Art Therapy for Grief - The Why and How from Art With Heart

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The following is an excerpt from Draw It Out a therapeutic activity book for children facing the pain of grief and loss. The information below explores how children grieve and how creativity can be part of a healthy grief journey.

CHILDREN GRIEVE TOO

Grief is a natural, normal, and necessary response to death. It is made up of many different emotions— ranging from sadness to anger to guilt and everything in between. It effects our thoughts, emotions, and behaviors in many ways. Adjusting to loss is a lengthy process and is unique to each and every person. Children face the same jumble of confusing emotions, but they mourn differently than adults. Unlike grown ups, children do not usually have the words to express their grief, so it tends to show up in their mood, play, and behavior.

Even if they look content on the outside, on the inside they may be experiencing many feelings that they do not know how to identify or talk about. The loss may affect them in many ways—they may be sad that someone important to them is no longer with them, and they may also miss the sense of security and comfort that the person gave them. Children do not “get over” or recover from a death, but instead, find new ways to cope and live with that loss. You can help comfort them so that they feel like someone understands what they are going through and that they do not have to mourn alone. You can also gently guide their grief so they can mourn in healthy ways that will allow their hearts to mend.

HELPING CHILDREN COPE

Listen with Your Heart

It is normal for adults to be nervous about talking with a child about grief or death. It is hard to know what to say or how to answer questions; and no one wants to cause additional pain. It can also be hard for children to talk about how they feel and tell their version of the story. But when kids don’t have a chance to let their worries out, the feelings can grow bigger and come out in their behavior.

The most helpful thing you can do is simply be there, offer your companionship in the moment, listen without judgment or advice-giving, and help them learn how to manage their pain and adapt to their loss. Children will overhear conversations about the death and may develop their own imaginative or scary stories about it. Listen for their understanding of the situation and offer reassurance. Say things that validate their feelings such as, “I understand why you feel that way; sometimes I feel that way too” or “I feel angry right now too.” Give them freedom to feel the way they feel. Don’t try to “fix” them. And finally, don’t push them to talk if they don’t feel like it; when they are ready to share, they will—as long as they feel safe doing so. Just by being available, you are helping them through the pain.

As they talk about how the loss affected them, you may realize you are experiencing grief too. Like all emotions, grief is meant to be shared. Make it a priority to find healthy ways to vent your grief as well so that you can maintain your own sense of balance and strength as you support their needs as well.

Tell the Truth & Help Them Understand

It is hard for children to understand the permanence of death. When you provide honest information and answers to their questions, you help grow their understanding and dispel misconceptions. Your child may ask you over and over again about the death in an attempt to understand it better. Telling the truth does not necessarily mean a complete description of all the details.

How much you share depends on the child’s age and the questions they ask. Do not over-explain, but let their questions guide your discussion. You do not have to have all the answers, but be honest in your explanation. Use simple, clear words, like “death” and “dying.” Saying “she went away” or “left us” or “is sleeping” may be easier to say, but can cause more confusion or fear. Through careful listening, you will find out exactly what the child needs to know—nothing more, nothing less.

Create Opportunities for Rituals

A ritual is an activity that represents the feelings you have for someone you miss. Ask the child if they have ideas about how they might like to honor the person who died. Brainstorm together, making a list of activities that the person loved to do, songs they liked, places they liked to go, or snacks they enjoyed. Rituals range from lighting a candle on a certain day, or making that person’s favorite foods. Create a “memory place” and fill it with special things to remember that person, or fill a “Memory Bank” with notes to or about that person. Allowing them to participate provides a tangible way to channel feelings.

Model Healthy Grieving

It is helpful for children to know that they are not alone in their grief. They often pick up cues from those around them about how they should act and cope with the death. You may simply share, “Today was hard. I felt sad today.” You can also ask them to join you in activities that help you feel better; “I think I’ll go for a walk to help me feel better. Would you like to join me?” It is your opportunity to demonstrate what it means to grieve in a healthy way and take care of yourself at the same time.

Know that Grief will Continue to be a Part of Their Life

One moment, your child may seem completely unaffected by the death, and the next, may be crying. This is not abnormal. Children can transition quickly and frequently between expressing grief and simply being children. In addition, as they get older and progress through life, feelings of grief can resurface from time to time. Losses can be grieved again and again—triggered by holidays, birthdays, and other special events, including non-related losses. Sad feelings and memories can also be triggered by sights, sounds, or smells.

