The Stages Of Grief
The Stages Of Grief
David Kessler (Director of Palliative Care, Citrus Valley Health Partners and Hospice) gives expert video advice on: What are the most common symptoms of grief?; What is the 'bargaining' stage of grief?; What is the 'acceptance' stage of grief? and more...
What are the most common symptoms of grief?
The most common symptoms of grief are a deep sadness, there can be an incredible loneliness, and many times there is anger. You may also have physical symptoms. You can mimic the symptoms that your loved one had. You may also have a deeper sense of being lost than you've ever had. People often talk about how they can't find a place to sit, or they don't know what to do with themselves. These are normal feelings that happen in grief.
What are the 'five stages of grief' described by Elisabeth Kubler-Ross?
The five stages of grief described by my co-author, Elisabeth Kubler-Ross, are: denial, anger, bargaining, depression, and acceptance. She first identified them in 1969, in her book, "On Death and Dying", and the stages have now become as legendary as she is. They are very well-known, and commonly used by many people to identify milestones that we go through in grief. But, as she always said, those stages are as individual as we are. We're all going to go through them in different ways. They don't have to be linear. You don't have to have one month for each stage. Some people may spend more time in anger and less time in depression. They are very different, and we always say that one of the biggest misconceptions is that we have to follow the stages, when the truth is that the stages reflect where we are. So just do your grieving, and you may notice from time to time: "oh, I'm in that stage", but just know that it's not a prescribed formula that you have to do. It just helps you normalize where you may be. And you may go through the stages more than once.
What is the 'denial' stage of grief?
The denial stage of grief is usually the first stage that happens after a loss. It is when you're in shock and you go numb. Your body has more feelings to process than it could possibly do in a short amount of time. Too much information about that loss is coming in. What happens is we process it little by little. Someone who's in denial is going to be making statements: "I can't believe they're dead", "This can't be true", "This couldn't have happened". The other way denial sometimes looks is, as grief goes on, it looks a bit like distraction. All of a sudden, from talking about the loved one dying, you're suddenly talking about an interesting place that you visited, or a current event. Other people might not understand how they are going to a movie, or how they are doing this when this loss has occurred. Denial is an escape from the pain. So, that movie is a distraction from the pain. That talking about a current event is a distraction from the pain, because the pain is too enormous to sit with constantly.
What is the 'anger' stage of grief?
The anger stage of grief is the stage we feel usually after we're beginning to move out of the denial and the shock phase. We are hit with enormous amounts of anger. Why did my loved one die? Why did they have to be taken away? It's not unusual to just be surprised at the amount of anger you may feel. Just know anger is our strongest emotion. It covers up all our pain, all our fears, all our sadness underneath. We often want to strike out. We always talk about if you need to get the anger out, get it out using things not people. Don't get angry at people if you can, but yell in the car or bang on your pillow, externalize that anger and just know it's an appropriate response. There are people who are sometimes going to go "calm down" and it's many times because the anger makes them uncomfortable. Sometimes we may even find the anger is with God, and its okay to be angry with God. God is big enough to handle your anger, and an all-loving god knows that anger is appropriate when someone you love has died.
What is the 'bargaining' stage of grief?
The bargaining stage of grief looks different after death. Before death, the bargaining stage is where you try to do some deal making, “Please, I'll become a better person if my loved one can just live five years longer”. After death, it's really going back and examining the “what if's”. What if we had gone to the doctor sooner? What if this had been caught in a different way? What if we had lived a healthier lifestyle? Would my loved one have not died? It's all that review of the death we do. It's also sometimes the deal making that we may do just around simple acts like “I'm going to go to bed tonight, and I hope when I wake up I realize this has all been a bad dream, and that my loved one hasn't died”. It is a lot of trying to bargain for them to come back.
What is the 'depression' stage of grief?
After a loved one dies, we become depressed. And, that's the depression stage of grief. Many times people want to do something about that stage. And I think it's important to remember depression is a natural response to losing a loved one. Many times I will hear the saddest story in the world of someone who has lost their husband and children in a terrible car accident and someone will go, "We've got to do something about their depression". And, I think, I'm depressed just hearing that story; of course, they're deeply depressed. So, know that depression is very normal, very expected, does not need, necessarily, to be medicated. Certainly, there are times that the depression is bottomless. And, if you feel like the depression is more than you can handle seek out professional advice from a physician or psychiatrist who can help you evaluate your depression. But just know, we all get depressed, especially after a loved one dies.
What is the 'acceptance' stage of grief?
The acceptance stage of grief is the stage that we will often go through after we have experienced many of the other stages and people have a lot of misconceptions about acceptance. Acceptance is really acknowledging the loss as a reality. People will think sometimes to find acceptance they have to be ok with the loss happening, or they have to like it. We're never going to like a loved one dying, we're never going to be ok with a loved one's death. So just know that acceptance is really about the fact that a loved one has died and you accept that reality, as hard as that may be, you do acknowledge it as permanent and real.
What is the sixth or 'meaning' stage of grief?
I have identified a possible sixth stage and I believe that this sixth stage is the stage of meaning. Many people, many years after a loss will find meaning in that loss. I caution people that meaning is not something you find at the funeral, and meaning is not something you find in the first year or first week or first month. Sometimes when you look at a loss later you see how that arc of the loss that was left behind by your loved one has helped you to create other things or become a different person, or maybe helped you find great meaning to go on and do other things in your life. People often think when they hear about meaning that it means it was okay and it was worth it. It's never going to be worth it even if you go on to do, as many people have, meaningful nonprofits to help those in grief or mothers against drunk driving after someone lost their child through a drunk driver. You may find great meaning but it doesn't mean complete understanding, and it doesn't mean it's worth the cause. It just means you find a deeper understanding in the years to come.