July 5, 2007: Sibling Bereavement in Childhood - Betty Davies

HEALING THE GRIEVING HEART
Sibling Bereavement in Childhood
Hosts:  Dr. Gloria Horsley and Dr. Heidi Horsley
With guest:  Betty Davies
July 5, 2007
G: Hello.  I’m Dr. Gloria Horsley with my co-host
H: Dr. Heidi Horsley.
G: Each week Heidi and I welcome you to Healing the Grieving Heart, a show of hope and conversation with those who’ve suffered the loss of a loved one and for health care professionals who work in this most difficult field.  And as always the message is others have been there before you and made it.  You can too.  You do not walk alone.  If you’re listening to our Thursday live Internet show, please join Heidi and me on the show by calling our toll free number, 1-866-472-5792, with questions or comments regarding the losses in your life.  These shows are archived on our blog, www.thegriefblog.com as well as www.thecompassionatefriends.org websites.  All shows can be downloaded on Itunes and the transcripts can be accessed on www.thegriefblog.com.  Good morning, Heidi.
H: Good morning, mom.
G: We’re very happy to tell you today that we’re broadcasting the show from the University of Utah School of Social Work and Dean Jannah Mather, the Dean of the School of Social Work, has very graciously allowed us to come in and broadcast from here.  They’re putting up a brand new Social Work School here, aren’t they, Heidi?
H: Well they’re putting up I think a community center attached to the Social Work School which is going to be very comprehensive and offer a lot of services and coordinate with the community and collaborate.
G: That’s going to be very nice and they’re doing a lot with the elderly here.  We wanted to talk to you before we get started with our wonderful guest and talk to you a little bit about www.thegriefblog.com.  If you noticed yesterday was July 4 and we have something about the Fourth and we hope the Fourth went well for you because we talked last time a little bit about the holidays can be difficult, right, Heidi?
H: Absolutely.  Yes.
G: So we hope that your holiday went well.  Also we have continued the essays of Patrick Malone on there.  I think he did five and you can go on and look at those.  We’ve got some great poetry.  And we’ve got places on there at the end of all the things we have on the blog where you can put in your comments so the blog is just moving along very well and we’re getting wonderful comments on it so we hope you’ll go there and participate with us on the blog.
H: And also I think we said in the past let us know what shows you’d like to hear.  What kind of topics you’d like us to cover, and we’ll get guests and cover those areas.
G: Absolutely, so you can go through the blog and let us know about that.  Well, Heidi, would you like to introduce our guest today?
H: I’d love to.  I want to say that I’ve co-authored an article with our guest, Betty Davies, on continuing bonds after the loss of a sibling and I think she’s written more than any person in the world on sibling loss.  Betty, I think you have.
B: Well, I think so.
H: She’s amazing.  When I wrote my doctoral dissertation on the death of a sibling, I cited her.  This is way before I even knew who she was.  I cited her all over the place because there was so much out there that she had written and she really got it way before other people did and realized that siblings, surviving siblings were unacknowledged and needed to be heard and validated and needed to be worked with so I’m very honored to introduce her today and our topic today as I said is Sibling Bereavement in Childhood.  Our guest is Dr. Betty Davies.  Betty Davies is Professor at the University of California San Francisco.  She has gained international recognition for her work in the grief and loss field through numerous publications, including two books:  Fading Away: The Experience of Transition in Families with Terminal Illness and Shadows in the Sun: Experiences of Sibling Bereavement in Childhood.  She also was one of the founders of North America’s first children’s hospice in Vancouver, Canada.  Betty is on the Advisory Board of SuperSibs! a non-profit organization for siblings of children with cancer.  She is one of the world’s leading experts on bereavement and has won numerous honors and awards for her groundbreaking work.  Welcome to the show, Betty.
B: Thank you, Heidi.
G: Hi, Betty.  It’s great to have you on today.  I wanted to ask you how did you get into this field?
B: Oh, well, that goes back a long ways actually.  I guess the short version is that I’m a nurse and my whole life I wanted to be a pediatric nurse.  And mostly I wanted to teach pediatric nursing.  So when I got my first job, I was on pediatrics.  I thought I had achieved as much as I could possibly do.  I was so happy.  Well, throughout my nursing education before that point, we were taught that nursing was about three things.  It was about first of all preventing illness so that people would stay healthy.  If they couldn’t stay healthy and got sick, then it was about trying to help them get better.  And if they couldn’t get better and were going to die, then it was about helping them to die as comfortably as they could and with dignity and throughout my experiences as a nursing student with many patients who were seriously ill and who died, I realized that what we were learning in nursing school focused primarily on caring for the sick, secondarily on prevention, and none at all on caring for the dying.  And I became very interested in why was that?
