Talking To Teens: Expert Tips for Parenting Teenagers

Andy: Can you talk a little bit about what got you interested in this field? Children going through grief is really a specific thing to be interested in or to dedicate yourself to. What drew you to that or how did you find that?

Elena: Yeah, that's such a great question because it is the basis of the passion for what I do. When I finished medical school and residency and the child fellowship and all that, I was not specializing in grief. I got married during my fellowship. I had a child, then I had another child. My second child, my younger daughter was diagnosed with leukemia when she was four, and she spent the next two years battling it with lots of ups and downs of course. Then she died of leukemia when she was six. At that time her older sister was nine. I had two young children, and we lived with it with both children knowing that our younger daughter was dying. She actually sensed it, knew, and told me that she was dying.

Elena: My husband, myself, and my kids, we all together had three months when we knew she was dying, until she died, that we were all together. We talked about dying a lot. Then I was with my daughter afterwards as she grieved, but part of it was that I could see that my younger daughter was five and a half, that she could talk about this was astonishing. Of course, she seemed spectacular to me, I'm her mom, but it felt to me like a lot of young children probably can. We worked with my older daughter's school. We went to her third grade class, there's a story about that in the prologue, and I sat with 120 third graders, and all of them could talk about it. That was when I changed course in my career and decided I wanted to help people to deal with this, and in particular help parents deal with their children about loss because we found it very hard to find people who could talk to us about it. I just felt, did not want other people to feel as emotionally alone as we had during our journey.

Andy: Wow. It's really a powerful story that starts out the book. It really got me thinking, this whole book, you have really great examples and go really specific into different situations in depth, but also there's a compelling argument throughout the book that it's better to discuss these dark and difficult topics that we think maybe as parents that we'd want to protect our kids from, that it's actually better to discuss it with them, and that they will have a better time coping with it and going through it and it will be better for everybody. It's really interesting and is what played out at the school I guess is that you went in and talked about it with everybody and got all the parents talking to the kids.

Elena: There are a lot of stories, and we put those in on purpose because this is my experience as a clinician. We felt it made it more real and accessible for people. You are so right about the main thrust of what we believe. We believe that one should talk openly and honestly in a gentle, compassionate, and age appropriate way with children about death. In fact, we believe the best protection is when you talk with them about it not talking about it. A way that becomes protection is, I mean none of us want to think about this, none of us want to talk about this, but we have to because death and loss are inevitable, and so it means it's an inevitable part of parenting. Since it's going to be there, if you allow your child to have some facility with it, to have some mastery to understand what they feel, to know what's going on, they learn that they can handle hard stuff.

Elena: When they learn they can handle hard stuff, that means they look at the future and they say, oh well, I handled hard stuff. I can handle other hard stuff. Whereas if you don't talk with them about it, they never have the chance to learn resilience, and we think that's real important. The story that you were referring to, Andy, was a different school. I was called to consult, and I do a lot of consultations in schools, kids of all ages. In one school, kindergartners, there was a teacher who was dying and I suggested and recommend they called me in, recommended that they tell the children that this teacher was dying, beloved teacher, partly because I believe in this, and partly because the children were asking, how come Mrs. So-and-So was out.

Andy: It's easy to make up a story of oh vacation and …

Elena: Yes, exactly, yes.

Andy: Won the lottery, and she's in Bora Bora.

Elena: Right, exactly, if only, right? But the parents knew, and so that's the other risk. If you do not talk with a child directly, they're going to overhear it, and then they're going to be left alone with it because you don't know they know. They know that you didn't tell them, so maybe they don't want to ask you about it. In that school, after the teacher died, I continued to work with them because I believe in working with people where they are. It was not my recommendation, but I felt that I wanted to at least be on the journey with them. Those children had a lot of symptoms. They were wetting their beds. They were clingy. They were having difficulty separating. A lot of stomach aches, going to the school nurse all the while before she died. Then she was absent, really terminally ill. They were never told she wasn't coming back.

Elena: Then she died and the kids were just really, really devastated. In the other school, same grade, also a teacher dying, they said, okay, if you believe that we should tell the children, then we're going to create an environment in which we can do that. We worked for the parents to help them understand how to talk about it and why I believe that we should talk about it. Those kindergartners had several episodes, weeks with their dying teacher in a hospital bed, on FaceTime. They sang him songs, and they made him cards, and they told him how much they were going to miss him, and he told them how much he loved them and how he was sad that he wasn't going to be able to finish the year with them, but he knew they were going to get a great new teacher.

Elena: Those kids did not have symptoms. They were sad. They cried, but they knew that they had told this person what they felt and how good a man he had been for them. They were not left with a lot of residue about it. They cried and they were upset, but they did not have difficulty sleeping. They did not wet their beds. It really was a concrete demonstration of how, if you don't tell, it can be really damaging.

