an essay about death of a son

The Sitting Bee

Short Story Reviews

Death of a Son by Njabulo Ndebele

In Death of a Son by Njabulo Ndebele we have the theme of grief, resilience, loss, doubt, acceptance, responsibility and renewal. Narrated in the first person by an unnamed woman (mother) the reader realises from the beginning of the story that Ndebele may be exploring the theme of grief. The narrator and her husband Buntu have yet to grieve the loss and killing of their son. They have been busy trying to recover their son’s body and as such grief is coming late to them. It is also noticeable that both the narrator and Buntu are resilient when it comes to retrieving their son’s body. They will not give up even though what is happening to them may be a result of corruption within the police. A possible failure on the police’s behalf to take responsibility for killing the narrator’s son. There is also a sense that due to the circumstances that the narrator finds herself in she is reliant on others, the police, lawyers, newspaper to help her get her son back. Which again may suggest that there is a degree of corruption within the police. They are after all responsible for killing the narrator’s son. Firing randomly from the Casspirs. It may also be case that the narrator has doubts when it comes to Buntu. Some of which may have grown from the time she was assaulted on the streets and Buntu did not react apart from saying ‘the dog.’ After her son is killed the narrator distances herself somewhat from Buntu.

Whether this is because she may be in shock over the death of her son is difficult to say. It is possible that the narrator is displeased at the circumstances she finds herself in and Buntu though he is being proactive in trying to get their son’s body back is not a man of action. And it may be action that the narrator is seeking.  It is as though Buntu has a responsibility to the narrator to get their son’s body back but instead of personally taking action he is looking towards others to help him. Which may be the point that Ndebele is trying to make. At the time the story was written it would appear that the levels of corruption where so high in the police that in order to get a loved one’s body back. The police had to be paid. This may seem bizarre to some readers however that may have been the state of affairs in South Africa under the apartheid regime. Where black people had no rights or where not supported by those in authority (white people).

It is also possible that Ndebele is exploring the theme of acceptance. Throughout the story there is a sense that the narrator accepts what has happened to her. Though again whether this is just shock is difficult to say. There is no anger in the narrators tone as she is telling her story which suggests that she accepts not only the death of her son but also how her son was killed. Forces that she has no control over and who appear to be unanswerable to anybody are the real cause of the narrator’s pain yet she accepts that this is what life in South Africa is (at the time the story was written). The sense of avenging herself when she was attacked three years previously is non-existent though what has happened the narrator is far worse than being pushed to the ground. Throughout the story the narrator remains calm and logical. Even though what has happened to her (and Buntu) is horrific. It might also be a case that the acceptance that the narrator has is part of her grief. She may be fully aware due to the circumstances she finds herself in that the best she can hope for is the return of her son’s body. She will not defeat the police as her voice will remain unheard. Which in many ways is ironic considering that the narrator is a journalist.

The end of the story is also interesting as Ndebele appears to be exploring the theme of renewal. As the narrator is lying on bed there is a sense that she is being to not only accept what has happened to her but that she is also looking towards the future. She knows that she has lost her first and only child however she also knows that she can have another child. Though some critics might suggest that the narrator is quickly forgetting her son it is unlikely that this is the case. Instead the narrator though still grieving the loss of her son knows that what was lost can also be gained. If anything there is a trace of optimism appearing in the narrator’s life. For the first time in the story the narrator is looking at things through a positive lens. There is nothing stopping her being a mother again. She will still carry the loss of her son but she can still have a family. Life may never be the same for the narrator but all has not been lost. The scars of what has happened may be real but they do not always have to show.

• Rain by Richard Rive
• Meeting Elise by Nam Le
• The Son from America by Isaac Bashevis Singer
• The Case of The Lower Case Letter by Jack Delany

The role of the narrator

The role of the narrator in this particular story appears to be to tell the reader a story about the events that have occurred. To try and allow the reader inside the narrator’s mind (and heart) in the hope that the reader will realise just how difficult things are for the narrator.

Who is the journalist? Is it the wife or Bunty?

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Notify me of follow-up comments via e-mail

Currently you have JavaScript disabled. In order to post comments, please make sure JavaScript and Cookies are enabled, and reload the page. Click here for instructions on how to enable JavaScript in your browser.

Death of a Son

AUTHOR: Njabulo S Ndebele PUBLISHER: Viva Books ISBN:  9781874932154 DATE: 1996

DESCRIPTION:  Death of a Son is a short story. A two year old boy is killed during random shooting by police in a township. This is the story of how the parents cope with the loss of their child and how it effects their relationship. In particular it deals with the father’s sense of impotence under the apartheid regime, how the parents deal with authority and finally how they come to terms with their loss. Unfortunately the book is now out of print and can only be accessed through public libraries.

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

• We're Hiring!
• Help Center

Download Free PDF

NJABULO NDEBELE’S DEATH OF A SON: RACISM AND APARTHEID IN POST-COLONIAL AFRICAN LITERATURE

2012, Revista Cesumar Ciências Humanas e Sociais Aplicadas, v.17, n.2, p. 459-476, jul./dez. 2012 - ISSN 1516-2664

Discrimination against Negroes is an unforgotten fact. Current article analyzes the denunciation against racism and apartheid in post-colonial literature, specifically in Njabulo Ndebele’s short story ‘Death of a son’ (1996). A bibliographical research based on post-colonial premises shows how the author reveals the situation of Negroes during the apartheid period, their objectification and their erasure as subjects, or rather, the product of the Dutch and British colonial process, during the early 20th century.

Related papers

Resumo Este artigo analisa obras da literatura africana, a fim de apresentar elementos de aproximação entre as composições ficcionais de Nigéria e África do Sul. Foram analisadas as obras A flecha de Deus (2011) de Chinua Achebe e A arma da casa (2000) de Nadine Gordimer, Infância (2015), Juventude (2013) e Desonra (2003) de J.M Coetzee, para se pensar o diálogo criativo entre literatura e história na produção ficcional pós-colonial africana. Estas produções possuem o discurso histórico como principal mecanismo criativo para a literatura desses países. A investigação baseia-se nos pressupostos da literatura comparada e nos estudos de Tânia Franco Carvalhal (2007) sobre o método. Buscaram-se os aspectos históricos e a presença/influência da história colonial britânica na produção literária tanto da Nigéria quanto da África do Sul. Palavras-chave: Literaturas africanas. Literatura Pós-Colonial. História.

Rangel Cerceau Netto, 2017

Resumo: Um dos propósitos deste artigo é o de incentivar leitores/graduandos(as) a lerem melhor compreender os discursos verbais e iconográficos sobre enfoques acerca da história do negro em livros paradidáticos e didáticos, contribuindo para releitura dessa história. A discussão é perpassada por alusões à promulgação da Constituição de 1988, que contém artigos sobre cidadania e sua prática no Brasil, à Lei de Diretrizes e Bases de 1996, que regulamenta a educação básica, pelos Parâmetros Curriculares Nacionais – PCN, diretrizes elaboradas pelo Governo Federal que orientam a educação, e pela Lei 10.639, de 2003, que estabeleceu a obrigatoriedade do ensino da história da África e da cultura afro-brasileira na escola básica. A partir de tais referências, busca-se incentivar leitores e graduandos a lerem textos paradidáticos e didáticos, à luz de novas referências teórico-historiográficas e de pesquisas sobre a história do negro na sociedade brasileira. Este estudo procura sensibilizar o público leitor a realizar leituras da temática sob um outro olhar, que possa esclarecer e interpretar a presença do negro como uma das matrizes formadoras da cultura brasileira. Palavras-chaves: Representação, histórica do negro. Escravismo. Livro didático. Abstract: One of the purposes of this article is to encourage readers to read and understand verbal and iconographic discourses about the history of the Negro in paraphrased and didactic books, contributing to re-reading this story. The discussion is permeated by allusions to the promulgation of the Constitution of 1988, which contains articles on citizenship and its practice in Brazil, the Law of Guidelines and Bases of 1996, which regulates basic education, by National Curricular Parameters - PCN, directives elaborated by the Government Federal Law that guide education, and Law 10.639 of 2003, which established the obligation to teach the history of Africa and Afro-Brazilian culture in basic school. From these documents, readers and graduates are encouraged to read paraphrased and didactic texts in the light of new theoretical-historiographic references and research on the presence of the black in Brazilian society. This study seeks to sensitize the readership to readings of the theme in another way that can clarify and interpret the presence of the Negro as one of the formative matrices of Brazilian culture. Keywords: Black historical representation. Slavery. Textbook. Recebido em: 24/07/2017 – Aceito em: 25/08/2017

Este artigo analisa obras da literatura africana, a fim de apresentar elementos de aproximação entre as composições ficcionais de Nigéria e África do Sul. Foram analisadas as obras A flecha de Deus (2011) de Chinua Achebe e A arma da casa (2000) de Nadine Gordimer, Infância (2015), Juventude (2013) e Desonra (2003) de J.M Coetzee, para se pensar o diálogo criativo entre literatura e história na produção ficcional pós-colonial africana. Estas produções possuem o discurso histórico como principal mecanismo criativo para a literatura desses países. A investigação baseia-se nos pressupostos da literatura comparada e nos estudos de Tânia Franco Carvalhal (2007) sobre o método. Buscaram-se os aspectos históricos e a presença/influência da história colonial britânica na produção literária tanto da Nigéria quanto da África do Sul. Palavras-chave: Literaturas africanas. Literatura Pós-Colonial. História.

Este trabalho apresenta parte da pesquisa de mestrado “Etymologias, preto: Hemetério José dos Santos e as questões raciais do seu tempo (1888-1920)”. Através da trajetória do intelectual Hemetério dos Santos, maranhense radicado na cidade do Rio de Janeiro desde 1875, discuto alguns aspectos das relações raciais no imediato pós-abolição. A principal marca desse homem negro, professor da Escola Normal e do Colégio Militar, foi a mobilização nas páginas dos jornais e em conferências em torno da positivação e valorização do negro na história do Brasil e do mundo. Nos primeiros anos do Pós-Abolição, Hemetério dos Santos colocava em pauta outras histórias e leituras da diáspora negra.

Revista TransVersos, 2021

Este texto tem como objetivo analisar, a partir das ideias propostas no livro África Insubmissa de Achille Mbembe, os significados da experiência religiosa como resistência ao processo de colonização cristã no continente africano, em contextos e construções narrativas pós-coloniais, em dois romances da literatura nigeriana: Things Fall Apart, de Chinua Achebe e Purple Hibiscus de Chimamanda Ngozi Adichie.

Lex Cult: Revista do CCJF, 2017

Revista Digital do Programa de Pós-Graduação em Letras da PUCRS, 2018

O conto “Foram as dores que o mataram”, de Dina Salustio, escritora cabo verdiana, traz a lume uma discussao impar sobre a realidade de violencia a que muitas mulheres estao subjugadas em algumas ilhas de Cabo Verde, mas tambem em diferentes rincoes do mundo. A luz dos estudos e do conceito da Literatura e da Antropologia sobre esta realidade vivenciada por mulheres sofridas, silenciadas, decorrente do machismo e do patriarcado, este ensaio apresenta uma analise sobre violencia de genero que, atraves da narrativa contemporânea, anuncia um tipo de realidade que se abisma na lente de contato da inscritura africana. Nessa travessia, a artimanha de contar historia vem traduzida pelo legado das culturas dos povos insulares.

Horizontes Antropológicos, 2005

O texto analisa dois poemas de Castro Alves que retratam a mulher negra na prática do auto-aborto e do infanticídio, confrontando-os com as estratégias de domínio sobre a vida e sobre o corpo da mulher negra da política racial do século XIX. Propõe que as noções de culpa originária, diferença-inferioridade e a criação de mecanismos gerenciais de populações são os elementos persistentes da categoria raça. Nos poemas de Castro Alves, transparece a imagem da mãe escrava, divinizada, mas sob domínio de forças externas a sua vontade. Ela constitui-se num espaço de intervenção da moralidade social que defende a sua participação nos males decorrentes da escravidão.

