Bereavement and Grief in Children and Young People: Understanding Loss and Traumatic Bereavement

Bereavement can have a profound effect on children, teenagers and young adults, influencing their emotional development, relationships and sense of who they are. Although grief is often associated with sadness and longing, it can also emerge through anxiety, anger, withdrawal, difficulties at school or changes in behaviour. Sometimes a young person appears to carry on much as before, while struggling with feelings they cannot easily explain or may not fully recognise themselves.

No two people experience bereavement in quite the same way. Even within a family, where several people are grieving the death of the same person, each will have had their own relationship with them and will experience their absence differently. Their grief is shaped by their stage of development, previous experiences and the particular place the person occupied in their life. A psychoanalytic understanding of bereavement recognises this individuality, including the conscious and unconscious feelings that can make the experience of loss difficult to understand.

Understanding Grief and the Inner World

When someone important dies, we lose more than their physical presence. We also lose the particular place they occupied in our lives, the relationship we had with them and the future we imagined together. Their influence does not simply disappear with their death, because our relationships become part of how we understand ourselves and others.

Psychoanalytic thinking offers a way of understanding why bereavement can be so emotionally complicated. Freud, in his 1917 paper Mourning and Melancholia, explored the psychological work involved in responding to loss. Mourning involves gradually coming to recognise the reality of a death and finding ways to live with the absence of someone who has been deeply significant. This is not simply a matter of accepting that someone has gone, but involves changes in our emotional lives, our relationships and sometimes our understanding of ourselves.

Freud was particularly interested in the distinction between mourning and melancholia, a term he used to describe a form of depression. He wrote:

"In mourning it is the world which has become poor and empty; in melancholia it is the ego itself."

By this, Freud meant that in mourning, the world can feel painfully empty because someone important is no longer there. Familiar places, activities and experiences may seem to have lost their meaning because the person with whom they were shared is absent. In melancholia, however, the loss becomes more deeply connected with the person's feelings about themselves. Rather than experiencing only the painful absence of someone loved, they may come to feel that something is fundamentally wrong with them, becoming intensely self-critical, worthless or undeserving of love.

Freud's use of the word ego refers here to the person's sense of themselves. His distinction helps us understand how grief can sometimes become entangled with depression, particularly when feelings associated with a lost relationship become directed against the self. This does not mean that ordinary grief cannot affect someone's identity or confidence, but that the emotional consequences of loss can take different forms, some of which are especially painful and difficult to recognise.

Our relationships with other people become part of our internal emotional world. We carry memories, feelings, expectations and identifications with those we love, and these continue to influence us even when the person is no longer physically present. The psychoanalyst Melanie Klein developed this understanding further, describing how bereavement can disturb our internal sense of security and revive earlier fears of separation and loss.

Our closest relationships are also emotionally complex. Even in loving and secure relationships, there will be moments of frustration, disappointment and anger alongside affection, pleasure and dependence. Psychoanalysis uses the term ambivalence to describe the way different, sometimes contradictory feelings can exist towards the same person. These are ordinary aspects of human relationships and do not diminish the love we feel. Indeed, the people who matter most to us are often those towards whom we experience the greatest range and depth of feelings.

Some of these feelings may be unconscious, meaning that we are not fully aware of them, even though they can influence how we experience ourselves and others. Following a bereavement, feelings that were once part of the ordinary experience of a relationship can become more difficult to understand or tolerate. The person is no longer there, and the possibility of sharing, expressing or resolving those feelings with them has been lost.

For some children, the death of a parent can also be experienced as a form of abandonment. Although they may understand that their parent did not choose to die, the emotional experience of being left behind can be very different from that conscious understanding. A child may desperately miss their parent while also feeling hurt or angry that they are no longer there. Such feelings can be confusing, particularly when the child believes that anger towards someone who has died is disloyal or wrong. Unconscious guilt may also become involved, with earlier thoughts or feelings taking on a significance that they did not have before the death.

These experiences are not universal, but they illustrate how grief can involve feelings that are difficult to recognise or reconcile. A psychoanalytic approach seeks to understand the particular experience of the individual, rather than assuming how someone should grieve.

How Bereavement Affects Children and Young People as They Grow

Children's understanding of death changes as they develop, and their experience of bereavement changes with it. Younger children may not fully understand the permanence of death and may expect the person to return. Their grief can emerge through play, separation anxiety, sleep difficulties or changes in behaviour. They may also connect a death with their own thoughts, wishes or actions, particularly when they are still developing an understanding of cause and effect.

