The Drowning Support Group (Working Together to Support Families)
By Petra den Hartog
Red Nose Grief and Loss counsellor
Paper presented at the Seventh SIDS International Conference,
SIDS and Kids Victoria has a strong commitment to ‘self help’ and ensures that services and programs are developed in response to the emerging needs and interests expressed by families, and that families are involved in their implementation. This keeps the services and programs fresh and responsive … The relationship between professionals and parent supporters is based on mutual respect for different experiences, skills and knowledge. Experience has shown us that this model is based on the premise that bereavement support (including groups) work better when there is a balanced involvement of trained parent supporters with professional staff.
In 1997 SIDS and Kids Victoria extended its services to families of all children six years or under who had died suddenly and unexpectedly. Causes of death include drowning, motor vehicle accidents, fire, fast onset illness, homicide, perinatal death as well as SIDS. This paper will discuss the experience of two social workers who facilitated a support group for parents whose children had drowned. It argues that the homogeneity of the group as well as the working together of professionals and trained parents in the co-facilitation of the group contributed to its success – a successful ‘marriage’.
The working together of counsellors and specially trained parents (called parent supporters) to run support groups is a key component of the groups held at SIDS and Kids. Many parents feel the need to meet with other parents who have experienced a similar bereavement and wish to be guided and supported by them, especially after the first six months or so. Individual counselling and support by professional social workers continues to be available on a needs basis.
The biggest causes of death in children over one year are drowning and motor vehicle accidents. Between 1996 and 1999 twenty-five families of children who drowned were referred to us. In the year of 2000 alone the figure was eleven. One of the counsellors, who had been supporting many of these families, suggested the setting up of a drowning support group (hereafter called the DSG) hoping to further facilitate the healing process for these bereaved parents. Families indicated strong interest so all parents whose child had drowned in that summer and earlier years were invited to attend. Sixteen parents indicated interest and although quite a large number, this allowed for natural attrition in numbers.
Although the agency had provided other forums for bereaved parents to meet as a support group, this group was the first more structured bereavement support group since the agency had extended its service to families whose children had died unexpectedly from causes other than SIDS. This group also separated SIDS from non-SIDS families. A support group is more likely to be successful when group members are relatively homogenous as people bereaved in similar ways have a ‘subject focus’ and a common identity.
Robyn Bradey in her paper ‘Loss in the Backyard Pool: The Great Australian Leveller’ (1989:35-36) outlines four specific issues related to this type of death of children:
- It’s unnatural, causing the initial reactions of shock from disbelief and disorientation
- It’s unexpected, so that parents have no time for preparatory grief or to say goodbye
- It’s unnecessary, being potentially preventable, ‘leading to overtones of guilt and recrimination’, and
- It’s unacceptable, leading to feelings of shame compounded by the possibility of a coronial inquiry.
In any death anger can be a huge issue but in drowning the anger is usually more specific – anger at the partner, self, caregiver, relative or friend who had responsibility of the child. It ‘compounds the normal anger associated with the loss and can be quite devastating’ (Bradey, op cit: 1989:39). The likelihood of marital breakdown then is more likely when a partner is held responsible and recrimination results. Accusations need to be brought out in the open, confronted and worked through. Likewise ‘guilt cannot simply be dismissed or excused. It becomes an issue of forgiveness’ – of others and themselves (ibid). The level of anger and guilt makes the death of a child all the more difficult to come to terms with, to learn to live with.
The DSG was co-facilitated by two trained counsellors. The group gave them the opportunity to increase their knowledge and understanding of the parents’ needs. The counsellors were supported by a couple who had been bereaved three years earlier. They were seen as ‘role models’ and a symbol of hope for other parents. At the same time as these parents were assisting the other parents they were continuing to heal themselves. This process is based on the ‘wounded helper’ principle.
The role of the counsellors was to:
- Establish the need for a particular group
- Organise parent supporter involvement
- Provide support, advice and backup to the parent supporters
- Facilitate group discussion
- Provide information, written material, findings from research, insights and suggestions
- Support and emphasise positive changes and comments and de-emphasise less positive comments
- Remind parents of the date and time of each group, start each group (get the ball rolling), end the group on time and ensure that all participants had an equal say. Having two counsellors made it possible for one to leave the group with an upset parent if required.
The role of the parent supporters was to:
- Tell their story
- Describe the problems and issues they encountered
- Demonstrate that you can survive such a loss and re-establish a quality of life
- Outline the strategies that were helpful to them.
The DSG was loosely structured, closed-ended and issues for discussion were brought up by both the counsellors and parents. Topics discussed during the five sessions held included -
- Blame, anger, shame and guilt
- Coping strategies, especially on how to handle the pain
- The time their child was resuscitated, put on life support and then having to turn it off – their child ‘dying twice’
- Visiting the cemetery and memorialising the memory of their child
- Learning how to remain living in the house where the child died
- How time and another child helped the healing
- The coronial process and autopsy
- Spiritual and religious views, rituals, personal and spiritual growth
- The effect of the death on the parent’s relationships and on their children
- The effect of the death on other people and how to cope with other people’s reactions
- The experiences of the person supervising the child, anger and guilt, forgiveness, and
- The danger of drowning / pool safety issues, the need for improved legislation.
At the first session, each parent was asked to introduce themselves and, if able, to explain the circumstances of their child’s death and show the group a photo of their child. During this and other sessions opportunity was given to participants to describe their child and the happy life they had made possible. The parents expressed strong feelings, related to the preventable nature of drowning. They showed enormous respect for the feelings of others in the group, providing mutual support and acceptance. No one was made to feel shame or guilt. They showed understanding when some individuals felt like a murderer when they had to make the decision to turn the life support off. Many feelings were normalised. This helped to create an atmosphere of forgiveness – accidents do happen, they had done their best, and their child was much loved and would not condemn them. These are all components of a successful self-help group. Counsellors were often about to empathise or respond positively to a parent when other parents jumped in and made this unnecessary.
