Discussing Death With Children
Gerry Koocher is a fellow of 11 APA divisions and holds ABPP diplomates in Clinical Psychology, Family psychology, Forensic Psychology, & Health Psychology. He maintains an independent practice and is licensed in MA and NH, in addition to serving as Dean of Simmons College. He has received numerous awards, most recently the Florence Halpern Award for Distinguished Professional Contributions, which honors a clinical psychologist who has made "distinguished theoretical or empirical advances in psychology leading to the understanding or amelioration of important practical problems." He has published many scientific articles and books, among them The Psychologist's Desk Reference, 2nd edition. He became interested in the themes of this article early in his career: his doctoral dissertation was on children's understanding of death in developmental context.
"Why isn't the gerbil moving anymore?" This question has been known to strike terror into the heart of even the most experienced first grade teacher when the death of a classroom pet is discovered by a curious 6-year-old.
The issues raised are more distressing when a classmate or a classmate's parent dies and questions are asked. The simplest path is that of silence, or of trying to dispose of the questions as swiftly and painlessly as possible, but often that may solve only the teacher's problem.
By the age of five virtually every child has had some contact with death and some curiosity about it. Perhaps it was the death of a pet, a dead bird found on the street, a "squished bug," or the death of a family member. In any case, it is only logical that this curiosity will be carried over to the school setting, and it is important that the teacher -- as well as parents -- be prepared to cope with questions that come up.
What happens when questions go unanswered or are only partially answered? The best example I can think of is a boy named Mark. I first met him about five years ago at a university-affiliated psychological clinic. Mark, who was then five years old, had been brought in by his parents who were concerned about his refusal to go to bed at night. Although he had no history of bedtime problems previously, Mark had begun to throw bedtime tantrums two weeks earlier. He would cry and refuse to go near the bedroom, and, when finally overcome with sleep, he would often awaken with nightmares. His behavior and emotional development were all within normal limits aside from his rather phobic reaction to bedtime preparations. Neither parent was able to offer any insight into the possible precipitants of this behavior.
During one of the play sessions I had with Mark, he told me the story of a man who ". . . got a heart attack, fell out of bed, and died." He explained that he had overheard his mother telling this story to someone over the telephone. Putting events together with the help of his parents, I learned that a family friend had recently died of a heart attack, and Mark did indeed hear his mother describe the event to a friend over the telephone. Mark had no idea what a heart attack was or where one came from. He certainly knew what falling out of bed was, though, and if doing that could make you get a heart attack and die" then no one was going to get him into a bed.
With this information I was able to help ease Mark's concerns in short order, but the concreteness of his concerns remains an impressive example of the misconceptions children can develop about death. Mark also provides a prime example of the harm that can result from not talking about death when children have questions, although in this case Mark had not asked any.
The conspiracy of silence that seems to exist among adults when it comes to discussing death with children has at least three basic roots.
First, there is the adult's own emotional concern which may prevent him or her from confronting death-related issues. This may stem from actual experience or from fear of emotional losses.
The second root is a general uncertainty about what to say or where to begin. It is hard to know what issues will be of immediate concern and which will be unimportant.
Finally, there is the situation which combines the two mentioned above, when an emotional crisis such as the death of a parent or relative, for instance, forces an anxious adult into the awkward position of having to explain what has happened to a frightened child.
I would like to offer some suggestions to help teachers in planning classroom discussions about death, and in handling the topic when it comes up without planning. Parents, nursery school teachers and others who care for young children may also find some of the suggestions helpful.
Listening to Questions
Many adults make the unfortunate mistake of thinking that children are merely uneducated, miniature adults. This is understandable, since their outward appearance is much like that of the adult (only smaller). As most teachers and parents know, however, the mental equipment of children is not as well developed as that of adults, nor is it as capable of incorporating the experiences of others. The very young child (one under the age of 6 or 7) may not yet be capable of what Piaget calls "cognitive reciprocity." This means, in effect, that he cannot really benefit from learning outside the realm of his own experience. In talking about death, therefore, such children will naturally react in the light of their own experiences and of what they have been told by adults or have seen in the media.
Listening carefully to a child is important, because adults may tend to read into a question much more than is asked. The analogy of sex questions also fits this paradigm. When the 5-year-old asks "Where do babies come from?", he may not particularly care to hear about egg and sperm, birds and bees, etc. Usually, "They grow inside their mothers" is a satisfactory, direct answer. Similarly, when a child asks about what made a pet die, an answer which involves "going to heaven" or "being called to be with God" can be much more confusing than a simple "He didn't have enough water to drink" or "He got very very sick, and we couldn't make him better."
