Speaking of Psychology: Children, loss, and stress, with Bonnie Zucker, PsyD

Protecting children from sadness, anxiety and stress is a natural instinct for many adults. But, finding ways to help them address these inevitable obstacles to happiness is a challenge parents, teachers and other caregivers have to face head on. In this episode, Bonnie Zucker, PsyD, talks about how to explain death to young children as well as the research into the effectiveness of relaxation and mindfulness techniques for kids.

Bonnie Zucker, PsyD, is a licensed psychologist with a background and expertise in psychotherapy with children, adolescents and adults. She received her doctoral degree from Illinois School of Professional Psychology in Chicago.

Zucker specializes in the treatment of anxiety disorders in children and adults. She is the author of several publications, including, “Something Very Sad Happened: A Toddler’s Guide to Understanding Death,” which is published by APA’s Magination Press, and “Anxiety-Free Kids: An Interactive Guide for Parents and Children,” and “Take Control of OCD: The Ultimate Guide for Kids with OCD.” She also co-authored audio CDs entitled “Relaxation and Self-Regulation Techniques for Children and Teens: Mastering the Mind-Body Connection,” and “Relaxation and Wellness Techniques: Mastering the Mind-Body Connection” for adults.

Audrey Hamilton: It’s never easy to see a child experiencing pain, sadness, even loss. But it’s those experiences that can help them learn how to be emotionally healthy adults, if they have the right tools. In this episode, we speak with one psychologist about how to talk to children about loss as well as the importance of mindfulness and other self-regulation techniques as they attempt to manage stress and other day-to-day challenges. I’m Audrey Hamilton and this is Speaking of Psychology.

Bonnie Zucker is a licensed clinical psychologist. She has a private practice in Rockville, Maryland where she works with young children, teens and their families. She can often be found out in her community at schools and talking with parents about how to help children manage stress and everyday challenges. She is the author of several books, including “Anxiety Free Kids” and “Take Control of OCD: The Ultimate Guide for Kids with OCD.” Her latest book is called “Something Very Sad Happened: A Toddler’s Guide to Understanding Death” published by Imagination Press. Welcome, Dr. Zucker.

Bonnie Zucker: Thank you so much for having me.

Audrey Hamilton: I want to start with your latest book because I think this is something many parents struggle with. You know, talking with your kids about death at any age really, but particularly, very young children. What made you want to write this book and what is it about?

Bonnie Zucker: Thank you. So actually, I was personally motivated unlike my other books which my clinical experience developed the concepts. For this, about six years ago my mother passed away and my son who is now eight was two at the time and my go to was to find a book for him and I went to the book store, I could not find a book written on death written for two and three year-olds. They had a really good one called “I Miss You,” which was for ages four and up, which I did buy and simplified for him. But, I remember at the time in the midst of my grief thinking, I have got to write a book for kids at this age because at two and three parents are in the habit of reading every night to their kids. And usually by the age of two or three, kids can identify with books. It’s a great way of teaching them something and also for grief, it allows them to go back and re-hear over and over the things that are important for them to learn about it.

Similarly, the developmental understanding for a two and three year-old – it’s very different than someone who’s four or five or older. I wrote it in a language that was designed for the developmental understanding of a two and three year-old child.

Audrey Hamilton: So what happens in the book?

Bonnie Zucker: So, what happens in the book – it’s actually, the illustrator made this book. I mean, people, I show them the book and they say “wow, this looks amazing!” I said, “I know, doesn’t it?” And really, I’m not speaking of my work, I’m speaking of the illustrations, which just express the story so beautifully. They’re really – she was very sensitive in her approach, even the expressions of the mother and the little boy in the book. So what happens is the mom and the child who again looks like a three year-old boy are sitting down and the mother explains that something very sad has happened – grandma died.

And I wrote the book with the words “grandma” and the pronouns “she” and “her” coded in red so that the reader who should prepare in advance to read this book to the child by reading it once themselves can be cued to change at let’s say it’s a father who died or an uncle that it can be switched to – something very sad happened – uncle so and so died – he and then they would be able to personalize it so it makes sense for the child.

And so the boy and the mom go through sort of these pages of emotions – feeling sad; you might see your mom feel sad; you might feel angry; you might see your mom feel angry – and what was amazing about the illustrations is it actually goes from lighter toned colors to more vibrant colors as the book progresses and then toward the end of the book it talks about how we can remember grandma. We can look at pictures. We can talk about her and listen to stories about her and then the very last line of the book is love cannot die. You know, love never dies. And so, that’s a very vibrant, colorful page, the last few pages.

Audrey Hamilton: I know that you work with families and also you have children yourself, so you have personal experiences. But, as a therapist, as a psychologist, I’m sure that parents are always worried about saying the wrong thing, further confusing the child. So, is there anything that people who are adults should not say to children when they’re dealing with death?

Bonnie Zucker: That’s a great question and I do think that while we just want to be as authentic as possible in our parenting, there are times when you have to limit what you say and mostly when it comes to conversations about death, I think for a young child you have to be very clear and planned about what you want to say.

You want to avoid terms like “sleep” or “long-sleep.” You don’t want to say when someone dies it’s like they’re sleeping because it’s not like they’re sleeping. They’re not going to wake up. And for the child at this age, they don’t understand so much the irreversibility of death so we want to be very clear in that message and we also don’t want to make them anxious about sleep. Right, I don’t want to go to sleep if it’s going to be like death.

