Facilitation of Mourning During Childhood

Sections of this chapter previously appeared in a chapter by Kliman in Gerber, et al (1979) Perspectives on Bereavement, Arno. NY Times Press.

Here you will meet several children helped by Cornerstone who suffered from tragic losses and tragic circumstances. This chapter is essentially practical in its orientation to technique, describing several forms of treatment of bereaved children, with a minimum of theoretical essay. Probably the best definition of "mourning" for our current purposes is, "the totality of reaction to the loss of a loved object." We omit from this definition any immediate consideration of whether mourning can occur at various stages in childhood, and if so, to what extent one or another investigator judges it has occurred, although such consideration is worthy of volumes. To simplify the task somewhat, because it is actually of extreme complexity, Freud's (1915) definition of the work of mourning will be used, with no detailed reference at this time to the more modern contributions such as those of Bowlby (1960). Since considerable review of literature on childhood mourning, including the few clinical cases reported in the literature in any detail, has been made elsewhere by me (Kliman, 1968), a repetition will be avoided here.

The Center for Preventive Psychiatry (White Plains, New York) was created to assist adults and children in dealing with severe emotional burdens and situational stresses and strains. Over 1000 persons came to the Center during its first 12 years of operation. Many were victims of severe, traumatic sudden crises other than the loss of a loved one (object loss). Some were children who were sexually molested, or who had been badly beaten, or who had witnessed murders in their families. Some were suffering adverse effects of their involvement in highly over-stimulating experiences, such as witnessing romantic involvement with adults of the same sex, or incestuous relations within their own families. Some were severely physically ill. Some had sustained psychological trauma, developmental derailment and loss of home and property due to sudden, mass disasters such as floods or tornadoes. No patients however, attracted more of our systematic professional interest and consumed more of our professional energies than adults and children who suffered the sudden and then chronic strains of bereavement.

Never a momentary injury, loss of a loved person is often a long-enduring pathogenic influence. It deserves preventive intervention whenever the loss has occurred early in life, and especially when the early loss is that of a parent. From its beginning, the Center for Preventive Psychiatry had been interested in helping healthy orphans in order to develop techniques of primary prevention of mental illness. Data concerning a series of 18 untreated orphans show that few orphans are free of neurotic symptomatology. Often we found that even orphans referred to us very soon after bereavement -specifically for preventive support- already presented important neurotic symptoms. In fact, the majority of recently bereaved children suffered recognizable symptoms of neurosis, and in some cases, psychosis.

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