A Father's GriefMichael Carr-Gregg is a psychologist specialising in adolescent loss and grief. He is the founder of CanTeen, an organisation which supports teenage cancer patients. When he experienced the loss of a child six years ago, he was shocked to find how little support was available for himself and other grieving fathers. He started a fathers' support group which has been very successful, and has been working to improve the medical profession's understanding of the special problems of fathers whose children die in the womb or shortly after birth.This article is based on a paper published in Australian Family Physician, which Michael co-authored with Nick Lennox, Department of Public Health and Community Medicine, University of Melbourne. In Australia nearly 1 in 100 babies are stillborn or die shortly after birth. These deaths have as significant an impact on the family as does the death of an older child. Yet for some time, it was thought that because the life of a newborn child has been so short, there was not enough time to form the same strong bonds that one forms with the longer-lived members of the family. Much attention is given to mothers on the loss of a newborn. Seldom is it recognised that fathers are also profoundly affected by the death of their child. In many instances a father's grief is simply not recognised because of misconceptions that men don't feel as much as women, and that fathers aren't as close to children as mothers. Studies indicate that men begin bonding to their unborn children even during pregnancy, when they begin to dream and plan for their role as a father. They have hopes and exciting ideas of the things they will do with their children. Many men share in the birth of their children, documenting the event with pictures, videotapes and with plans to savour the moment forever. Aftermath of the birth and death of a childBoth mothers and fathers respond to the loss of a newborn with typical grief reactions: physical distress, anger, guilt, resignation and finally acceptance of the death of their child. Many fathers also experience a range of emotions from uncontrollable rage and anger to loneliness and isolation, as well as anguish and despair. Fathers are often expected to take charge because their partners may be exhausted or temporarily disabled by the birth and the death. They have to inform other family members, arrange the funeral, write the obituary and make endless calls to spread the terrible news. Although many men feel that a part of themselves has been buried with their child, they are plagued by strong guilt feelings, over not having spent enough time with their partner, wondering whether it was some genetic defect in them that caused the death. Unable to share these thoughts, many men respond by constructing a wall to fence in their emotions: protection at any price. The erection of such a wall is often legitimised by friends, relatives and work-mates who ask how his partner is taking it while forgetting to acknowledge the pain he is experiencing. These same people may remind him that he is young and can have another child, as if a replacement child is all that is needed to ease the pain. The result may be that many fathers tend to grieve longer than their partners. A child is the father's conduit to the past, as well as the bridge to the future. A child carries on family tradition and a sense of immortality that fathers invest in emotionally. When his child dies, a father's dreams are lost and shattered. To cope with their conflict and confusion, some men become mechanical at the time of their grief. They often appear calm and withdrawn, shouldering their burden, "like a man", and try to provide balance and comfort to those around them, keeping hopes and reality in check, while crying inwardly. A man caught up in this emotional maelstrom may resort to alcohol, drugs, work, silence and other forms of stoic behaviour designed to dull the pain he cannot allow himself to feel. A father is expected to provide financial, emotional, intellectual and moral support for their kin. When he is not able to save his child, many question the very essence of his ability to ensure security for his family. When a man's child dies his identity as a protector may be shattered. The father and the partnerIt is a cruel paradox that just at this particularly painful time when they need each other most, men often experience isolation and estrangement from his wife or partner. Although both have endured the same loss, research suggests that they do not necessarily grieve in the same way or at the same rate. Because of the fluctuating effect of grieving, the relationship is in a constant state of confusion: when one partner is up, the other is down. The father usually feels the need to move on and not to discuss the dead child for fear of making things "worse" for his mate, who in turn experiences this as uncaring and distancing. This lack of togetherness only serves to exacerbate the difficulties they may be experiencing. Each partner may remind the other of the missing child they once had. Sexual contact frequently diminishes, especially if the woman is recovering from the effects of the birth. The fear of another child dying can create an anxiety that can contribute to this problem. Circumstances and history can conspire against the bereaved father, and it is little wonder that he often finds himself stuck in a pit of loneliness, pain and sadness. For some men the only solution will be psychotherapy. Some men may feel frustrated when they are confronted with a partner who cries often and is able to talk openly about her pain, seeing it as a strong reminder of his inability to verbalise his sorrow. Interpersonal difficulties may arise when the man attempts to support and understand his partner, who may misinterpret the man's lack of openness as indifference. Some men fear for their partner's sanity, because they are still deeply affected after many months. How can fathers be helped?There is much that can help the bereaved father. Doctors need to establish, whenever possible, the cause of the baby's death and to explain this, often repeatedly. Both parents may need several hours to say goodbye, and this will be the only parenting time they will have with their child. Doctors need to listen to the father, anticipate his needs, offer options and generally help him regain a feeling of control over his life. The father (as well as mother) can be helped at the time of death by a doctor and hospital staff in many ways, such as allowing the father to see and hold the baby; encouraging the father to call the baby by name; allowing the father to have private time with the baby; offering the father the options of taking photographs, gathering mementos (clothing, hat or blanket) and of having a baptism or blessing certificate. Such memories and mementos can bring reality to the life of the baby. For the next few weeks, the bereaved father needs to be listened to, acknowledged and have his feelings legitimated. This can be a vital part of the grieving and healing process. The man needs to know that grief does not last just a few days but may continue for years. The man needs to be encouraged to "uncork" his feelings and find appropriate ways to release them, and given permission to feel sorry for himself, to be weak, to cry or be angry. Using the dead child's name when referring to the infant often helps the grieving process. Clichés, such as, "you are young enough, you can have another" and "there was probably something wrong with the baby, anyway" are not helpful. It is important for those in the therapeutic setting to listen carefully to what the person is not saying. Many fathers frequently feel great guilt and disguise their belief that they could or should have done something more. Active listening can uncover this well-kept secret and thereby provide relief. With the passage of time, the father's grief will lessen, however the grieving process continues throughout a lifetime. It is one of the factors that mould and shape individual's lives. The grieving process can profoundly change value systems, and force a re-evaluation of life's goals. Some men can resume a normal life after a year or two, but many never stop thinking about their child, never stop missing their child, never stop wishing it hadn't happened. The issue is to recognise that a man's grieving and mourning is to be expected, encouraged and listened to. Angry tears are essential and ventilation is a necessary part of healing. SANDS INC. SANDS offers support to families who have experienced miscarriage, stillbirth, neonatal or infant death. SANDS holds a ceremony especially for fathers on the day before Fathers' Day each year. For information, call SANDS (NSW) on (02) 9906 7004
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