- The Washington Times - Tuesday, October 3, 2000

Judy Bryden says she had to come to terms with her mother's impending death from lung cancer before she could help her two sons cope with the inevitable loss.

Mrs. Bryden's 69-year-old mother had been ill with chronic lung disease for several years before her death in January, and she often would stay in the Bryden home in Burtonsville when she was unable to take care of herself.

"They did ask if Grandma was going to die, and we did tell them that Grandma will die," Mrs. Bryden says. "We wanted them to see this was not a tragic event, but is part of the life cycle. As they had concerns, we would sit down and answer those questions at an age-appropriate level. I would never answer more than they asked."

One of the most difficult jobs of being a parent is talking with children about tough issues, such as death, fear, divorce, drugs and sex. While many of these issues don't kick in until a child hits puberty and begins the passage into the turbulent teens, child specialists advocate talking with children early and often.

Months after their grandmother's death, 6-year-old Timothy is coping well, but 7-year-old Joseph is expressing anger at her for smoking.

"It was the tone of his voice, his face and his body language," says Mrs. Bryden, when Joseph told her, " 'I'm really mad at Grandma because she smoked.' "

Children grieve differently than adults, Mrs. Bryden says. "I am finding with my children that it comes and goes. They still have things they are working through."

What should a parent do?

Children are intuitive and are aware of parents' emotional distress, says Dr. John Evaldson, a board-certified child and adolescent psychiatrist in Santa Fe, N.M. He is the father of three boys, ages 4, 6 and 9.

"The first thing for a parent to do is take deep breaths and calm down," Dr. Evaldson says. "When I talk to my kids about something tough, I calm myself down, and second I touch them. There's clear evidence that physical touch helps children calm their arousal."

Dr. Evaldson further explains, "The main thing I am saying is if there is something difficult to talk about, try and get attuned to what they are experiencing and feeling … find a way for the child to express whatever they are feeling."

Children worry about whether things are dangerous, he says. "They may not be able to verbalize fear. But try to observe their body language or other ways they have of communicating."

He gives an example of his 6-year-old son who was drawing pictures of fires after watching the Los Alamos fire on television. "He was scared. I decided to pick him up and carry him outside and let him see there was no fire in his immediate vicinity. By doing this, it helped him to feel safe," Dr. Evaldson says.

Dr. Robert Needlman's is a developmental behavioral pediatrician and director of behavior and child development at DrSpock.com. His field is a newly recognized specialty within pediatrics.

"We straddle the boundary between general pediatrics and child psychiatry," he says. "The difficult thing is not providing accurate information; what's difficult is to find a comfort level."

Talking with children

Dr. Needlman suggests these tips for talking with children:

• Tell the truth don't lie, sugarcoat or conceal. Children almost always know what's happening.

• Give a child as much information as he or she asks for, but not necessarily all the information at your disposal at any given time.

• Listen and do not assume anything when talking with a child about death, divorce or sex. One of the most important things is to listen to the child.

What is very difficult for grown-ups is to be comfortable with the issue. The parent has to be able to handle the topic without getting angry. That is hard if the topic is drug use or sexual activity by a child.

• Respect where the child is coming from. For example, when talking about divorce, a parent may feel wronged, furious, betrayed or depressed. Telling the truth does not mean spilling these emotions on a child. It also doesn't mean putting on a smiley face and saying everything is fine the child knows that is not true. Once a child discovers one lie, he or she wonders if there are others.

"Maintaining trust is really important," Dr. Needlman says. So how does a parent talk to a child about divorce?

Divorce

Dr. Needlman suggests first taking a few deep breaths. Then he suggests talking to a friend until it's possible to talk about emotions without feeling them.

"If you can't do that … you will be burdening [children] with an unfair burden, which is all of your adult emotions," Dr. Needlman says. He adds that once a parent reaches the necessary level of detachment, he or she can sit down with the child and say, "This divorce really stinks, and I feel sad and mad, and I am really upset. How do you feel?"

Dr. Needlman explains it's very important to say this. "As important as the content of what you are saying, what's even more important is the message that no matter how bad things are, we can still talk about it and nothing terrible happens from our talking about it."

He says the worst thing for a child confronting a difficult issue is to face it alone.

"It's always helpful for a child to hear from an adult, 'I know this is hard for you, but you don't have to deal with it alone because there are people that can help you,' " Dr. Needlman says.

Sex

Many parents wrestle with how to talk to their children about sex.

"Probably the most important thing for a parent to communicate to their children is that sex is something they can talk about," Dr. Needlman says. He says the key is starting young and talking at a level appropriate to the child's development.

"It's not a bad idea for the child to see parents smooching sometimes because kids understand that's a way parents show affection," he says. As children become more aware, point out provocative images where sex is being used to sell a product. "This way the child becomes aware of how sex is used in the culture," he says.

With preteens and teens, there is always the privacy issue, but, Dr. Needlman says, a parent still can broach the subject. Parents should share their values with their children, tell them how they feel about those values and ask them what they think, he says.

Dona Caine, a Raleigh, N.C., sex therapist says, "It makes good sense for parents to sit together and talk about the issues of homosexuality, birth control and abortion so when they have 11- and 12-year-old children they know how they as parents want to share their values and morals."

Jay Canova of Vienna is a full-time dad and father of 16-year-old Joshua and 14-year-old Joseph. He says when the affair of President Clinton and Monica Lewinsky dominated the news, "… it brought up topics that you had to cover." He saw it as "an opportunity to say that sex outside of marriage creates a lot of problems, other than just relationship problems with the girls. It makes you grow up; it makes you do things … anytime you get into lying, it hurts a lot of people."

What if a parent doesn't feel comfortable talking about sex? Mrs. Caine, a mother of three children, suggests getting a resource book and keeping it in a visible place for children. She also urges parents to use formal anatomical terms for body parts. From the time a child is 2 years old, there are going to be predictable questions, and Mrs. Caine suggests thinking about some of those questions and how to answer them.

What if a parent hasn't had these discussions and now suspects a teen-age son or daughter may be experimenting with sex?

"I think it's wise to take responsibility and say … 'I haven't sat down and talked with you about sex, and I wish I would have. I am concerned … because this is often the time when young people experiment.' "

Mrs. Caine suggests that a parent should admit to a teen-ager that he or she is afraid of the risks and outline the concerns.

Drugs

Mr. Canova says a TV commercial spurred discussions with his sons about drugs. The ad shows a man and his son eating breakfast and not talking and then displays the words, "Another missed opportunity to talk to your kids about drugs."

"A lot of the quality time that all of us spend with our kids is driving to and from some place," he says. "You've got them in the car, and they are locked in, and so we talk about issues and about how I have family members who have been affected by drug abuse and the problems that can cause. And then right back into the lying issue, and how that can hurt people, and all of that goes hand in hand."

A 1997 study published in the Journal of the American Medical Association found that of the primary forces that influence adolescent behavior, family and school are the most critical.

"Protecting Adolescents From Harm" is the report on a national study of 12,118 children in grades 7 through 12 that assessed emotional distress, suicidal thoughts and behaviors, violence, substance abuse and two types of sexual behaviors (age of sexual debut and pregnancy history).

This study reinforces what child specialists advocate. Talking to children and being involved in their lives is the best strategy for keeping them healthy and helping them avoid high-risk behaviors as they experiment during the turbulent teen-age years.

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