Adolescent Grief: Title and subTitle Break"It Never Really Hit Me . . . Until It Actually Happened"

In September 2002, Grace H. Christ, DSW, Karolynn Siegel, PhD, and Adolph E. Christ, MD, DMSc,¹ introduced Robert, a bereaved 14-year-old who had been interviewed 1 year after the death of his mother. The authors advocated that even if physicians do not have direct contact with the children of a dying patient, awareness of, and integration of, the family's needs are hallmarks of competent end-of-life care. Developmental factors shape an adolescent's reactions to a parent's death, whether it is sudden or, as in Robert's case, long expected. Through information and discussion, physicians can help support the adolescent in coping, and the family in preparing for the terminal phase of illness and the death and its aftermath. The authors stressed the importance of acknowledging the intensity of adolescent grief, and of observing the crucial differences between adolescent and adult grief, both in its expression and duration.

Using Robert's story, the authors described the path to an adolescent's successful reconstitution, which requires: (1) engaging in the process of mourning the dead parent; (2) changing the relationship with both the dead parent and the surviving parent or caregiver; and (3) overcoming barriers to fulfilling developmental tasks. Now 16 years old, Robert was interviewed by a Perspectives editor in November 2002 and describes life 3 years after his mother's death.

Every day I miss her, but it is just something that I've accepted, that I have to deal with and can't change. One time I followed someone until she turned, because she had the same color hair as my mom. Even though I knew it wasn't her, there was the fascination of, "What if it was . . . ?" Sometimes I dream about her, but then I wake up . . . and it knocks me back down to earth. It isn't a sad thing, because it is nice to see her again. . . . The thing that stops me in my tracks is seeing her handwriting. I still have a list of chores she'd written out—there was so much personality in her voice and in her writing, that even though it was just a chore list it is something that is so beautiful to me.

The biggest thing for me is how much I've pushed myself, whether it has been in sports or academics because I knew how hard she tried to stay alive, and to stay healthy. I feel like I'd be shortchanging her, or shortchanging myself, if I didn't apply myself as hard . . . in that sense she taught me, inadvertently, about work ethic. When I came to high school, people told me I wasn't really good enough to play baseball, so I just worked harder at that than anything I'd ever worked at before, and got very good at it. I love it more than anything else right now. I think it's helped fill some of the void in my life . . . the intangible things that you need for baseball are the things I admired in my mom: drive and competing, and the need to win and the need to survive, especially in baseball where the odds are stacked against you. I'm able to translate what she did, and use it as drive and motivation in my own life.

I figured my dad would find another person to have a relationship with, so when it happened, it didn't surprise me. It wasn't healthy for him not to have a relationship, and it wasn't healthy for him and my brother and me to be in a house together. You need a yin to your yang, you need a female presence to be there with all of these male personalities.

For people I want to let into my life, it is not a problem [to tell about my mom] because there are so many people who have experienced worse things even than I've been through . . . that puts things in perspective, and I'm more able to openly express myself. People have a right to know, if they're going to be part of your life—they have to know your past to allow them to be a healthy, loving influence on you.