she talks to 3 year olds about suicide.

This is an interview I did with Jill Macfarlane, the program direct at a grief support program, about how she talks with young children about death and suicide. Just a note, along with many other things, we talk about suicide, gun violence, sexual violence, racism and police brutality.

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EMMA: I am really grateful to be talking to you for a couple reasons. Your work is very moving to me personally as I have been figuring out how to be in the world after two people I love committed suicide together.  I also am in a masters of education program right now focusing on doing work with preschoolers around race and racism. I see a big overlap between our work in the sense that parents, especially white parents, may be almost as opposed to talk about racism with their preschooler, as they are about suicide. The way you respect the emotional lives of young children is very moving to me. So thank you so much for talking to me, this is very meaningful to me. To begin, can you explain your job?

JILL: I’m the program director of the Sharing Place, which is a grief support program for children, so kids come to us after the death of a loved one in their family. I am the director of the program so I do all of our intakes, assessments, placements in groups and management of families and program curriculum. All of that plus a little bit more. When you work for a non-profit you wear many hats.

EMMA: I think one hard thing about talking with young children about race is figuring out what words to use, to translate very complex concepts into language that will resonate with children—not simplifying the concepts but perhaps simplifying the vocabulary. I really loved the part of the interview I heard on a This American Life episode where you described how you explained kidney failure and suicide and overdose—it just felt like a way of seeing and honoring the intellect and emotions of young children in a very profound way. What helps you figure out how you are going to describe these very complex ideas? What does your tool box look like in terms of how you are going to talk about these things?

JILL: So there really are no resources, this really is just a theory I have developed on my own. I have been doing this for 15 years and it just kind of has evolved over time. But really what I started with was in Child Life we use something called ‘age appropriate language’ or ‘soft language’ and it’s a theory that you use words that kids can understand based on their developmental level and that you soften the words. But this is all starting in the medical world with medical terminology. Kids don’t understand medical terminology so I started there. And then when I translated it over to the grief world I just used the same concepts of really figuring out where the kids are developmentally and using simple and concrete words. Sometimes if somebody surprises me with something it may take me a minute for me to think through the actual physiology of what happens to the body, so that I can translate it, but really honestly, it’s such a case by case thing. I’ve never come across two deaths that are the same here at The Sharing Place. Even if two people died from cancer, it’s different cancer and different processes. It really is truly is case by case. I have a few steps—I use simple and concrete language that they can understand, I think through the physiology of what is actually happening, and then chose words that kids can understand. And then I just start really simple and basic and with a simple sentence—just one sentence about what happened. And then as the kids ask me questions, I start to elaborate on things. Kids ask questions when they are ready to hear the answers. So, I answer honestly as the questions come.

EMMA: That’s a wonderful way of thinking about it, that kids ask what they are ready to hear. In the radio bit I listened to, a mother at the Sharing Place asked her son, ‘what did you learn here that helped you most?’ and he responded ‘to understand how he died.’ Why is that true? Why is it true that a child knowing perhaps even gruesome details about the death of their loved one, why is that so helpful to them?

JILL: Because kids have this magical thinking that just is normal—it’s a normal part of development with kids, but when you add in really complicated things with that magical thinking, the death becomes all about them. We’ve had so many kids here who thought, for example, somebody told them that the heart attack meant their heart was broken. And they died and then the kid thinks “well I was naughty this morning and my dad yelled at me so it was my fault that he died.” So really what we are doing is trying to help kids understand the physiology of what happened so they don’t internalize it and think that it’s their fault. And, so they can process really truly what happened and be able to move forward. In the case of the kids on This American Life and suicide in general, people are always questioning, “why would you tell kids that their father shot himself?” I have this one family—the dad committed suicide, and he’d gone to the mountains and he’d shot himself. But the family was worried that he would have this gruesome image in this head, so all they said is that he “went to the mountains and committed suicide, and suicide means…” But they didn’t tell him that he’d shot himself so the child just imagined in his head—they think these things through—that he’d jumped off a cliff. And he started having nightmares about falling and it was a horrible thing for him. Then he found out that the story he imagined in his head was 10 times worse than what actually happened and knowing the truth about it really helped him be able to process it and move forward.

EMMA: I was telling a woman the other day about your work and her response was “but that will traumatize them”—a sentiment I really understand. I told her, though, that I thought the trauma was the experience of a loved one dying, not the language used to talk about it. How would you respond to this idea that an adult would be unnecessarily traumatizing a child to explain to them, the specifics of the death, for example, that a parent shot themselves?