G: Now would this be around?  What year?  Was this around the Kubler-Ross time?
B: It was just after.  It was in the early 70s and just around that time and her book had just come out and actually it’s funny you mention that because one of my first teaching positions was with a community college and I had felt that no student of mine would ever pass through my hands without having some discussion about caring for dying patients and about their student’s own feelings about death and dying and I had talked about Kubler-Ross and her book and her teachings and my students discovered.  I had a group of 11 students who discovered that she was coming to – at this time I lived in Edmonton, Alberta, in Canada, and she was coming to a place called Medicine Hat which was about 5-600 miles away to put on a two-day conference and my students decided that they would write a proposal for the director of our school outlining what a valuable contribution this would be for them and therefore they should be allowed to miss school for three or four days to travel down and attend this two-day conference.
G: Oh, and how right they were.
B: And the director was so impressed with their initiative that she allowed us all to go so that was my first encounter with Kubler-Ross, and I was moved by the woman and what she had to say, and from that point on, I developed a very good friendship with her and she became my mentor in many ways.  And one of the ways in which she did help me was I went to graduate school in Arizona and while I was there, the following experience happened that made me aware of the experience of siblings, and until this time, I had cared for children who were very ill and, of course, back in the early 70s, most children with cancer in particular died.  It’s much different today than it was then.  And so we had quite a few deaths on our nursing units when children were sick with cancer.  And through those experiences, I learned that children who are seriously ill are so much wiser than the adults who care for them.
G: It’s quite a change.  I’ve noticed that with children that are terminally ill or very ill.  They’re quite wise, aren’t they?
B: Oh, they’re very wise.  So I learned a lot from the children and I felt so much for the parents because I could see the agony and the distress they were experiencing.  Well, there I was working as a head nurse on a pediatric unit in Tucson and one evening late in the evening, we had a family being admitted into the hospital and to our pediatric unit came three of the four children in this family.  The fourth child, the oldest one, had died in the accident.  And little Juan was – they were a Mexican family from south of the border and little Juan was 8 years old and he was the second oldest child and his younger brother and sister were 5 and about 18 months.  His mother had also been killed in the accident and his father was in intensive care.  So these children were admitted and little Juan, of course, wanted to know what was happening and he could speak English.  So I thought, how am I going to tell him?  And just as I was thinking about that, the phone rang and we learned that the local parish priest was coming to the hospital to be with the family, and knowing that the best person to give bad news to a child is someone they know rather than a complete stranger, we thought it was best to wait until Father Gonzalez arrived.  So he came the next morning and he was an elderly man who I often said was bent over with the weight of many sad stories, I think.  And I asked him if I could help him in some way to talk to Juan; and he said, no, this was something he felt he had to do himself.  So he went down to the child’s room and little Juan was sitting up in his bed with one hand, he had a broken collarbone so one hand was in a sling and his other little hand was holding his head on the overbed table and he was looking so forlorn and just the saddest little boy and when Father Gonzalez walked in, he kind of perked up because he recognized him.  Father Gonzalez was very nervous and he stood on the opposite side of the overbed table at a distance from little Juan and he cleared his throat and he said, Juan, I have some bad news for you.  In the accident, your mother was killed and your brother was killed and your father’s in intensive care and we don’t know if he’s going to survive.  So that means that now you, Juan, need to be the man of the family and the big brother for your brother and sister.  And in the second it took to say that, that little boy went from being this weak and forlorn and sad little boy to sitting up straight with his little shoulders straight back like a little soldier taking on that responsibility that had been given to him and my heart just ached for him and I thought what happens to these siblings?  What happens when their brother or sister dies?  And in this case, it was because his older brother had died that he was expected now to take on this responsibility.  I thought what happens?  And so that set me off on a course of study that has continued until now.  So I’ve talked to families and particularly the children from points in time immediately after the death right through to talking to elderly adults who in their childhood lost a sibling.
