• Self-harm.
• Have suicidal thoughts or actions.

• Dated: May 19