JILL: This is exactly where the start simply come in. You could traumatize a child by saying “your dad shot himself and yes there was blood and yes there was a hole in his head and there was this and that.” That is traumatizing. But if we just say “he died by suicide, he used a gun” then the kids will ask questions when they are ready to hear it. In that way it’s not traumatizing. So that’s why we start simple and basic with one simple sentence with what happened. We don’t overwhelm them with details. But when they come to us and ask us questions like “when dad shot himself, was there blood all over the room?” These are questions that they are already thinking of, and if we lie to them or we shut them down and we don’t answer their questions we are sending them the message that it’s not okay to think about their person, and what happened, and process it. So, by answering their questions openly and honestly we are giving them the message that it’s okay to talk about this and its okay to process this. In a way its more traumatizing to not talk about it because you are sending the message that it’s not ok to talk about. And that’s when all the effects of unresolved grief comes in and start to play into a child’s life.

EMMA: Two people I love committed suicide together last summer, and the young people who also knew and loved them, were told that they had died, but weren’t told that they had made the choice to die. In my personal case, the people who died were elderly so the fact that they died wasn’t necessarily shocking, but the piece that the kids were confused about was that they both died at the same time. But they didn’t ask a lot of questions other than, “they both died?” And the answer was “yes,” and they didn’t ask further. For you, what is the value, to explain to the young people, from the jump, that their these folks made the decision to die together, to make their own body stop working, instead of just saying “they both died last night?”

JILL: Well number one is trust. I mean obviously other people know they committed suicide. People don’t give kids enough credit. They hear things and they understand things and when they just overhear things or they hear it from somebody else, the confusion comes in, and the mistrust. So if you are not going to tell the whole truth about something really big that happened to them as kids, what else have you not told the whole truth about? So first and foremost, it creates trust issues because they will find out at some point. At sometimes they will know the truth about this, everyone else knows about it, the neighbors know about it, the man in the grocery store knows about it. At some point in time, if they don’t already, they are going to find out, and it creates a trust issue. And second, it just sends the message that mental health issues and suicide are not okay to talk about. And that right there creates the stigma, and is creating our suicide epidemic in the first place.

EMMA: Wow, that’s a powerful thing to think about. One of the questions I had written before we talked was “What is at stake to not tell kids the truth?” And you’re talking about trust, and I think that’s so important. I completely agree with what you’re saying, and I’m interested in having language to talk to other people when they push back on these ideas. I’m wonder what is the issue with a parent just saying to a child, once they found out what really happened, “you were too young for me to tell you?” Why can’t that justify being dishonest when they are young?

JILL: Well, I just don’t feel like there is justification for dishonestly ever. That’s an important subject to even talk to your kids about in general. Saying “it wasn’t the right time to tell you” or “you were too young” implies that kids couldn’t handle it or that the parents didn’t trust the kids. I mean that opens up a whole other can of worms about why the kids shouldn’t have known.

EMMA: Part of my reaction to hearing you talk, is wondering if it’s impossible to heal if we don’t know what exactly we are even healing from. For example, can a child heal from the suicide of a loved one if they think it was a car accident? Do you believe that to heal from something we need to know exactly what happened?

JILL: Yes 100%. You can’t process what happened unless you know the truth of what happened. If you find out later, you know 20 years later, that it actually was a suicide, you have to start the whole process over. And it becomes a whole new process. We’ve seen that over and over with kids, here at The Sharing Place. They get through the first year and then it’s like being right back on that first day—they have to start the whole process over. And then you’re doing it with all the baggage of the mistrust of who told you, the confusion and the guilt and the “I wasn’t important enough for my mom to tell me these things” feelings, or whatever it may be.

EMMA: So a 5 year old, would you wait for a 5 year old to ask you how, or from the jump would you tell a 5 year old?

JILL: We start at age 3. We would say they died by suicide. I do the Littles group, we call the 3-5 year olds Littles here at The Sharing Place, and I do my group and my 3 year olds are some times more articulate about it than my teenagers are.

EMMA: The thing that is so incredible to me about what you’re doing, it literally flips on its head everything, I mean most common conceptions of what children are emotionally and intellectually capable of, in a way that I think is such an act of love to children.