G: You know, we have to go to break, and I think this is the perfect time to go to break because I think that lead in to how you got into the field is very moving and we’re talking to Dr. Betty Davies about Sibling Bereavement in Childhood.  I’m your host Dr. Gloria Horsley with my co-host Dr. Heidi Horsley.  If you’d like to join us on the show, you can call our toll free number, 1-866-472-5792, and if you’d like to email us about this show or upcoming shows, you can reach us through www.thegriefblog.com.  Please stay tuned for more.
When we went to break, we were talking a little bit with Betty Davies about how she got into the field of thinking about in terms of sibling bereavement and she told us a very heart-rendering story about a little guy who had family members die and how she was so moved hearing about seeing him and got interested in sibling bereavement.
H: And also struck by the fact that the message given to him was that now that your parent has died and your older sibling, you have to be the man of the house and you have to be strong for the family and that made a shift in his process.
G: So Betty, in looking at this, what have you found out about sibling bereavement?  What did you first move on to and what have you found out?
B: Right.  Well my first project looked specifically at children where a sibling had died from cancer.  And then since then, I’ve moved on to children who’ve died from a variety of causes but always focusing on the sibling responses. 
G: Now can I ask you a question coming into that? 
B: Yes.
G: Because I know a lot of our audience is interested in this.  Is there a difference in your mind between a sudden death and a long-term illness when you’re looking at these as far as the sibling bereavement and ideas and patterns?
B: I think the responses are somewhat the same, but I think that they’re greatly emphasized in cases of sudden death.  In the same way that it is for we as adults to lose someone unexpectedly and suddenly, it’s such a – it just tears one’s soul apart so immediately.  That happens also for siblings so that there are differences.  However, that doesn’t mean to say that if people have had a chance to sort of “get used to” the idea that the child might die at some point, that doesn’t mean to say that the grief is less in any way.  There’s so many other factors that come into play that the cause of death in and of itself is just one of those factors and there’s so many other things that we have to consider, and one of the ways that I look at those factors and just to try to keep track of them all because it’s not the sort of thing that you can just list off, but I think about them in terms of three categories.  There are those factors that affect the individual child so individual characteristics of the child, the sibling, such as their gender and their age and their temperament.  Their past experience with death.  Their self esteem, those kinds of things.  And then characteristics of the situation itself.  The death situation.  And that’s where the suddenness of the death would come in to play.  The duration of the illness if the child has been sick before.  And then environmental characteristics, which, in fact, I believe and my research shows turn out to be among the most important, and those have to do with things like how well the family is functioning, particularly the parents, and how the parents grieve greatly affects and impacts on how the children grieve.  The shared life space between the child who died and the child who’s surviving.  So if you think of two overlapping circles and the greater the degree to which those circles overlap, the greater the shared life space if those circles represent the surviving child and the child who died.
G: So how many contacts they had with them.
B: Um hm.  And it’s not just the contacts.  It has more to do with the amount of life they shared and the attachment, the closeness to the sibling.
G: Now what about where the siblings didn’t get along, you know, they go through those periods.  Is that a strong attachment?  I think sometimes people think because the kids fight that they’re not that attached.
B: Right.  It has not so much to do with attachment.  It has to do with this idea of being very involved with one another on a daily basis.  For example, if two children do not get along very well, oftentimes, they occupy a lot of energy for each other.  They spend a lot of time arguing, bickering, fighting, whatever.  So when that one child is gone, the other one misses that interaction that they have.
H: That’s interesting.  So even if it was negative, they still miss that.
B: Yes, and where this – moving to adults for a minute.  Where this becomes very clear, it came very clear to me was I used to give workshops on coping with loss and I remember often – these were for adults – and I remember oftentimes there would be spouses there who would say things like my husband and I had such a good relationship.  I’m just so distressed over it, but my neighbor, she and her husband fought all the time.  I can’t understand why she thinks she’s as badly off as I am.  And this shared life space concept explains it to me because even when spouses don’t get along and they argue all the time and they bicker with one another all the time, when one of those spouses is no longer there, the surviving spouse misses that interaction even though it was negative.  It leaves a big empty space in their lives.  Now getting back to siblings for a minute, the other thing then that comes into play when siblings do have not such a good interaction, a good relationship, is that when the one child dies, then the surviving sibling can often feel guilt or remorse for the previous interactions that they had. 
G: Yeah, oftentimes they have them that day especially if it’s a sudden death.
B: Exactly.
