HJAR May/Jun 2022

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2022 19 “restoration orientation.” We could leave the glass in our hand and do our best to go on with life. We could ignore the pain and stay “busy.”While possibly tempting in the short term, this approach has some real long-term problems. The wound could get infected, causing complications with our hand and the rest of our body. The unat- tended hand will not heal well and will be limited in its usefulness. And leaving the glass in our hand could hurt those closest to us. It’s a silly choice, really, to ignore the glass in our hand, but we all know people who choose this path. They have big hurts and losses that deserve and need atten- tion, but they focus exclusively on moving on. They ultimately create other hurts and problems for themselves and those they love. It is likely that most, if not all of us, have done this to some extent in our lives. Along with vacillating between loss and restoration, we make meaning of our loss. We find ways to integrate the loss and grief experiences into our life stories. Part of meaning-making is sense-making — how we understand and make sense of loss. Another part is benefit-finding, where we can sometimes find benefit amid loss. This doesn’t mean that the benefit is worth the loss. Rabbi Harold Kushner put this beauti- fully in his book, When BadThings Happen to Good People, as he described the impact of his young son’s death: “I am a more sensitive person, a more effective pastor, a more sympathetic counselor because of Aaron’s life and death than I would have ever been without it. And I would give up all of those gains in a second if I could have my son back. If I could choose, I would forego all the spiritual growth and depth which has come my way because of our experiences, and be what I was fifteen years ago, an average rabbi, an indifferent counselor, helping some people and unable to help others, and the father of a bright, happy boy. But I cannot choose.” With meaning-making, the better sense we can make of the loss and the more ben- efit we can find amid loss, the more likely we are to make a healthy adjustment. The more we struggle with this — the more the loss resists integrating into our life story — the more at-risk we are for adjustment complications. Losses can be deeply pain- ful, of course, even when they make sense to us and lend themselves to finding ben- efits. Perhaps a grandparent dies peacefully following a long illness during which there are times of poignant connection. While sad, we know we all eventually die, and we are grateful for a long life and special moments. What if, instead, the loss is a child who dies from a long illness? That loss is more challenging to make sense of for most of us. Or perhaps a person dies unexpect- edly. Or maybe the person dies violently. Some deaths are much more challenging for sense-making and benefit-finding. It’s still possible to make a healthy adjustment, and most of us eventually do, but the chal- lenges are greater. We often think of grief as an emotional experience, but it is much more. Grief is a whole-person experience, impact- ing us emotionally, cognitively, behav- iorally, socially, and spiritually. Leaning into the cognitive and spiritual aspects of grief, author and grief expert John Schnei- der described grief as a discovery process through three questions: What is lost?What is left? What is possible? These are not one-time questions. We will revisit these questions repeatedly through- out our lives following significant losses. Imagine a 6-year-old girl whose mother dies. She will answer these questions dif- ferently when she experiences puberty, finishes high school, has a job of her own, becomes a mother, and again when her child is 6 years old. Grief and the Child Children and adults have many of the same needs in grieving but different ways of understanding and processing. When think- ing of a preschool child who experiences the death of an important person in their life, the child needs several basic supports: • An explanation that is true and fitting to their comprehension. • Reassurance that while some things will be different, other things will remain the same. • Understanding that others are upset but those who are upset will still do what needs to be done to care for the child. • Opportunities to talk about the per- son who died and ways to remember and be connected to them in this new reality. As adults, we have these same needs. Our capacity to comprehend and express needs differ depending on developmental level, though. Let’s consider a 3-year-old boy whose father dies. What might we expect to see? Perhaps he is more anxious around new people and new situations. Maybe he clings more to his mother, fearing that she may also go away. He might search for his father and have continued expectations that he will come home. The boy’s moods may be more volatile, and tears may come more easily. Perhaps he withdraws. Bedtime and sleep may be more challenging, and his appetite might be affected. He could also regress developmentally, perhaps struggling again with potty-training, and this regres- sion can signal a need for greater care and comfort. We would not be surprised if the boy’s mother had some of the same grief reac- tions. She may feel most comfortable and secure with familiar surroundings and people. She might cling to her son and still expect his father to come through the door at the end of the day. Perhaps she cries more easily and unpredictably and finds herself uncharacteristically losing her patience. Withdrawing from her friends and previ- ous activities, her sleep and appetite may