Table 8.1. Concepts of Death and Implications of Incomplete Understanding for Adjustment to Loss
|
Concept
|
Example of Incomplete Understanding
|
Implication
|
|
Irreversibility
|
|
Death is seen as a permanent phenomenon from which there is no recovery
or return.
|
Child expects the deceased to return, as if from a trip.
|
Failure to comprehend this concept prevents child from taking the
first step in the mourning process, that of appreciating the permanence
of the loss and the need to adjust ties to the deceased.
|
|
Finality (Nonfunctionality)
|
|
Death is seen as a state in which all life functions cease completely.
|
Child worries about a buried relative being in pain or trying to dig
himself or herself out of the grave; child wishes to bury food with
the deceased.
|
Can lead to preoccupation with physical suffering of the deceased
and may impair readjustment; serves as the basis for many horror stories
and films directed at children and youth (e.g., zombies, vampires,
and other "living dead").
|
|
Inevitability (Universality)
|
|
Death is seen as a natural phenomenon that no living being can escape
indefinitely.
|
Child views significant individuals (i.e., self, parents) as immortal.
|
If child does not view death as inevitable, he or she is likely to
view death as a punishment (either for actions or thoughts of the child
or the deceased), leading to excessive guilt and shame.
|
|
Causality
|
|
A realistic understanding of the causes of death is developed.
|
Child who relies on magical thinking is apt to assume responsibility
for death of a loved one by assuming bad thoughts or unrelated actions
were causative.
|
Tends to lead to excessive guilt that is difficult for child to resolve.
|
Source: Adapted from Schonfeld D. Crisis intervention
for bereavement support: a model of intervention in the children's school. Clin
Pediatr 1989;28(1):27-33. Reprinted with permission of Sage Publications,
Inc.
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