G: And what about when the family, say it is a long-term illness in the family, sometimes we know kids are saying there’s so much time spent with that other child.
B: Yeah.  That also plays a role because the surviving child often feels resentful, jealous of the time that the parents have to spend with the surviving child.  I just talked to a family recently where the family was getting ready, the father was recounting a story where the family was getting ready to go to church on Easter Sunday.  It’s a very special Sunday because the ill child was finally well enough to be up and about so all the children had new clothes and they were going off to Easter Sunday.  When the ill child looked at herself in the mirror, she was only about eight or nine years old, when she looked at herself in the mirror in her brand new outfit, she burst into tears because she could see that the clothes that they had bought no longer fit her and that her spine had curved and she felt just so self conscious for the first time really.  And so the family stayed home.  So the impact on the siblings then who were just as excited about their new clothes and going to church for the first time in a long time lost that experience.
G: Yeah, and Heidi talks about that a lot with holidays and things, don’t you, Heidi?
B: Exactly.
H: Right.  The kids still feel, want to have positive experiences in their family even if there’s a death or an illness, which is understandable.  They want to lead as normal a childhood as they can.
B: Exactly.
G: Now, Betty, what do you tell families.  I know we’ve got families out there that are listening who know exactly what you’re talking about.  Their kids fought or whatever and they’ve just had a child die or they’ve had to take care of a child over the long term.  What would you say to them?  What should they do with their other kids?  And let’s say that the kids are all under 18.  They’re at home.
B: Right.  Well, just before I answer that question, can I just tell you a little more about the responses of children because I think it would help me explain what advice I would give.
G: Okay. And we’ll probably do this with this segment and then when we get into the next segment, we’ll let you give some interventions.
B: Okay.  So what I have found from talking to siblings themselves is that their responses can fall into four categories and these are in the words of the children themselves.  One is I hurt inside.  That is they feel sad.  They’re irritable.  They’re angry sometimes.  They have tummy aches.  Their head hurts.  They have all of what we consider the normal or typical symptoms of grief.
H: Which are oftentimes like you said physical symptoms.
B: Exactly.  Not being able to sleep.  Eating too much.  Not eating enough.  It really stems from their vulnerability of just being human because it’s the human response to grief.  And then the other category is I don’t understand.  And this is where children don’t know what’s happening.  Sometimes if they’re young, they don’t have the capacity to understand.  They don’t understand what’s happening with their sick sibling or what death is about or where their brother or sister has gone and what all this means.  The second or the third one is I don’t belong.  And this one comes about when normal day-to-day activities are interrupted, particularly not only during the illness but at the time of death.  They’re overwhelmed by a flurry of activity and they often don’t know what to do.  They want to help in some way but they just don’t know what to do and oftentimes this is where people will find ways to exclude the children out of a need or the desire to protect them and, in fact, that just makes it worse for the children because it emphasizes the fact that they just don’t belong anymore.  And the fourth one is I think the most poignant one, and this is the one where children say they feel like they’re not enough.  It results from not having their first three responses tended to.  Not being comforted when they hurt.  Not having things explained to them.  And not being included.  And oftentimes, they will end up feeling as if I’m not enough.  I’m not enough to make mommy happy again.  I’m not enough to make daddy love me as much as he loved Johnny, my brother who died.  Or they often end up thinking, I should have been the one to die.  I wasn’t as smart as Johnny and I didn’t do as well in sports.  I should have been the one who died.  Nobody really liked me as much as him anyway.  So those kinds of feelings that children have make them feel as if they’re just not enough anymore and I think if what I have done in my work is to think of these four responses that I’ve learned about from studying children for so long and have identified specific things that we can do in response to each of them, that might help parents help their children.
G: So it’s time for us to go to break now and when we get back from break, we’re going to look at those responses that children have with Dr. Betty Davies and then we will have her give you all some advice on what you might do if you’ve seen these kinds of problems in your family. 
Well, Betty, when we went to break, you had just kind of gone over your four children’s responses to loss and I want to give them to our audience that have just tuned in.  The first one, a response that a child might have or a sibling response would be I hurt inside, and the second would be I don’t understand, and the third would be I don’t belong, and then the fourth would be I’m not enough.
B: Right.
G: And so let’s start with if you have a child, would they say I hurt inside or would you just know that they do and how, for our audience, you’ve got a child who’s hurting, obviously, a sibling who’s hurting, what is your suggestion to our audience?
