Fathers Grieve Lost Child With Stoicism, Self-isolation, Work

By Lisa Rapaport

March 02, 2021

(Reuters Health) - Fathers who are grieving the loss of a young child may not discuss their feelings with others, instead coping with stoicism and self-isolation or by throwing themselves into work, a systematic review suggests.

Researchers examined data from 21 studies of grief and bereavement experienced by fathers after the loss of a young child, excluding cases of miscarriage and stillbirth, that were published from 2007 to 2019. Three of these studies focused exclusively on fathers and 14 were published after 2015.

"Some of the most referenced papers on grief and bereavement in fathers were from 20-30 years ago, and with an increasing presence of fathers in the home, we were interested if the experience of grief also changed," said lead study author Dr. Michael McNeil of St. Jude Children's Research Hospital in Memphis, Tennessee.

"However, what we found is that some of those machismo features of stoicism, isolation, and 'staying busy' remained despite these shifting norms," Dr. McNeil said by email.

The studies in the analysis used a variety of methods to assess grief and bereavement in fathers, including in-depth interviews as well as open-ended questions on surveys. Some studies included quantitative assessments of factors such as physical and psychological impacts of grief; some studies had qualitative assessments of self-reported questionnaires focused on posttraumatic stress, depression, and spirituality.

Across all the studies, one common feature of paternal grief appeared to be a tendency to grieve in private rather than in public, researchers report in Pediatrics.

Another common feature of fathers' grief included frustration emerging from differences in communication and processing of bereavement between the men and their partners or other children.

In addition, fathers were more apt than mothers to focus on work or projects around the home as a coping mechanism.

Fathers did often cite the importance of rituals such as keeping toys as a remembrance, writing to their deceased child, or visiting the grave as an important part of the grieving process. Fathers who participated in spiritual activities seemed to have fewer symptoms of grief and depression, but not less posttraumatic stress, these studies found.

Over the first six months after a child's death, fathers did have more acute illnesses, medication changes, and hospitalizations. These changes decreased with time, however.

I think it is also critical to recognize that while there may be some general features of grief specific to fathers and mothers, each individual has a unique grief journey and may not fall nicely into one bucket," Dr. McNeil said.

One limitation of the study is the lack of information about grief following a miscarriage or stillbirth, the study team notes. Results from the assessments of grief following the loss of a child under 21 years may also not be generalizable to bereavement following the death of a young adult child.

Even so, the results underscore that bereavement following the death of a child regardless of age can be a gendered experience, said Vicki Flenady, director of the Stillbirth Centre of Research Excellence at the University of Queensland in Brisbane, Australia.

"It's so important not to make assumptions about experiences of fathers due to their under-representation in research and the selection bias of those studies that have been done and lack of social and cultural diversity," Flenady, who wasn't involved in the current study, said by email.

"Although significant differences in recent years with fathers having a more active role in family life, there are ongoing gender-based differences in our society," Flenady added.

Clinicians and therapists need to recognize that fathers may express grief differently and require different interventions and support than mothers, said Dr. Michael Yogman, a pediatrician at Cambridge Hospital and an assistant professor of pediatrics at Harvard Medical School in Boston.

The current study confirms how so-called toxic masculinity may influence the way that fathers experience and express grief, Dr. Yogman, who wasn't involved in the current study, said by email.

SOURCE: https://bit.ly/3e0j9Qa Pediatrics, online March 1, 2021.

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