The real key is in addressing the question that is intended, whether or not it is the one that is verbalized. The unspoken question is often "Could that happen to me?" When a parent dies the parallel question is "Who will take care of me now?" Often, these questions are not raised directly, but may come out in such form as "What if I get very very sick?" or "Why didn't anyone give him extra water?"
Children over the age of seven can be more open and direct (some adults would add, more morbid) but many of the concerns remain the same. It has been my experience that children are generally very interested in discussing their ideas about death with attentive adults. In addition, most children show a desire to "master" death in some sense by learning about it and knowing, as much as is possible, what happens to make things die.
Children's ideas about death develop along clear developmental lines and can be grouped by levels of mental functioning. A good example of this are the ideas children have about what causes living things to die. In the youngest group (under age 6 or 7) the answers children tend to give to such questions are often magical and quite egocentric. Typically, they might include such causes of death as "Eating a dirty bug" or "Going swimming alone when your mother says no."
In middle childhood (approximately ages 7 to 11) children tend to become more concrete in their reasoning, and they will typically cite as causes of death "cancer," "guns," "dope" or "poison."
When children reach early adolescence (approximately age 12 and over), they become capable of more abstract formal reasoning and their explanations also take on a more abstract quality. Often they fall into such broad groups or general categories as "illness," "old age," "accidents" or "part of the body doesn't work right any more."
Large numbers of children under the age of seven may also fail to recognize the irreversibility of death. In answer to questions about how dead things can be brought back to life, such children might offer such answers as: "Take them to the emergency room," "Keep them warm and give them hot food" or "Take them to Grandma's house." In such cases the child has not yet developed the ability to break away from his own history of first-hand experiences. Since he has not died, he cannot realize the permanence of death. When he reaches the more concrete level of mental operations he will be able to incorporate the experiences of others. He will then know that the gerbil in the question I quoted at the beginning of this article is not "asleep," or not believe that the gerbil is now active and alive somewhere else.
Talking about death in the classroom will be most effective and useful to children if the teacher is able to listen appropriately and is aware of general developmental trends in this regard. A warm and supportive atmosphere is also important to prevent any minimal anxiety from becoming magnified. Children tend to become anxious when they sense anxiety in adults whether they are in the classroom or at home. If a parent or teacher is very nervous about handling the topic, this tension will be communicated to the child.
From the child's point of view, a discussion of death and dying in the classroom should he general and open-ended. This allows the child who does not want to confront such issues to he present and listen, but it does not force him or her to participate in a discussion that would provoke undue anxiety. The child who would become upset by such a discussion in the classroom is very rare, but his rights and feelings must be respected. By the same token, the child who holds defensive positions with regard to his or her thinking about death may do this as an emotional necessity. In such cases the teacher should not attempt to force a "re-education" about death onto the child.
If, for example, a 9-year-old boy were to insist adamantly that people die only "When God reads their names in His book," it would be inappropriate to attempt to persuade him otherwise, first, because this idea might represent a central religious belief of his family or, second, because he might need to cling to such a belief to relieve his anxiety about death or loss. If another child insists that his grandmother "can bring dead plants back to life" or that "Her chicken soup can make anyone all better," it might be best to avoid attacking such beliefs. This is especially true when the child's beliefs seems quite emotionally "loaded."
The topics which might provide a general source of classroom discussion about death could include: differences between living and non-living things, cultural differences in ideas about death as seen in history or social studies, or the death of a classroom pet. The occasion may also arise unexpectedly when a pupil's relative or friend dies and this is mentioned aloud in class. In general, the teacher will get many cues in the form of questions when the class is interested in such a discussion. Caution must be exercised, however, not to focus attention on children who have suffered a significant emotional loss.
If Johnny Jones, for example, comes to class and announces with some degree of tension that his little brother was hit by a car and killed the week before, this could be an opportunity for a classroom learning experience-and a chance to give Johnny some extra support as well. It would be appropriate to mention how people feel sad and miss others very much when they die. It would also be in order to comment that even when people are dead, we can remember them and keep a part of them alive inside our heads.
