The Bystander Effect is pretty much as it sounds. It refers to standing by while something, usually somewhat horrific, is going on and choosing to do nothing. The term became famous in the 1964 when a young woman, Kitty Genovese, was stabbed to death in front of her apartment building in the Kew Gardens neighborhood of Queens, New York. In a New York Times article at the time it was claimed that 38 people saw or heard her attack and no one called 911 or came to help her.

The Bystander Effect would be coined following the Kitty Genovese murder after psychologists showed they could reproduce similar results in laboratory research studies.

Every introductory psychology book refers to Kitty Genovese and this horrible night as well as what we would come to learn in psychology about what people do when faced with overwhelming events, fear, and a host of other emotions.

To be fair, we have all been in situations that were edgy. These are those times when to act or not to act have consequences. People often say, ‘Someone else will call for help.’ Or they say, ‘I don’t want to get involved.’ And, ‘What if the perpetrator turns on me?’ These are all legitimate and not indicators of selfish people who simply don’t care. It is normal to have fear, to not want to involve oneself in messy situations, and to take care of yourself.

The bystander phenomenon has been heavily studied in psychology. Recent studies suggest people actually do come to the aid of people. For example, in a car accident or when someone collapses on the sidewalk or is screaming for help.

The Bystander Effect is back in the news with the latest chapter of our Pandemic Playbook.

Can you be a Bystander in regards to yourself? Let me explain. What if you had breast cancer or bladder cancer or you have high blood pressure? Have you chosen to stay away from doctors, follow-up appointments, or screenings? Since the beginning of the pandemic and COVID-19 crises many people are avoiding seeing their doctors. Emergency room visits are down in most cities, trips to primary care or booking telemedicine with primary care is down, visits to specialists such as cardiologists, urologists, dermatologists, and other specialists are down. Has everyone become healthier and their symptoms simply vanished?

Physicians are worried that people are letting their fear of COVID-19 act in such a way as to make for a Bystander Effect in regards to your self and your health.

I believe we can be a bystander with ourselves. Apathy and fear are hallmarks of the Bystander Effect.

An antidote to becoming a bystander is empathy.

It seems people have become rather apathetic about their own well-being and health. Sometimes we all need a nudge. Get out there and take care of matters. Get that appointment. Have your doctors explain what they are doing to keep you from getting COVID-19. Know that doctors are going to keep you safe because it also keeps them safe. Have empathy for yourself. Not everyone entered the pandemic in perfect health. Let’s not let something horrific happen in our own life and not call 911 or get help. We can just as easily be that man or woman on the street being attacked. Or we can be that man or woman ignoring the signs of our health and well-being. Shall we step up and step in to intervene in our own well-being. I say, Yes.

I’d like to end with a quote by Susan Sontag, from her book titled, Regarding the Pain of Others.

“Compassion is an unstable emotion. It needs to be translated into action, or it withers. The question is what to do with the feelings that have been aroused, the knowledge that has been communicated. If one feels that there is nothing “we” can do–but who is that “we”?–and nothing “they” can do either–and who are “they”?–then one starts to get bored, cynical, apathetic.”

Be well and Take Care.

Nanette Burton Mongelluzzo, PhD

Relationships are a mixed bag. We love them and sometimes we don’t. Just how has the Pandemic impacted your relationships? I am speaking about our partners, children, friends, neighbors, community members, and fellow citizens of both this country and the world.

Stress and its resultant anxiety, depression, and vulnerabilities influences all of us. It kind of depends where we were when the stress or stressor hit.

I work with children, teens, families, couples, and adults. I hear stories every day. It is through the story format that we learn. Stories may encompass themes, especially during key times. The stories during this Pandemic are no exception.

We all entered the Pandemic the same way. Whatever we struggled with, whatever the name of our disorder or neuroses, we entered the Pandemic as we are. Take a picture of this. Who were you coming into the Pandemic? What defined you? What were your struggles, your stories, your key themes? You may have been operating with a low-grade form of depression, or you may have had panic attacks separated by months. Or, you might have had a migraine or two a month or your blood pressure was fine  and your dentist said, “My what excellent gum health!” We want to remember who we were in January, February, and March 2020. This is important.

Now let’s fast forward to July 27th, 2020. Where are you now? Take another picture. This is the before and after scenario. In home makeovers we expect to see a sad before picture of a neglected room and an after picture that pops and sparkles. The same may not hold true for people in a pandemic. Our after picture may be sad and the before picture depends on how well you were doing and how well your relationships had been tended.