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

Missangas: Estudos em Literatura e Linguística

Revista Labirinto, 2016

RDC - Revista de Divulgação Cultural, 2016

Signótica, 2014

Uniletras, 2020

Chasqui, 2019

AEDOS: Revista do Programa de Pós-Graduação em História da UFRGS, 2022

Conjecturas

Revista Cadernos do Ceom, 2020

Building the way - Revista do Curso de Letras da UEG (ISSNe 2237-2075)

Fronteiras: Revista Catarinense de História

Revista Diadorim, 2016

•   We're Hiring!
•   Help Center
• Find new research papers in:
• Health Sciences
• Earth Sciences
• Cognitive Science
• Mathematics
• Computer Science
• Academia ©2024

Essays About Grief: Top 5 Examples Plus 7 Prompts

Discover our guide with helpful examples of essays about grief and inspiring writing prompts to help you begin writing about this sensitive and emotional topic.

Grief is a human being’s normal but intense and overwhelming emotional response to painful events like the death of a family or friend, disasters, and other traumatic incidents. To cope, we go through five stages of grief : denial, anger, bargaining, depression, and acceptance. 

Writing about grief can trigger strong emotions. However, many also find acknowledging the subject helpful in processing their feelings. Grief is a sensitive topic that covers morals and beliefs. It requires empathy and awareness. 

5 Essay Examples

• 1. Death And Stages Of Grief  by Anonymous on IvyPanda.Com

2. Loss And Grief by Anonymous on GradesFixer.Com

3. coping with grief by writer faith, 4. the main stages of overcoming grief by anonymous on ivypanda.com, 5. stages of grief and people’s perception of grief based on age by anonymous on gradesfixer.com, 1. what is grief, 2. the best way to handle grief, 3. grief and depression, 4. when grief becomes dangerous, 5. books about grief, 6. a personal experience with grief, 7. art inspired by grief, 1. death and stages of grief   by anonymous on ivypanda.com.

“… Ignoring various philosophical and religious views, death can practically be interpreted as a complete cessation of the body’s vital functions. When faced with the death of loved ones, as well as with other traumatic events, a person usually experiences grief.”

This essay expounds on the five stages of grief defined by Elisabeth Kübler-Ross and what people go through in each phase. The author uses the story of the philosopher Nicholas Wolterstorff who lost his son Eric in an accident. The piece further discusses how Nicholas went through each stage, including believing in God’s promise that his son would have eternal life in heaven. The writer believes that grief doesn’t usually follow an order and sometimes appears random. Such as in Wolterstorff’s situation, where he experienced depression before the bargaining phase.

Looking for more? Check out these essays about losing a loved one .

“The loss of a loved one will always be a painful personal journey, and a coping experience that no one is ready for or can prepare for till it happens. The after effect or grief is always personal for everyone that loses a loved one.”

The author presents different poems that reflect her loss and sadness for her mother’s passing. She connects to the poem “ The Courage That My Mother Had ” and values the things her mother left behind. There are times when grieving individuals think they are healed, but one event can bring back the pain in an instant. The writer believes that grief doesn’t end after the acceptance phase. It’s because whenever we think of our loved ones who have already passed away and relive the memories we had of them, we always wish they were still with us.

“Grief is an emotion that unfortunately, we all come to experience at some time or another. However, that terrible feeling can open the door to acceptance and appreciation. Mourning and reflecting upon a tragic event can cause one to look at an issue through a different perspective, and maybe even help them to accept it.”

Faith’s essay demonstrates how tragedies can cause people to unite and support each other. Processing grief teaches the bereaved to be stronger and appreciate the people who offer comfort and encouragement. It also teaches us not to take anything for granted by cherishing even the simple things in life. Faith sees grief and terrible events as negative experiences, but they can lead to positive results that steer people to be grateful.

“Grief is one of the most complicated processes which is to be combated. Some people are able to cope with grief individually, others need assistance. There are even cases when people need professional help to cope with grief.”

The essay contains various passages that discuss the five stages of grief. The author believes denial is the root of grief in all phases. The author supposes that people can overcome grief through several methods, such as reading the bible, getting support from family and relatives, accepting the loss, and learning to live with it.

“The intensity and duration of grief may depend on many factors, such as the personality of the individual, the relationship to the deceased, and the circumstances of the death. Unexpected, sudden, or accidental death can be extremely shocking. Death of one’s child at any age is difficult to accept.”

The essay discusses how various factors, such as relationship, age, and cause of death, affect grief’s intensity and duration. It mentions that grief can last years and that losing a child at any age is the most challenging case to accept. 

The author presents various scenarios showing how these elements influence the state of grieving. For example, a person grieving the loss of their spouse may hear their voice and feel their presence in the room. 

7 Prompts for Essays About Grief

Simply defining grief in your essay won’t make it stand out among the rest. To make your piece enjoyable, describe grief in a way that probes your readers’ feelings and imagination. You can personify grief or compare it to another familiar feeling to give you an idea. For example, you can say grief is a stranger persistently reaching out to you to make you remember hurtful memories.  

We deal with grief in our own way; some take it in their stride, while some become a wreck. Use this prompt to enumerate excellent ways to deal with this heavy emotion. Ask yourself what you’ll do if you can’t get over grief and research thoroughly. Pick the most effective methods of overcoming grief and support your findings with relevant data.

There are many effects of grief, and depression is one of the most significant. Loneliness can negatively affect how a person thinks and acts, but grief makes depression worse. Write an essay with a series of situations that show how grief can lead to depression and ways to prevent it.

Here are some essays about depression to give you an idea of how to write this topic.

Grieving is a normal reaction to losing a loved one but it can turn dangerous when the individual grieving stops normally functioning for at least a year after the death. For this prompt, include reasons people break and let grief consume them, such as extreme depression and fatigue. Add signs and symptoms that can help others detect when someone’s grief becomes unsafe for the individual and the people around them.

In your essay, recommend books, documentaries, or movies detailing grief. These books can be accounts of those who already went through the grieving process and are sharing their experiences. For example, Every Word You Cannot Say by Iain S. Thomas is a delicate book that guides readers into acknowledging their feelings. Detail why these books are helpful for people grieving and recommend at least three books or other forms of media that the reader can use to cope.

Share an encounter you had with grief. Describe what you felt and narrate how you grappled with the situation. For instance, if you have ever helped someone suffering from grief, explain the step-by-step method you used and why you decided to help that person. Even if you don’t have any personal experience with grief, you can interview someone who has gone through it. Remember that it’s a delicate subject, so your questions should be diplomatic.

There are many mediums people use to process their strong feelings. One is through creating art. When writing your essay, list arts made by grief or inspired by grief. Add comments on how the artist managed to relay the loss and grief through the art. You can also share your favorite art you think best depicts grief. Like Vincent Van Gogh’s 1890 painting called “ Sorrowing Old Man .”Learn about transition words for essays to improve your work.

115 Best Loss of a Son Quotes (with Commentary)

The loss of a son is one of life’s most profound and painful experiences, leaving parents and families in a state of deep suffering and longing.

Quotes about this loss often convey the immense pain, love, and treasured memories that remain after such a heartbreaking event.

They provide solace and understanding, reflecting on the journey of healing, the indestructible bond between parent and child, and the significance of remembrance in navigating the path of grief.

Top Loss of a Son Quotes

Losing a son is one of the deepest sorrows a parent can endure. These quotes reflect the love, loss, and memories that remain even in the face of such a profound experience.

“Where you used to be, there is a hole in the world, which I find myself constantly walking around in the daytime, and falling in at night. I miss you like hell.” – Edna St. Vincent Millay

“What we have once enjoyed deeply we can never lose. All that we love deeply becomes a part of us.” – Helen Keller

“Grief is the price we pay for love.” – Queen Elizabeth II

“It’s so much darker when a light goes out than it would have been if it had never shone.” – John Steinbeck

“The reality is that you will grieve forever. You will not ‘get over’ the loss of a loved one; you will learn to live with it.” – Elisabeth Kübler-Ross

“When someone you love dies, you don’t lose them all at once; you lose them in pieces over a long time.” – John Irving

“Grief is like the ocean; it comes on waves ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.” – Vicki Harrison

“Tears shed for another person are not a sign of weakness. They are a sign of a pure heart.” – José N. Harris

“The risk of love is loss, and the price of loss is grief.” – Hilary Stanton Zunin

“You will lose someone you can’t live without, and your heart will be badly broken, but you will come through.” – Anne Lamott

Also Read: Aatrox Quotes (with Commentary)

Loss of a Son Quotes on Grief and Heartache

Grief can be an overwhelming force, especially in the loss of a child. These quotes help to articulate the heartache and the depth of sorrow that often accompany the grief of losing a son.

“Everyone can master a grief but he that has it.” – William Shakespeare

“The best and most beautiful things in the world cannot be seen nor even touched, but just felt in the heart.” – Helen Keller

“There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues.” – Washington Irving

“Grief is the last act of love we have to give those we loved.” – Unknown

“I will not say: do not weep; for not all tears are an evil.” – J.R.R. Tolkien

“When you lose someone you love, you gain an angel you know.” – Unknown

“There is no greater sorrow than to recall happiness in times of misery.” – Dante Alighieri

“Tears are the silent language of grief.” – Voltaire

“Grief is just love with no place to go.” – Jamie Anderson

“Sometimes, only one person is missing, and the whole world seems depopulated.” – Alphonse de Lamartine

Loss of a Son Quotes on Love and Remembrance

The loss of a son creates a void that love and remembrance try to fill. These quotes reflect the enduring bond between parents and their children, reminding us that love transcends time and space.

“Those we love and lose are always connected by heartstrings into infinity.” – Terri Guillemets

“To live in hearts we leave behind is not to die.” – Thomas Campbell

“What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.” – Helen Keller

“You may be gone from my sight, but you are never gone from my heart.” – Winnie the Pooh (A.A. Milne)

“I carry your heart with me (I carry it in my heart).” – E.E. Cummings

“Your absence has gone through me like thread through a needle. Everything I do is stitched with its color.” – W.S. Merwin

“Grief changes shape, but it never ends.” – Keanu Reeves

“I thought of you today, but that is nothing new. I thought of you yesterday and days before that too.” – Unknown

“I hold onto your memory, for it is my greatest treasure.” – Unknown

“The song may have ended, but the melody lingers on.” – Irving Berlin

Loss of a Son Quotes on Healing and Hope

Healing after the loss of a son can seem impossible, but these quotes offer hope that, in time, grief softens, and love remains. They remind us that healing is a journey, and hope is always present.

“The pain of grief is just as much a part of life as the joy of love: it is perhaps the price we pay for love, the cost of commitment.” – Colin Murray Parkes

“Although the world is full of suffering, it is full also of the overcoming of it.” – Helen Keller

“He spoke well who said that graves are the footprints of angels.” – Henry Wadsworth Longfellow

“In the night of death, hope sees a star, and listening love can hear the rustle of a wing.” – Robert Green Ingersoll

“Grief does not change you, Hazel. It reveals you.” – John Green, The Fault in Our Stars

“Hope is like the sun, which, as we journey toward it, casts the shadow of our burden behind us.” – Samuel Smiles

“What is lovely never dies, but passes into another loveliness.” – Thomas Bailey Aldrich

“There is no footprint too small to leave an imprint on this world.” – Unknown

“Sadness gives depth. Happiness gives height. Sadness gives roots. Happiness gives branches.” – Osho

Loss of a Son Quotes on the Impact of Loss

The loss of a son leaves an indelible mark on the hearts of those who loved him. These quotes reflect the profound and lasting impact of such a loss, capturing the deep grief and love that remain.

