Monday, November 9, 2020

Taking A Look At The Stages of Grief

I have loved and lost, and I am so much more than five stages. And so are you. It's not just about knowing the stages. It's not just about the life lost, but also the life lived.  ~ Elisabeth Kübler-Ross  

A reader writes: I'm no expert but I just came across a grief model called "The 7 Stages of Grief" and thought I would just pass it along as a way to understand this process we are going through: 

1. SHOCK & DENIAL
You will probably react to learning of the loss with numbed disbelief. You may deny the reality of the loss at some level, in order to avoid the pain. Shock provides emotional protection from being overwhelmed all at once. This may last for weeks.

2. PAIN & GUILT
As the shock wears off, it is replaced with the suffering of unbelievable pain. Although excruciating and almost unbearable, it is important that you experience the pain fully, and not hide it, avoid it or escape from it with alcohol or drugs.

You may have guilty feelings or remorse over things you did or didn't do with your loved one. Life feels chaotic and scary during this phase.

3. ANGER & BARGAINING
Frustration gives way to anger, and you may lash out and lay unwarranted blame for the death on someone else. Please try to control this, as permanent damage to your relationships may result. This is a time for the release of bottled up emotion.

You may rail against fate, questioning "Why me?" You may also try to bargain in vain with the powers that be for a way out of your despair ("I will never drink again if you just bring him back.")

4. "DEPRESSION", REFLECTION, LONELINESS
Just when your friends may think you should be getting on with your life, a long period of sad reflection will likely overtake you. This is a normal stage of grief, so do not be "talked out of it" by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.

During this time, you finally realize the true magnitude of your loss, and it depresses you. You may isolate yourself on purpose, reflect on things you did with your lost one, and focus on memories of the past. You may sense feelings of emptiness or despair.

5. THE UPWARD TURN
As you start to adjust to life without your dear one, your life becomes a little calmer and more organized. Your physical symptoms lessen, and your "depression" begins to lift slightly.

6. RECONSTRUCTION & WORKING THROUGH
As you become more functional, your mind starts working again, and you will find yourself seeking realistic solutions to problems posed by life without your loved one. You will start to work on practical and financial problems and reconstructing yourself and your life without him or her.

7. ACCEPTANCE & HOPE
During this, the last of the seven stages in this grief model, you learn to accept and deal with the reality of your situation. Acceptance does not necessarily mean instant happiness. Given the pain and turmoil you have experienced, you can never return to the carefree, untroubled YOU that existed before this tragedy. But you will find a way forward.

You will start to look forward and actually plan things for the future. Eventually, you will be able to think about your lost loved one without pain; sadness, yes, but the wrenching pain will be gone. You will once again anticipate some good times to come, and yes, even find joy again in the experience of living.

My response: Although you haven't cited the source of the information you've shared, it is true that many authors have written about the so-called "Stages of Grief." Your article happens to describe seven stages, and by now most of us have heard about the five stages of dying originally described by  Elisabeth Kübler-Ross in her still popular book, On Death and Dying. Unfortunately, since that book was first published (in 1969, more than 50 years ago!) many people have taken her findings far too literally, expecting the dying process to occur in neatly ordered stages, one following the other.

The stages of dying originally described by Elisabeth Kübler-Ross are:

1) Denial and Isolation

2) Anger

3) Depression

4) Bargaining

5) Acceptance

It is important to understand that, as significant as her groundbreaking work in death and dying was, Kübler-Ross's "stages" model was never meant to apply to those who are in mourning. Her studies were focused on patients who were terminally ill and dying. That is a common mistake you will find repeatedly in the literature still today. But there has been a wealth of research done since Kübler-Ross' pioneering work that focuses specifically on bereavement, loss and grief, and those of us working in the field of thanatology (death, dying and bereavement) have been trying for years to de-bunk this particular myth. For example, in a newsletter from Hospice Foundation of America (HFA), Kenneth J. Doka, PhD (Associate Professor of Gerontoloty at the Graduate School of The College of New Rochelle and Senior Consultant to HFA) was quoted as follows:

Dr. Ken Doka succinctly talks about why this matters. "Certainly Stage Models are ingrained within the popular imagination - references to them appear in television shows and movies, and they also remain prevalent in health education...How should one respond to persons, especially supervisors, still tied to older models?" He then goes on to point out that, for anyone who works with those facing the end of life, "It is an ethical mandate to work from the most current knowledge. After all, would a cancer patient wish to be treated by an oncologist steeped in the approaches offered in 1969?" [source: "Message from Amy Tucci," President and CEO, HFA July/August Newsletter Vol. 11. No. 7/8, July/August 2011]

Based on years of experience and extensive research, we now know that grief is the normal response to the death of a loved one, and it doesn't happen in neatly ordered "stages" as such. We also know that it is both normal and healthy for us to move in and out of grief, at times allowing ourselves to “fall apart” and experience all the pain of loss, and at other times enabling us to put our grief aside for a while, so we can engage in activities of daily living and find some temporary respite from the pain.

Most of us who specialize in grief counseling prefer to think of grief as the personal experience of the loss, and mourning as a process (not a single event) that can affect us in every dimension of our lives: physical, emotional, social, spiritual and financial. 

As I have stated elsewhere, everyone's grief journey is unique, and there is no specific time-frame for it. Although grief is different for each individual, finding a way through it successfully requires some knowledge and understanding of the normal grief experience and the work of mourning. That is one reason why members of our online Grief Healing Discussion Groups find our site so helpful, because so many of the posts there are packed with useful information that comes from the hearts and minds of so many different people who have walked this grief journey before us, learned some very valuable lessons, and are willing to share their hard-won experience with those who come after them.

For those interested in reading more about this, see:

The 5 Stages of Grief and Other Lies That Don't Help Anyone by Megan Devine

There Are No “Stages” of Grief by Dr. Terri Daniel

Helping Dispel 5 Common Misconceptions About Grief by Alan Wolfelt

The Truth About Grief: The Myth of Its Five Stages book review by Margarita Tartakovsky

It’s Time to Let the Five Stages of Grief Die by Ada McVean

Renaming the Stages of Grief by Maria Kubitz

That Sticky ‘Stage Theory’ of Grief by Leanne Billiau

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