Andy: There's also an example towards the start of the book of this girl who's at summer camp. She comes back from a summer away at camp, and her parents tell her, actually, in the first week while you were gone, grandpa passed away. We didn't want to tell you because we wanted you to have a great time at camp. Then it's like they've all processed it all summer and are in one place with their mourning process. She's just hearing the news now and trying to start going through the grief. It really got me thinking that would be a tough decision as a parent. What do you do? You just sent your kid away to camp and then something like that happens.

Elena: I mean, I've worked with families where a parent is dying and it's time for summer camp. What we often come to is that the children go to camp with the understanding that if that parent worsens, they'll be called, and they can come home for a while and be with that parent perhaps until they die, and then go back to camp if they feel up to it. All the names have been made different and ages are different so that you can't recognize anybody. We really want to protect the privacy of the people we work with. The situation you're talking about in our book is a little girl who's called Brianna, and Brianna's grandpa dies. What happened for Brianna is that she felt completely distanced from her family. As you well said, they were in a different place on their mourning process, and she felt betrayed, and then she felt guilty.

Elena: She'd been off having this great time at camp while they were all sad and did that make her a bad person? Then she felt she couldn't talk with her parents about all sorts of other stuff because they didn't talk with her about stuff. If you talk with your child about stuff when they're younger, when they get to be teens and there's a lot of complicated stuff to talk about, they will trust you that you respected them enough to be honest with them earlier. They will come to you with the tough stuff because you've come to them with the tough stuff. I think Brianna actually felt unable to be around loss and had a very hard time for years after because of it. While that's one example, in the two schools I was just referring to, we use those examples because they're typical. It's not a rare outcome. That is a common situation where if a child is not told when somebody dies when they're away, it leaves them feeling alone and unable to process loss and talk with their parents for years to come.

Andy: Does anybody worry that maybe talking too much about death and some of these topics might really freak kids out? Cancer or terminal illnesses and stuff like that might get kids obsessing about these things or something and that maybe it's better just not to talk so much about that kind of stuff?

Elena: Andy, that's such a great question because this is a major concern we run into with parents. I haven't seen it. It does not happen. I think the reason is because children are exposed to death all the time. I mean, I don't know whether you remember your Disney movies, but in every single Disney movie a character dies, in books, in nature. You're not teaching your child that death happens. They know. What you're doing is providing them an opportunity to talk about it. You are also not talking about it every day. You introduce it and maybe you come back to it sometime down the line. It's not like it's the only thing you talk with them about, which would be terrible.

Elena: We give an example of let's say you had to tell your child that there was something really sad happened, Aunt Jane died. You tell, listen, we have some sad news. Aunt Jane died and we're going to spend some time together. That's one way we recommend telling. You and your child sit and you talk about it. Then you always recommend, do you have any questions? Ask, do they have any questions? Your child says no. Then you have in mind an activity you can do afterwards. Okay, let's go make mac and cheese for lunch. In other words, you're not dwelling constantly, even in the face of a loss within the family. You're showing that we weave this into life.

Andy: What I thought was really interesting about how you think about this is that there's different levels to process it on. You have some event that happens when a kid is eight years old or something. You might give them one version of the events leaving certain elements of it that you don't go into as deeply, and as they get older, then as you revisit talking about it, you might go more into those things. What does that look like, or how do you think about what age a kid is and how to gauge what to tell them and what to not tell them or we're going to save for later?

Elena: Sure. Well first of all, organically, I mean you may remember this from your old childhood growing up, things that you learned and thought about when you were six, when you think about them when you're 12, you think about them differently because now you've had six more years of experience and you're more sophisticated and all those things.

Andy: Right. Yeah, yeah, yeah.

Elena: The same thing happens about a loss or death in general. That's going to happen. It'll happen automatically, that you look back on things that happened when you were younger and you look at them with your older eyes. The best thing you can do as a parent is make sure you're available. Let's say a teacher died when a child was four. Then this student is now in 10th grade, and they're thinking back to when they were in kindergarten and now they have some questions. If you talk with them when they were four, they'll come to you and say, you remember when Mrs. So-and-So died? Why did she die? They'll start asking questions because now they know different questions to ask and that's great. It's an ongoing process.

Elena: One thing we say a lot, it's not one conversation. It's many and over many years. We are thoughtful about how old a child is, so we recommend that if there are siblings in the family and they're different ages, you speak to the youngest child, and you offer to the older child, you and I can have a follow up conversation later. We like that because we want to convey that this is a family thing and we go through it together.

Andy: So everyone gets these collectively at the same time.

Elena: Exactly, yeah. Also older sibling knows what younger sibling learned. Then later you can have a more detailed conversation. It's hard to do exact ages, but if you gave me an example, I could think about how much one would say, that kind of thing. We are thoughtful about the age and we are gentle in our recommendations. It's a gentle situation in which you're resonating with your child. It's really about where they are and how they understand what's going on. It's not about telling them something. It's a conversation.