B: Right.  Children themselves don’t say I hurt inside necessarily.  They’ll say I’m sad or oftentimes.  The thing of children is they don’t often identify how they’re feeling.  They don’t put words to it in the same way that adults often try to do so that’s why we have to be very sensitive to a child’s behavior and to see if they’re withdrawn, if they’re more aggressive, if they’re irritable, if they look sad, if they’re having trouble sleeping or eating, or look for things that are different.
G: And just their little faces.
H: Or they say they don’t feel well.
B: Uh huh.  Exactly.
G: They’re lonely.  Maybe they want to stay connected with you.  They don’t want you to leave.
B: Mm hm.  Oftentimes they’re anxious and they’re more clinging, particularly younger children.
G: And I understand some children can really do better in school work.
B: Well, yes.  Sometimes children do very well at school and sometimes that’s good but we also have to be aware that that may have another edge to it like most things in life.  There’s more than one side to the story.
G: So they might be pushing it.
B: Well sometimes they do really well in school because they’re trying to protect their parents from having another child who has a problem which is not a bad thing necessarily.  When it has an edge to it is when their other sibling was very good in school and they’re trying very hard to be like that sibling so that their motivation is to be like the other sibling in ways that discounts what they themselves are.
G: And that might be something about I’m not enough to your fourth point.
B: Yes, that’s how they’re all related together so oftentimes when children feel as if they’re not enough, what they do is try to make up in some way for the deficit they perceive they have.  They are looking for the attention that they just don’t feel that they’re worthy of.
H: And are they also trying to fill the void of the sibling that died and try to replace them, those kinds of things, or not?  When a sibling dies, there’s a big part, the family’s got a big hole in it in a sense and the siblings kind of come in and try to replace some of those family roles.
B: Sometimes they do and sometimes parents will impose that on children.  Like in my first example of little Juan.  His parish priest imposed that on him and he took on that responsibility.
G: That he had to be the man of the family.
B: That he had to be the man of the family and he now had to be the big brother for his younger brother and sister.
H: And it’s interesting because even today, it’s amazing how often we as bereaved siblings get the messages from society that we need to be strong for our parents because they’ve been through so much.
B: Um hm.  Exactly.  And oftentimes siblings will say to me, mostly what people ask me, they’ll say, is how’s your mom doing?  Sometimes they say, how’s your mom and dad doing? but nobody ever asks how I’m doing.  And that is so true.  Now one of the things I really want to emphasize for parents is that this is really hard for parents.  It’s very difficult for parents to have a child who’s ill and who died or a child who dies suddenly.  No matter how it happens, it’s incredibly hard for parents.  I have not yet met in all of my work a parent who was not concerned about their other children.  They are concerned about their other children.  It’s just that sometimes they don’t know what to do, what to say, or they don’t have the energy to do it.
G: The other thing is, as I recall when my son died and my daughter was 14, there’s nothing you can – you hate to see your kids hurt that much.  It’s a terrible thing but you can’t stay up all night with them every night and they’re crying at night.  You don’t want them to cry.  You don’t want them to do this.  But you’ve only got so much left to yourself.
B: Right.  And one of the things about that is grief does hurt and one of the ways people cope with their grief is to cry so our goal isn’t to stop the crying at night but to let the children know it’s okay to cry.  I have to tell you about one of the experiences I had with one family who told me that.  They were a very loving, caring, cohesive family, and so when I was talking with them and I asked them about crying, how did they manage crying in their family, the father cleared his throat and sat up straight and he said, well, you know, we have a rule about crying in our family, and that rule is you don’t cry.  And I was dumbfounded because that seemed totally contradictory to my perception of this family, but he said also, he said, you don’t cry alone.  And so his message was, we know you have to cry, and it’s okay if you want to cry by yourself, but always know that there’s someone who will cry with you or sit with you while you’re crying.  So the message there is the sharing of children with their – between children and parents of how they’re feeling.
G: But let me ask you a question.  To our audience out there, would you want to tell a child that you don’t cry alone.
B: Uh, no.
G: That might be that family’s tradition but
B: Right.  No.  My point there is the sharing
G: Right.
B: that’s emphasized.
H: And that you want to keep communication open.  It gets more difficult with teens, though, doesn’t it?