“The loss of a child is the most unimaginable and profound heartbreak a parent can endure, leaving an unfillable void in life’s journey.” – Jimmy Carter

“There is no greater sorrow than to recall in misery the time when we were happy.” – Dante Alighieri

“When you lose a child, you lose part of your heart forever, and you spend a lifetime learning how to live with the ache.” – Elizabeth Edwards

“When someone you love becomes a memory, the memory becomes a treasure.” – Unknown

“Those who we love and lose are always connected by heartstrings into infinity.” – Terri Guillemets

“A parent’s heart never truly heals from the loss of a child, but rather learns how to carry the pain in silence.” – Sylvia Browne

“Grief is the last act of love we can give to those we loved. Where there is deep grief, there was great love.” – Unknown

“No one ever really dies as long as they took the time to leave us with fond memories.” – Chris Sorensen

Loss of a Son Quotes on Family and Togetherness

The loss of a son brings families together in shared grief, love, and support. These quotes reflect the importance of family bonds and the strength found in togetherness during times of immense loss.

“Family is the compass that guides us. They are the inspiration to reach great heights and our comfort when we occasionally falter.” – Brad Henry

“A family stitched together with love seldom unravels, even in the darkest moments of loss.” – Unknown

“What is lovely never dies, but passes into another loveliness, star-dust or sea-foam, flower or winged air.” – Thomas Bailey Aldrich

“In family life, love is the oil that eases friction, the cement that binds closer together, and the music that brings harmony.” – Friedrich Nietzsche

“The bond that links your true family is not one of blood, but of respect and joy in each other’s life.” – Richard Bach

“We do not heal from grief by forgetting; we heal by remembering. A family’s strength is in the shared memory of those they love and lose.” – Elisabeth Kübler-Ross

“The love of a family is life’s greatest blessing. Even in loss, that love remains eternal.” – Unknown

“There is no greater comfort than the warmth of family during times of grief and loss.” – Unknown

“In the darkest moments of life, family is the light that guides us through.” – Unknown

“What greater thing is there for human souls than to feel that they are joined for life—to be with each other in silent, unspeakable memories.” – George Eliot

Loss of a Son Quotes on Finding Strength in Memories

Finding strength in the cherished memories of a son can offer a path toward healing. These quotes remind us that memories are powerful and eternal, serving as a comforting presence in moments of loss.

“The memory of my son is a light that never dims, even in the darkest moments.” – Unknown

“Memories are the treasure we keep of the ones we love, carried in our hearts forever.” – Tanya Lord

“The ones we love are never truly gone; they live on in our hearts and memories.” – Leo Buscaglia

“When grief is deepest, words are few, but memories hold us in a silent embrace.” – Pam Brown

“Your memory is a keepsake from which I will never part. Though you are gone, your spirit lives on in my heart.” – Unknown

“Grief is the price we pay for love, but memories are the gift love leaves behind.” – Queen Elizabeth II

“What we once enjoyed and deeply loved, we can never lose, for all that we love deeply becomes part of us.” – Helen Keller

“Though my arms cannot hold you, my heart will always embrace the memory of you.” – Unknown

“The greatest tribute to someone who has passed is not grief, but gratitude for the memories shared.” – Unknown

“Death leaves a heartache no one can heal, but love leaves a memory no one can steal.” – Irish Proverb

Loss of a Son Quotes on Coping with Pain

Coping with the pain of losing a son is a journey that takes time, patience, and resilience. These quotes provide insight into the process of grief and healing, offering words of comfort and strength.

“Grief is the last act of love we give to those we loved. Where there is deep grief, there was great love.” – Unknown

“Grief, I have learned, is really just love. It’s all the love you want to give, but cannot.” – Jamie Anderson

“There are no shortcuts through grief, only a path that must be traveled with patience and courage.” – Unknown

“The pain passes, but the beauty remains. Your love and memory will forever be my guide.” – Pierre-Auguste Renoir

“The wounds of grief may heal, but the marks it leaves behind remind us of the depth of our love.” – Unknown

“Coping with loss is not about forgetting but learning to live with the love and pain intertwined.” – Mitch Albom

“The pain you feel today is the strength you feel tomorrow. For every challenge encountered, there is opportunity for growth.” – Unknown

“Grief never ends, but it changes. It’s a passage, not a place to stay. Grief is not a sign of weakness, nor a lack of faith. It is the price of love.” – Unknown

“We must embrace pain and burn it as fuel for our journey.” – Kenji Miyazawa

Loss of a Son Quotes on the Unbreakable Bond

The bond between a parent and their son is an eternal connection that even death cannot sever. These quotes emphasize the strength and love that transcends the physical loss of a child, honoring the enduring presence of that bond.

“The love between a mother and her son is forever, unbreakable, even in death.” – Maya Angelou

“No matter how far away you may seem, the love I have for you, my son, will never fade.” – Mary Jo Putney

“A son may leave your sight, but never your heart.” – Helen Keller

“The bond between a parent and their son is forged in the fires of love, and no distance or time can break it.” – Edna St. Vincent Millay

“My son, though I cannot hold you in my arms, I will forever carry you in my heart.” – Emily Dickinson

“There is no greater bond than that of a mother and her son, for it is bound by love and eternity.” – Jane Austen

“A son’s love is a fire that burns long after the candle of life has gone out.” – Charles Dickens

“Though I cannot see you, I know you are always with me, forever a part of my soul.” – Henry Ward Beecher

“A son may grow old and leave the home, but a mother’s love for him never ages.” – Agatha Christie

“In the heart of every parent lies the soul of their son, an unbreakable link that lives on.” – Victor Hugo

Loss of a Son Quotes on Navigating the Journey of Grief

Grieving the loss of a son is an incredibly personal journey that takes time, strength, and reflection. These quotes offer comfort and understanding as they acknowledge the deep pain of loss while also pointing towards the possibility of healing.

“Grief is the price we pay for love, and the journey through it is a testament to how deeply we cared.” – Queen Elizabeth II

“Grief is like the ocean; it comes in waves, ebbing and flowing, sometimes calm, sometimes overwhelming. All we can do is learn to swim.” – Vicki Harrison

“It’s not about moving on; it’s about learning to live with the grief and carry your son’s memory with you always.” – Nora McInerny

“The pain of losing a son never fully leaves, but it becomes a part of you, shaping who you are as you move forward.” – C.S. Lewis

“Healing is not about forgetting, but about finding ways to live through the heartache and honor the memory of your child.” – Elisabeth Kübler-Ross

“Grief is the last act of love we have to give to those we loved. Where there is deep grief, there was great love.” – Jamie Anderson

“The grief of losing a child is like no other, but through love and time, we find ways to cope and continue.” – Harriet Beecher Stowe

“Grief is not something you conquer. It’s something you learn to live with.” – Anne Lamott

“The journey of grief may be long and hard, but the love of your son will be your guiding light.” – Mitch Albom

“Grief changes shape but never ends. It’s a journey that takes us to unexpected places of pain and healing.” – Joan Didion

Loss of a Son Quotes on Cherishing Moments

When we lose a son, the moments we shared become priceless treasures that live on in our hearts. These quotes honor those cherished memories, keeping them alive in our thoughts as we reflect on the joy and love we experienced together.

“Sometimes, the smallest moments take up the most room in your heart.” – Winnie the Pooh

“The days we spent together may be gone, but the memories will forever live on, giving me comfort.” – Mitch Albom

“Every moment spent with you was a gift, a memory I will hold onto forever.” – Dr. Seuss

“Though the moments were brief, they were filled with enough love to last a lifetime.” – Helen Keller

“It’s not the number of moments we shared but the depth of each one that truly matters.” – Leo Buscaglia

“In the end, it’s the moments of love and laughter that are our greatest legacy.” – Fred Rogers

“The memories of my son are etched in my heart, and each one brings a smile even through the tears.” – C.S. Lewis

“A moment in your arms, a lifetime in my heart.” – Edna St. Vincent Millay

“Cherish every moment, for the love between a parent and child is a story that never ends.” – Victor Hugo

“Though we may be apart, the memories of our time together will always be close.” – Emily Dickinson

Loss of a Son Quotes on Acceptance and Moving Forward

Accepting the loss of a son is an emotional journey, but it’s one where healing and growth eventually find their place. These quotes remind us that while we move forward, we carry the love and lessons of our children with us, finding peace in the process.

“Grief is not about moving on, it’s about learning to carry the love you had with you forever.” – Nora McInerny

“The healing process doesn’t mean forgetting, it means cherishing their memory while embracing the future.” – Harriet Beecher Stowe

“Acceptance is not about forgetting; it’s about finding the strength to live with the memories and move forward with love.” – C.S. Lewis

“It’s okay to mourn, but don’t forget to live. Your son would want you to continue with strength and grace.” – Elizabeth Kubler-Ross

“We do not heal from the loss, we learn to carry the memory with us as we move forward.” – Jamie Anderson

“Sometimes acceptance isn’t about letting go, it’s about learning to live a new way, with their memory.” – Joan Didion

“The love we shared will always guide me forward, even in your absence.” – Henry Wadsworth Longfellow

“Grief may change with time, but the love and memories remain constant, allowing us to move ahead.” – Maya Angelou

“Moving forward does not mean leaving you behind; it means carrying you with me in a new way.” – J.R.R. Tolkien

Also Read:  Quotes About Guardian Angels (with Commentary)

Final Thoughts

Quotes about the loss of a son are reminders of the love that lasts even in the face of unthinkable heartache.

They encourage you to embrace your memories, honor your feelings, and pursue healing in the midst of sorrow.

By sharing these quotes, you not only validate your own experiences but also create a room for connection and understanding among those who have faced identical losses.

Prime day is here! Shop Apple AirPods, Levi's and more deals up to 75% off

• Share this —

• Watch Full Episodes
• Read With Jenna
• Inspirational
• Relationships
• TODAY Table
• Newsletters
• Start TODAY
• Shop TODAY Awards
• Citi Concert Series
• Listen All Day

Follow today

More Brands

• On The Show
• TODAY Plaza

Lisa Marie Presley’s memoir explains why she kept her son’s body in her house for 2 months after his death

This story discusses suicide. If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network at  800-273-8255 , text HOME to 741741 or visit  SpeakingOfSuicide.com/resources  for additional resources.

Lisa Marie Presley kept her son Benjamin's body on dry ice in her home for two months after his death so she could properly say goodbye, her new memoir says.

Presley began writing her memoir, "From Here to the Great Unknown," and her daughter Riley Keough finished it for her after Presley's own death in 2023 at age 54 from a small bowel obstruction. In it, Presley explains why she kept her son's body in her house.

Benjamin died by suicide at age 27, leaving Presley “completely heartbroken, inconsolable and beyond devastated,” according to a statement her representatives gave TODAY at the time.

In her memoir, Presley writes that she decided to keep Benjamin's body on dry ice for two months after his death, in the bedroom of a seperate guest house at her Los Angeles home.

“There is no law in the state of California that you have to bury someone immediately,” Presley writes.

Keough goes on to explain her mother's decision in the book, noting that she wanted "ample time to say goodbye" to her son like she did with her dad, Elvis Presley.

“‘Guys,’ he seemed to be saying, ‘This is getting weird.’”

Riley keough, imagining her late brother benjamin's reaction

When Elvis died, his open casket was kept in his Graceland estate for about two days before he was buried on the property.

“I went down to where he was lying in the casket, just to be with him, to touch his face and hold his hand, to talk to him,” Presley, who was 9 when her father died, writes in her memoir. “I asked him, ‘Why is this happening? Why are you doing this?’”

Presley said she "didn't know what to do with (her) grief," but that having her dad's body in the house helped her.

“Having my dad in the house after he died was incredibly helpful because I could go and spend time with him and talk to him,” she writes.

Her memoir is not the only time Presley has opened up about grieving her son. In 2022, she published an essay in People on National Grief Awareness Day.

“Death is part of life whether we like it or not — and so is grieving,” she wrote in the essay . “There is so much to learn and understand on the subject, but here’s what I know so far: One is that grief does not stop or go away in any sense, a year, or years after the loss.”