As children grow older, their understanding becomes more developed, but this does not necessarily make grief easier. A child who lost a parent at four may begin to understand that loss differently at ten, fifteen or twenty. They may encounter new aspects of the absence as they reach developmental milestones, form relationships or begin to understand more about the person who died. Someone who initially grieved the absence of a parent may later begin to grieve the conversations they cannot have, the questions they cannot ask or the experiences they will never share.

Grief does not necessarily belong to a single period following a death. A loss may be revisited throughout development, taking on new meanings as the young person changes. This does not mean that the earlier grieving was incomplete, but reflects the way our understanding of relationships develops throughout life.

Adolescence can make bereavement particularly complicated. It is already a period of considerable psychological change, involving questions of identity, independence, sexuality and relationships. Young people are beginning to separate emotionally from their parents while continuing to need their support. The death of a parent during this period can disrupt that process, bringing feelings of dependence and vulnerability into conflict with the adolescent's developing wish for independence.

Some teenagers respond by withdrawing from family life or turning towards friends, while others become unusually responsible or protective of the surviving parent. Their distress may appear through difficulties at school, changes in relationships, risk-taking or an apparent indifference to the death. These responses can be difficult for adults to understand, particularly when the young person seems unwilling to talk about what has happened.

Bereavement during adolescence may also involve the death of a sibling or close friend. These relationships often occupy a different place in a young person's life from their relationships with parents, particularly as friendships become increasingly important to their sense of identity and belonging. The death of someone close in age can bring an unfamiliar awareness of their own mortality, disturbing assumptions about the future and the relative safety of childhood and adolescence.

For young adults, bereavement can interrupt the process of establishing an independent life. Losing a parent, sibling, partner or close friend may change their sense of the future at a time when they are developing relationships, making decisions about work or education, and forming a more established adult identity. The death may also alter family relationships and responsibilities, leaving the young person feeling that they have had to grow up suddenly or that their life has become divided into a before and after.

Bereavement, Family Relationships and the Fear of Further Loss

Bereavement is experienced within relationships, and the death of someone important can affect how a young person experiences the people who remain. Losing a parent or another close family member may disturb a child's sense that the people they love will continue to be there. Ordinary separations, previously taken for granted, can become more frightening when the possibility of another loss feels real.

This fear may be particularly apparent in the relationship with a surviving parent. A child who has experienced the death of one parent may become anxious about the safety of the other, finding it difficult to be apart from them or needing reassurance that they will return. The same concerns may extend to siblings and other important people. Sometimes a young person responds by becoming more dependent, while at other times they may try to protect themselves against further loss by appearing unusually independent or avoiding emotional closeness.

These experiences can influence relationships as the young person grows older. Adolescence and young adulthood bring new attachments, including close friendships and romantic relationships in which feelings of love, trust and dependence become important. Earlier bereavement may make the possibility of losing someone especially difficult to bear. A young person may find ordinary separations unsettling or become fearful when someone important is unavailable, even when there is no immediate reason to believe that the relationship is threatened.

Such responses are not inevitable consequences of bereavement, nor do they necessarily indicate a lasting psychological difficulty. They reflect how an experience of loss can change a person's expectations of relationships, particularly when the death has been frightening or has occurred at a vulnerable point in their development.

Bereavement also affects the wider emotional life of a family. When a parent dies, the surviving parent may be grieving the loss of a partner while their children are grieving the loss of a parent. Although they have experienced the same death, their relationships with the person who has died are different, and so are their experiences of grief. Each family member may be trying to make sense of what has happened while also adjusting to changes in everyday life.

Grief is not something a parent can simply set aside in order to protect their children. It is a natural response to losing someone important, and it may involve periods of profound sadness, exhaustion or difficulty concentrating. The ordinary routines of family life can become harder to maintain, particularly when the death has also brought practical, financial or social changes. These difficulties are part of the considerable demands that bereavement can place upon a family, rather than evidence that a parent is failing their child.

Children are often sensitive to changes in the people around them, especially those upon whom they depend. They may notice that a parent is sad, preoccupied or less able to participate in familiar activities. Some children become concerned about the parent's wellbeing and try to protect them by concealing their own sadness or avoiding conversations about the person who has died. Others may need more reassurance or closeness at a time when the parent is also struggling with their own feelings.

The psychoanalyst Donald Winnicott emphasised the importance of the emotional environment in supporting a child's development. Children gradually develop the capacity to manage difficult feelings through relationships in which those feelings can be recognised and understood. During bereavement, this process may become more demanding for everyone involved, as parents and children are each trying to manage experiences that can be painful and unfamiliar.

