STAGES OF GRIEF/DYING

• http://www.youtube.com/watch?v=Fz917TTgMig

• Elizabeth Kubler-Ross in her book “On Death and Dying” in 1969

• Stages are responses to loss, but there is not typical response to loss as there is no typical loss (David Kessler)

• Tools to help us identify what we may be feeling

• Do not proceed in a liner timeline

• Not everybody goes through them or in a prescribed order

• Don’t last for weeks or months

• They are responses to feelings that can last for minutes to hours

• Often slip in and out of them

Stage 1: Denial

• “No, not me, it cannot be true”

• Person who is dying: may look like disbelief

• Person who is grieving the loss of a loved one: more symbolic than literal

• First reaction: to be paralyzed by shock or numbness

• Reassurance-seeking, doctor-shopping, seeking re-evaluations

• Denial functions as a buffer after unexpected, shocking news

• World seems meaningless and overwhelming

• Helps us to survive the loss, pace our feeling

• Nature’s way of letting in only how much we can handle

• Temporary defense to be replaced by partial acceptance

• As acceptance of reality sets in, healing process begins

• But as we proceed, feelings that we have been trying to deny, begin to surface

STAGE 2. ANGER

• Anger can present itself in many ways – at yourself, lived ones, doctors and the world

• It surfaces once you know that you are going to survive whatever comes

• “Why me?”

• Feelings of sadness, loneliness, panic also appear, but anger is at the forefront

• Unexpected, undeserved and unwanted situation

• Necessary stage of the healing process

• There are other emotions under this anger

• We are used to managing anger and we choose to avoid feelings underneath until we are ready

• It gives temporary structure to the nothingness of loss

• Natural reaction to the unfairness of loss

• Difficult to cope with from the point of view of family and hospital staff

• Anger is displayed in all directions

• Few people place themselves in the same position and hence wonder where it’s coming from

STAGE 3. BARGAINING

• “if only…” or “what if…” statements

• We want life returned to what it was, our loved ones back

• Go back in time, detect the illness earlier or stop the accident from happening

• Associated with guilt

• Finding fault with ourselves and what we could have done differently

• Even bargain with pain, trying to remain the past

• Most bargains are made with God

• Attempt to postpone the inevitable

STAGE 4: DEPRESSION

• Anger, rage, numbness get replaced by a sense of great loss.

• Past loss and impending loss

• Added losses such as financial troubles

• Depression has elements that are helpful in grief

• Slows us down and helps us take stock of the loss

• Helps us rebuild ourselves

STAGE 5: ACCEPTANCE

• Often confused with the notion of being alright or okay

• Accepting the reality that a loved one is gone and this new reality is the permanent reality

• Final healing and adjustment

• Awareness of the common-sense reasons of loss, though we may not understand them

COMPLICATED GRIEF

• Intense longing and yearning for the deceased

• Intrusive thoughts or images of your loved one

• Denial of the death or sense of disbelief

• Imagining that your loved one is alive

• Searching for the person in familiar places

• Avoiding things that remind you of your loved one

• Extreme anger or bitterness over the loss

• Feeling that life is empty or meaningless

THERAPY

• Crisis Intervention

• Bereavement Counselling

• Grief therapy