“Grief is something you will have to carry with you for the rest of your life, in spite of what certain people or our culture wants us to believe,” she continued. “You do not ‘get over it,’ you do not ‘move on,’ period.”

Shortly before the “Elvis” film by Baz Luhrmann came out in 2022, Presley opened up on social media about how her son’s death had affected her.

“I haven’t posted in quite some time because there really isn’t much to say, as I am and will forever be mourning the loss of my son,” she  ssaid on Instagram. “Navigating through this hideous grief that absolutely destroyed and shattered my heart and my soul into almost nothing has swallowed me whole.”

In her memoir, Presley writes about the process of getting Benjamin's body into her home, saying she was helped by a "very empathic funeral home owner" who understood her wishes.

Keough writes, “They told us that if we could tend to the body, we could have him at home, so she kept him in our house for a while on dry ice. . . And I would go and sit in there with him.”

Benjamin's body was kept in a room cooled to 55 degrees, and Presley took care of him.

“I felt so fortunate that there was a way that I could still parent him, delay it a bit longer so that I could become okay with laying him to rest,” she wrote.

Presley and Keough decided to honor their son and brother by getting his name tattooed on them. Benjamin had had Keough's name tattooed on his collarbone and Presley's name tattooed on his hand, so the mother and daughter got his name tattooed in those same places.

To get the tattoo placement and font right, Keough writes that that her mother invited the tattoo artist to see Benjamin's body.

"The tattooist agreed to go in there with us, bless him, and my mom led us into the casitas (guest house), opened the casket, and, in the most matter-of-fact way imaginable, proceeded to grab my brother’s hand and point out the tattoo, discuss its positioning, show the tattooist where she wanted it on her hand," Keough writes. "I stood there aghast, watching him try to engage in the conversation and pretend this was fine. I’m sure he was thinking, 'What the f--- is going on?' But he stayed that day and did the tattoo perfectly, right afterward, back in the house."

“I’ve had an extremely absurd life, but this moment is in the top five,” Keough adds.

During the time Presley kept Benjamin's body in her home, she was debating about where to bury him: Graceland or Hawaii.

“That was part of why it took so long,” she writes. “But I got so used to him, caring for him and keeping him there. I think it would scare the living f------ piss out of anybody else to have their son there like that. But not me.”

Eventually, Keough writes that she and her mother both “got this vibe” that her brother didn’t want his body to be in the house anymore.

“‘Guys,’ he seemed to be saying, ‘This is getting weird,’” Keough writes. “Even my mom said that she could feel him talking to her, saying, ‘This is insane, Mom, what are you doing? What the f---!’”

The family decided to bury him in Graceland, next to his grandfather Elvis, after holding a funeral service in Malibu. Keough writes that she ensured that her yellow Nike sneakers he had always loved were buried inside his casket with him.

Georgina is an editorial intern for TODAY.com, based in New York City.

• Login / Sign Up

With 30 days left, we need your help

The US presidential campaign is in its final weeks and we’re dedicated to helping you understand the stakes. In this election cycle, it’s more important than ever to provide context beyond the headlines. But in-depth reporting is costly, so to continue this vital work, we have an ambitious goal to add 5,000 new members.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

5 moving, beautiful essays about death and dying

by Sarah Kliff

It is never easy to contemplate the end-of-life, whether its own our experience or that of a loved one.

This has made a recent swath of beautiful essays a surprise. In different publications over the past few weeks, I’ve stumbled upon writers who were contemplating final days. These are, no doubt, hard stories to read. I had to take breaks as I read about Paul Kalanithi’s experience facing metastatic lung cancer while parenting a toddler, and was devastated as I followed Liz Lopatto’s contemplations on how to give her ailing cat the best death possible. But I also learned so much from reading these essays, too, about what it means to have a good death versus a difficult end from those forced to grapple with the issue. These are four stories that have stood out to me recently, alongside one essay from a few years ago that sticks with me today.

My Own Life | Oliver Sacks

As recently as last month, popular author and neurologist Oliver Sacks was in great health, even swimming a mile every day. Then, everything changed: the 81-year-old was diagnosed with terminal liver cancer. In a beautiful op-ed , published in late February in the New York Times, he describes his state of mind and how he’ll face his final moments. What I liked about this essay is how Sacks describes how his world view shifts as he sees his time on earth getting shorter, and how he thinks about the value of his time.

Before I go | Paul Kalanithi

Kalanthi began noticing symptoms — “weight loss, fevers, night sweats, unremitting back pain, cough” — during his sixth year of residency as a neurologist at Stanford. A CT scan revealed metastatic lung cancer. Kalanthi writes about his daughter, Cady and how he “probably won’t live long enough for her to have a memory of me.” Much of his essay focuses on an interesting discussion of time, how it’s become a double-edged sword. Each day, he sees his daughter grow older, a joy. But every day is also one that brings him closer to his likely death from cancer.

As I lay dying | Laurie Becklund

Becklund’s essay was published posthumonously after her death on February 8 of this year. One of the unique issues she grapples with is how to discuss her terminal diagnosis with others and the challenge of not becoming defined by a disease. “Who would ever sign another book contract with a dying woman?” she writes. “Or remember Laurie Becklund, valedictorian, Fulbright scholar, former Times staff writer who exposed the Salvadoran death squads and helped The Times win a Pulitzer Prize for coverage of the 1992 L.A. riots? More important, and more honest, who would ever again look at me just as Laurie?”

Everything I know about a good death I learned from my cat | Liz Lopatto

Dorothy Parker was Lopatto’s cat, a stray adopted from a local vet. And Dorothy Parker, known mostly as Dottie, died peacefully when she passed away earlier this month. Lopatto’s essay is, in part, about what she learned about end-of-life care for humans from her cat. But perhaps more than that, it’s also about the limitations of how much her experience caring for a pet can transfer to caring for another person.

Yes, Lopatto’s essay is about a cat rather than a human being. No, it does not make it any easier to read. She describes in searing detail about the experience of caring for another being at the end of life. “Dottie used to weigh almost 20 pounds; she now weighs six,” Lopatto writes. “My vet is right about Dottie being close to death, that it’s probably a matter of weeks rather than months.”

Letting Go | Atul Gawande

“Letting Go” is a beautiful, difficult true story of death. You know from the very first sentence — “Sara Thomas Monopoli was pregnant with her first child when her doctors learned that she was going to die” — that it is going to be tragic. This story has long been one of my favorite pieces of health care journalism because it grapples so starkly with the difficult realities of end-of-life care.

In the story, Monopoli is diagnosed with stage four lung cancer, a surprise for a non-smoking young woman. It’s a devastating death sentence: doctors know that lung cancer that advanced is terminal. Gawande knew this too — Monpoli was his patient. But actually discussing this fact with a young patient with a newborn baby seemed impossible.

"Having any sort of discussion where you begin to say, 'look you probably only have a few months to live. How do we make the best of that time without giving up on the options that you have?' That was a conversation I wasn't ready to have," Gawande recounts of the case in a new Frontline documentary .

What’s tragic about Monopoli’s case was, of course, her death at an early age, in her 30s. But the tragedy that Gawande hones in on — the type of tragedy we talk about much less — is how terribly Monopoli’s last days played out.

• Health Care

Most Popular

• How Hurricane Milton exploded into a terrifying Category 5 storm in just hours
• Leaked recordings detail a major environmental agency quietly gutting its workforce
• The Supreme Court appears to have found a gun regulation it actually likes
• The profit-obsessed monster destroying American emergency rooms
• Wait, why is Dr Pepper so popular now?

Today, Explained

Understand the world with a daily explainer plus the most compelling stories of the day.

This is the title for the native ad

More in Politics

The “care economy” agenda collapsed despite a Democratic trifecta. A divided government is more likely next time.

Victory in Pennsylvania might be all about losing by less in the other party’s strongholds.

Howard Stern and Alex Cooper do something the New York Times simply can’t.

Looking to understand the Israel-Hamas war? Start with these Vox podcast episodes.

A year after October 7, Gaza may be turning into Israel’s “forever war.”

The acclaimed writer takes on another intractable problem.

When Your Child Dies, You Are the Sum of Your Parts

Juggling complex and paradoxical feelings is part of the grieving process..

Posted October 8, 2024 | Reviewed by Gary Drevitch

• Understanding Grief
• Take our Depression Test
• Find a therapist to heal from grief
• There's no wrong way to grieve.
• Juggling complex and paradoxical feelings is just part of the grieving process.
• Whatever you're feeling is what you should be feeling.

One part of you knows that you must go on with your life, while another part doesn’t ever want to get out of bed.

One part of you feels like you did everything possible to save your child, while another part takes you to task for not having done enough.

One part of you believes that you were the best parent a child could ever have, while another part questions how you could possibly be the best parent when you failed to keep your child alive.

One part of you accepts the reality of your loss, while another part remains lost in disbelief.

One part of you acknowledges that love never dies and that grief lasts a lifetime, while another part wonders how you could possibly continue to live like this.

One part of you understands that enduring the worst thing that could ever happen to a parent makes you a stronger person, while another part asks how you can be stronger when a piece of you is missing and can never be replaced.

One part of you has begun to process your grief by facing what scares you the most, while another part simply ignores it.

One part of you has stopped crying all the time and feels a tiny bit better, while another part suffers an intense sadness that will never go away.

One part of you doesn’t allow the loss to define you, while another part feels like the poster child for bereaved parents who are endlessly pitied.

One part of you is slowly letting go of denial , guilt , anger , and fear , while another part is drowning in an ocean of sorrow.

One part of you has been able to experience joy again, however short-lived, while another part feels terribly guilty about it.

One part of you has become a warrior, while another part is exhausted and ready to give up.

One part of you is hopeful that you’ll survive your tragic loss as so many have before you, while another part is certain that nobody has ever experienced the depth of pain you’re living through.

One part of you is certain that nothing can ever hurt you again, while another part is an open wound that will never heal.

One part of you takes great comfort in your faith, while another part admonishes God for taking away the most cherished gift He ever gave to you.

One part of you is becoming yourself again, while another part feels that the best part of yourself is gone forever.

One part of you has stopped torturing yourself by asking unanswerable questions, while another part stays up all night trying to answer them in vain.

One part of you needs to be strong for your other children, while another part secretly fears for their lives.

One part of you has changed and evolved with your grief, while another part is scared that if you change too much, you’ll lose the connection with your child.

One part of you senses that what you’re feeling is exactly what you should be feeling and that you’ll feel differently in the future, while another part views the future as meaningless.

One part of you realizes that juggling all these complex and paradoxical feelings is just part of the grieving process—that you can hold opposing thoughts at the same time—while another part, after making a fuss, reluctantly agrees.

One part of you concedes that the whole is greater than the sum of its parts, while another part still wonders how to become whole again.

Larry Carlat is a grief coach and group leader for bereaved parents at Our House Grief Support Center in Los Angeles, and sits on its Board of Directors.

• Find a Therapist
• Find a Treatment Center
• Find a Psychiatrist
• Find a Support Group
• Find Online Therapy
• United States
• Brooklyn, NY
• Chicago, IL
• Houston, TX
• Los Angeles, CA
• New York, NY
• Portland, OR
• San Diego, CA
• San Francisco, CA
• Seattle, WA
• Washington, DC
• Asperger's
• Bipolar Disorder
• Chronic Pain
• Eating Disorders
• Passive Aggression
• Personality
• Goal Setting
• Positive Psychology
• Stopping Smoking
• Low Sexual Desire
• Relationships
• Child Development
• Self Tests NEW
• Therapy Center
• Diagnosis Dictionary
• Types of Therapy

It’s increasingly common for someone to be diagnosed with a condition such as ADHD or autism as an adult. A diagnosis often brings relief, but it can also come with as many questions as answers.

• Emotional Intelligence
• Gaslighting
• Affective Forecasting
• Neuroscience

Warning: The NCBI web site requires JavaScript to function. more...