JILL: Yeah, I really truly believe that what we are doing is right. Because I can see the faces of these kids and I can see the comprehension, and I can see them start to sleep through the night, and potty train again, and you know, have a real true, conversation about their person. And it’s not just the way they died. We are doing work around how they died, but that’s like maybe 10% of the work we do. The other 90% is remember their person and honoring them and still carrying on those relationships even though the person died. Really helping children process what they have been through, develop coping plans for the future and honest and true healthy ways to deal with these feelings. I mean grief feelings, they carry with you the rest of your life.

EMMA: I’ve done work with survivors of domestic violence and sexual violence and have some work writing curriculum for child witnesses of interpersonal violence in the home, and I’m interested if this philosophy of talking honestly with children about death, if you would apply to sexual violence. If sexual violence is involved either involved in the death, or separate from death, if a child for example was living with an obviously grieving parent who was assaulted, do you believe in talking to young children honestly about this kind of trauma as well?

JILL: Absolutely, if it effects their everyday world, absolutely. I think we should talk to kids this way about every subject in their lives, whether it be sex or drugs or rape or terrorist attacks. We don’t give kids enough credit because we are trying to protect them but we’re not preparing them for the real world. For the last 30 years, with the DARE program, we talked to kids about drug use and drug use declines. If we are not talking about these things how are we going to prepare our children to cope with them as they grow up?

EMMA: What about this idea that, for example, a mother was a survivor of rape and she was obviously dealing with the trauma of that experience, she lives with her children, her children were witness to that every day—so what about the argument that that is exposing the children to a kind of violence that they wouldn’t have known even existed if you hadn’t of told them. People’s argument is that they are protecting them from the violence of the world, but then is the response, that was shattered when the event happened, not the conversation that shattered that?

JILL: Yeah. I mean it’s the same thing that we’ve been talking about. It’s not the fact that we talk about it the fact that it happened. Kids need to know their five senses, so when I am talking to kids about things, I only talk to kids about things they would have seen, felt, heard, smelled, something that happened to them personally, those 5 senses. They don’t know need to know, if they weren’t there to smell the gun powder, you probably don’t need to talk about it. If they weren’t there for the rape and they didn’t know about the rape, then that’s a whole different story. I mean you wouldn’t want to sit a child down and be like “you know when mom was 12-yr-old a bad man raped her, and that’s why she acts like this” but you should probably talk about the behaviors of what mom is doing now. And it could be, just simple, like “mom drinks a lot, she has a disease in her brain called addiction, that makes her drink alcohol too much” or whatever it is. You talk about the behaviors that the kids see, the things that affect their everyday lives.

EMMA: So let’s say a mother is crying a lot, as a simple example, and the children see that but the sexual violence did not happen near them, they have no reason to believe that is what happened—they didn’t hear it, they weren’t in the house. In that case, would you explain the crying to the child simply as “mom is feeling sad” or because they are experiencing her sadness, you would explain why she’s sad?

JILL: I would not explain whys she’s sad. I would say something like “you know, there’s a thing in mom, in her body, called anxiety, and anxiety makes her feel worried, and because she’s so worried all the time she cries a lot. And it has nothing to do with you. She’s not crying because you’re bad.” Normalize the situation, that it has nothing to do with them, “she still loves you,” all those things. But I would keep it very simple.

EMMA: I’ve been talking to parents about how they talk to their own children about race and racism. I remember after Tamir Rice was killed, I heard a little white girl tell a little boy who was making a fake gun with his hand “don’t make pretend guns because the police might think it’s real and kill you.” She was four and she had heard something on the radio and then her parents, who I know have really rich and meaningful conversations with their young children, had talked to her about what happened. And in a case like that, in terms of talking to children about things that are happening in the world, would you only have a conversation with a child about for example about Tamir Rice if they heard something and came home and asked or if they saw something on the TV? Would you bring that up with a child if they wouldn’t have known about it, if you hadn’t brought it up?

JILL: Probably not as young as 4, but as kids get older, older elementary, absolutely. I do that with my own kids now. I talk to them about stuff that’s happening in the world. Because I feel like I want to educate my kids from a very young age about issues like that. With a four year old, if they see something on the news, I would again keep it simple, “some people believe your skin color makes you a bad person. And that’s racism is. And it’s not okay. And in our home, we don’t do this,” whatever it may be. It’s the same concept, it doesn’t matter if it’s around death or race or trauma or bullying, it’s the same exact concept of being open and honest with kids in the most simple and concrete way that you can.

