The Process of Grief–Part 2

As I mentioned in my previous blog, in the realm of counseling, there is a commonly understood process of grief. Elizabeth Kubler-Ross was a woman who spent much time researching those in hospice care who were in the process of dying, so that she could learn how we as humans approach death. She identified 5 stages of dying which described those with terminal illness, who know about their impending deaths, and how they integrate that knowledge in their last days. These stages have also been applied to those who are grieving a loss—with understanding the differences from those experiencing death. It is worth reviewing these stages to gain some recognition that grief is a process—not one point in time but a process of accepting a change you do not want to embrace.

Generally speaking, these stages are similar with all kinds of losses. With sudden loss, however, there may be unique tweaking to these stages. Sudden loss brings with it the potential for anxiety and trauma at a more powerful level than an expected loss. Sudden loss enhances the feelings of perceived loss of control. I will discuss that in more detail later.

The stage of DENIAL is the first stage. When you are confronted with something you do not want, your first response is to ‘push-back’. Think about it. If you are told something negative about someone you know and trust, your first response is likely to be something like: “Oh no, not him. He’s a committed Christian and a good person!” That’s a push-back response. The most common push-back to death is to deny the diagnosis, deny the loss, deny that your world has the potential to completely change at a moment’s notice. We are creatures who like stability, homeostasis, and predictability. When someone gets a diagnosis of terminal cancer, for example, those who love that person can insist on a second opinion in order to eliminate any doubt. Of course, that is a reasonable request, but often this demand for another opinion is a push-back against the unsavory truth. There can be a lot of ‘drama’ from family around these situations, because no one wants to hear a diagnosis of terminal cancer. Finding the ‘right’ hospital, the ‘right’ doctor, the ‘right’ treatment, etc.—these can be ways of denying the diagnosis and ultimate fate of the one you are losing. (I am not suggesting that it is unreasonable to consider alternative treatments; rather I am saying that often the pursuit of the ‘miraculous treatment’ is a push-back response.)

Another aspect to consider about denial is timing. That is, you can act like you have accepted something, from an intellectual stance, but emotionally be in denial about the immense loss and how it impacts you, until after the death, after the funeral, at the point when life is supposed to get ‘back to normal’. Often, loved ones manage through a funeral and all the preparations in a ‘zombie’ state, distanced from emotions. It is often after the ceremony that the emotional denial lets go, and you ‘fall apart’ as the reality of the loss, and all its implications, hits you.

The next stage is ANGER. Anger is a powerful emotion, and at times, a very useful one. When dealing with a situation you don’t want, anger is a terrifically useful push-back. When you discover you really do not have control over the loss of someone—either through illness or sudden tragedy—the emotion of anger can give you a sense of power. This powerful feeling helps you stand up against the perceived loss of control. Very often when a family loses a loved one to cancer or some health issue, the family will try to bring suit against the doctor, the hospital, people who are perceived as responsible for the death. Many challenge even God in anger. His love gets called into question for many when faced with a loss. And He is gracious enough to know that sometimes you will stomp your ‘spiritual foot’ and complain while in this process of grief. Anger can also be funneled into a useful benefit: MADD (Mothers Against Drunk Driving) was formed by Marie Tursi when her 20 year old son was killed by a drunk driver. She became ‘outraged’ when she learned the drunk driver who killed her son received a sentence of 4 years of probation and a nominal fine for reckless driving. The anger she had was the impetus to this successful national program which supports and advocates for families of those killed by drunk drivers.

The next stage is BARTERING. This stage makes a lot of sense when applied to the one who is dying from terminal cancer, but can also be applied to those loved ones who are losing someone. Bartering describes a tentative acceptance of death, but also a last hope against hope for a different outcome. At this stage, people often ask God for a miracle. As Christians we know that God is capable of miracles. I am aware of a recent miracle in which someone’s tumor, which was clearly evident from scans, was not there when the doctors opened him up—a miracle indeed! In the bartering stage, you look for this miracle to avoid embracing the diagnostic truth. You often hear people promising God things at this point, like a total life-change for God—becoming a missionary, doing something specific and huge for God, etc. Bartering suggests that the one experiencing loss is beginning to recognize he does not have control, and yet still might have enough control to tip God’s plan in another direction.

The stage of DEPRESSION is all about giving up any pretense of having control. This can feel incredibly defeating to both the one dying and those around him. You can feel very deflated if you give up the push-back and realize you cannot change what is happening. In your emotional and even spiritual frailty, you can swing to the opposite end when letting go of control, to a place of despair and defeat. Most of us live with the ‘delusion’ that we have a lot of control over our lives. Certainly you have volition and the ability to make choices; but the majority of factors in your life are way beyond your control. You can work to be healthy by eating right, exercising, and taking care of yourself, but you cannot make a cancerous tumor go away no matter how many miles you run. For many, this confrontation with limitation of control can reach a crisis level.

When you come to the end of yourself and your false sense of control, then you are ready to receive God’s strength in facing whatever you must face. Now you are in the stage of ACCEPTANCE. Acceptance comes with feeling ‘okay’ with what you cannot control. Facing death, or the loss of a loved one, is not easy—grief is normal in these circumstances. But once you accept what you cannot change, you can engage in ‘real time’ with the love you have with family and friends in the time you have left together. In a way, it can even feel more intensely sad, yet rich in love at the same time.

It is important to know that these stages are predictable, but how they express themselves in your experience is unique to you, your family, and your situation. Grieving takes time. Even within your own family, people grieve differently, and it is important to allow differences in how you grieve. Our culture presents some taboos about grief, which are gender specific—men are not ‘supposed’ to cry, so men feel compelled to suck it up and ‘be strong’. In other cultures, crying and great displays of angst are the protocol, which in my opinion, allows a healthier response to the loss of a loved one. What is important is to allow for each other in this difficult process, and give permission for the differences in expression of grief, and at the same time, receive support from each other.

In my next blog about grief, I will address sudden loss and the trauma around it, and rituals you can develop to help process grief.