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Institute of Medicine (US) Committee on Palliative and End-of-Life Care for Children and Their Families; Field MJ, Behrman RE, editors. When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Washington (DC): National Academies Press (US); 2003.

When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families.

• Hardcopy Version at National Academies Press

APPENDIX E BEREAVEMENT EXPERIENCES AFTER THE DEATH OF A CHILD

Grace H. Christ, D.S.W., * George Bonanno, Ph.D., * Ruth Malkinson, Ph.D., † and Simon Rubin, Ph.D. ‡

• INTRODUCTION

The death of a child of any age is a profound, difficult, and painful experience. While bereavement is stressful whenever it occurs, studies continue to provide evidence that the greatest stress, and often the most enduring one, occurs for parents who experience the death of a child [ 1 – 6 ]. Individuals and families have many capabilities and abilities that allow them to respond to interpersonal loss and to emerge from the experience changed but not broken. The few studies that have compared responses to different types of losses have found that the loss of a child is followed by a more intense grief than the death of a spouse or a parent [ 5 ]. This conclusion must be considered cautiously, however, since these studies have typically confounded sample differences in age and degree of forewarning [ 7 ]. Forewarning is important because according to the Centers for Disease Control and Prevention [ 8 ], about half of child deaths occur during infancy, most with limited preparation time. Unintended injuries are the leading cause of death in children age 1 to 14 and account for more than half of all deaths among young people 15 to 19 years of age. In addition, while the overall death rate for children aged 14 and younger has declined substantially since the 1950s childhood homicide rates have tripled and suicide rates have quadrupled [ 9 ]. Recent findings suggest that parents of children who die from any cause are more likely to suffer symptoms of traumatic stress and experience more severe problems with emotional dysregulation than occurs with the death of a spouse [ 10 ].

Integrating the loss of a child into the life narrative, making sense and new meanings of such a wrenching event, presents a challenge to parents and family [ 11 ]. Although once common, deaths of children between the ages of 1 and 14 now account for less than 5 percent of all deaths in the United States; about 57,428 infants, children, and adolescents died in 1996. In contrast to the past when families might have had several children die, death in childhood is now rare. Children are expected to live to adulthood. Conflicting with current life-cycle expectations, the death of a child may be experienced as the death of the parents' future dreams as well as creating a profound change in their present roles and functioning. Increases in the incidence of suicide and homicide in adolescents and random acts of violence in our society have increased the risk of traumatic stress responses for bereaved family members.

Medical advances have prolonged the dying process for children as well as adults, making terminal illness in children longer and more complex, often requiring parents to make difficult decisions about end-of-life care. Preliminary research evidence suggests that family bereavement may be adversely affected by the inability to reduce suffering during the child's dying process [ 12 ].

This appendix reviews the unique features of the parent role; the importance of the parents' continuing memory of the child; the impact of variations in atypical, unresolved, and catastrophic deaths; and the special features of parents' loss of an infant, a school age child, and an adolescent, and the impact of a child's death on siblings and other family members. Also reviewed are interventions and research directions.

• BEREAVEMENT, MOURNING, GRIEF, AND COMPLICATED GRIEF

Bereavement is a broad term that encompasses the entire experience of family members and friends in the anticipation, death, and subsequent adjustment to living following the death of a loved one [ 13 ]. It is widely recognized as a complex and dynamic process that does not necessarily proceed in an orderly, linear fashion [ 14 , 15 ]. Rather, individuals have concurrent and overlapping reactions that may recur at any time during the family's bereavement process. Bereavement includes the internal adaptation of individual family members; their mourning processes, expressions, and experiences of grief; and changes in their external living arrangements, relationships, and circumstances.

Grief is a term that refers to the more specific, complex set of cognitive, emotional, and social difficulties that follow the death of a loved one [ 16 ]. Individuals vary enormously in the type of grief they experience, its intensity, its duration, and their way of expressing it. Mourning is often defined as either the individual's internal process of adaptation to the loss of a loved one or as the socially prescribed modes of responding to loss, including its external expression in behaviors such as rituals and memorials. Taken together, the grief and mourning processes are understood to be a normal and universal part of the natural healing process that enables individuals, families, and communities to live with the reality of loss while going on with living [ 17 , 18 ].

Complicated grief in adults refers to bereavement accompanied by symptoms of separation distress and trauma [ 19 ]. It is defined as occurring following a death that would not objectively be considered “traumatic” (i.e., not resulting from an unanticipated, horrifying event) and requires that the person experience (1) extreme levels of three of the four “separation distress” symptoms (intrusive thoughts about the deceased, yearning for the deceased, searching for the deceased, and excessive loneliness since the death), as well as (2) extreme levels of four of the eight “traumatic distress” symptoms (purposelessness about the future; numbness, detachment, or absence of emotional responsiveness; difficulty believing or acknowledging the death; feeling that life is empty or meaningless; feeling that part of oneself has died; shattered world view; assuming symptoms of harmful behaviors of the deceased person; excessive irritability, bitterness, or anger related to the death). These symptoms must have lasted at least six months and led to significant functional impairment. Because parents of children who die are at greater risk for traumatic stress symptoms and emotional dysregulation, they are at greater risk of complicated grief [ 10 ].

Siblings of children who die have also been found to be at greater risk for externalizing and internalizing problems when compared to norms and controls [ 20 - 23 ] within 2 years of the death. Complicated bereavement has been less clearly defined for children but is also thought to include symptoms of PTSD, other psychological characteristics associated with this disorder, and grief. The Expanded Grief Screening Inventory is a 20-item measure developed to assess complicated bereavement in children and adolescents. Factor analysis indicates three independent factors including positive reminiscing, intrusion of PTSD on the grieving process, and existential loss [ 24 - 27 ]. This measure has shown strong psychometric properties and is currently being used to follow the clinical course of such complicated bereavement in children.

• THE PARENT ROLE AND LOSS OF A CHILD

The process of conceiving, giving birth, and raising offspring is shared by virtually all living animals. The human experience of this process, however, adds many elements of psychological, social, and meaning construction. At various stages in the life cycle, men and women relate to child-conceiving and child-rearing roles as central to their existence. Of the bonds formed within the family, the parent–child bond is not only particularly strong, it is also integral to the identity of many parents and children [ 4 ]. Much has been written about the significance of the parent–child attachment bond as a major organizer of the individual parent's positive sense of self and significant relationships with others [ 17 ].

Parents of children and adolescents who die are found to suffer a broad range of difficult mental and physical symptoms. As with many losses, depressed feelings are accompanied by intense feelings of sadness, despair, helplessness, loneliness, abandonment, and a wish to die [ 28 ]. Parents often experience physical symptoms such as insomnia or loss of appetite as well as confusion, inability to concentrate, and obsessive thinking [ 17 ]. Extreme feelings of vulnerability, anxiety, panic, and hyper-vigilance can also accompany the sadness and despair.

Grieving parents evidence anger as part of the normal reaction to the loss of their child [ 17 , 29 – 33 ]. This may be expressed as intense rage or as chronic irritation and frustration. It may be directed at the spouse, at other family members, at the professional staff, at God, at fate, or even at the dead child. Anger may also be directed at the self, creating feelings of self-hatred, shame and worthlessness [ 28 , 34 - 36 ].

Children take on great symbolic importance in terms of parents' generativity [ 37 ] and hope for the future. All parents have dreams about their children's futures; when a child dies the dreams may die too. This death of future seems integral to the intensity of many parents' responses. Three central themes in parents' experience when a child dies include (1) the loss of sense of personal competence and power, (2) the loss of a part of the self [ 38 , 39 ], and (3) the loss of a valued other person whose unique characteristics were part of the family system. While guilt and self-blame are common in bereavement, they are especially pronounced following the death of a child. The parent's role competence as the child's caregiver, protector, and mentor is severely threatened by untimely death.

Parents assert that their grief continues throughout their lives, often saying, “It gets different, it doesn't get better.” Words such as “closure” can be deeply offensive. The few studies that have followed parents for years after the child's death support the concept of their preoccupation with the loss of children across the life cycle [ 4 , 40 – 42 ]. Klass [ 39 ] refers to the “amputation metaphor”: the vivid sense of a permanent loss of a part of oneself that may be adapted to, but will not grow back. Freud's letter to a friend about the loss of his eldest daughter describes this eloquently:

For years I was prepared for the loss of my sons (in war); and now comes that of my daughter. Since I am profoundly irreligious there is no one I can accuse, and I know there is nowhere to which any complaint could be addressed. “The unvarying circle of a soldier's duties” and the “sweet habit of existence” will see to it that things go on as before. Quite deep down I can trace the feelings of a deep narcissistic hurt that is not to be healed [ 43 , p.20].

Parents resist the idea that they will recover from their child's death. Rather than “recovery” or “resolution,” which suggest a return to pre-loss functioning, “reconciliation,” and “reconstitution” have been used to describe the post-death period because these terms more adequately reflect the profound changes that take place when a child dies. They express the reality that even the successful mourning process results in a transformation in the person consequent to the death of a loved one [ 44 ]. Despite traditional assumptions that all bereaved individuals must mourn, prospective studies have shown that considerable numbers of bereaved individuals evidence no overt signs of grieving or of the reconstitutive processes associated with grieving (for a review see [ 1 ]). The question these findings raise is to what extent this type of resilient pattern may also be found among those mourning the death of a child [ 27 ].

• CONTINUING BONDS: THE TWO-TRACK MODEL OF BEREAVEMENT

There is little doubt that most persons respond with emotional and physiological distress following loss. Equally apparent is the fact that the bereavement response is predominantly one of readjusting and recalibrating the often covert psychological attachment to, and preoccupation with, the person now deceased. However, most studies have assumed that a reduction of symptoms defines “recovery” and constitutes a successful bereavement outcome. The parent's continuing investment in the relationship with the deceased has often been neglected. In a recent study of parents of infants who died of SIDS (sudden infant death syndrome), the phenomena associated with the bereavement response had a very different time frame and trajectory when the continuing investment in the relationship with the deceased was assessed [ 4 ].

The Two-Track Model of Bereavement [ 41 , 42 ] combines the perspective of both the symptomatic bio-psychosocial response to bereavement and the relationship with the deceased. The bereavement response is understood to unfold along two multidimensional axes or tracks that are generally significant to understanding human adaptation to life demands. The first track focuses on how people function generally, and in the case of loss, it focuses on how functioning is affected following death. The second track focuses on how people are involved in maintaining and changing their relationships with significant others. In the case of bereavement, this relational track focuses on the bereaved parent's emotions, memories, and mental representations as they relate specifically to the deceased. Thus, the human bereavement response is not only triggered by the death of a significant person, but also initiates a degree of a continuing, albeit quite varied and modified, relationship to that person across the life cycle.

The implications of the Two-Track Model of Bereavement are relevant to theory, research, social support, and clinical and counseling interventions. It is important to consider not only the degree of overt function and dysfunction following loss, but also the ways in which memories and thoughts about the deceased are discussed, thought about, and serve an active role in the emotional and mental life of the bereaved. This ongoing connection is most vividly and consistently reported, indeed insisted on, by many bereaved parents in relation to the death of a child.

The two-track model proposes 10 domains for assessment on each of these axes following loss. On Track I, the individual's functioning is assessed in relation to (1) degree of anxiety and depressive responses and triggers of such responses; (2) other affective responses such as guilt and helplessness; (3) somatic concerns and dysregulation; (4) psychiatric symptoms including orientation and mental status, PTSD (post traumatic stress disorder) in both full-blown and partial forms, and suicidal ideation; (5) self-esteem; (6) the individual's ability to work or perform major life tasks; (7) the management of family relationships, including the relationship to spouse or partner, to other children, and to the extended family; (8) the nature and degree of involvement in interpersonal relationships outside the family; (9) the meaning framework or structure in which the bereaved is embedded and its current power; and (10) the degree to which the bereaved is able to invest emotional energy in life tasks and the type of life tasks that are engaged.

