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Helping children and their parents deal with divorce and separation

Divorce is the termination of the family unit, and thus, it is often characterised by painful losses. Divorce and separation may be solutions to a discordant marriage, and any decrease in hostility may be constructive. However, for many children and their parents, tensions continue and the entire divorce process is a long, searing experience. For these children and their parents, this process can be emotionally traumatic from the beginning of parental disagreement and rancour, through the divorce, and often for many years thereafter.

Age-appropriate explanation and counselling is important, so that children realise that they are not the cause of, and cannot be the cure for, the divorce. Family guidance should be offered in dealing with children through the troubled time. They can be referred to professionals with expertise in the emotional, social, and legal aspects of divorce and its aftermath. The divorce itself is usually not the first major change in the affected child's life. Children's sense of loss is ongoing and may increase, especially on holidays, birthdays, and special school events and when trying to integrate new family relationships. Other losses for the child or adolescent relate to changes in home, extended family, school, playmates, financial status, and parental work schedules. Up to half of children show a symptomatic response during the first year after their parents divorce. Risk factors for continuing childhood difficulty include ongoing parental discord, maternal depression, psychiatric disorders in either parent, and poverty. Long-term follow-up studies indicate that divorce may limit or delay children's capacity for intimacy and commitment as young adults.

Children’s reactions:

The clinical manifestations of divorce in children depend on many variables, including the child's age; the predivorce level of the family's psychosocial functioning; the parents' ability in the midst of their own anger, loss, and discomfort to focus on their child's feelings and needs; and the child's temperament and temperamental fit of parents with their children.

  • Infants and children younger than 3 years may reflect their distress, grief, and preoccupation; they often show irritability, increased crying, fearfulness, separation anxiety, sleep and gastrointestinal problems, aggression, and developmental regression.
  • At 4 to 5 years of age, children often blame themselves for the break-up and parental unhappiness, become more clingy, show externalising behaviour (acting out), misperceive the events of the divorce situation, fear that they will be abandoned, and have more nightmares and fantasies.
  • School-aged children may be moody or preoccupied; show more aggression, temper, and acting-out behaviour; seem uncomfortable with gender identity; and feel rejected and deceived by the absent parent. School performance may drop, and they may agonize about their divided loyalties and feel that they should be punished.
  • Adolescents may feel decreased self-esteem and may develop premature emotional autonomy to deal with negative feelings about the divorce. Their anger and confusion often lead to relationship problems, substance abuse, decreased school performance, inappropriate sexual behaviour, depression, and aggressive and delinquent behaviour.
  • At all ages, children frequently have psychosomatic symptoms as a response to anger, loss, grief, feeling unloved, and other stressors. They may try to play one parent against the other because they need to feel in control and test rules and limits. However, they are likely to feel guilty and responsible for the separation and feel that they should try to restore the marriage.
Parents’ reactions:

Parents also suffer detrimental effects from divorce and manifest a variety of negative and uncomfortable reactions. Mothers are likely to react to daily stressors as well as untoward major events; to consume more alcohol; to use more mental health services for depression, anxiety, or feelings of humiliation; and to feel overwhelmed and less capable as parents. Fathers often feel pushed away, are likely to seem less accepting of their children, and also may develop depression, anxiety, and substance abuse. Grandparents as well often perceive a decreased quality of relationship with their grandchildren, with custody arrangements being more influential in determining visiting schedules than is geographic distance.

How can doctors assist children and families:
  • Be alert to warning signs of dysfunctional marriage and impending separation.
  • Discuss family functioning in anticipatory guidance and offer advice pertinent to divorce as appropriate.
  • Always be the child's advocate, offering support and age-appropriate advice to the child and parents regarding reactions to divorce, especially guilt, anger, sadness, and perceived loss of love.
  • Paediatricians must try to maintain positive relationships with both parents rather than taking sides. If there is evidence of an abusive situation, referral to child protective services is indicated.
  • Encourage open discussion about separation and divorce with and between parents, emphasizing ways to deal with children's reactions and identifying appropriate reading materials.
  • Refer families to mental health resources with expertise in divorce if necessary.
Long-term follow-up:

Although many children have long-lasting emotional and adjustment problems associated with their parents' divorce, most adjust and function well over time, particularly those who have supportive relationships and a positive temperament and receive professional counselling. Substantive periods of change during the process can demand new adjustments on the part of children. Although the legal divorce is an important event for parents, it may be an insignificant event to a younger child who knows little of the legal process or a very significant event for the older child who experiences further proof that his parents will not reconcile. Among troublesome issues for children may be the parents' dating and sexual activities. Parental discretion and truthfulness are important for the maintenance of respect for the parents. Step-families introduce another adjustment challenge for children and their parents.

As children develop and mature, their emotions, behaviours, and needs with regard to the divorce are likely to change. A custody arrangement that made sense for a younger child may need adjustment for a preadolescent or adolescent. With their advancing maturity, awakening sexuality, and important steps toward their own adulthood, their parents' divorce is reinterpreted and requires rediscussion and readjustment. Many behavioural and emotional reactions from the separation can be reawakened at times of subsequent loss, at anniversaries, with the child's advancing maturity, and with the need to adjust to new and different family structures.

Being single isn't the end of the world. For some people it's just the beginning. Breaking up isn't the end of the road - it is rather an opportunity for change, for the start of something new.