Each person is responsible for what they carry, both prior to the world crises of COVID-19 and since its excruciating unfolding of horrors.

As a young therapist I remember reading numerous books and articles on topics about third world horrors, Amnesty International interventions of the most profound kind, and any form of human rights tragedy I could lay my hands on. I recall my family thought I was engaging in a variety of morose voyeurism. I explained I needed to understand how truly unspeakable things happen at the hands of and to perfectly normal people. Sounded simple. It wasn’t.

Most folks are perfectly normal people with a splash and dash of the things that make us who we are. These include our anxiety, depression, relationship struggles, and our gifts, personality, resilience, and attitude.

Human beings, even normal people, can be taken to the edge. Once at that edge some pretty unsavory things can happen.

Some of my early readings were about how torturers become a torturer. These studies  were collected in a book titled, The Politics of Pain: Torturers and their Masters. It is a book of fascinating entries edited by Ronald D. Crelinsten and Alex P. Schmid. It was published in 1993 in The Netherlands. One position voiced by a contributor, Erwin Staub, PhD, is “…in my view, the whole society tends to get prepared for violence: people have intense needs and deal with them by entering into a process of devaluing or scapegoating some group or identifying it as an ideological enemy.” (Staub, E. in Crelinsten and Schmid, 1993, p. 117.) He goes on to say, “They accept propaganda against the group. The people who become perpetrators, like many others in the society, psychologically join those who assume leadership in identifying enemies and potential victims. All this creates a general preparation.” (Ibid).

Preparation for what?

Staub is talking about how violence and the perpetuation of violence, in any of its numerous forms, has psychological and cultural origins. He also points out that not everyone will become a perpetrator even with cultural and psychological preparedness for this end.

As soon as we begin to identify with Us versus Them we are headed down a path that is potentially dangerous. This applies to us as a nation, us as citizens of the world, and us with loved ones, friends, children, co-workers, and so forth. Staub points out, “It is deep human connection, of many kinds, that is required to increase resistance to forces that create antagonism, violence, and torture.” (Staub, Ibid, p. 123). You may say you don’t torture. I hear you. We can however render others helpless, powerless, and without options. We can limit and restrain. We can cast a blind eye to those in need. We can choose to not listen. We can choose to be bystanders. We can be unmonitored in our communications and cast stones without realizing we have done so. All of us have a responsibility. We won’t always get it right. We are human. An aspiration is to be conscious and make an attempt at being mindful, to consider all of Us as people and to resist the label of Them.

Staub says, “We need to work with the media, politicians and opinion makers who influence the public and the political process…..A basic long-term goal is to humanize groups of people in each others’ eyes.”

We need to humanize everyone in our eyes.

Thank you for reading.

Be Well. Be Safe.

Nanette Burton Mongelluzzo, PhD

Anger.

It is an emotion. It might be delivered as a behavior. It creates and destroys. It motivates and fragments. It is the king or queen of our emotional and behavioral arsenal. People believe emotions are evidence of truth. What is the truth they are evidence of?

Anger is simply one of our primary emotions. Depending which theorist you talk to there are generally five or six primary emotions. The remainder of the many other emotional responses are known as secondary emotions. Secondary emotions are thought to stem from the primary emotion.

Primary emotions include anger, fear, joy, sadness, and love.  Secondary emotions include examples such as frustration, embarrassment, loneliness, jealousy, admiration, horror, and disgust. There are many emotions when you look at primary and secondary types.

Are emotions evidence? Many people in therapy believe that what they feel defines reality. If they are angry they feel justified to take the emotion and create a plan of action based on the anger emotion. I say the emotion is fine but let’s hold off sending anger in to do the job/behavior that might actually belong to another emotion. This statement is often followed by raised eyebrows, a look of puzzlement, confusion, and perhaps more emotions.

What we feel is simply what we feel. What we think is simply what we think. If we are only conducting conversations with ourself it may not matter much beyond our feelings and thoughts. Human beings are largely social animals. We do best in relation to others in some format or another. The soon as we have one other person we now have a responsibility to inventory our feelings and thoughts and to query or consider the thoughts and feelings of others. Reality is not what we decide. It is a place we arrive at upon discourse with others where consensus of some type has been reached. Our feelings are real, to us. Another person’s feelings are real, to them. What happens when you put the parts together? It will depend on how open we each are to understanding one another and being satisfied with arriving at a reality that is a composite of what each feels.

