Table Of ContentHealing after Parent Loss
in Childhood and Adolescence
Healing after Parent Loss
in Childhood and Adolescence
Therapeutic Interventions
and Theoretical Considerations
Edited by Phyllis Cohen, PhD,
K. Mark Sossin, PhD,
and Richard Ruth, PhD
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Healingafterparentlossinchildhoodandadolescence:therapeuticinterventionsandtheoretical
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ISBN978-1-4422-3175-7(cloth:alk.paper)--ISBN978-1-4422-3176-4(electronic)
1.Griefinchildren--Treatment.2.Griefinadolescence--Treatment.3.Loss(Psychology)inchildren.
4.Loss(Psychology)inadolescence.5.Children--Counselingof.6.Teenagers--Counselingof.7.
Parents--Death--Psychologicalaspects.8.Childrenanddeath.I.Ruth,Richard.II.Cohen,Phyllis.
III.Sossin,K.Mark.
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Contents
Foreword vii
NancyMcWilliams
PartI:Overview xi
1 LossofaParentduringChildhoodandAdolescence:A
PrismaticLookattheLiterature 1
K.MarkSossin,YelenaBromberg,andDianaHaddad
PartII:TherapyintheOfficewithChildrenandTheirCaregivers 29
2 “DoYouKnowAnyoneWhoisDead?”:AFourYearOldBoy
ComestoUnderstandtheUnexpectedLossofHisFatherinthe
ContextofCulture 31
LuzTowns-Miranda
3 WalkinginTheirShoes:TherapeuticJourneysWithYoung
GirlsWhoLostMothers 47
JoAnnPonder
4 “MyDaddyIsaStarintheSky”:UnderstandingandTreating
TraumaticGriefinEarlyChildhood 73
ChandraGhoshIppen,AliciaF.Lieberman,andJoyD.Osofsky
PartIII:TherapyintheOfficewithAdolescents 95
5 ATerribleThingHappenedontheWaytoBecomingaGirl:
TransgenderTrauma,ParentalLoss,andRecovery 97
DianeEhrensaft
v
vi Contents
6 MourningChildhoodLossinAdolescence:AnIndirect
ApproachtoFeelings 117
DanielGensler
7 Revisiting,Repairing,andRestoring:TheDevelopmental
JourneyofaBereavedAdolescent 135
NorkaT.Malberg
8 AllYouNeedIsLove:PrimaryPaternalPreoccupation 159
SethAronson
PartIV:TherapyintheOfficewithEmergingandOlderAdults
afterEarlierLossofaParent 177
9 Death,Mourning,andaDaughter’sDiary:APsychoanalytic
Perspective 179
BillieA.Pivnick
10 MourningaGhost:AChallengeforHolocaustChildSurvivors 201
EvaFogelman
PartV:InnovativeApplicationsinGroups,Consultations,and
CourtAssessments 219
11 WhentheContextShifts:AChildTherapistHelpingChildren
WhoHaveLostaParentinForensicSystems 221
RichardRuth
12 MaintainingHopeintheFaceofDespair:TheTransference-
CountertransferenceMatrixinTreatingAdolescentsCoping
withTraumaticParentalLosses 237
EttyCohen
13 TakeMetotheMoonandWait:AModelforAccompanying
FamilieswithYoungChildrenThroughParentalIllness,Death,
andMourning 257
ArianeSchwabHugandDanielS.Schechter
14 FatherQuestandLinkingObjects:AStoryoftheAmerican
WorldWarIIOrphansNetwork(AWON)andPalestinianOrphans 283
VamıkD.Volkan
15 DeathofaFatheronSeptember11,2001:Video-informed
ConsultationswithWidowedMothers 301
K.MarkSossin,PhyllisCohen,andBeatriceBeebe
Index 323
AbouttheEditorsandContributors 335
Foreword
Nancy McWilliams
This book began as a gleam in the eye of my colleague, Richard Ruth. In
2007,whenIwasnewtothepresidencyoftheDivisionofPsychoanalysisof
theAmericanPsychologicalAssociation,Iaskedhimtochairataskforceon
outreach that would make a contribution to dismantling the stereotype of
psychoanalysis as a dated, office-bound technique of psychotherapy, fueled
byarigidideology,applicableonlytomildlydistressed,cooperative,articu-
late adult patients. At the time, it had become clear that the psychoanalytic
therapies were being represented to the public as a set of ritualized, self-
serving,anddiscreditedapproachestohelpingpeople.Thismischaracteriza-
tionwasbeingperpetratedbybiologicalpsychiatristsexcitedbythepossibil-
itiesofdrugtreatments,byrepresentativesoftheinsuranceindustryeagerto
cuttheircosts,andbyacademicpsychologistswhoresentedthearroganceof
someFreudiansandwhohadscantexposuretocontemporarypsychoanalytic
practice.
In the public sphere, the voices of actual psychoanalytic clinicians were
seldom heard. By the time I appealed to Prof. Ruth, I had become aware of,
and often close to, many psychoanalytic colleagues who were working with
thepoor,thehomeless,thecomplexlytraumatized,theaddicted,thepsychot-
ic.They practiced in varied settings,with diverseandoften overwhelmingly
challenged populations, sometimes completely outside conventional office
practice.Ihaddoneconsiderableworkmyselfthatwentbeyondthewallsof
myconsultingroom,andinmyexperience,thisoutreachwastheruleamong
psychoanalyticpractitioners,nottheexception.