On Track II, the nature of the relationship to the deceased is assessed on 10 other dimensions. These include (1) the degree of preoccupation with memories and thoughts of the deceased; (2) the extent to which the description of the deceased is characterized by an inability or unwillingness to express the personal feelings brought about by the death; (3) the degree of idealization of the deceased; (4) the report of psychological conflict or contradictions in the relationship; (5) the degree and type of positive affect and emotion; (6) the degree and type of negative emotion toward the deceased; (7) the degree of closeness or distance from the relationship and experience of the deceased; (8) the affective experience when discussing the deceased (e.g., a parent who might say, “I always feel guilty thinking about how my son died”); (9) the presence of previously described grief phases of shock, seeking reminders of the deceased, disorganization, and restoration of a coherent life flow; and (10) the manner in which the deceased is memorialized both publicly and within the family. The individual with complicated grief is at greater risk for a variety of psychopathologies and physical illnesses.

• ANTICIPATED, SUDDEN, TRAUMATIC, AND CATASTROPHIC DEATHS

The particular circumstances of the death (i.e., whether it was an anticipated death from illness, a sudden death, the result of a natural disaster or a terrorist attack that affects an entire community) also shapes families' bereavement reactions and service needs. When a child's illness is long, arduous, and filled with chronic crises, parents may develop unusual coping skills to sustain themselves and their family over many months and years or they may become worn down and depleted emotionally and financially by the entire process. Therefore interventions that provide practical and emotional support, skills training, and respite throughout the often long and crisis-filled period of the child's illness may aid families' bereavement. Psychological processes that parents have described as helpful include working through the need to assign blame for the disease including self-blame, becoming well informed about the disease and treatment, developing a more realistic assessment of the medical care system and an ability to communicate with professionals, becoming the child's advocate, and focusing on immediate treatment successes while maintaining a long-range perspective.

When the child's death can be anticipated, evidence suggests that effective management of the terminal illness period may also benefit the family's bereavement. In Wolfe's study [ 12 ], parents who were informed in a timely way that their child's illness had become terminal, that death was now inevitable, were able to make decisions that lessened their child's experience of pain and suffering. Compared to parents who were informed later, parents informed closer to the time the physician documented the terminal nature of the illness were able to reflect on the death with greater feeling of their own effectiveness in providing their child a peaceful death. With the longer terminal illness period made possible by medical advances, it is important for physicians to recognize and inform families when there is no realistic possibility of significant extension of life so that they can make informed decisions about palliative care or other concurrent model of care rather than curative treatments. Wolfe also found that families may be helped during this highly stressful period by mental health interventions.

Trauma theories and grief theories developed in separate literatures, and only recently has research begun to integrate the findings, concepts, and responses related to these overlapping but distinct conditions [ 45 – 48 ]. There is some evidence to suggest that those bereaved by traumatic deaths may benefit from initial interventions focused on reducing terror, fear, and anxiety about the circumstances of the death—that is, by interventions similar to those typically used for PTSD. Grief therapies have also been found effective in situations of complicated grief, of which traumatic grief is one example [ 47 ]. A failure to address the intertwining of these symptoms of trauma and loss early in their bereavement may compromise the individual's capacity to experience optimal recovery. For example, cognitive behavioral interventions suggested for trauma symptoms in a treatment manual by one research team include stress inoculation therapy, gradual exposure, and cognitive processing. Stress inoculation involves such techniques as feeling identification, relaxation techniques, deep breathing, progressive muscle relaxation, thought stopping, cognitive coping skills, enhancing the individual's sense of safety, psycho-education, and understanding the connection between thoughts, feelings, and behaviors [ 48 ]. Gradual exposure aims to separate overwhelming negative emotions such as terror, horror, extreme helplessness or rage from thoughts, reminders, or discussions of the death of the loved one. Cognitive processing aims to identify, correct, and challenge thoughts about the death that are unhelpful or inaccurate (for example “my dad must have suffered terrible pain during the explosion in the WTC”). In contrast, bereavement interventions focus on understanding the mourning process including feelings of loss and anticipation of reminders; resolving ambivalent feelings about the deceased, preserving positive memories of the deceased, accepting that the relationship is one of memory and recommitting to present relationships [ 48 ]. Nader describes convincingly how trauma prevents reminiscence necessary to grieve by evoking feelings of terror [ 25 , 49 ]. Conversely, grief can also act as a traumatic reminder to the individual who may be experiencing a sub-clinical response to trauma or meet criteria for a formal diagnosis of PTSD, increasing anxiety in either situation. Those bereaved by deaths seen as nontraumatic are more apt to focus on their relationship to the deceased as an important feature of the experience of loss [ 44 , 50 ]. Many aspects of parental grief reactions in response to the death of a child have been viewed as overlapping with traumatic symptoms, and indeed even parents whose children have cancer have been assessed to experience high levels of traumatic stress [ 51 ].

While the added stresses on families' bereavement related to violent and intentional death have been documented, bereavement interventions or follow-up care have only recently been offered in emergency room settings in a systematic way. Even when offered, families affected by homicide have seldom participated in follow-up bereavement services [ 52 , 53 ]. Management of the final moments of an intentional or unintentional sudden death of a child continues to challenge professionals. Trauma research consistently supports the benefit of early intervention with traumatized individuals or families close to the time of the death in order to prevent later adverse reactions [ 54 ]. However, which interventions are most effective in which situations continues to be debated and awaits further research. For example, a summary of studies of critical stress debriefing in a 2001 review of the effectiveness of psychological debriefing concludes that though debriefing holds potential as a screening procedure, it does not prevent psychiatric disorders or mitigate the effects of traumatic stress. Still, people generally find the intervention of debriefing helpful in the process of recovery [ 55 ].

Catastrophic events such as the Oklahoma City bombing and the New York City World Trade Center attacks are very public with broad media coverage. They involve large numbers of deaths and unusual situations that present unique coping challenges during bereavement. Each catastrophic event has important commonalities with other catastrophes, but also important differences. It is these similarities and differences that need to be identified and studied in order to sharpen the ability not only to treat grief reactions, but also to prevent the development of PTSD as well as other forms of complicated bereavement

The World Trade Center attacks involved an attack from an outside hostile enemy that mobilized patriotism and national anger and gave rise to an ongoing war on terrorists throughout the world. Victims, especially firemen, policemen, and rescue workers were hailed as heroes in a war, killed in the act of protecting or saving others. Victims were mostly adults. Particular stresses for survivors include the ongoing search for bodies or body parts and the many continuing reminders related to the ensuing war as well as the many public memorials. For some, finding no remains hinders progress with the mourning process. Early reminders included frequently announced threats of other impending terrorist attacks and other purported enemy acts, such as sending anthrax in letters. The war itself constitutes a reminder interspersed with media reports of investigations about “what went wrong” that permitted the attack and the deaths of thousands.

• POSITIVE AND NEGATIVE IMPACT OF A CHILD'S DEATH ON SELF, MARITAL RELATIONSHIP, AND FAMILY

Bereaved parents report a number of potentially positive as well as negative reverberations as a consequence of adjusting to loss. Bereaved individuals discuss their experience of having changed as a result of the loss, of learning to value anew what is really important to them, and of reviewing priorities. Some relationships with families and friends are strengthened, others are found wanting. Perhaps the most important relationship affected by child loss is that of the parents.

The majority of studies on this issue have focused on divorce as an indicator of stress upon the parents. However, there is a great deal of variability across studies regarding the divorce rates following a child's death. A recent review of these studies concluded that some writers give overly high estimates of divorce for which there is no empirical support [ 32 ]. On the other hand a substantial minority of couples do seem to experience severe marital distress. Bohannon [ 33 ], for example, conducted a longitudinal study of couples' grief responses and marital functioning. In her study, about 30 percent of husbands and wives reported having more negative feelings toward their spouse since the death; 19 percent of husbands and 14 percent of wives felt their marriages had deteriorated since the death. About the same proportion had considered divorce after the death of their child. A major difficulty in doing such research is that the frequency of divorce in the U.S. population is about 50 percent. Separating the “real” contribution of the death of a child from other causes of marital strife in bereaved families is a difficult research challenge.

To address this issue Compassionate Friends, a self-help organization for bereaved parents, recently completed a survey of 14,852 parents who had lost a child. When a Child Dies: a Survey of Bereaved Parents, was conducted by NFO in 1999 and published on the Web site of compassionate friends” ( www.doorsofhope.com/grieving-healing/compassionate friends.htm ). Its concern was how troubled newly bereaved parents frequently feel when they read or hear about high divorce rates among couples following the death of a child (80-90 percent by some estimates). The survey found that of those who completed it 72 percent of parents who were married at the time of their child's death are still married to the same person. The remaining 28 percent included 16 percent in which one spouse had died, and only 12 percent of marriages had ended in divorce. While acknowledging the potential bias in its sample, the conclusion was that the divorce rate among bereaved parents was substantially lower than is often cited.

Most studies of parent divorce after the death of a child are limited by methodological problems including the lack of a control group, selection bias, and high attrition rates. The highest estimates of divorce seem overstated. Indeed some studies have found that as many as 25 percent of couples experience increased closeness in their marriage [ 2 , 33 ]. As Rando suggests [ 56 ] bereaved couples need to be informed that grief is a very individualized process experienced differently by each partner and reassured that relationships can and do survive after a child's death.

A number of studies have investigated the marital relationship and tried to identify gender differences that may account for conflict and distancing between couples. These and other common problems between parents after the death of a child include the following:

Conflict and anger, at times directly or indirectly blaming the spouse for the death, [ 34 , 56 ] are frequently described as a way of dealing with painful feelings.

Breakdown in communication, such as avoidance of all discussion of the death or misunderstandings about it, is often associated with marital distress.

Discordant coping is related to differences in grief expression between men and women. Women tend to use more emotional expression as they process discussions to cope with the stress, while men try to control their emotions and cope with them alone, engaging in solution-focused discussions and activities.

Incongruent grieving in which father and mother react to the infant or child death with different levels of intensity and for different periods of time—women typically grieve more intensely and for longer periods of time than do their spouses [ 13 ]. One study reported continued marital distress from such variations in grief as long as two to four years after the child's death supporting the enduring nature of such stresses [ 57 ].

Low intimacy in which the combination of incongruent grieving, discordant coping, communication breakdowns, and other misunderstandings, as well as different needs for sexual intimacy are thought to contribute to a low sense of intimacy between parents [ 58 , 59 ]. Lower levels of intimacy and support from one's partner are associated with greater incidence, intensity, and duration of grief symptoms for both men and women [ 14 , 38 , 60 - 62 ].

• IMPACT OF THE LOSS ON SIBLINGS AND OTHER FAMILY MEMBERS

The death of a child may be one of the most difficult and profound experiences for surviving siblings, grandparents and other family members as well as parents. In the case of an illness such as childhood cancer, the death may have been preceded by months or years of stressful treatments in which family attention and resources were focused on the ill child. In 1981, the title of an article on sibling loss, “Siblings: The Forgotten Grievers” [ 63 ], reflected the lack of attention in practice and research to sibling bereavement. Over the past two decades, clinical and research attention to sibling loss, although relatively new, has increased significantly [ 64 ]. This development occurred in response to a growing awareness that earlier beliefs of children's inability to grieve were incorrect. In addition, qualitative studies and personal narratives documented the intensity of sibling grief and sometimes lifelong negative consequences of failure to recognize and support siblings in their grief.

Retrospective qualitative studies suggest that surviving siblings may have feelings of isolation and social withdrawal at home and with peers [ 23 , 65 , 66 ]. They have reported feeling different from peers as a result of their experiences and typical peer activities (e.g., interests in fashion, sports) may seem less important after the death. Parents and teachers reported that siblings have significantly lower social competence and higher social withdrawal scores on standardized measures within two years of the death [ 20 , 21 ]. Siblings themselves describe feeling guilty, anxious, and depressed and parents have noted problems with sleeping, nightmares, anxiety and post-traumatic stress symptoms [ 22 , 23 , 67 , 68 ].

