What 622 young Swedes remembered
Is this one family’s story, or a pattern? In Sweden, researchers went looking on a national scale. Through the country’s population registers, they traced young people who had lost a parent to cancer between 2000 and 2003, at ages 13 to 16, while the other parent was still alive.
Six to nine years later, those young people were between 18 and 26. The researchers phoned them and mailed a long questionnaire to everyone who agreed. It came back anonymously, in a prepaid envelope. Of the 851 young people who met those criteria, 622 sent it back.
Several statements were about the first six months after the death. One of them read: “I withheld my grief to protect my other parent.”
About one in four agreed, moderately or completely.
Then came a question about the present: “Have you worked through your grief?” Of those who had held back for their parent’s sake, 60 in 100 answered not at all, or only a little. Of those who hadn’t held back, 45 in 100 said the same.
For the daughters alone, that gap was too small to be sure of. Among them, another statement made the clearest difference: “People stopped me from grieving by drawing away when I was sad or praising me when I was being strong.” Of the daughters who agreed, 74 in 100 had not worked through their grief years later. Of those who disagreed, 50 in 100.
The researchers note the limits themselves. People answered once, years afterward, about how they remembered those first months, and how they feel now may color that memory.
Do grieving children hide their sadness to protect a parent?
Many do. In a Swedish study of 622 young adults who had lost a parent to cancer between the ages of 13 and 16, about one in four said they held back their grief in the first six months to protect the other parent. Six to nine years later, more of them said they still hadn’t worked through it.
A trial in Arizona
What happens when a family gets it in the first year? Psychologists at Arizona State University tested that with 156 families in which a mother or father had died three to thirty months earlier. Their 244 children were between 8 and 16.
A computer decided at random what each family got. The program had twelve sessions. The parents met in their own group, and so did the children and the teenagers. The parents worked on their own grief, on their parenting, and on listening when a child talked about the parent who had died. Sometimes they practiced together: a child might show a keepsake of the parent who died, while the parent practiced listening.
The other families got three books about grief in the mail.
Fifteen years later, interviewers went back. The children were now about 27 on average. Each of them answered a fixed set of interview questions from the World Health Organization that checks whether someone has had depression.
In the book group, 28 in 100 had gone through a serious depression in the previous nine years. In the program group, 13 in 100.
The program worked with parents and children at the same time, so there’s no way to tell from this trial how much of that difference came from the parents’ side.
Does support for a grieving parent protect the children?
It seems to, though in this trial the children got help too. At Arizona State University, grieving families got either twelve sessions for parents and children, or three books by mail. Fifteen years later, 13 in 100 of the program children had been through a serious depression in the previous nine years, compared with 28 in 100 in the book group.
Sharing it at home
None of these studies gives a grieving parent a recipe.
In the Swedish questionnaire, teenagers whose family held together well in the first six months more often found a way to grieve that felt okay to them. In Arizona, a large part of what the parents practiced was listening.
What can a grieving parent do for their child?
Make room for the child’s grief, even when you can barely carry your own. In an Arizona trial, parents practiced listening when their children talked about the parent who had died. In a Swedish study, teenagers whose family held together in the first months more often found a way to grieve that felt okay.
The letter you would leave
I built Last Hour Experience as one hour you spend alone, with headphones, as if it were your last. Near the end, you can write farewell letters to the people who matter to you. If one of your letters went to your children, what would you tell them about missing you?
Questions people ask. One of them is me.
Is it normal for a teenager not to cry after a parent dies?
It’s common. In a Swedish study, more than four in ten young adults who lost a parent to cancer as teenagers agreed with this statement about the first six months: “I clenched my teeth, built a wall around me and lived on as if nothing had happened.” Whether that was healthy, the researchers couldn’t tell.
How long does it take a child to work through a parent’s death?
There’s no set time. In a Swedish study of young adults who lost a parent to cancer as teenagers, nearly half said six to nine years later that they had worked through their grief only a little, or not at all. Daughters said so more often than sons: 52 in 100, versus 37.
Should a teenager talk with a dying parent about what matters?
If they can, it seems to help. In a Swedish study, young adults who as teenagers had talked with their dying parent about what was important more often found a way to grieve that felt okay than those who hadn’t and wished they had.
Can grief a child never works through lead to depression later?
The two often go together. In a Swedish follow-up of young adults who lost a parent to cancer as teenagers, those who hadn’t worked through their grief six to nine years later more often showed signs of depression: the daughters almost twice as often, the sons more than three times. Which came first is unclear.
Sources
Acute and long-term grief reactions and experiences in parentally cancer-bereaved teenagers, the 2021 study by Tove Bylund-Grenklo, Dröfn Birgisdóttir and colleagues at several Swedish universities, in BMC Palliative Care, a research journal about care for people who are dying. It is free to read. The statements, the numbers and the limits come from the full text.
Unresolved grief and its consequences, the 2016 article by Tove Bylund-Grenklo and colleagues about the same 622 young adults, in Supportive Care in Cancer, a research journal about care for people with cancer. The links with depression come from the summary the journal publishes.
Developmental Pathways of the Family Bereavement Program to Prevent Major Depression 15 Years Later, the 2023 study by Irwin Sandler, Jenn-Yun Tein, Na Zhang and Sharlene Wolchik, psychologists at Arizona State University and the University of Connecticut, in the journal of the American Academy of Child and Adolescent Psychiatry, the professional association of American child psychiatrists. I read the free version in PubMed Central, the online library of the National Institutes of Health, the U.S. government’s medical research agency.
Voor wie de klok luidt, Dutch for For Whom the Bell Tolls, a column by René Diekstra, a Dutch psychologist, published online by Noordhollands Dagblad, a Dutch newspaper. The father and daughter in the opening line come from this column, and I told their story in full in an earlier article.