Children's Responses when Conditions are Unfavourable

Something it is which thou hast lost,

Some pleasure from thine early years.

Break, thou deep vase of chilling tears

That grief hath shaken into frost!

In the opening paragraph of Chapter 16 we noted the conditions that the evidence suggests are required if childhood mourning is to follow a favourable course: first, that the child should have enjoyed a reasonably secure relationship with his parents prior to the loss; secondly, that he be given prompt and accurate information and be allowed to ask questions and participate in family grieving; thirdly, that he has the comforting presence of his surviving parent or of a known and trusted substitute. Although these conditions, as we have seen, can certainly be met, it is hardly surprising that all too often they are not. Sometimes the shortfall is in only one class of condition, sometimes in two and not infrequently in all three. On the type of shortfall, their number and, perhaps especially, their combination turns the form taken by a child's responses to his loss. Since several forms of pathology can result, and each form can occur in every degree, the field of enquiry is enormous.

Because there are as yet no studies of a representative group of bereaved children, there is no way of gauging the incidence of each of these different forms of pathological response. The best that can be done, therefore, is to describe certain patterns of response which are met with frequently in clinical practice and to indicate the conditions, present before and/or after the loss, that are playing a part, often a large part, in producing them.

We start by presenting at some length the case reports of four children who, between them, show not only a fairly representative range of pathological responses but whose experiences illustrate with adequate detail the main conditions that appear to have been responsible