B: Yeah, and so the other thing that one can do with teens because the last person teens talk to usually is their parents.  A lot of teens I have found that I interviewed actually talked to the parents of their friends.  They turn out to be good listening blogs.  So one of the things I recommend to families is to identify an adult in the child’s life to whom the child feels close, who has a good relationship.  It can be an aunt, an uncle.  It can be the next-door neighbor.  It can be the mother of a best friend.  A scout leader.  A pastor.  Whoever.  Ask that person directly and specifically if they would be willing to help with family in this way.  Would you be willing to spend some time with Johnny, the surviving child, every week for half an hour?  Would you be willing to make sure that you sit with Johnny at the funeral and explain to him what’s happening if he has a question?  Someone that the child trusts and can go to knowing that that person will have time to listen and be with them.
H: I like that because usually the parents are going through so much of their own grief that these children really experience a double loss.
B: That’s exactly true, and most people who are close to the family, whether they be relatives or friends, are so eager to help but they don’t know how to help either.  So giving them a specific task, like the responsibility in a way for just spending some quality time with the sibling will help.  Now if it’s a family that has more than one sibling, you need one of those people for each of those children.
G: That’s a great idea and I think that comes into your second point which is I don’t understand which is a great way to help them.  I wanted to get.  Before you.  You’re going to leave us after this segment so I wanted to get to your third point which is I don’t belong.
B: Right.  Now oftentimes children end up feeling as if they don’t belong simply because they haven’t been involved or included and we have to try to include the children to the level that they’re able.  So sometimes as I mentioned before, the natural inclination is to send children away to protect them from what’s happening, from the sadness in a way.  How much better to include the children and to teach them how to deal with the sadness.  So, for example, when a child – when a funeral is being planned, to ask the siblings, is there anything that you would like to do for, during the funeral.  Would you like to sing a song or write a poem or would you like to just be there and sit quietly?
G: You know, Betty, I’m thinking because of our audience, most of them have had children die already, that you could have a memorial say in a year or six months or whatever or during their birthday or whatever, and you could include them in some kind of a ceremony then.
B: Exactly.
H: And maybe they can even help decide how they want it to go, what you want to do.
B: Yes.  One of the other things that I find helpful that parents have told me they find helpful.  If for example any parents in your audience today might be able to say to their child, you know, I listened to a radio program this morning and it was about what happens when a brother or sister dies and what it’s like for the other brothers and sisters.  We haven’t had much chance to talk about that and how it’s been for you.  Why don’t we do that?  It provides an opening for parents.  Rather than just to sit down and say okay, tell me how it’s been for you.  Kids kind of go, what?  What do you want to know for?
G: Right.  Why is this coming up now. 
H: I love that.  I love that.
B: So it just presents it in context and it allows the child to say, oh well, no, thanks, I’m fine, which in itself might tell you something.
G: And they also might be able to, at this point say to them something like we had to take care of Jane for a long time.  How was that for you?  Or if it was a sudden death, how was it to suddenly hear?  That kind of thing. 
B: Open it up a little bit to say I heard on the radio that it’s really hard for many brothers and sisters because not many people pay attention to them.  How is that for you?  So that it kind of neutralizes it a little bit.
H: Yeah, it really normalizes it.  I like that, Betty.
B: Now, I just want to share one other piece of information that I think is very important to this business about a child not feeling as if he’s enough.  And this often comes about from favoritism shown one child over another.  And this is my best example of this.  When I interview families I often and prefer to go to their home.  In some homes, families will tell me about the child who died and then they will show me a picture of the child and they’ll point on the wall and they’ll say, that’s Johnny.  That’s our child who died.  In other families, they’ll point to the picture of Johnny, but Johnny’s picture will not be the only one on the wall.  They will say, these are our children.  Johnny is the one on the left.  He’s the one who died.  Mary is below him and Peter is the one on the right.  Just having mementos of the deceased child around can make the other children feel as if they’re not special enough as was the child who died.  So one of the most important and simplest things that parents can do is to make sure that pictures of all of their children are around.  That all of the children’s awards, if there are any, or ribbons in school, or pictures they draw in school are posted on the fridge.  Not just those mementos of the child who died.
G: Oh, Betty, that is so great, and it’s time for us to say good bye to you and go to break, and I think that’s just a great thing to end on, don’t you, Heidi?
H: Absolutely.
B: Thank you so much.  I appreciate this opportunity very much.
H: Thank you, Betty.
