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During adolescence, attempts are being made at self-definition. Teens test limits and experiment with roles. For some adolescents, the idea of their own death or that of friends or family members becomes a fairly central concern. For others, death is very remote and little awareness or acknowledgement is shown. Responses by high school students to the question "What comes to your mind when you think of death?" ranged from awareness to denial to curiosity to contempt to despair. Universality Death eventually comes to be understood as a natural phenomenon that affects all living organisms. Some adolescents will become obsessed with making contributions by which they will be remembered. Others may show a lot of interest in religion, including cults and 'alternatives'. The acceptance of death's universality seems to result from the increased ability to engage in abstract thought. Remoteness of Death Most teens consider death to be something that happens to old people and so keep death at some distance from their immediate future. As a result, teens may at times seem quite blasé and almost callous upon hearing the news of a death of someone who is not close to them. On the other hand, the death of someone close interrupts the assumed remoteness of death. Understanding and accepting the death of a young person is particularly difficult for young people. Egocentrism Adolescents' initial reaction to the news of a death will often be "What does it mean for me?" This concern is primarily for how the death or reactions to it will make them appear in the eyes of other people. Changes in routine or drawing attention to their grieving, tears, sadness and distress may be met with discomfort as they are concerned about being different from peers. Similarly, they may feel ill-at-ease expressing condolences and may appear off-handed. In the case of a teen with a serious illness, the effects of treatment or progress of disease may be given more importance than the life-threatening nature of the illness. "I'd rather die than lose my hair." Implications: The young person's goals may be affected by the death and the teen's grief. Parental death may affect the career possibilities foreseen by the adolescent. Anxiety about personal death may lead teens to respond with such defenses as denial and attempts to distance themselves from the possibility of death in the near future. Death of an age-mate is a concrete affirmation of the possibility of personal death. One response to such a death is to glorify the deceased. Reactions such as tears make teens stand out from their peers and are to be avoided. Adolescents may vacillate between clear awareness of death and a seeming belief in immortality. Helping Skills Develop self-awareness Check things out: Direct approach - ask teens what they need Indirect approach - watch for reactions to tentative offers. Be particularly careful about physical contact. Invite: grieving people often have difficulty asking for help; they are preoccupied with their mourning, afraid of being a burden or being seen as weak. They may not be aware that talking can help them. Respect and verbalize your energy limits Be clear about the type of help you are offering Listen Provide information Encourage rituals for teen grief Resources: Help for the Hard Times. Earl Hipp. Hazelden Press: 1995 But Won't Granny Need Her Socks? Donald E. Knowles & Nancy Reeves. Kendall/Hunt: 1983 The Dying and the Bereaved Teenager. John D. Morgan, PhD. Ed. The Charles Press: 1990. "When Your Friend's Parent Dies." Julia Moore. Thanatos: Summer, 1992.