EMMA: I’m interested too in this idea of age appropriateness. I don’t at all deny at all that children go through developmental stages and neurologically they have different capacity and often the capacity expands as they get older. I also think that, especially white parents, sometimes use this idea of “age appropriateness” or really “age inappropriateness” ultimately as a tool of racism, to avoid having difficult conversations with children about the violence of whiteness. I think that those people aren’t using this idea of age appropriateness saying that kids of color experiencing racism, or experiencing police violence, or experiencing ICE raids is way more age inappropriate. There’s an investment in what is age appropriate or inappropriate when it comes to not having certain conversations, but they often are not applying that same criteria of age appropriateness to what it does to children to experience these kinds of violence.

JILL: I’m talking about age appropriateness in a completely different way. I’m talking about age appropriate in the language you use, so kids can understand it. I don’t think any topic is not age appropriate. I just really don’t. I think the way you deliver the information, that’s where the age appropriateness comes in. I agree that people avoid talking about things because its not “age appropriate” but you can make any topic age appropriate, as long as you are using language that kids can understand.

EMMA: That’s such an important distinction. No topic is age inappropriate, but certain words are.

JILL: Exactly. It’s about the comprehension. If you are using terminology, medical terminology to talk about your mother’s cancer diagnosis, kids don’t understand what that means and it comes out in crazy misconceptions. For example, one of my Littles, her mom died from breast cancer, and for the longest time she would say in group her mom died from “the monsters.” She had misheard “cancer” and “monsters”. It was not age appropriate for her to hear those medical terms so she misinterpreted them. She was drawing pictures of monsters all the time because she really truly thought that her mom had died by monsters. That’s what I mean by age appropriate terms.

EMMA: Age appropriateness then literally is vocabulary that children can understand.

JILL: Exactly.

JILL: I had another little boy who was in a group we do in the schools. I was in a school and he was a kindergarten and his grandmother had died from a heart attack and for many many weeks he came to  group and said “well I don’t know anybody who died.” And then one day we were talking about causes of death and what that means and we talked about heart attack. And he raised his hand and he said “if you have a heart attack does that mean you’re dead?” and I said “yea it can” and he said, “then I do know someone who is dead. My grandma had a heart attack and I haven’t seen her since.” He was never told that his grandma died, he was told that she had a heart attack. So just by simply changing those words, he didn’t know what heart attack meant, so by simply switching that word to dead or died—that’s a whole new meaning for him.

EMMA: That’s really fascinating. If you are worried that kids are told more than they can hold, what do you do at that point? I guess you are saying that if you just answer kid’s questions, you are never going to tell them more than they can hold or handle?

JILL: And what happens if you do overwhelm them?

EMMA: Yeah. How do you respond if you feel like kids are told too much?

JILL: I feel like you do the best you can in the moment that you have. And if you tell a kid too much and you overwhelm them, it’s a simple process of “you know what I’m really sorry. I got a little out of hand. I’m sorry that I scared you. What was it that scared you?” You do the best you can and it doesn’t help anybody to say you did it the wrong way. It’s just a process of being, again, weird I have a theme, of being open and honest with kids about our own failings as parents.

EMMA: I think about that too—I think parents sometimes feel like they have one chance to answer their kids in the perfect way about hard topics. But once we shift so conversations, about race for example, are not just one conversation after a kid hears something about a murder on the news, to a conversation that happens regularly, first of all, the stakes aren’t as high when the child asks something because there is already a context, and second there is an environment around those conversation so a parent can go back and say, “I wish I had said that a little differently.” This shows that parents make mistakes, and that we can revise and reflect. It seems like that’s what you’re saying too, if we misspeak, we can go back and have conversation about how the kids are handling that misspeak. It’s all a process.

JILL: This is not a one-time shot. This opens the door for conversation, and I mean really, isn’t that what we want with our kids regardless of the topic? We want an open door, we want them to be able to talk to us. Having a conversation about not drinking in high school is not a one conversation. You aren’t going to say the perfect thing that one time and they absorb it. They’re not going to be like “oh yeah she talked to me that one time”. And I think it also shows our kids that we are humans and that we make mistakes and it shows kids how to apologize and take responsibly for their mistakes. There are so many lessons that come with it. When it comes to death and dying, this is new for mom too—“I don’t know how to get through this, I don’t what to say, I don’t know how to do this, Let’s get through this together.” Really real and honest relationship building moments you can have with your kids.

EMMA: Thank you. I keep saying this, but the work you are doing and the way that the work you are doing see’s children as complex, complicated human beings is really inspiring, and I’m very grateful. Thank you.

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