And also, we really want to be sensitive to not telling them what to feel. So you don’t want to say things like, “you know you can feel happy now because the person is no longer in pain.” That’s not going to make sense to them – that’s going to further confuse them, particularly when they’re watching people go through, their family members go through a loss and they’re sad a lot. And also if it’s a suicide or a homicide, I really recommend in those times to not be authentic and not say so and so killed themselves or so and so was killed. I think you have to essentially lie to the child. Because it’s too complex – they can’t understand it and I think you just have to say things that, you know, basically mislead the understanding of how they died and then when the child is older you can be more honest with them.

And then one final point is really – I do think it’s important to not encourage the child to move on too much or to tell them that we don’t want to talk about this anymore. As shocking as that might sound to say to a child, I’ve actually had this happen a couple of times. One was with a foster child I was working with whose biological mom had died and then he was adopted by the foster family and they cued him, this is your family now, we don’t need to talk about your birth family. Yet, in the therapy room with me he was really not ready to move on. And so I think we just have to trust kids. They do a really good job when it comes to being authentic to their feelings and navigating their emotions and we want to take their lead and figure out what they bring to the table in terms of their emotions and have sort of fundamental respect for their process.

Audrey Hamilton: I want to switch gears a little bit and talk a little bit about the mind-body connection with kids. You see a lot of schools now are focusing on this. For example, my own daughter’s kindergarten classroom, they’ve started incorporating mindfulness practices in the classroom, which I find really interesting and that she finds interesting, as well. How do these types of programs and practices work and what does the research tell us about the benefits?

Bonnie Zucker: It’s a great question and I’m thrilled that your daughter’s kindergarten class is doing this because I find overall that when it happens in the school it starts happening at home too because kids come home and they want to do these kinds of practices. So, we know there’s a very strong mind-body connection and there’s really good research done by Herbert Benson, who is one of the first to really write about anxiety in a popular way and he wrote this book a couple of years back called “Relaxation Revolution” which summarizes his findings through studies on mind-body practices – and by the way those mind-body practices include things like meditation and yoga and listening to certain chants and music.

And what they found – and they did this really amazing study with over 2,000 genes that they looked at in these experienced mind-body practitioners. And when you think about genes you think about are you genetically predisposed to something. So, I may have a genetic predisposition to something like lung cancer, but that gene never gets switched on if I don’t smoke, if I exercise, if I eat well. And so a gene doesn’t mean you will have it. Instead, you want to look at the conditions that turn a gene on or don’t turn the switch on.

So they found that these genes in these mind-body practitioners, especially ones associated with cardiac problems and oxidative stress were not expressed in the same way as in the genes of the inexperienced practitioners. So, this is sort of remarkable evidence that shows that when you do things like mindfulness and relaxation training and yoga, that you are setting your body up to not express certain genes that could cause a lot of illness and disease in people. And the idea of kids learning this, especially when we add in the different environment that kids these days are growing up in with technology. While we love our phones and some of us love them more than others, we really are creating an entirely different experience for kids these days and in fact some people even say that when kids are using phones a lot and they’re switching between topics quickly that it could encourage some inattentive behavior. And the idea of having this mindfulness to rely on, to clear your mind, to enter into a thoughtless state and to really align your mind and body in a very positive way – I would view it as preventative medicine.

Audrey Hamilton: How do you know if your child or children would benefit from relaxation and self-regulation techniques? I mean, an argument can be made that all children should be.

Bonnie Zucker: That’s the argument I would make, of course.

Audrey Hamilton: But, how do you go about finding the best program?

Bonnie Zucker: Yes. That’s an excellent point. My goal is for kids to be working on this at home with their families. And I find in my work with families that parents are just as happy to be doing it as kids are. And I essentially think all kids need to learn how to do calm breathing and one nostril breathing, which is where you close one nostril and you close your mouth and breathe in very slowly in and out through the other nostril. Usually you breathe in for seven and out for nine. Something like that. And you do it for several minutes until you get really relaxed.

But, there are all of these apps now where parents can help their children learn how to relax. For example, C-A-L-M, which is an app, it's calm.comopens in new window — C-A-L-M — they have an amazing bedtime stories part of the app. Part of the app is free and part of it you have to pay for and the bedtime stories unfortunately is something you have to pay for. But, I’ve had kids who’ve had a lot of trouble relaxing before bed and they listen to these stories. There’s one where the man’s voice is like this. And you almost want to fall asleep the second he starts talking. And of course, that’s one way to use it. Another way is not at bedtime, but for them to really learn how to relax and how to decompress. And what I suggest is getting on, you know, getting on your phone and looking at the different ones. I have a list in my head that I often recommend – InsightTimeropens in new window is a really good one. Buddhifyopens in new window is another one. And again, C-A-L-M is excellent. There’s also CBT tools for youth that has a lot of tools on there.

And so, the idea is to take action. So, the specifics of it are not as important as the practice of it in the beginning. So, the goal in the beginning is to say hey, we need to carve out some time to unwind where we’re not thinking – where we’re suspending or thinking or getting into our bodies or learning how to do some awareness. I have a family – they watch YouTube videos of people doing yoga for ten, 15 minutes after – well, they have this routine where they eat much earlier in the day and then they go on a little bit of a walk and they come back and do these yoga poses. But I think the idea is for parents to make time for it. And then once they’re doing it, then they can really refine what kinds of things their child likes and benefits from.

Audrey Hamilton: Well, Dr. Zucker, thank you so much for joining us today. This was really helpful.

Bonnie Zucker: Thank you so much for having me.

Audrey Hamilton: Thanks for listening. If you would like more information on the topics we discussed or if you would like to hear more episodes, please go to our website. With the American Psychological Association’s Speaking of Psychology, I’m Audrey Hamilton.