Anger  is one of our most powerful emotions. Many people send out the big guns first. They reach for the canon, the grenades, and other weapons of choice. Right beneath anger is usually another emotion with a softer and more meek voice. It says, “But wait, what about me, I think I might have a contribution here.”

Many folks don’t listen to that little guy or gal inside. Instead, they push her or him aside and send out anger, now transformed into an action or behavior to do the job. Ahh. We know what anger looks like. It is in the face, the eyes, the tightness of the body, the clenching of the jaw, and the pursed lips. It is tense and often ugly. It may be loud and it conjures awful words linked together in macabre ways intended to hurt, shame, and render an emotional insult. It is scary and most folks back off unless they too have sent their angry emotion out to become an angry behavior.

Most anger is typically about fear. Remember, fear too is a primary emotion.

When angry we typically don’t pause to ask, “What am I afraid of?”

With a pandemic and the COVID Fatigue that has engulfed us there is plenty to fear. A young teen said to me in his wisest voice, “It’s not a matter of “If”, it is a matter of “When.” He was talking about the COVID-19. He believes everyone will get COVID. He said, “some will get sick and recover, some won’t know they have it or have minor symptoms, and others will die.” He said, “There’s not much any of us can do about it except try to help others feel less afraid.” This teen is only fourteen-years of age.

It is wise to ask yourself about your anger. What are you really angry about? Are you sure your anger isn’t really fear?

Some say, “This is America and I don’t have to wear a mask.” Or, they place things in a political perspective. And, they may even think the whole COVID crises is fake. We can’t do much about what people will think or how they will feel. We can however look at ourselves and offer up the best possible job of understanding. Is is possible many people are simply afraid, but don’t know how to look at their fear or perhaps, even to acknowledge it? Might we be afraid too?

Psychology is about understanding and it is about creating tools based on the sovereignty of each person. Our sovereignty requires a measure of mindfulness. Where do our beliefs really come from? And, what is truth? It is a good thing to consider our emotions, our thinking, and our decisions. It is also an excellent idea to consider what others may be doing with their feelings. There may be a way to help. It may help you be less afraid too.

Thank you for reading.

Wishing you peace.

Nanette Mongelluzzo, PhD

As we look at and attempt to support people and their mental health needs at the time of this pandemic the issue of suicide has emerged in an odd manner. I say odd because it is a different take. Let me explain.

A number of people including clients, friends, associates, and more socially distant acquaintances have mentioned the C Word. COVID. They say they actually wish they would contract COVID-19. Initially I was a bit shocked, but this was quickly followed with the scientist in me the wanted to hear and understand more about what was being shared.

What is passive suicide? Passive suicide is when a person has thoughts of death or dying but generally has no plan and doesn’t plan to take any action toward ending their life. Or, passive suicide is when people think they would be better off dead. We also hear people saying they don’t really feel invested much in life. The twist here with Pandemic Shock is hearing people say they do not plan on taking any action to prevent harm to self.

Passive suicide is reported more often among middle age and elderly populations. In a 2019 study by Dong and Gonzalez they found 10-13% of adults fifty years of age or older had passive suicide ideation. Ideation refers to ideas or thoughts of. In middle or older age groups suicide rates are higher and passive suicide ideation, which is a Red Flag, is also higher.

Passive suicide can be not putting on a seatbelt. It can be driving too fast and simply not caring. It can be drinking and driving fast and not caring. It involves taking risks. It encompasses a reference point of ‘I don’t care’ or ‘Who cares.’ Passive suicide might even apply to not wearing a mask or otherwise exposing oneself to the COVID virus unnecessarily. It likely isn’t socially correct to say, “I think I will expose myself to the virus and hopefully get it and die.” That statement is a bit edgy. But, if one says they are not wearing a mask because the virus isn’t real, or everyone is making too much of it, or even that mask wearing is evidence of cowardice or of a political position you gain latitude and permission. 

The people I hear speaking about COVID-19 and ‘who cares’ all have clinical depression. It fits. We talk about it. We attempt to stay on task and work through this in therapy. But what about all the people who are not seeing counselors?

We don’t want to make the mistake of assuming everyone is talking about the same thing. A person who is suicidal and passively suicidal can hide in plain sight. They can hide under the cry of politics, to mask or not to mask, or other position taking that has some social acceptability. They don’t have to feel strange or left out, which may be an underlying aspect to the passive suicide composite within. They can be a part of something bigger and if they die from COVID-19, one woman said, “It would be an acceptable way to die. Think of it. ‘She died of COVID. Poor Kathy.’ Better that as a legacy than Kathy killed herself.”

