The Stages of Grief?

[Guest guest]

Many of you who have experienced grave personal loss or worked with suddenly

incapacitated patients will be well acquainted with the so-called " Five

Stages of Grief " which was adapted from Kubler-Ross' " Stages of Receiving

Catastrophic News " , namely Denial, Anger, Bargaining, Depression, Acceptance.

This grief does not simply refer to the death of a loved one, but also loss

due to divorce, loss of a limb, loss of health or loss of some former

capability, so an understanding of the nature of loss and grief is important

to anyone who works with special needs groups or even athletes who have suddenly

dropped from former glory. In other words, one cannot simply be a competent

instructor or therapist by dealing solely with the methods of training, but not

also knowing the mind behind the person with whom you are working.

No doubt you have also noticed that people do not necessarily adapt to

catastrophe in the same " Five Stages " sequence, at the same rate or with the

same predictability. You also may have noted that many people relive the

stress over and over, cycling in and out of the different " stages " of grief

in any order, but never really attaining a prolonged state of full acceptance.

The following website is useful to read in this regard:

<http://www.counselingforloss.com/cllc/article8.htm>

Some extracts from this article run thus:

<We've heard about (the alleged " Five Stages of Grief " ) from professionals in

all areas of the healthcare system (who should know better) as well as from

lay persons of all ages (who shouldn't). There is even a lengthy comedy

routine about it by Hoffman playing Lenny Bruce in the movie Lenny.

The time has now come to ditch it as the concept has done more harm than

good.

Three Common Myths about the 5 Stages:

1. The 5 Stages of Grief were defined by beth Kubler-Ross In her book

" On Death and Dying " , Macmillan Publishing Company, 1969, she presents 5

stages terminally ill persons may go through upon learning of their terminal

illness. She presents them as " an attempt to summarize what we have learned

from our dying patients in terms of coping mechanisms at the time of a

terminal illness " . These stages were not originally the 5 stages of Grief but

better: The 5 Stages of Receiving Catastrophic News. Over the next 28 years,

healthcare professionals, clergy, nurses, doctors, caregivers, students, and

other readers of the book somehow mutated the stages into the 5 stages of

Grief.

2. The 5 Stages define the process a bereaved person must go through in

order to resolve their grief. Grief is a complicated, multi-dimensional,

individual process that can never be generalized in 5 steps. In fact, as will

be shown, a person will generally have to go through the 5 stages before true

grieving can even begin.

3. A person who isn't progressing through the 5 stages in sequence and in a

timely manner needs professional help. This common belief has caused a lot of

problems and misunderstandings. One researcher has shown that some caregivers

have actually gotten angry at the bereaved person for not following the

stages in order! The person shouldn't be angry yet because they haven't been

through.>

The following web page tries to rectify the simplistic five stages by

creating Ten Stages of Grief, thus:

<http://www.aomc.org/HOD2/general/stress-THE-3.html>

1. Shock Release

2. Depression

3. Loneliness and Utter Isolation

4. Physical Symptoms of Distress

5. Panic

6. Guilt Feelings

7. Hostility

8. Inability to Renew Normal Activities

9. Gradual Overcoming of Grief

10. Adjustment to New Realities.

Possibly some of you have developed your own model for understanding and

managing stress or grief. If so, it would be great to hear from you.

Personally what I have found valuable is to allow myself the periodic

'indulgence' of about 15 minutes of experiencing or role playing any of the

aspects of stress or grief, be it denial, anger or depression, during which I

philosophise about the whole grief process, express any emotion that I wish

in private, undergo a catharsis (possibly something like Minelli

shouting in the noisy underground in the film " Cabaret " ) and then return to

the " real " world again.

At other times, I will choose one of several different methods of formal

meditation (be it raj yoga, seated Zen, walking Zen, hatha yoga, pseudo Tai

Chi, music focus, ritual dance or other methods from different philosophies

or religions). At other times, I may use heavy weightlifting, long walks,

swims and other mindless physical activities and recreations to allow my mind

to automatically choose the most appropriate inner program at that time.

Talking with others or even being with a pet can be major stress reducers.

Do any of you have your own 'pet' ways of handling stress, either in yourself

or working with others? If so, do let us hear about them!

Dr Mel C Siff

Denver, USA

mcsiff@...