HEALTHY BEHAVIORS AFTER A DEATH

You may be surprised by children’s reaction to loss; and many behaviors can give you a hint that they need extra attention to get through. The following sample reactions are considered “typical” by grieving experts and may be a clue that they may simply need extra care, comfort, or consolation:

  • Physical changes: Children may have trouble sleeping or eating, get headaches, or stomachaches.
  • Emotional changes: Children may feel shock, sadness, anger, fear, worry, guilt, shame, loneliness, or relief—or all of these feelings at the same time. Or, they may seem to feel nothing at all.
  • Changes in behavior: Children may lose interest in things they once enjoyed. They might start getting bad grades, be increasingly irritable or controlling, or behave differently than normal.
  • Changes in play: As children play, it may seem that they do not care, but they may just be thinking things through. By watching their play and creative expression, you may be able to understand what they are feeling. They also may use playtime with friends to help them feel “normal” again.
  • Obsession about details: Children may fixate on the details of the death. They may ask questions that seem morbid or macabre – or they may repeatedly talk about or act out the event.
  • Changes in friendships: Children may want to be left alone or may look for new, more accepting friends.
  • Changes in thinking: Children may have constant thoughts and memories about the person and become overprotective of you or others. They may be worried or have a hard time making decisions.
  • Magical thinking: Children may believe that the death can be reversed, that the person can come back, or that (through a leap in logic) it was their fault.
  • Change in sleep patterns: Nightmares may keep children awake, causing difficulty concentrating at school. They may also be clingy and want to sleep with someone by their side.

RED FLAGS: WHEN TO SEE A PROFESSIONAL

Over time, a new routine settles in after a loss. But sometimes, especially if the loss was traumatic, a child’s behavior will not improve over time. The following “red flags” are signs that treatment is needed from a mental health professional since without treatment, symptoms can grow worse:

  • Taking big risks or explosive anger
  • Harming themselves or others
  • Having suicidal thoughts or behaviors
  • Self-medicating with substances
  • Vigorously avoiding help that is o offered
  • Becoming overly withdrawn; or no emotion at all
  • Having extreme nightmares or night terrors
  • Becoming obsessive about the loss
  • Loosing or gaining excessive weight
  • Extremely fatigued because of lack of sleep

HOW DOES CREATIVITY HELP?

When children draw or color, words are not needed. There’s a connection between the head, the heart, and the hand which helps them express many feelings that had previously been trapped inside. Creativity helps children put those emotions outside, so they can see their experience from a different perspective, making things clearer and giving them distance. Creativity gives children a sense of control and allows them to tell their story over and over again so they can let go and make sense of it. It is an important coping skill that can serve them for the rest of their lives.

“DRAW IT OUT” SUPPORTS THE GRIEVING PROCESS

Designed by 27 grief experts, including staff from The Moyer Foundation, Draw It Out is a therapeutic activity book for ages six and over that helps children use art and writing to express and share their worries. It offers a safe and comforting way for them to ask difficult questions and release their concerns.The book may look like just pure fun, but every activity reflects a thoughtful combination of research-based, therapeutic approaches designed to strengthen children’s social and emotional skills, allowing them a safe place to navigate feelings such as grief, loss, anxiety, or fear. The following are some ideas on how to use the book with your child:

  • Give your child control: Ask how your child would like to use Draw It Out – do they want to work on it on their own privately, only sharing certain pages when they are ready? Or do they want you to be part of the process, inviting you to sit beside them as they go through the book, sharing answers aloud as they read the prompts on each page? Either way is ne.
  • Use the book to start meaningful conversations: The prompts in the book can be a great way to starting honest dialog about feelings. What your child draws or writes can provide clues to what they are struggling with. Ask open-ended questions about their art, and o offer non-judgmental comments to validate their feelings, rather than trying to convince them not to feel a certain way. Should you feel that your child needs additional help, the Draw It Out book can also be used by a therapist in conjunction with their treatment plan.
  • Use the following sample pages as the child works on their corresponding pages in Draw It Out (pages 11, 14, and 36). Get out the markers and answer the questions for yourself. You may be surprised at what you discover about your own feelings. By using creativity to express how you feel, you can help your child better understand how creativity helps heal.

Text excerpted from A Caregiver's Guide to Draw It Out by Art with Heart. To order the full booklet by mail, please contact info@artwithheart.org.

Copyright ©2016 Art with Heart • artwithheart.org • Draw It Out Caregiver Companion

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