Think about your positions. Think about what friends and family are saying. It is likely you are all on the same page. But what if you’re not. If you have a friend, co-worker, family member, or loved one who has any history of depression or other mental health concern, it is important to listen carefully and not assume you and this other person are really speaking about the same thing. Suicide risk comes in many forms. Passive suicide is real and it is a red flag. Passive suicide hides in plain sight.

If you are depressed or suicidal or you know of someone who may be please seek help from your local guidance center, local counselors, your primary care provider, the emergency department of your hospital, or call one of the numerous local or national hotlines for helps.

Stay safe. Be well. Pay attention.

Best,

Nanette Burton Mongelluzzo, PhD

Children lie.

The behavior itself is related to many things depending on the child, the child’s family, and life events experienced by the child. Culture, religion, and  belief systems can play into the narrative about the lie. The viewing angle of the parties involved influences the context within which the lie will be understood or whether it is even viewed as a lie.

In and of itself lying is a form of withholding the truth, distorting the truth, completely rearranging truth, or a sign of something completely unrelated. It could be a sign of a physiological issue.

Most definitions of a lie involve an element of “knowing” and “intention” behind the creation of the false statement.

Paul Ekman, PhD is a psychologist and considered one of the best experts on the lie and lying. He owns the company, the Paul Ekman Group. The popular series entitled, Lie to Me, staring Tim Roth was inspired by the work of Dr. Ekman.

We are intrigued and maddened by lying and the nature of a lie. It consumes considerable therapy time and it finds its way into the arts by way of literature, music, and film. It takes parents to the edge and becomes a reason for divorce, separation, break-ups, and disharmony. People want to trust one another. People say they want to know the truth. 

Dr. Ekman acknowledges that there are literally hundreds of reasons why people lie. He condensed them down to the reasons that are the most common. These include: 

Avoiding Punishment

Concealing Reward or Benefit

Protecting Someone from Harm

Self Protection

Maintaining Privacy

The Thrill of it All

Avoiding Embarrassment

Being Polite

Again, keep in mind that there are so many reasons for lying and in my clinical work with young people (children and teens) I often find they lie due to loss. Or perhaps because they are angry. And, at times because they feel powerless. Some teens explain that lying is a form of taking something from another, such as another’s peace of mind. In this context it is a form of aggression. With children I recommend treading lightly on the territory encompassed by a lie, especially if it has become a pattern. Seek professional assistance.

The fascination with truth and its partner, the lie, has been a part of human life for a very long time. In fact, according to Wikipedia the first known written account of Lying was done in AD 395 by Augustine de Hippo with the “Magnum qucaestio est de Mendacio.” Translated it means, “There is a great question about lying.” Lying has been written about in religions, philosophy, psychology, anthropology, and is found in popular culture by stories such as, Pinnochio and best selling books where an unreliable narrator or narrators take readers on a ride of false paths. For example, Gone Girl by Gillian Flynn and Girl on a Train by Paula Hawkins. We also have the much beloved, The Little Boy Who Cried Wolf.

A very contemporary preoccupation with The Lie is the Pandemic Battle Cry of late known as Fake News, which is another word for a lie.

Lying has taken on a life of its own. We have many words for lying depending on the context in which the lie takes place. As such, words such as disinformation, fraud, memory hole, mutual deceit, perjury, puffery, forked tongue, and many more have emerged.

As a therapist I have always felt each story helps us explain that which rests before us. No two people with depression hold and contain that depression in the same way. The same is true of anxiety, loss and grief, and lying. It behooves us to seek to understand the lie in the context of the person who uses the lie. It seems this is the only way to arrive at a real understanding.

Thank you for reading.

Until next time, take care!

Nanette Burton Mongelluzzo, PhD

Children act-out. They act-out their emotions because they don’t know how to express what they are feeling with words. Or, they have reached an emotional saturation point where this is deemed pointless from their perspective. There may be emotional or physical problems interfering with communication and processing. We also know the reason may yet to be determined. Acting-out in children as well as adults serves the purpose of expressing emotion without words in favor of behavior. There are times acting-out involves words and the words are excessive or mean-spirited. When words are used as weapons the words become more like behavior. Angry behavior.

Children and teens are often a bit easier to read than adults. They have less history and less baggage built up over a lifetime of events, challenges, traumas, disappointments, and successes. Children (where I include teens) often want nothing more than to talk to someone, to express something or even everything. They are hungry for a clean interaction. The key word here is clean. Kids worry about telling their parents how they feel. Parents are wonderful, but they can get stretched thin where emotional availability is concerned. So kids might talk to one another or they might talk to a grandma or grandpa, aunt or uncle, or a close friend of the family. This also depends on many factors.