G: Nice to have you on the show and we’re going to try to – we will put the children’s responses, your four points
H: And Betty’s books are in our bookstore.
G: Yeah, and the books are in the bookstore, and I’m sure your points are all in your book, right?
B: They are.
G: Great, and which one for those four points would they look at, which book would they get?
B: It would be the Shadows in the Sun: Experiences of Sibling Bereavement in Childhood.
G: Great, so it’s the Shadows in the Sun and you can get those off our website and I’m sure you can also get them on amazon, right, Betty. 
B: Yes.
G: Well, thank you so much for being on the show.  It’s been very helpful and I hope to get to meet you in San Francisco.
B: Thank you.  I hope so, too.
H: Thanks, Betty.  Take care.
B: Bye bye.
G: We’re coming up on break and I’m your host, Dr. Gloria Horsley and please stay tuned to hear more with Dr. Heidi and Dr. Gloria.
Before we get to the information we got from Dr. Davies which is really amazing—she’s quite an amazing woman and fabulous information, I wanted Heidi to have you talk a little bit about our new book which is finally around.
H: Which also deals with sibling loss and all sorts of losses.  This is a book called Teen Grief Relief:  Parenting with Understanding, Support and Guidance.  It is for teenagers and their parents and it’s a way for parents to help their teens that are grieving and also a way for teens – a great resource for teens.  You can get it on our blog.  There’s a 1-800 number, right, mom?
G: Yeah, there’s a 1-800 number right now where you can order it because it won’t be on amazon or in the bookstores for about a week so Heidi and I are very excited about it.  And Heidi, some of the information Dr. Davies talked about today kind of brought me back to some of the things in the book and a lot of the things that we’ve talked about on our show.
H: Right, and it’s a great reference book.  You don’t have to read it all the way through from the start to the finish and there’s a lot of things that will help teens that are grieving feel better and it’s not a long book either.
G: It’s a good read and I also was looking at it and thought wow, I could have used some of this information myself for myself, too, after Scott died.
H: I definitely could have used the information as a bereaved sibling after my brother died.
G: Yeah, so Heid, lets talk a little bit about what Dr. Davies said on the show and then I’ve got an email that we – I think we want to go over maybe using her information.
H: Okay.  One of the things that I liked that she said is that for those parents out there that are listening today to this show, a great segue way into opening up communication with your kids is to go to them today and just say, I listened to the radio show today, and I heard a lot about sibling loss, and I just wondered how it’s been for you because I’ve heard that it’s really hard for other brothers and sisters and that sibling loss is often unacknowledged and overlooked and you’re often told to be strong for your parents, and I was wanting to check in with you and seeing how that’s been for you and how it’s been to have a sibling die, and it must be really hard.
G: And the idea that I also understand that you could really hurt inside and how are you feeling?
H: Absolutely, yes.  And Betty made a good point that oftentimes children will not be able to verbalize, that teens may be able to, but children may not be able to answer that question; however, we need to look at their behaviors.  Are they acting out?  Are they withdrawn?  Are they aggressive?  Do they have somatic problems, physical problems?  Stomachaches, headaches, poor concentration in school, aggression.  We need to look at sleep problems, eating problems.  We need to look at all these signs because that is part of grief and so they may not be able to tell you but they may be able to show you that it’s been very hard and things aren’t going well.
G: You know we always talk about the fact that kids oftentimes don’t do well in school or have trouble concentrating but it’s also interesting from listening to Dr. Davies that sometimes kids will over perform.
H: I think that’s interesting, too, because it’s actually been more of my experience working with kids that they have poor concentration, not that they over perform, but we can’t forget, like you said, mom, that over performing is part of the bereavement process also.  They may want to be really good kids because their parents have been through so much, they don’t want to cause them any more problems or any more pain.
G: I also thought Dr. Davies’ idea about this shared life space where if your kids have been fighting, they still share that life space.
H: I agree, and I think that we have to realize if a relationship means a lot to you and you’re invested in it, people are going to be worth arguing with and fighting with, and having a conflictual sibling relationship is normal.  It’s normal that we.  Our siblings are in our lives hopefully forever.  It’s safe to fight with them because they’re always going to be there for us and I don’t know any siblings that never argue.  It’s a normal thing.
G: Another area I thought was really interesting because we know.  We see a lot of people that kind of create shrines for their kids, don’t we?