Explanations for siblings' distress have focused on the parents' preoccupations with the child who has died and distraction with their own grief causing the neglect of the siblings. Bereaved parents have reported high levels of parenting stress as they are confronted with many new daily responsibilities. Siblings describe a lack of communication, decreased availability and support from parents [ 23 ]. Some have suggested bereaved parents may also become closer to and overprotective of surviving children [ 69 ].

As understanding of children's capacity to grieve has grown [ 44 , 70 ] attention has turned to studying the variations in their grief experiences. Research has focused on the development of a measurement tool for assessing sibling bereavement, studied effects of sibling death on younger children and adolescents, identified longer term outcomes of sibling bereavement, and documented the natural history of sibling bereavement [ 3 , 65 , 71 , 72 ]. Practice guidelines for interventions with bereaved siblings have also been developed [ 73 ].

Few interventions of bereaved siblings have been systematically studied in relation to their effectiveness [ 74 ]. However, Davies, in her overview of the literature, suggests a number of principles that have emerged that may inform the structure of interventions and provide helpful thematic foci with the individual child and adolescent [ 64 ]. The following principles expand on Davies' discussion.

Children of all ages can benefit from validation of the normalcy and appropriateness of a broad range of grief reactions to the death of a sibling. Recognition of their unique relationship to the sibling and their individual responses to the loss of that relationship within their personal and familial situation is fundamental to intervention with bereaved siblings.

Context is important and includes taking account of the timing and specific circumstances of the death, the ethnicity and culture of the family. Siblings are likely to benefit from being included in interventions earlier in the trajectory of the sibling's death and continuing follow up contact over a longer period of time than generally occurs. Children facing the impending death of a parent experience greater anxiety and depression than they do immediately after the death occurs [ 44 ]. This finding suggests that the terminal illness period offers the opportunity for family members to prepare for a loss and provides the possibility of preventive intervention. Similarly, facing the death of a sibling gives an opportunity to provide information, education, emotional support, and preparatory actions that can mitigate the adverse consequences of the death. Knowledge of longer term effects of sibling and parent death is limited, therefore interventions need to provide for monitoring of children's and families' functioning over time in order to identify later effects and infuse timely services.

The details of the specific circumstances of the death, (e.g., anticipated, sudden, catastrophic) affect how siblings and family members experience the loss. They may confront more or less traumatic stress, greater or less avoidance of reminders and thoughts about whether the death could have been prevented, and more or less hopefulness about the consequences of the death on the family and their future opportunities in life.

The importance of the family's ethnicity and traditional way of coping with stresses including death is important in intervening effectively with a broad range of diverse family cultures. For example the level of openness in communication of facts and feelings about the loss with both adults and children, the expectations of the length and quality of the grief process, the use of particular rituals and symbolic processes, and decision making patterns can vary enormously and should inform intervention approaches.

Developmental attributes are likely to influence how siblings experience and express their loss. For example, young children are more likely to harbor unrealistic fears of their own vulnerability to the illness, injuries, or condition their sibling experienced. Adolescents are more vulnerable to depression in response to the parents' grief and subsequent withdrawal from them as the adolescent goes through normal separation from the family. Knowledge of these differences in cognitive, emotional, and social/ ecological capacities should be integrated into intervention approaches and thematic foci.

A family and interpersonal focus is essential, whether the primary target of the intervention is the parent or the child. The parents' management of their own grief and construction of the meaning of the loss has an enormous impact on surviving children. The degree to which they blame the surviving children, are able or unable to re-establish a positive relationship to the siblings, to engage in the siblings' growth and view their progress and development as uniquely important as the lost future of the child who died has an impact on the stress of the situation for siblings. Facilitating communication and understanding between parents and their children about these often unacknowledged dilemmas and management of family communication during terminal illness and after death is an important component of intervention efforts. Similarly the parents' own positive mental health and ability to fulfill important life goals going forward contributes to a stronger support system for surviving siblings.

Empowering a broad range of support systems is also an essential part of an intervention. As children develop, they are affected by an increasing number of social, service, and political systems: e.g. extended family and friends, teachers, coaches, peers, health and mental health professionals, religious groups and institutions, community services, and national and international policies and structures [ 75 ]. Influencing these systems through education, dissemination of information, consultation, and support can significantly expand the help available to siblings and other family members.

Qualitative analyses of sibling experiences highlight the following themes as a focus for interventions with siblings.

Loss of affection, attention, continuity, and stability within the family due to parental distress and preoccupation with their own bereavement. This can include multiple separations and lack of attention from parents during the ill sibling's terminal illness or unavailability due to parents' traumatic stress responses after the sibling dies. Stresses on the marriage after the death of a child affect the siblings as well.

A lack of social validation of siblings' grief experiences. This can be due to lack of understanding of children's grief, underestimation of the importance of the sibling relationship, or fear and lack of knowledge about how to respond to the grief of another child by peers and adults. A student bitterly reported a teacher's question, “Why are you upset, he was only your step-brother?” “But he lived with me all my life,” she said to herself. Siblings experience a high level of social constraint in response to their grief.

Perceptions of not being good enough to fill the void in the parents' affection. Parents' intense preoccupation with the dead child is interpreted as a lack of love of the surviving sibling—“the wrong child died.” The sibling feels devalued, alienated, and isolated from both family and peers.

Davies summaries these themes from the sibling's perspective [ 64 ] (pp. 211-216):

“I hurt inside” requires comfort, consolation, and validation of the child's unique experience of the loss. This is a particularly challenging task for grieving parents and may be assisted by the use of peer support groups.

“I don't understand” requires explanation and interpretation provided at a level appropriate to the child's cognitive developmental level. Concerns about the child's own safety and well being in addition to other facts about the situation should not be overlooked. Resources available to parents and professionals include books that focus on helping children with a broad range of grief reactions and types of losses [ 76 - 78 ].

“I don't belong” requires including and involving the child before the death occurs in the case of anticipated loss, during the death and burial rituals, and in the post-death bereavement process. Research continues to support the helpfulness of children's and adolescents' involvement in these processes when they are given adequate preparation for their particular role.

“I'm not enough” requires continued reassurance and validation of the unique worth of each child. This response is somewhat unique to sibling loss compared to other types of losses and has at times powerfully affected siblings' adaptation.

• IMPACT OF THE DEATH OF INFANTS, OLDER CHILDREN, AND ADOLESCENTS

Infant Death

The deaths of infants, either through miscarriage, stillbirth, newborn death, or SIDS, were until recently regarded even by most professionals as “nonevents” or “non-deaths” affecting unnamed “non-persons” [ 79 ]. Greater awareness of the importance of validation and recognition of the significance of the loss of infants to parents has resulted in the development of programs to guide parents in their expression of grief and to encourage them to engage in rituals from their particular religious, cultural, or ethnic background. While there are common issues in bereavement for all infants, each of these circumstances of infant death brings its unique stresses related to the way in which it occurs as well as to the individual parent(s) [ 80 ].

Stillbirths. A stillbirth turns an anticipated joyful event into tragedy. Stillbirth can assume two forms. The more common occurs when the baby was viable and then dies during labor or delivery. In the second type the fetus dies in utero and the mother is forewarned of the death days or even weeks before the delivery. Particularly difficult and stressful for the mother is carrying a dead fetus when movement has ceased. Parents often describe these situations as the simultaneous birth and death of the child.

Perinatal Deaths. With the dramatic increase in the survival of low birth weight babies, the death of a very tiny, sick, or deformed newborn is no longer always expected. Parents' hopes may be buoyed with the suggestion of each additional medical procedures, and the added time that the child lives increases their attachment. The advent of new technologies and surgical procedures that might prolong survival but at a price of pain, discomfort, or survival with gross disfigurement or retardation presents new problems to both parent and physicians. A not-uncommon situation occurs when careful diagnostic assessments and open discussions between physician and family have led to a decision not to perform a life-saving operation, with a change of mind by the parent following delivery when the full-blown symptoms of a lifelong disability are only minimally apparent. This situation may engage them in complex legal and ethical issues that intensify the emotional difficulties parents have in dealing with their loss.

Sudden Infant Death Syndrome. SIDS deaths declined by 46 percent from 1983-1996 due to successful education and broadly disseminated ad campaigns. SIDS usually occurs within the first year of life and is the most common form of death after the neonatal period. The particular stress of this type of death relates to the ambiguity about its cause that leads parents to struggle with guilt and whether the death could have been prevented. Family and friends often do not know how to respond and therefore withdraw, inadvertently creating a “conspiracy of silence.” Here, health care personnel can make a contribution by providing information about the nature of SIDS that helps reduce ambiguity about the cause of the death.

Grief Reactions to Infant Death

A very common grief reaction after perinatal or SIDS death of an infant is intense preoccupation with thoughts and images of the dead baby. According to several studies, between 65 and 95 percent of mothers and 51 and 85 percent of fathers report problems with preoccupation or irrational thoughts about their dead baby during the acute phase [ 81 , 82 ]. Many parents report a sense of the baby's presence—of hearing their dead baby cry—and some mothers say they feel fetal movements for months after the delivery. Others report illusions or hallucinations that their baby is still alive. This can be disconcerting to parents and family members; however it is reported in studies of many bereaved parents. Like many other traumatic events, the death of an infant challenges parents' assumptions about their own and their families' safety in the world. Anger and irritability about the injustice and unfairness of losing their child are common grief responses and may be directed toward health care professionals, their spouse, God, or fate. Alternatively, these may be emotions directed inward toward themselves resulting in lowered self-esteem, self-blame, and depression. Parents also experience intense anger and jealousy toward other parents who have living babies.

In general, parents of infants who have died from whatever causes share the experience that their friends and family do not know their infant, that they may not recognize or empathize with the full extent of their loss [ 83 ]. Many parents of infants who die report being particularly stressed by people who avoid any discussion of the loss or offer clichés or dismissing statements such as “you can have another child”. The advice to have a new child as a way of bypassing or avoiding the pain of loss for the particular child who died remains controversial because findings from research are contradictory [ 4 ]. Friends as well as other family members may be impatient about the “slow” rate of parents' recovery from the loss. As in most forms of bereavement, depressive feelings are often present following this type of loss. In fact, bereaved parents have been found to experience elevated symptoms of depression more than two years following perinatal death of their child [ 57 , 84 ].

Almost all parents search persistently for explanations of the cause of the death following perinatal or SIDS death. Studies suggest that most families believe that it is highly important for them to understand the cause of their baby's perinatal death. Often there is no definite answer or explanation, which they find frustrating. Of interest in one study was the tendency of parents to blame the mother for the baby's death (26 percent of mothers and 13 percent of fathers), despite explanations by their physician to the contrary.

Across studies, mothers consistently report more intense and prolonged grief reactions than fathers except for the area of denial where fathers report greater denial in the immediate aftermath [ 84 ]. These differences are reported to cause additional stress and strain on the marriage relationship and to reduce the support available from the intimacy it could provide. A range of theories are suggested to explain differences that could be the subject of future research such as the differences in the bond formed between mothers and fathers and the developing infant [ 2 , 85 – 87 ]; general gender differences in reaction to stress; and differences in gender-role socialization involving emotional expressiveness and willingness to acknowledge and report emotions [ 58 , 61 , 88 – 90 ].