Children leave a trail of what they feel by way of behavior and by way of the small and seemingly insignificant things they say. Here is an example based on something real that happened.

I knew a girl once. Let’s call her Sally. She was seven years of age and acted out a lot at home. She was prone to rages, kicking and screaming, refusing to do her very limited school work, and insisting on watching television whenever she wanted. One day mom and dad said it was time to brush her teeth before bedtime and she could have thirty more minutes of television after the teeth were brushed before bedtime. Sally demanded she get the thirty minutes of television before brushing her teeth. She would do her teeth later. Mom and dad felt some rules had to be followed and they felt they were being reasonable. So they insisted on teeth first and TV later. Sally came undone. She started screeching, throwing toys at her mom, and said, “I hate you. You never loved me. I want to live somewhere else!”

What do you see so far in Sally’s example? Is she just another spoiled ungrateful kid? Perhaps not.

What are the breadcrumbs? We have Sally throwing things at mother, not father. Her words seem extreme for a situation related to brushing teeth and television time. They seem to be unconnected. The words are important. “You never loved me. I want to live somewhere else. I hate you.” 

I realize it is unfair to you the reader because you don’t know the full story. Think about the fact that we may not even know our own children’s full story, at least not from their angle of viewing. We may know the history of our children but perhaps not how they felt in that history at certain key points.

Sally was adopted at age three by the family in our story. Sally was born to a substance abusive and dependent mother who relinquished Sally and she was placed in foster care. Sally spent two years in foster care before adoption. Recently Sally’s biological mother died and the biological grandparent told Sally. The biological grandparent was allowed to have phone calls with Sally from time to time.

We would come to find out that Sally felt she had done something wrong or else her biological mother wouldn’t have given her away. Sally felt her foster family gave her away because, again, she must have been a bad child. She came to the adoptive family with the proverbial chip on her shoulder known as abandonment and not enough explanation or processing about what happened here. Sally was confused, which is normal. Sally was experiencing loss, also normal. Children who feel bad often act bad. Sally was familiar with being moved from home to home. She felt unloved. She was also angry as seen in “I hate you.” This is the open door. Anger is a normal response. If we could help her with her anger, might her behavior and acting-out improve?

Sally would learn to express her anger but not initially with words. She learned to create plays in play therapy. She would be the child and have the therapist be the relinquishing biological mother, but by way of puppets or stuffed animals.. She would use a stuffed animal collection and give the lion one role, the rooster another, and the bear yet another role. She played with me. She had me give a voice to a penguin who was a a very naughty penguin. This was the made-up script Sally asked me to follow. Then the penguin had to be sent away. On one occasion in this repetitive screenplay directed by Sally, the mother penguin, played by Sally, cried. There was a pause. Sally, no longer in the role as mother penguin was feeling as Sally. She cried hard and with such deep inconsolable pain.  She couldn’t stop crying for several long minutes. Sally looked imploringly at me, “I can’t make the tears stop! I don’t know how.” 

I said, “Let the tears come for now.”

Sally said, “But it doesn’t feel good. I don’t like it, the way it feels. I want it to stop.”

I said, “The tears will stop when it’s time, when you are ready.” 

“But I am ready now,” Sally cried.

I said, “Ok. You are crying because it hurt to be given away.” We talked with words about this.

And Sally cried some more and then stopped. The Acting-Out stopped at home. Sally would begin talking to her parents little by little about feelings. Things did get better.

Thank you! Tune in next time for more breadcrumbs to follow.

Best,

Nanette

One of my more popular blogs through PsychCentral is titled, Children Who Want to Hurt. I notice how many times this continues to be viewed and thought it might be a good idea to revisit that topic.

My most comfortable genre for writing and communicating is that of storytelling. I like telling stories that impart wisdom and I use this approach often in my clinical practice with adults, teens, and children. Stories teach, inspire, motivate, and give us a picture of what it is that we are tossing about.

I work with children and have for over forty years. I started in the field of mental health when the DSM II was in place. We are now on the DSMV. Over the years I have seen disorders added and dropped. I have seen how culture changes the way we look at mental health and mental health challenges, including disorders.

If I take a trip down memory lane child diagnostics has certainly changed in the time since I entered the field. Some additions include ADD, ADHD, and Generalized Anxiety Disorder. Another addition is Gender Dysphoria as well as Intermittent Explosive Disorder, Conduct Disorders of several flavors, and more.