Wesawourselvesastryingtoreducethesufferingofthepeoplewecame
to care about, whatever their circumstances, with a critical reliance on
psychoanalytic knowledge, but not with technical rigidity. Instead, we tried
to apply analytic understanding sensitively and flexibly to the demands of
vii
viii NancyMcWilliams
whatever situation we found ourselves in. Often, such work was movingly
effective. I wanted a way to speak of our experience beyond the narrow
confinesofthepsychoanalyticcommunity.Inresponsetothiswidelyshared
concern, Prof. Ruth invited Drs. Cohen and Sossin to present their non-
traditional work with the women and children bereaved by the attacks of
September 11, 2001, ataDivisionof Psychoanalysisspring meeting.Out of
thatpresentationthisbookwasborn.
The focus on bereavement in childhood and adolescence was only one
possible outcome of many directions this group of therapists and scholars
could have taken. I did not know until the project was well underway that
losswastobethedomaininwhichtheirclinicalwisdomwouldbeelaborat-
ed. Itwas amoving surpriseto mewhenthecommittee membersultimately
zeroed in on an area that is dear to my own heart and central to my own
psychology (about this, more shortly), and about which I have always felt
thereis—asSossin,Bromberg,andHaddaddemonstrateintheirreadableand
comprehensive literature review—a valuable but insufficient psychoanalytic
bodyofwork.
The accounts in this book capture some universal themes that attend
early,irreversibleloss,buttheyalsocapturetheidiosyncrasyofeachchild’s
experience. Across different ages and developmental phases, different expe-
riencesofgenderandsexualorientation,differentfamilycircumstances,dif-
ferentsocialenvironments,differentreligioussensibilities,anddifferentcul-
tures, the voices of these young people can be heard here in all their com-
plexity and nuance. Some were orphaned by a parent’s disease, some by
violence, some by war, some by the Holocaust, some by the September 11
attacks, some by the negligence and abuse of caregivers from whom they
weretakenbythejusticesystem.Thesenarrativesbringreadersintointimate
connection with both the general and the particular, and they illuminate the
special strengths, not justthepsychologicaldeformities, that canresult from
childhoodbereavement.
By depicting the therapist’s emotional engagement, theoretical inclina-
tions,andeffortstowardmeaning-making,thenarrativesalsobringalivethe
healingprocessthatisatthecenterofthepsychoanalyticvocation.Inmostof
the chapters, a therapist sees the bereaved client in a traditional clinical
setting. In others, the therapeutic interventions involve actions that may in-
fluence the legal system, facilitate a group response, educate surviving par-
ents, provide for social support, require political action. We meet in these
chaptersnotonlythemiddle-classAmericanandEuropeanbereavedchildren
who have more commonly been studied (as in Erna Furman’s classic A
Child’s Parent Dies), but also children of poverty and children and families
ofLatinAmerican,African-American,Vietnamese,Kuwaiti,andPalestinian
origin. The disciplined humanity that each therapist brings to the task of
offering comfort to a particular person or group of persons, in a particular
Foreword ix
context, emerges from these pages as a phenomenon that is just as complex
andnuancedasthepsychologiesofthebereaved.
A few of the voices, like that of John in chapter 8 or Paulette in chapter
10, are those of older people who have tried to find ways of understanding
andrecoveringfromtheirearlierlosses.Inthosechapterswehavethebenefit
of hard-won wisdom from individuals who can put their memories into a
shared adult language of grief. But most of the characters who people these
pages are children and adolescents, struggling in the present without much
prior education in loss and how to articulate its effects. The therapists who
aretryingtobuildrelationshipswiththemarestrugglingaswell,ofteninthe
face of realities that Ruth calls “unthinkable, unspeakable and intolerable.”
Both their therapeutic passion and their openness to learning from their pa-
tientscomethroughinwhattheauthorshavewritten.
Many of the themes developed in this book are emotionally familiar to
me.Ilostmyownmotheratnineandmybelovedstepmothertenyearslater,
both after extended bouts with cancer. If I had not gone into psychoanalysis
inmytwenties,thepainofmyearlylossanditsweirdrepetitionwouldhave
remained ungrieved, unprocessed, unreflected-upon. I have good reason to
believe I would have gotten locked into a kind of arrested development in
whichfortherestofmylifeIwouldhaverationalizedmytendencytoactout
oneafteranotherself-defeatingversionofwhatFreudwouldhavecalled“the
returnoftherepressed.”
One of my central defenses—one that my analyst was determined to
defeat—was a counterdependent attitude replete with unconscious contempt
forpsychological“weakness”and“self-pity.”Thatorientationhadoncebeen
the best adaptation my latency-age self could make to a cruel loss followed
byinsufficientemotionalsupport.Asseveralauthorsheremention,giventhe
survivingpartner’sdesolation,achildwholosesoneparenttendstolosethe
other as well. My father, whose emotional range had been compromised
neurologicallybyencephalitislethargicaintheepidemicof1916–1927,had
lost his own mother at thirteen to a rheumatic heart condition. He was then
told,byaresentfulauntwhoinheritedresponsibilityforhim,thathismother
had died from the exhaustion she had suffered taking care of him when he
was comatose with the sleeping sickness. He was, not surprisingly, psycho-
logically devastated in the aftermath of his wives’ respective deaths, which
recapitulated the early loss for which he had been made to feel responsible.
His capacity for sensitive responsiveness to his daughters’ diverse reactions
totheirownbereavementwasconsequentlyminimal.
Itwouldhavebeenultimatelydeadlytomygoalsasapsychotherapistto
haveretainedtheunconsciousdisdainforsufferingthatallowedmetodisso-
ciate my own pain at age nine and move on developmentally in most other
ways. Via my engagement over several years in the systematic mourning
process that wereferto as psychoanalysisor intensivepsychoanalytic thera-