On the other hand, it would be unwise to focus on Johnny and ask, "How do you feel about what happened?" A child who brings up such a topic is often asking for support in the face of his own loss. Listening to the comments and ideas of others can often provide such support, while forcing a child to focus on his own feelings in a group context is more isolating and a greater emotional strain. Once again, one must listen to the emotional need being expressed and not simply address the direct question.
These suggestions apply as well in the family context as they do in the classroom. Such discussions in the home take on added meaning and may enrich the communication bonds between parents and children.
The best approach in the classroom context is usually one that is guided by the interests and questions of the children. In a science class questions about life cycles and causes of death will come up quite naturally. In social studies the concepts of death and the pyramids of Egypt or burial caves of the American Indians are also natural areas of children's interests.
Morbidity or Mastery
Virtually every child who has ever gone "Trick-or-Treating" knows what a skeleton is, and most children over the age of six or seven are able to verbalize the notion that dead bodies are usually buried in our culture. Adults are often amazed by the gruesome details some youngsters are able to recount in talking about what happens after death. It is not unusual to hear stories from an 8- or 9-year-old about how "Your body rots away after you get buried." Thinking and talking along these lines may actually serve a psychologically adaptive function for some children. In a sense the child may be saying to himself, "If I know exactly what's going to happen when I die, then I won't have to worry about it now." While a constant preoccupation with death-related thoughts is an indication that a psychological or psychiatric consultation should be sought, casual references may be quite normal even though the content seems morbid by adult standards. The normal child may use detailed exploration of what happens to a body after death as a means to master his own anxiety about loss and separation.
Potential Classroom Projects
Classroom projects with regard to death and dying ought to fit into a teacher's lesson plan in a fashion that is consistent with the teacher's usual style. Such projects may be planned well in advance or brought into class on short notice, if an acute situation creates a need. The teacher might plan to get into the topic using regular course material in science or social studies as a logical context. On the other hand, a sudden event such as the death of a classroom pet or a relative of a classmate could provide a context for different kind of classroom project. There is a definite place for both types of programs, and each provides its own special perspective on the matter of death and dying.
The first kind of project is a scholastically based one. A class discussion of different cultures in social studies or history lessons could compare funeral practices and religious beliefs about death on a "then and now" basis. In primary grades, science classes could talk about the differences inherent in what is "alive," "not alive" or "dead." This kind of lesson would help to teach the concept that life is an ongoing process and that death is the end or interruption of this process. It is a reality-based, somewhat intellectualized approach to teaching about death that fits well into regular curriculum areas and seldom arouses any emotional stress.
The second type of project addresses more acute situations. It offers a different sort of learning about death and dying, but one which is no less important: the feeling component. This kind of classroom project is a logical follow-through to minor or major tragedies of death that come to the attention of a school class. In one case it may be a dead gerbil, in another the death of a classmate's parent or sibling, or of a classmate himself. The assassination of public figures in recent years has also been a focal point for such classroom discussions and projects. Because of the feelings which are naturally involved, such programs should be open-ended and allow each child to participate up to the level of his or her interest and capability.
In the case of a dead classroom pet, an art lesson or short essay-writing period aimed at representing how class members feel about losing the animal could be an appropriate medium. The teacher might offer some guidance in terms of feelings by telling the class how he or she feels. Acknowledging that it is all right to be sad, but remembering the fun we had playing with the gerbil, would be one approach.
When a human being is the deceased, the class might focus on the survivors and the teacher could invite the class to write or design brief messages of condolence. Aside from being socially appropriate and helping to teach social behavior, such exercises expose children to their own feelings and allow for an emotionally constructive follow-through to the event. An added benefit is the support that such gestures offer to the families of the deceased individual.
These ideas may also be used at home by parents to help their children deal with similar circumstances. When a child expresses his or her own feelings, parents may suggest ways to communicate them by presenting suggestions for writing a sympathy note or allowing the child to bury a deceased pet. These activities should not he rituals which are forced on the child, but rather ideas to which the child may wish to respond.
I have tried to offer some discussion ideas and starting points, which can he individualized and elaborated upon to fit the specific age and classroom situation of any given group of students. The thoughtful teacher should consider the needs of his or her class and attempt to gauge potential reaction in planning such lessons as those described here.
My prime concern, however, is not so much the implementation of discussion as it is the idea of doing something like this in the classroom. If a reader comes away from this article with a single thought, I would like it to be: at home or in school, talking about death is more necessary and potentially beneficial than not talking about it. A classroom can be an important, supportive place in which real learning about death on many levels can take place.