It would appear that children are often the focus of concern. Parents are often concerned about their children and their mental health. Parents I encounter are afraid of having the next sociopath, psychopath, or a young adult who ends up in prison. They fear being blamed. They fear not doing enough. They are sure something very wrong is going on and they want it fixed before it’s too late.

The reported symptoms are common: lying, stealing, not talking or withdrawing, being mean verbally, physical lashing out at siblings, friends or parents, and a suspicion of drug use. Add to that a level of apathy, avoidance, attitude, and overall surliness. Sometimes grades are bad and sometimes the child or teen is an A student. Parent’s report a far-away in their child’s eyes, as though they aren’t really there or aren’t really listening. The list is as general as each of us are individual.

There are some symptoms and signs that do point to problems down the road. There are choices in counseling. Pursue reducing or eliminating symptoms, pursue understanding the symptoms and their origin, or do both. Parents often ask for symptom elimination, but upon speaking further with them they actually want to understand what happened here. This is my favorite approach. Let’s roll up our sleeves and figure out what is at the core of what we see on the outside.

Most children whom I encountered, including teens have loss embedded inside. Loss comes in many forms and doesn’t always have to do with death of a loved one. We lose friends, we move, parents separate or divorce, parents argue, school teachers change, disappointments of one type or another abound. Children and teens are actually asked to deal with a lot of stuff. They endure the same things as adults, but they have limited ways of expressing what is felt. They don’t understand what they feel. They get very confused. Their confusion adds another task to parent’s long lists of things going on. Some parents do a great job of pausing and seeking to understand. Others find it an annoyance that gets in the way of what they need to do. I don’t blame parents. I don’t blame the children or teens. It is a family problem and one of creating space for communications that help rather than hurt.

Children are going to act-out. This is what we call it in my field. Acting-out what? Acting-out refers to acting out emotions, feelings, conflicts, or things that lie beneath that bother us. Adults act-out as well, but we assume they do less of it because they have command of their feelings and understand more about what it means to be humans in a society and culture with conflicting messages coming from everywhere. Adults likely understand the influences of their personal history a bit more than a child or teen.

Children act-out and the acting out is a bread crumb on this bread crumb trail we are given clues to the emotions or conflicts going on with the child.

For example, a child yells at you because you are asking too much about their school work. You are confused and perhaps angry. You may think, “This ungrateful child.” Think about yelling. Yelling is a behavior and it involves emotion. It is a form of anger being displayed behaviorally by way of a loud and unfriendly verbalization, which we call yelling. Parents can react and yell back. This, as we all know, leads nowhere. All behavior is a breadcrumb and part of a clue that leads to some form of understanding. What if a parent says, “Oh my, I hear your anger.” Or, “Ouch, what’s going on Sally?” Or, “I’m sorry honey, it feels like your frustration level is up a bit.” There are as many choices as there are thoughts. When we don’t react we invite and when we invite the child puts down their sword. You simply cannot fight with someone unwilling to fight.

We will talk more on strategies for understanding breadcrumb trails, children, behavior, and choices for how to intervene.

Wishing all of you a peaceful week.

Best,

Nanette Burton Mongelluzzo, PhD

Children do experience loss and they do grieve.

They are not typically forthcoming about loss and grief in the same way as an adult. This is because they are kids, because they often don’t know how to express what they feel, and because they don’t want to bother adults or parents. Children are highly perceptive. From their angle of viewing, they see adults as having plenty going on to begin with. They may have also learned to not share thoughts or that people don’t have time.

If you are interested in leaning into the private world of a child how do you begin?