Andy: You don't have to necessarily just throw all the information at them at one time. For instance, in the chapter on suicide, you were talking about maybe letting a kid know for one thing, hey Uncle Harry maybe passed away and ran into a tree. Then later on you could re approach it and say that we think maybe he left a note or whatever. He took his own life. What does that mean and get into it. I thought that was an interesting way of thinking about it is that you don't have to come out with everything all at once. Maybe even within the same day or something, you can revisit it and add more information as you build out the picture for them or something. That's cool.

Elena: Yeah, that's exactly right. Suicide is very hard for, I mean, it's so painful for everyone as is loss in general. Many people think young children can't understand. I mean it's hard for all of us to understand at any age, right? It's talked about. At funerals now they will say that somebody died by suicide. By the way, I don't use the phrase committed suicide because I think that implies something like a crime, so when somebody died by suicide. If you don't allow your child to have some conversation with you about it, they're hearing these words, and they don't know what they mean, and they come to their own ideas. Maybe even a four year old looks it up on the internet if they know how to read. They're finding things out, and you don't know what they're finding out and how reliable are the sources.

Elena: We have an idea that at age six and above, you would lean toward including maybe in the second conversation that this person died by suicide. Younger than that, if they ask a question, you answer honestly. If they don't ask questions, you may wait to fill that in until they're a little bit later. Yeah.

Andy: Yeah. Interesting. Yeah, it's such a delicate balance to walk and also just being sensitive and knowing your child and what they're ready for, I think. Not to be underestimated.

Elena: That's right. Know your child, I think, is the name of one of our chapters because we advocate that you think about who your child is. How have they responded to losses in the past? Do they like to be held and cuddled when they're getting difficult news, or do they like to sit on the other side of the room with a toy truck or some blocks in front of them or something. You think about who your child is and you convey hard news in the way that is most accessible to them. Not you, it's not about you at that moment, you parent or grandparent or teacher. It's about what the child needs and how they'll best be supported through handling hard stuff.

Andy: I like your focus on working through your own emotions first. That's a starting point and important.

Elena: The queen died recently, as I'm sure you know. A lot of people who didn't know the queen are having reactions to it because it's reminding them of losses they had in the past, completely unrelated to the queen. A loss brings up past losses for all of us, everybody. If you take the time to check in with yourself and think, what does this loss mean to me? Is it bringing up losses I've had in the past? Did I grieve for those losses? You get yourself all centered and grounded. Okay, I understand that this is upsetting me tremendously, and this is why. It's reminding me of when my grandpa died when I was eight and I never got a chance to say goodbye. This is a loss that happens when they're a parent adult, and they never got to say goodbye to the person who died.

Elena: This is a parent thinking to themselves, I get it now. I'm reacting to more than one thing right now. Let me give myself some time to collect myself and think about that. Am I angry? Am I numb? Am I sad? So that when you go in to talk to your child, you're not busy in your own head. You're there for your child. That way your own noise doesn't get in the way and you can really focus on what your child needs because those are tender moments with a child. The more you can ground yourself, the more reassured they'll be that the two of you, or the three of you, or four of you are going to get through whatever it is you're facing.

Andy: You talk about these four elements in your book to be sure to communicate with your child, for them to have a full understanding of death and their universality, irreversibility, finality, and causality. Is that more things that apply with younger kids or is that something that you would be thinking about with teenagers as well?

Elena: If you think about it yourself, how did you learn about death and understand that it's final and that somebody can't come back and so on. We would say, you're not going to sit down with a child of any age and say, so let me teach you about death.

Andy: There's four things you got to know. Let me break it down for kid. Right?

Elena: Exactly. Right.

Andy: Irreversible.

Elena: Right, and there's a quiz at the end. Those are the things you want to be thinking about that they understand because if somebody dies in their world, you want them to understand that that person can no longer do human body things. That person is not going to come back to life. Think about computer games. The figures come back to life all the time, but that doesn't really happen, that death happens to everybody and that it happens for a lot of different reasons. They're very simple things, but they help a child understand the whole concept. What is death all about after all? That it helps you if you're grieving, and it also helps you if you're just learning about death. We would suggest that, you have sex ed in school, that maybe it's worth having death education in school too for kids so that they learn about it and talk about the hard stuff in conjunction with parents.

Andy: Then parents wouldn't have to do it. Yeah, that would be good.

Elena: No, with the parents. With the parents.

Andy: That's the great thing about sex ed is now we can just totally trust the schools to just take care of it for us.

Elena: No, I'm doing it. It's a collaboration, Andy, and you know it.

Andy: Okay. Yeah, yeah, yeah. Yeah.