It is important, however, not to confuse a parent's grief with an absence of care. Children do not need parents who never become upset or who conceal the reality of their sadness. Being able to share grief within a family can help children understand that painful feelings are part of loving and losing someone. A parent's openness about their sadness, together with continuing reassurance and care, may provide an important example of how difficult experiences can be lived with.

Families may also draw upon grandparents, relatives, friends, schools and other trusted adults during this period. These relationships can provide continuity and reassurance when ordinary family life has been disrupted. There may be times when additional support is helpful for a parent, a child or the family as a whole, not because their grief is abnormal, but because bereavement can place considerable emotional and practical demands upon everyone involved.

Understanding a child's bereavement therefore involves recognising both their individual experience of loss and the circumstances in which the family is grieving. It also means recognising the resilience that can exist within family relationships, even during periods of considerable sadness and upheaval.

When Bereavement Becomes Traumatic

All bereavement involves loss, but some deaths are experienced in ways that become traumatic. This may follow a sudden accident, suicide, violence, a frightening illness or circumstances in which a young person witnesses or encounters something overwhelming. However, traumatic bereavement is not defined solely by the circumstances of the death. It also concerns the way the experience affects the person's ability to grieve.

The UK Trauma Council, hosted by the Anna Freud Centre, has developed resources to help families and professionals understand traumatic bereavement in children and young people. Their work describes how the traumatic aspects of a death can interfere with the grieving process, making it difficult for a child to remember the person who has died without becoming overwhelmed by frightening thoughts, images or feelings.

A young person whose parent has died in an accident may find that memories of their parent immediately bring thoughts of the accident itself. Rather than being able to remember ordinary moments together, they become preoccupied with how the person died, whether they suffered or what might have happened differently. Even photographs, familiar places or conversations about the deceased can become difficult to tolerate because they bring the traumatic experience back into awareness.

In this way, the trauma surrounding the death can begin to obscure the relationship that existed before it. The young person may avoid thinking about the person they have lost, not because the relationship was unimportant, but because remembering has become associated with overwhelming distress. Others may experience intrusive images, nightmares, persistent anxiety or a sense that the death is still happening in some way.

Bereavement following suicide can bring particular difficulties. The death may leave a young person struggling with unanswered questions about why it happened and whether it could have been prevented. Their understanding of the person who has died may become unsettled, particularly when the death seems difficult to reconcile with the relationship they believed they had. Feelings of responsibility can become especially painful, with the young person repeatedly returning to earlier conversations, disagreements or moments when they believe they might have acted differently.

For some, a suicide may also be experienced as a rejection or abandonment, even when they understand that the person who died was experiencing profound psychological distress. The young person may struggle to reconcile their love and longing with feelings of hurt, anger or confusion. These feelings can be made more difficult by silence, secrecy or uncertainty within the family, particularly when adults are themselves struggling to understand or speak about what has happened.

From a psychoanalytic perspective, trauma can be understood partly through the difficulty of making sense of an experience that has overwhelmed the person's capacity to think about it. While grief involves gradually finding ways to live with an absence, traumatic experiences may remain frighteningly immediate, difficult to understand or disconnected from the ordinary flow of memory. The death may be understood as something that has happened, yet remain difficult to experience as an event belonging to the past.

The circumstances of a death are important, but they do not tell us everything about how it will affect a young person. Earlier experiences of separation, neglect or abandonment may influence how the loss is experienced, particularly when the death seems to confirm fears that important relationships cannot be relied upon.

Bereavement can be especially complicated when the relationship with the person who died was already troubled. A child who has experienced a parent's absence, neglect or emotional unavailability may have spent years hoping that the relationship would change. When that parent dies, the possibility of such a change disappears. The young person may therefore be grieving not only the parent they knew, but also the relationship they had hoped might eventually become possible.

The loss of this hoped-for relationship can be difficult to recognise, particularly when other people assume that bereavement must be less painful if the relationship was unhappy. In reality, grief may involve profound disappointment and longing alongside anger or relief. Understanding these experiences requires attention to the particular history of the relationship, rather than assumptions about how the young person ought to feel.

When Grief Becomes Difficult to Manage

Grief can affect many areas of a young person's life, including their ability to concentrate, sleep, maintain relationships or participate in ordinary activities. Feelings may change considerably from one day to another, and periods of happiness or apparent normality do not mean that the loss has ceased to matter.

There are times when bereavement becomes associated with more persistent emotional difficulties. A young person may become increasingly withdrawn, anxious or depressed, struggle to attend school or college, or experience a profound loss of confidence and interest in life. Some may direct anger and guilt towards themselves, while others find it difficult to trust relationships because they fear losing someone else.