• First think about who the child is. Your son or daughter, the child of a friend, your grandchild, niece, or nephew? The first step involves an honest inventory regarding your relationship with this child. As part of the inventory think about any issues pre-existing with the child. Can you move into an emotionally responsive role with this child and do no harm? If your answer is yes, then move to the next step.
• Step two involves making a mental or written list as to what you feel this child’s losses have been. This isn’t about what the child has said but what you, as an adult, have witnessed with the advent of the COVID-19.
  • Was the child out of school?
  • Did the child have a Zoom Classroom? Did they attend?
  • Did the child do their homework and finish out the school year?
  • Did the parents of the child lose their job?
  • Are there financial problems at home? Substance use or abuse? Domestic Violence? Is this a single-parent household?
  • Are there mental health concerns in the family? Does any family member have an existing mental health challenge? Are they getting help?
  • Is the child in self-quarantine? Was he or she?
  • Did anyone close to the child contract the COVID-19?
  • Anything else unique about this child’s circumstances? Does the child have an illness or existing health condition? Does anyone in the family?
• The third step is to create a sense of calm in yourself. Step two is about availing yourself of information ahead of time. You are not going to use this at this time. It is much like knowing the entire history of someone and waiting for a moment to use what you know for the purpose of assisting and guiding.
• Step four is about listening. It is also about creating the space with a child for the child to simply be with you. This can be accomplished in many ways. You can take a walk with the child, bake a cake, water the plants outside, or do some cleanup in the garage. You can watch a movie together and after the movie simply sit together and maybe have a bowl of fruit or ice cream. When we listen, it is important to suspend judgment. I have noticed people seem to think certain communications are more important than other communications. They may also think a person will go right to what is bothering them. Even adults don’t do this. It is highly unlikely most children will either. People, even child people, give us clues as to what’s on their mind. A child might say, “Why are people so mean?” What would you say in response? Would you respond? I might say, “What’s on your mind right now?” In this way I allow movement to go a bit deeper. Something caused the child to say that. Or, if the child says, “I hate spiders!” What would you say? Would you say anything? I might say, “What do spiders make you think of?” It is in this way that I ask to continue the conversation. Invite the child to talk more and before you know it the child may share some pretty interesting stuff you never imagined was there.
• Step five is about suspending judgment. Thoughts and feelings are just thoughts and feelings. They are neither right nor wrong, good or bad. They are temporary positions we hold as we think more and feel more and eventually take to action what we have decided. And the cycle repeats itself over and over. We are always redesigning our thoughts and feelings. Hopefully we are able to allow for growth and change in ourselves and others around us.

Have a wonderful week. Stay safe. Be well. And remember you were once a child too. How is your grief and loss doing with the pandemic and all the storms that have gathered in our world?

My best to you!

Nanette Burton Mongelluzzo, PhD

Children don’t name the loss or their state of grief.

Children may not cry or act sad.

Children may act out and refuse to do chores or cooperate in other things a parent requests.

Children may show anger and typically withdraw in one fashion or another. They frequently become depressed, despondent, and at times, desperate.

Elisabeth Kubler-Ross is famous for her stages of grief. To quote her, “The five stages – denial, anger, bargaining, depression, and acceptance – are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief.”

When looking at the COVID-19 and Pandemic it assists us to define “the one we lost.”

Our children lost school in the way they knew it. They lost their social network of friends and classmates. They lost their teachers, school nurse, and school counselors. They lost getting up and brushing their teeth to head out to catch the bus or walk a short or long distance in the early morning hours to be part of a gathering, a tribe, a place known as school. This giant collective, filled with many feelings that both draw and repel children, was taken from them and became “the one we lost.”

“The one we lost” was parents. Parents were worried, most were overwhelmed, and many lost their jobs. Money, finances, rent, and mortgages became new words in a dictionary emergency search for children who were five or fifteen. Parents were hoarding, mom was baking, and tempers may have been hard to control. Some parents who kept their jobs were overwhelmed because the children were home. Single moms and dads struggled to get kids up and have them go to their online school or do the packets of 250 pages the school sent home in March when the pandemic began. Children told me, “But I don’t understand.” Of course they don’t, how can they?

Some kids lost a parent to a separation or divorce. “The one we lost” became mom who moved out or dad who moved in with his girlfriend or mom and dad sent the children to live with uncle Carl and aunt Emmy because their state had fewer COVID-19 cases. Some dads and moms sent their spouse and children away because they worked in the hospital or emergency room and they were terrified coming home at night. What if they didn’t clean off well enough in the garage? What if they made a now forgotten mistake while in the ICU? “The one we lost” for children was the disruption the family would feel in one way or another.

Some parents had gotten clean from drugs or alcohol. Others were finally getting better on their anti-depressants or anxiety meds and doing psychotherapy. With the pandemic parents often slipped back. Drinking increased, drug usage increased, and wherever you were before it was likely you would be there again where mental health challenges were concerned. This, for children, would be “the one we lost.”

Children go through denial: They don’t know how real this whole thing is. Some kids took risks. Some became depressed and confused.

Children engage in bargaining: If this could just go away and things would go back the way they were I would promise to do my homework every night. If mommy would just come back I promise to be good.

Children experience depression. Signs of depression include withdrawal, apathy, anger, irritability, restlessness, and difficulty engaging in usual activities that would have conjured some joy or happiness.