H: Absolutely, and I thought that was really good what Betty said.  It’s okay if you have a shrine and if you have things that represent the bereaved sibling.  However, you need to have just as many things that represent your surviving siblings around the house. 
G: So you might just want to go count them, seriously.
H: I was just thinking that, mom.  Counting would be a great idea.
G: And maybe you’ll put up a shrine for your kids that are living.
H: Absolutely, and when I work with bereaved siblings, they always say to me and I know from experience, how can I compete with a deceased sibling?  They’re perfect.  They’re gone now.  There’s no way to compete with that memory and it’s just a lot of pressure so like you said, going around and counting and making sure that your surviving sibling is well represented in your house, I think that is very important in your pictures, in your photos, in everything you have.
G: Because we don’t want the other kids to feel like they’re not enough.
H: Absolutely and that the wrong child died.
G: Right.
H: And you know oftentimes bereaved parents, and this is very normal, say I don’t know how I can stand the pain any more.  I don’t know how I can go on.  I can’t handle this.  I mean, I heard it from my parents.  That’s normal.  You love your children.  However, as surviving siblings, we often hear we’re not enough to keep them here.  We’re not enough to take the pain away.  We’re not good enough.  Maybe the wrong child did die.  So just to know what your kids are hearing even though you don’t mean it that way.
G: Yeah, and I was thinking also, if you’re going to have another child, you know, a lot of times you’re going to naturally in the course of life have another child and you need to tell your child that if you decide to have another child, that this child is not replacing the child who died.  This is another addition to our family and could be a natural thing and we may have had another child anyway.
H: Well, and it’s interesting with that in mind, you can never replace a child ever.  And everyone listening knows that, and it’s interesting when people will say to people, oh, you had a brother that died?  Do you have other siblings?  Well, yes, I have other siblings, but my sisters and my other siblings can’t replace my brother.  He was his own person.  And you hear that with bereaved parents, too.  People will say to the bereaved parent, oh, do you have other children?  And yes, they have other children but no one replaces the child that died.  That’s, you know.
G: And you know for our folks out there, I know that you don’t want your child to feel that way.  I think the key here, Heidi, is to let parents know that sometimes children are feeling that way and that this might be an opportunity to say, you know, are you feeling that way and that’s not the case, you know.
H: And we love all of our children in different ways.  We love them all just as much but in different unique ways.
G: Yeah.  You know, Heidi, I said I was going to do an email and I’ve got to quickly do it because we’re almost out of time.
H: Okay, but I need to bring up one more point.
G: Okay, well we may skip our email till next week.  Go ahead.
H: Okay, how about when Betty said the listeners out there need to identify an adult in the child’s life to whom the child can go to for help.  But you don’t only need to identify this adult for them.  You need to go to that adult and tell them the task that they need to do.  Remember that?  In other words,
G: Exactly, the education, and also there’s a little touchy thing about how does the family decide who it’s going to be, and do the parents agree, and there could be all sorts of issues around that.  That’s not quite as clear cut but I think it’s a great idea. 
H: It is because the bottom line is when my brother died, my parents were emotionally unavailable.  They were grieving.  And I hear this all the time from siblings.  And it was a double loss.  I lost not only my brother, I lost the parents I once knew and I did need to look outside the family for somebody that could acknowledge what I was going through and help me through the process.
G: Well, Heidi, let’s leave.  Have you got one point as a sibling as we get ready to close the show that you think would be helpful for families out there?
H: I think just letting the children know that I’ve had a child die but I haven’t had a sibling and it’s very hard for you and I’m here for you if you need me, and what can I do for you or do you want to talk about it?
G: And as you always say, it doesn’t what, define your life?
H: Losing a sibling does not – it defines your life.  It does define your life but it does not destroy your life.
G: And we’ll close on that note.  I’m your host, Dr. Gloria Horsley with my co-host
H: Dr. Heidi Horsley.
G: Please stay tuned again next Thursday when our guest will be Nancy Thomason.  In February of 2000, Nancy Thomason’s 17-month-old son, Cade, died due to a brain tumor.  In honor of Cade, Nancy founded the Oklahoma Brain Tumor Foundation.  This show is archived on our blog, www.thegriefblog.com, as well as www.compassionatefriends.org website.  Thanks for listening.  I’m Dr. Gloria Horsley, and
H: Dr. Heidi Horsley.  Betty, thank you for helping all bereaved families and siblings to heal.