Moving Through and Understanding Grief
Understanding the experience of grief allows friends, family, and medical/mental health providers to support the unique needs of people suffering from grief and loss.
Dr. Elizabeth Kubler-Ross introduced the most commonly taught model for understanding the psychological reaction to imminent death in her 1969 book, On Death and Dying. In it, she identified the five stages of grief: denial, anger, bargaining, depression, and acceptance (DABDA).
The stages have evolved since their introduction, and they have been very misunderstood over the past three decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, however our grief is as individual as our lives. They are tools to help us frame and identify what we may be feeling and are not stops on some linear timeline in grief. Not everyone goes through all of the stages or in a prescribed order. Our hope is that with these stages comes the knowledge of grief’s terrain, making us better equipped to cope with life and loss.
Denial
Denial refers to the period of grieving during which a person refuses to accept the reality of a situation. Denial is different than not understanding. It is a defense mechanism that helps us protect ourselves from the shock of the upsetting hardship. A period of denial can be normal and even helpful during the grieving process, as we work to process a difficult situation. Examples of denial include:
refusing to accept or acknowledge the information
refusing or avoiding the topic in conversation
questioning the source
Anger
Once a person comes to understand the information they received, and accepts the reality, they often experience anger. Anger can be a natural response directed toward oneself, family members, doctors, a higher power, or even the deceased. Anger is a normal part of the grieving process, though it may seem hurtful or offensive to loved ones. Often, anger is just a manifestation of grief, and can present itself in various ways. For example:
blaming a medical doctor for not preventing an illness
blaming family members for a lack of care or support
feeling anger toward God or a higher spiritual power
feeling angry with oneself or blaming oneself for the death
experiencing a short temper or loss of patience
Bargaining
When we experience grief, we often feel hopeless and overwhelmed. It is common to be overcome by statements of "what if" and "if only", as we experience a loss of control over what is happening. During the bargaining stage of grief, a person attempts to negotiate or make compromises. We try to make agreements with ourselves, or a deal with a higher power, in exchange for feeling less sad or having a different outcome. Bargaining is often irrational. Examples of bargaining include:
"If only I had brought her to the doctor sooner, this would have been cured."
"If only I had been around more, I would have noticed something was wrong."
"God, if you bring him back, I promise I will never lie again."
Depression
Depression is a feeling of sadness and hopelessness that often results with loss. While the earlier stages of grief help to protect us from the emotional pain experienced with loss, often these feelings are inevitable. Symptoms of depression include:
feelings of sadness
loss of interest in activities you normally enjoy
changes in sleep
significant changes in weight
lack of energy
feeling agitated or restless
feeling worthless or guilty
decreased concentration
thoughts of hurting yourself or thoughts of suicide
Feelings of depression are a natural reaction to grief. Following the loss of a loved one, acute grief can impact your functioning for a limited time. Bereavement can lead to prolonged grief disorder if these feelings persist and continue to cause significant impairment and distress in your life for more than a year. Prolonged grief disorder is a diagnosable medical condition and can become disabling if not managed appropriately.
Acceptance
Considered the fifth and last of Kübler-Ross's stages, acceptance refers to the period of grief when we finally come to terms with accepting the reality of our loss. When we have reached this stage of acceptance, we no longer deny or struggle against our grief. During this time, we work to focus our energy on celebrating the life of our loved one, cherish the memories that were shared, and make plans for moving forward.
Rachel Brown, MSW, SWLC
References
https://www.health.harvard.edu/mind-and-mood/5-stages-of-grief-coping-with-the-loss-of-a-loved-one