Children can reach a place of acceptance. Acceptance is flexibility and rolling with the change. Let’s see where it brings us. After all, “When the table moves, move with the table.”

Grief and loss in childhood is real. Children will show signs of grief, but they are not always signs adult recognize. Pay attention. As Sanjay Gupta, MD stated about the COVID-19, “Assume everyone has it, including yourself.” The same applies to grief. Assume everyone has grief right now, including yourself.

Wishing you all the best.

Next week: Lost and Found in The Time of Pandemic: Children and Tools for Moving Forward.

Nanette Burton Mongelluzzo, PhD

At the beginning of the pandemic when masks had just begun to be worn and children had been warned I found myself checking out of a grocery store. At the checkout line a young mother of the age of thirty or so was with her son, who appeared five or six years of age. He was a handsome little guy with dark hair and eyes and eyelashes that looked like silken fans. He had a sweet smile. As is customary in most grocery stores there is that rack of candy and other child teasers just before the conveyor belt and cashier. I call it the impulse rack. It plays havoc on parents and children alike.

On this particular day the mother was softly saying,” No.” Her eyes conveyed, “Don’t do that”. The boy kept looking up at his mother and then away toward the rack, while he attempted to carefully touch, with only one finger, a small little box that contained candy. He held out his finger as though the desired object was a mouse trap, or on fire, or even worse, charged with electricity. He would reach, almost touch the little box and then pull his finger and hand back suddenly as if testing his resolve and courage. Then, he reached out throwing all caution to the wind as well as his mother’s words and obvious previous conversations that took place between him and her prior to coming to the store. In his quick but long reach he touched the taboo box of candy. He recoiled his hand back just as quickly. He looked up to his mother who quietly but knowingly shook her head. He said, “It didn’t do anything to me!”

He then reached again and gingerly picked up the box. He examined it while holding it between just two fingers as though it were contaminated. He looked under it, turned it around, smelled it, rubbed it, and looked back up at his mother. Again, the boy said to his mother, “But it didn’t do anything. It isn’t bad.”

I looked at his mother who was looking at me and said, “He can’t possible understand at this age.” She nodded her head.

The pandemic is almost impossible for a child to understand. It is equally impossible to help young children understand this unseen viral enemy lurking everywhere and living in a liminal world of neither here nor there, neither light or dark, nowhere and everywhere.

Charlie is eight years old. He is at a special age of innocence blended with magic and reality. He is a verbal child who is a bit too anxious to engage in play therapy. He said he had a secret, “Everyone is going to die.”

I asked what he meant.

“My whole family is going to die and then what will I do?”

Of course, in the time of a pandemic he is speaking about how the virus is going to take away his family. What he lost was the security that mom and dad and all his siblings would always be there. Buried in his narrative was something of a gem. He didn’t include himself among those who would die. Hmm, I thought. So, when in doubt ask questions.

Charlie said he didn’t think he would get the virus because he was strong. “I never get sick, I just have the worry problem, but I don’t get viruses.”

What we found was Charlie taking stock of his strengths and this was new and an important building block for moving forward.

Quinn is twelve. He just had a birthday today and we acknowledged it during our weekly telemedicine session. He is quarantined and out of school. His room is a boy cave and comes complete with computers, a television, microphones, and all the fixings for creating his own music. He said he is practicing for an audition if school ever begins again. He wants to be in the school musical. He has been practicing the song he would like to sing.

He said his dad didn’t think his voice was good enough and that he sounded like a foghorn.

I said, “I’m sorry.”

He said, “It’s ok, I have never been great at anything.”

He asked if he could sing me the song he is practicing. He said, “I think if I sing it for you it might have more emotion, because that is what’s missing. It shouldn’t matter if I don’t hit the notes right every time if I can only sing with emotion.”

He practiced a few lines and the chorus. We spoke about how similar he was to the boy in the song. At first, he hesitated with the lyrics as though he was trying to be another singer, another person, someone other than who he is. Then he offered up his own voice. The end result was an emotional rendering of these lines that came complete with his tears,

On the outside, always looking in
Will I ever be more than I’ve always been?
Can anybody see, is anybody waving back at me?

The pandemic has been hard for this boy. He was isolated before due to self-esteem and an awkwardness not unusual to his tender age. Stuck at home was more isolating and he felt forgotten. One effect of the pandemic on children and adults is that pre-existing issues can be exacerbated and made worse without our usual coping strategies. His coping strategies existed outside the house.

Check in next week for Lost and Found In the Time of Pandemic Part Two on Children of the Pandemic and Loss and Grief.