Although grief and depression are different experiences, they can sometimes become intertwined. A young person may struggle with persistent feelings of worthlessness, hopelessness or self-blame, particularly when bereavement has become connected with earlier emotional difficulties. Where these feelings become overwhelming or significantly interfere with everyday life, it may be important to consider whether the young person is experiencing depression alongside their grief.

For some young people, grief remains intensely disruptive over a prolonged period, making it difficult to engage with everyday life or adapt to the reality of the death. Others may experience significant trauma-related symptoms that require specialist assessment and treatment. Recognising these difficulties does not mean treating ordinary grief as an illness, but understanding when additional support is needed.

How Psychoanalytic Psychotherapy Can Help

Psychoanalytic psychotherapy offers children and young people a space in which their experiences of bereavement can be explored and understood. Rather than attempting to remove grief or encourage someone to move on from a death, the work involves helping them develop a relationship with their loss that can become part of their continuing emotional life.

Its attention to the individual is particularly important. Two young people may have lost a parent in similar circumstances, yet the psychological consequences can be very different. Understanding their difficulties involves exploring the relationship that has been lost, the young person's developmental history and the ways in which bereavement has affected their sense of themselves and their relationships.

For younger children, feelings about bereavement may emerge through play, drawing, stories and the relationship with the therapist. Children do not always have the language to describe their experiences directly, and their emotional concerns may appear through repeated themes of separation, disappearance, danger or reunion. Psychotherapy provides an opportunity for these experiences to be expressed and gradually understood.

Psychoanalytic psychotherapy can be particularly valuable when bereavement has become entangled with other emotional difficulties or experiences of trauma. Rather than treating the death as an isolated event, the work considers how the loss has affected the young person's developing sense of themselves, their relationships and their capacity to manage difficult feelings.

Within NHS Child and Adolescent Mental Health Services (CAMHS), psychoanalytic psychotherapy has been used with children and young people experiencing complex emotional difficulties, including traumatic bereavement. Such work can require sustained, in-depth treatment, particularly when the effects of trauma are closely connected with a young person's developmental history and relationships. The therapeutic process allows these experiences to be explored over time, including feelings that may initially be expressed through behaviour, withdrawal or difficulties in the relationship with the therapist rather than through words.

Specialist child and adolescent psychoanalytic psychotherapists undertake extensive training in child development, emotional difficulties and the unconscious processes that influence relationships and behaviour. This includes infant observation, supervised clinical work with children and families, and personal psychoanalysis. An important part of this training involves developing the capacity to understand emotional communications that cannot yet be expressed directly, and to work with powerful feelings without rushing to provide explanations or reassurance.

This depth of training is particularly relevant when working with complex bereavement and trauma. A young person's difficulties may not be confined to memories of the death itself, but may affect their trust in relationships, their sense of safety and their expectations of other people. These changes can also emerge within the therapeutic relationship, where fears of dependence, abandonment or further loss may gradually become more understandable.

Where traumatic bereavement is accompanied by significant post-traumatic stress symptoms, specific trauma-focused treatment may also be needed, with the choice of treatment informed by the young person's individual circumstances and clinical assessment.

An important part of mourning is finding ways for the relationship with the person who has died to continue internally. Memories, identifications and feelings towards that person can remain significant throughout life, taking on different meanings as the bereaved person develops. The aim is not to forget the person or to reach a point at which the loss no longer matters, but to make it possible for grief to become part of a life that continues.

Further Reading and References

Freud, S. (1917). Mourning and Melancholia. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIV.

Klein, M. (1940). Mourning and Its Relation to Manic-Depressive States. International Journal of Psycho-Analysis, 21, 125–153.

Bowlby, J. (1980). Attachment and Loss, Volume 3: Loss: Sadness and Depression. Hogarth Press.

Winnicott, D. W. (1965). The Maturational Processes and the Facilitating Environment. Hogarth Press.

Leader, D. (2008). The New Black: Mourning, Melancholia and Depression. Hamish Hamilton.

UK Trauma Council / Anna Freud. Traumatic Bereavement: Resources for Children, Young People, Families and Professionals. https://uktraumacouncil.org/resources/traumatic-bereavement

Child Bereavement UK. Support for Bereaved Children and Families. https://www.childbereavementuk.org/

Winston's Wish. Childhood Bereavement Support. https://winstonswish.org/

Written by Ben French BSc, C-Psych, C-Obs, MA Psych.

Ben French is a Child and Adolescent Psychotherapist. He is registered with the British Psychoanalytic Council as a Child, Young Person and Family Psychotherapist. He has over 20 years’ experience working with children and young people, including work in NHS CAMHS and education, and works with children, teenagers and young adults aged 2–25 at Eastbourne Child Therapy.