At the beginning of each of the next four monthly sessions participants were asked how they were feeling at the end of the previous session and what issues had come up since the last meeting. This helped ‘break the ice’ at the beginning of the meeting. No time limits were imposed on any issue being discussed; any topic could be brought up. In the second and subsequent sessions the parent supporters (a couple) shared with the other parents how they had survived after their child drowned. Their insights and practical suggestions were invaluable. At the end of each session each participant was asked if there were any issues they needed to talk about before they left, so that they didn’t leave feeling devastated. There was time at the end of each group for individual chats with other participants or a counsellor or to borrow books.
An extraordinarily successful feature of groups is actually the power of the group compared to a one on one dynamic. Several parents said how reassuring it was to see others going through what they were going through and felt a real bond with others in the group. At one meeting three of the mothers sat holding each other’s hands, another way of being supported when affected by negative emotions. They realised they were not ‘going crazy’ – they were reacting normally to an abnormal event. The workers were skilled, listened and offered positives. Knowing the participants individually meant comments could be ‘tailor made’.
Most participants said that the group was supportive and they could ‘connect positively’ with most members of the group, developing new friendships. At least half the participants made contact with others outside of the group and gave each other support in the period between meetings. This reduced the sense of isolation many felt, providing a sense of community and fellowship, an unquestioning acceptance by others who understood and didn’t judge. Having ‘their own group’ provided them with an identity and gave validation to them as people and what they had achieved, which in turn promoted an increase in self-esteem.
Focussing on blame can be destructive and result in parents not grieving for their child and not being able to ‘move on’ and learn to accept the death. Parents in the group blamed themselves or others for the drowning. The counsellors had been concerned about how participants who blamed themselves would react when confronted by the anger of others who blamed someone else. This problem did not arise as each participant was treated with respect and understanding. One parent who blamed the relatives who had been caring for her son at the time he drowned, started to consider for the first time what it was like for them. Listening to other parents whose child had drowned in their care enabled this woman to begin to consider forgiveness of the relatives concerned and understand how easily accidents do happen. Other parents provided valuable mutual support to enable her to do this. One of the parent supporters spoke of how she had made a decision not to blame her partner and how this had encouraged him to begin to forgive himself. This was very powerful. All participants could see how this enabled them to have a stronger relationship, allowed them to help each other and have more energy for healing and personal growth. Two other parents were still extremely angry and several participants could see how destructive going down the path of recrimination, bitterness and even legal action could be – it can ‘pull you down and you stay (stuck) at that level’ – and were able to check their behaviour.
Several participants expressed the view that the group provided the opportunity to talk about their child and keep alive their memory as well as to talk about their feelings of great loss. This is especially important as they had few opportunities outside the group to still talk about their child and their suffering after the first few months (even weeks!) after the death. The group was also an opportunity for parents to connect with their loved one, to not forget him / her, to maintain ‘continuing bonds’. Attending the group was a way of honouring their child’s life. As one parent put it, he had to make sure he wasn’t ‘disregarding his child’. One parent said that the process of connecting with her child (by talking about him) made her feel much better despite the pain.
The group was also ‘a safe place’ – ‘a lifeline’ – in which they ‘could let out all of their emotions’ – it had ‘medicinal value’ and ‘took the lid off their anger’. The group allowed participants to ‘get in touch with their emotions’ rather than continuing to be distracted by other commitments or distracting themselves, ‘coasting along’ and not dealing with them. ‘Naming’ the anger was a first step for dealing with it for some participants. However, several mentioned how painful this process was, resulting in one father deciding not to attend any more sessions, and how they felt drained afterwards, unable to ‘switch off the memories’.
Although it was hard to feel another’s pain as they struggled through similar experiences, seeing how others dealt with them provided other coping strategies that were not available to them at home or within their own circle of friends and relatives. This gave them a greater sense of control. Comparison with others promoted reflection – ‘Where was I at that stage? What could I have done or what can I do differently? Why am I different? How different am I? How different is my spouse handling things? Why is he or she handling things differently to me? What do I still need to confront?’
For some, participation in the group gave hope – that there was light at the end of the tunnel, they could get to the stage of learning to live with it, accept what happened. To discover that not only can you survive – have certain inner resources – but that you have the resources to help others, that you have ‘travelled a long way’, also promoted the development of courage and enhanced self-confidence. Two participants gained enough confidence to begin to lobby Government for improvements in safety signs and legislation; several aimed to train as parent supporters, others to participate in the coronial process and inquiry. At SIDS and Kids Victoria there are many avenues for reciprocity and involvement, based on the ‘wounded healer’ principle.
Several participants described the personal and spiritual growth they had undergone since their child died e.g. changing values (being less materialistic), changing jobs and career (wanting to help others), being more involved in their church and community, becoming more spiritual in perspective. This provided some meaning to the loss and made it more bearable - their child was and is important, their death had an enormous impact on their life and they owed it to their child to ensure their life was not in vain. Bringing back the memories, the grief, was also seen as a way of reminding themselves of the important things in life.
One of the parents said the group provided ‘mutual support’, was ‘warm, comfortable and welcoming’, ‘an addictive fix – good for the soul and a bandaid for the heart …’, and she ‘could not wait to meet again’. Six of the sixteen participants (including parent supporters) are still meeting informally as a group having decided formal meetings were no longer required. This decision is respected and encouraged.
Last reviewed: 17/1/19
- den Hartog, P. The Drowning Support Group: Working Together to Support Families. Unpublished paper presented at the SIDS International Conference (7th: 2002: Florence, Italy).