Deaths of Children and Adolescents

Deaths are less common among older children than among infants, with accidents, especially among adolescents, the most frequent cause. Cancer is the leading illness cause of death in children and adolescents. Parents who experience the death of an older child usually have many of the feelings already discussed in relation to infants. However, more is known about the grief of parents of children who die of an illness than about the grief of parents whose children die suddenly by accidents, homicide, suicide, natural, or man-made disasters [ 91 ]. One reason for this greater knowledge may be that parents already connected to the health system during their child's illness are more likely to participate in bereavement services after the death as well as having access to services during terminal illness [ 12 ]. Retaining parents in need of assistance who have experienced sudden death in formal longer-term bereavement services remains a challenge [ 92 ]. At the same time, the existence of self-help organizations focusing on child loss, such as Compassionate Friends, provides alternative avenues for bereaved parents to receive support; yet such organizations serve only 25 percent of bereaved parents. These organizations have been the focus of significant studies on the services they provide to parents [ 38 ].

Families' avoidance of formal and informal support services is thought to reflect, in part, avoidance of traumatic reminders. However, the lack of participation in interventions may also reflect inappropriate treatment models that fail to respond to the needs of families who have experienced the sudden death of a loved one [ 93 ]. An example of this problem was reported by the William Wendt Center in Washington, D.C., a program developed to provide trauma and bereavement services to families at the time of identification of the body of a loved one who died suddenly from accident, homicide, or suicide [ 94 ]. This innovative service established a site in the coroner's office where providers can immediately meet with families upon identification of the body. The center soon discovered that in addition to trauma and grief counseling, case management services were needed to help families with the consequences of such losses (e.g. loss of housing, dramatic loss of income, unsafe living environments, and the loss of support networks) [ 94 ]. Longer term follow-up of families affected by such traumatic deaths remains a challenge. With parents of older children, as with parents of infants, the intense nature of their response to the death of their child is thought to be related to multiple factors:

the love for the unique child who has died;

the special intimacy and strength of the parent–child bond, unlike most other relationships [ 17 , 28 ];

the connection with the parent's hopes and dreams for the future and even immortality [ 17 , 94 , 95 ];

the challenge to parental identity as competent protector, provider, nurturer;

the social stigma associated with child death [ 96 , 97 ];

the isolation and loss of social support that often follows such stigmatized deaths; and

the existential crisis of finding meaning in life without parenting this child.

• INTERVENTION APPROACHES

It is important to keep in mind that there are numerous individual, familial, and cultural differences that make responding appropriately to another person's grief anything but a formula. The United States, as most Western countries, has a variety of cultural, religious, and ethnic variations that mediate and modulate the experience of grief and mourning [ 98 ]. There is mounting evidence that forms of support that leave room for the bereaved to discuss their thoughts, feelings, and experiences are often seen as the preferred mode of response to bereavement [ 19 , 99 , 100 ]. This is in contrast to approaches that emphasize a more active approach to the bereaved, one that confronts them with models of the “appropriate ways” in which to grieve and expects linear progress along some stage model of grief. It is sometimes surprising to laypersons and professionals alike the degree to which people are willing to educate others about their culture, share elements of their experience, and feel benefited by the experience. What is needed in the listener is an ability to listen with a degree of empathy and patience.

Evidence suggests that parents of newborns, children and adolescents who die benefit from a range of early intervention services [ 62 , 101 , 102 ], yet bereavement programs connected with medical care are only beginning to develop. A small percentage of parents who experience child loss contact self-help organizations. Child death is infrequent in the United States and many parents feel stigmatized by their situation, become isolated, and find outreach difficult. This small number of parents who engage in support programs or participate in research on bereavement following the death of a child has limited knowledge development and innovation. Newer intervention models and interventions described below are promising as they are located at times and in places that are more accessible to parents and they focus on the broad range of needs of parents, siblings, and extended family after a child's death. While additional research is needed to clarify post-bereavement outcomes both short and long term, existing knowledge suggests the following interventions. Those specific to families of newborns who die might include:

help parents accept the reality of their loss by gently encouraging them to see, hold, and name their dead baby and to hold and then participate in memorial services;

help parents retain important mementos such as photographs and locks of hair, hand and footprints, tangible reminders and “evidence” of the child's presence such as bedding and clothing; and

connect families to other parents who have experienced this loss, to self-help organizations, or to professional counseling or services that address this issue.

Interventions for families of children and adolescents might include:

accept a broad range of grief reactions without becoming judgmental or withdrawing—this may include parent's anger, blame, humor, and inability to grieve;

provide information in multiple formats (e.g., written, audio/visual, public meeting, broader media programs, Internet based) about the bereavement process including gender differences, expected problems, needs of siblings and extended family, and available services;

include information on both trauma and grief responses of children and adults in all education efforts. This is especially important with children as so many children's deaths occur from accidents;

create opportunities for families to meet other families facing similar situations that can make the experience less lonely as well as provide a perspective on the loss process. This includes connecting parents to self-help groups, especially those that include siblings and extended family services;

make available professional bereavement follow-up counseling for grieving family members, including individual, family, and/or group;

create a range of intervention models that address the bereavement process and are accessible to families in time and location. For example services should not be limited to once-a-week psychotherapy for one hour, to a time limited series of meetings, but models may also include less frequent, more intensive meetings offered over a longer period of time. Interventions should also be provided at places convenient to families both geographically (e.g., at home or within local communities) and/or in relation to where the child's terminal condition is treated. Intervention models should address the broad range of families' needs including financial and practical needs;

bereavement interventions should begin before the loss when it can be anticipated in order to take advantage of the opportunity for preparation and prevention of later adverse reactions;

create models of follow-up care that provide ongoing access and increase knowledge of longer term outcomes;

provide family focused interventions that assist parents in connecting or reconnecting with their existing families, friends, and networks of support as a means of re-establishing coherence and meaning as they go forward; and

provide specific services and outreach for neglected sub-groups of parents and family members: e.g., parents who have lost an only child, parents who have lost multiple children, parents whose child died from accident, suicide or homicide, grandparents of children who die.

Interventions for surviving children and adolescents have been addressed in the section on siblings. Suggested models and approaches from the existing literature include the following:

provide information in multiple formats (e.g., written, audio/visual, Internet based, group meeting and larger event) for children and adolescents about the nature of grief following the death of a sibling and ways to cope with it;

provide information/consultation about ways to help bereaved siblings to parents, extended family, teachers, coaches, religious and social service organizations, hospitals and health care services, emergency services, mental health providers and the media. In this way the knowledge base and social and cultural context in which siblings experience their grief is improved. Information should include the emerging knowledge about the intertwining of trauma and grief, ways to recognize these symptoms and ways to manage them;

provide opportunities to receive mementos of the child who died and to participate in memorial services;

provide access of bereaved siblings to other bereaved children or adolescents who can share their experiences and reduce isolation. Since sibling death is infrequent in the United States, where possible, integrate children and adolescents who have experienced sibling death into existing bereavement groups and services that include children who have experienced loss from the death of a parent or peer or through divorce. Consider the use of the Internet and teleconferencing as additional ways to form sibling groups and facilitate communication; and

increase knowledge of, and provide for the special needs of particular sub-groups of bereaved siblings: those whose sibling died of homicide, suicide, accident or terrorist attack.

Newer intervention approaches have included:

Interventions that focus on developing ongoing networks of support within specific geographic, ethnic, or religious communities;

Interventions located within service organizations that treat the child's terminal condition and can direct parents early in the bereavement process to appropriate services—e.g., hospitals, emergency services, the coroner's offices, and schools;

Interventions that utilize intensive camp/retreat experiences or 1 day work shops with follow-up services in the community;

Combinations of professional and self-help leadership in groups; and

Novel uses of the Internet and technology to provide group information and on-line discussion groups. A recent qualitative analysis of an online perinatal bereavement group, not professionally led, identified themes of interpersonal connection, memorializing the child who died, and validation of the parent's unique grief experiences. Such technologies can provide important opportunities for access to social support and education.

• RESEARCH IN BEREAVEMENT

New intervention models have been developed for specific bereavement situations, some beginning during the terminal illness period [ 103 , 104 ]. Evidence suggests that this time period offers an important opportunity for preparation and prevention of unnecessary bereavement distress after the death of a child as well as the death of a parent [ 12 ]. Other variables that continue to be the focus of research include the role of symptoms of traumatic stress, particular types of child deaths such as suicide, homicide, and deaths from AIDS, gender differences in coping, marital distress and divorce, depressive symptoms, verbal disclosure, emotional expression in the face of social constraints, and the role and function of ongoing memories of and connection to the child who died [ 4 , 105 ]. Additional research questions include the following:

What are relevant bereavement outcomes for sibling, parents, and the family as a whole?

What prevention opportunities occur during the child's terminal illness?

What are the range of psychological symptoms including traumatic stress experienced by parents and siblings during a child's terminal illness and after a child's death and are they responsive to medical and psychosocial interventions?

Do current criteria for complicated grief in adults apply to bereaved parents?

Do symptoms and behaviors suggested for complicated or traumatic grief in children differentiate the grief experience of siblings?

Most studies of parents' grief for a child who dies have relatively short-term outcome evaluations. Longer term prospective research could improve our understanding of delayed and complicated grief and associated risk and protective factors that occur over time.

How is child and adolescent functioning after the death of a sibling affected by family functioning and social support?

What are the range of risk and protective factors that affect different outcomes such as the parent's decision making about the child's terminal treatment, timely information, and the use of psychosocial support services?

How do health professionals differ in their responses to parents during the child's terminal illness from their responses to parents whose children are not terminally ill?

Does professional training and skill development in working with bereaved parents and siblings affect outcomes of the experience?

Can studies move beyond outcomes such as grief symptoms, depression, and social support to include broader variables of self-esteem, personal growth, and flexibility [ 4 , 105 ]?

What are the barriers to recruitment of research samples in this area and how can they overcome?

Columbia University, School of Social Work.

School of Social Work Tel Aviv University, Israeli Center for REBT.

Professor of Psychology, Clinical Psychology Program, University of Haifa, Israel.

• Cite this Page Institute of Medicine (US) Committee on Palliative and End-of-Life Care for Children and Their Families; Field MJ, Behrman RE, editors. When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Washington (DC): National Academies Press (US); 2003. APPENDIX E, BEREAVEMENT EXPERIENCES AFTER THE DEATH OF A CHILD.
• PDF version of this title (15M)

In this Page

Related information.

• PMC PubMed Central citations
• PubMed Links to PubMed

Recent Activity

• BEREAVEMENT EXPERIENCES AFTER THE DEATH OF A CHILD - When Children Die BEREAVEMENT EXPERIENCES AFTER THE DEATH OF A CHILD - When Children Die

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

• Share full article

Advertisement

Supported by

Dealing With the Death of a Child

To the Editor:

Re “ Children Don’t Always Live ” (Sunday Review, Oct. 23):

Jayson Greene’s essay made me feel as if my father were reaching out to me from the other side, offering me an explanation he was never able to give in this life.

He, too, had a piece of his heart taken when his first child was killed suddenly by an accident — in this case, a plane crash. And I was the child he would have never had if my sister had lived. We all acknowledged this fact.

I was heartened to read of Mr. Greene’s awareness, and his inner apology to his new son, sorry that he “will never be the same father I was before.” Even though he will always miss his daughter, and grief may color his parenting, his writing makes clear that he deeply appreciates the new joy his son brings.

This awareness is the very reason that not all children born after the loss of another child are destined to be replacements for a dead child when parents are able to validate a subsequent child as a unique and special individual.

JUDY L. MANDEL

Newington, Conn.

The writer is the author of “ Replacement Child: A Memoir.”

It is often said that there is no greater emotional pain that a human being can endure than the loss of a child, be it at 2, or 12, or 22.

Jayson Greene’s most personal reflection on the unimaginable tragedy he and his wife endured took me back about 20 years to a chilly gray fall morning and the graveside in Queens where a 30-inch-long coffin was gently lowered into the ground, descending along with the tears of the dead child’s inconsolable parents.

We are having trouble retrieving the article content.

Please enable JavaScript in your browser settings.

Thank you for your patience while we verify access. If you are in Reader mode please exit and  log into  your Times account, or  subscribe  for all of The Times.

Thank you for your patience while we verify access.

Already a subscriber?  Log in .

Want all of The Times?  Subscribe .