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Working with Grief & Loss: A Q&A with Adolescent Girls Therapist, Kim Kelley

Kim Kelley, M.Ed., LPC | Clinical Therapist | Adolescent Girls Group

Featured Team Members: Kim Kelley, M.Ed., LPC, EMDR Certified


 

Q: What is the difference between grief and loss?

Grief is the response to a loss. It’s the emotional suffering that occurs when we lose something or someone. For example, this could be the death of a loved one, a divorce, a move, or a relationship break-up. Typically, the more significant loss, the more intense the grief. But for adolescents who experience loss, it may look much different. For them, grief can be an intense emotional experience, even if the loss may not seem very “significant” to others. For instance: the death of a public figure that they didn’t know personally or of a pet that they didn’t seem attached to. An adolescent’s grief response to these types of losses may be difficult for adults to understand. It’s important to remember that grief is very individual and doesn’t look the same across the board.

Q: How else do adolescents experience grief differently than adults?

For a lot of adolescents who grieve a loss of a loved one, pet, or famous figure, it might be their first experience with death. It’s their first time wrestling with the “big picture” of life and what happens after death. Developmentally, adolescents have a sense of invincibility and immortality, so dealing with a death in their life knocks them off kilter. They may begin to rethink their understanding of how safe the world is for them.

Often, death has more of a social implication for adolescents. For instance, if an adolescent has lost a parent, that might also mean moving homes, switching schools, or experiencing a change in socioeconomic status. It has many layering effects.

I also find that many adolescents prefer to grieve socially. While this is very appropriate, it tends to be hard for adults to understand that kids might want to grieve with friends as opposed to family. Parents might seem isolated and disconnected.

In adolescence, kids are experiencing some of their most life-changing and identity-forming experiences thus far. Whether the loss occurred recently or early on in the adolescent’s life, he or she must now face these moments without that loved one. So, it’s not just the one loss at the time the death occurred. It feels like a series of losses that must be grieved in present and future moments as well. Especially if it’s a daughter who lost a mother or a son who lost a father, this can be difficult when facing the physical changes of adolescence and the questions of what it means to be a man or a woman.

Grief can also look different for an adolescent who has experienced multiple significant losses in their lives. The grief compounds. If he or she wasn’t able to fully or properly grieve the first loss or first few losses, the grief piles up, resulting in a potentially higher grief response to a less significant loss.

Q: What can grief and loss reactions look like in adolescent girls?

I approach grief through the framework of the Kübler-Ross model of the five stages of grief. These stages are fluid and nonlinear.

  • Denial: this stage is especially strong for adolescent girls, particularly when the loss is unexpected. In her stage of life, she wants to be unique but also fit in. She might tell herself, “things aren’t that bad,” or, “everything is okay.” As a result, she might experience frustration or resentment toward others that have strong emotions surrounding the loss.
  • Anger: this stage can range from disrespect to showing violent behavior. Adolescents lack the coping skills that adults typically have, so anger is a way for them to discharge emotion; to cover up sadness or fear.
  • Bargaining: I listen for bargaining when working with grieving adolescent girls. It is a stage of feeling guilt; the belief that she could have controlled the situation or prevented the loss in some way. Sometimes it is specific: “if I had only said this or done that.” Other times, the guilt is broader: “I’m not perfect enough, so bad things happen to me.” This is a perfect time to look at spirituality; for her to make meaning of her beliefs.
  • Depression: this is an important stage to watch for, especially if the adolescent girl is already prone to depression. This can manifest as isolation, sleep or eating changes, statements of hopelessness, failing grades, unsafe sex, self-harm, preoccupation with death, and agitation. These are all common coping mechanisms and signs that point to depression.
  • Acceptance: For adolescent girls, acceptance might come sooner or later than it does for an adult. It’s natural for her to experience moments of acceptance and then cycle through other stages again, especially during big moments of her life. She might feel guilty when feeling acceptance, wondering if that means she didn’t care about the person. This is because adolescents generally think in terms of black and white; one or the other, not realizing she can have acceptance and miss the person all at once.

Q: What are some of the common mistakes that parents and other family members or well-meaning adults make when trying to support or comfort a grieving teen?

One mistake is to avoid the conversation: the adult doesn’t want to upset the child, but it ends up being the elephant in the room. It’s not helpful to try to protect an adolescent from talking or thinking about death, because it is a normal part of life.

Another mistake is to tell the child to “be strong” or hide emotions. This may keep the child from truly facing the loss and processing the grief. Hiding emotions now will also prove detrimental when dealing with future losses and compounded grief.

Our society, in general, has a lot of judgment about what grief should look like. It’s important to understand that everyone grieves differently and to strive to understand the behavior from the child’s perspective. If you think that a child is overreacting to a loss, remember that the child is human, and many feelings could be wrapped up in that figure in his or her life. Or if you think that the child isn’t showing enough reaction, consider that the child is so overwhelmed by the loss that he or she doesn’t know what to feel.

Q: What is your approach to working with adolescent girls that have lost a loved one? And how does wilderness therapy help?

My approach is to seek to understand what is the most upsetting part of the loss. I educate the child that grief and loss are normal part of being human and loving someone. Together, we explore what the loss means to my student about herself and the world. We visit the questions that she is wrestling with internally: Am I sad? Do I feel alone? Will I ever be loved again? Am I a bad person? Is the world unsafe?

I help the student to identify what is a normal/healthy response and what is actually cognitive distortion. For example, if she feels that the loss occurred because she is a “bad” person, she is distorting thoughts that result in feelings of sadness or hurt. Or, if she says she is alone, we talk about how she actually isn’t alone and has others around her to support her.

In wilderness, students develop coping skills to identify and reverse cognitive distortion. The XYZ skill helps: X – stop and breathe into the emotion. Y – identify the cognitive distortion. Z – flip the distortion.

In the wilderness, students see the ways death occurs in nature. They see bones of dead animals and the remains of dead plants. Even the changing seasons and leaves are symbolic of death and evidence of birth. This is a great context in which to talk about death and the seasons of life. It’s also an ideal place to process grief without the unhealthy escape to drugs, alcohol, sex, or unhealthy eating. Students have to learn to manage emotions, and that builds confidence. Sharing these experiences with peers helps them to not feel alone.

 

June 18th, 2018

Kim Kelley, M.Ed., LPC | Clinical Therapist | Adolescent Girls Group