Saturday, September 7, 2013

How long is long...

It's hard for me to believe that two weeks have passed since my brother died. And I know the five stages of grief as first outlined by Elisabeth Kubler-Ross, M.D. in her book, On Death and Dying, a book that was less a scientific study but more a psychological study. She collected observations from those who were dying and the loved ones surrounding them. The conclusions she drew about "stages" are mere guides; that is, they don't go in order, nor do they proceed graciously. They knock you down and lift you up in no particular order.

For the terminally ill and those hit with traumatic events including the death of a loved one, they are:

Denial — "I feel fine."; "This can't be happening, not to me."
Denial is usually only a temporary defense for the individual. This feeling is generally replaced with heightened awareness of possessions and individuals that will be left behind after death. Denial can be conscious or unconscious refusal to accept facts, information, or the reality of the situation. Denial is a defense mechanism and some people can become locked in this stage.

Anger — "Why me? It's not fair!"; "How can this happen to me?"; '"Who is to blame?"
Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the person is very difficult to care for due to misplaced feelings of rage and envy. Anger can manifest itself in different ways. People can be angry with themselves, or with others, and especially those who are close to them. It is important to remain detached and nonjudgmental when dealing with a person experiencing anger from grief.

Bargaining — "I'll do anything for a few more years."; "I will give my life savings if..."
The third stage involves the hope that the individual can somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle. Psychologically, the individual is saying, "I understand I will die, but if I could just do something to buy more time..." People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.

Depression — "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point?"; "I miss my loved one, why go on?"
During the fourth stage, the dying person begins to understand the certainty of death. Because of this, the individual may become silent, refuse visitors and spend much of the time crying and grieving. This process allows the dying person to disconnect from things of love and affection. It is not recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving that must be processed. Depression could be referred to as the dress rehearsal for the 'aftermath'. It is a kind of acceptance with emotional attachment. It's natural to feel sadness, regret, fear, and uncertainty when going through this stage. Feeling those emotions shows that the person has begun to accept the situation.

Acceptance — "It's going to be okay."; "I can't fight it, I may as well prepare for it."
In this last stage, individuals begin to come to terms with their mortality, or that of a loved one, or other tragic event. This stage varies according to the person's situation. People dying can enter this stage a long time before the people they leave behind, who must pass through their own individual stages of dealing with the grief.

* * *

So, I sit in this jumble of stages bouncing from one to the other. As I said, Kubler-Ross also extended this model to include those struggling with loss or trauma of any kind. The key is to not get stuck.

I saw my psychiatrist yesterday and actually had to fight with him NOT to give me more medicine. He insisted that I was depressed while I insisted I was grieving and sad but not clinically depressed. According to his 'protocol,' the traumatic event of my brother's death REQUIRED him to put me on more anti-depressant and anti-anxiety medications. I refused. I told him I knew where he was and how to get in touch with him and I would ask for help if I needed it.

In fact, although I am clearly grieving, I have never felt stronger in my life! With my brother gone, I have to prepare my shoulders to carry an even bigger load for my own children and future generations. It will take time...a long time. So what?

Finally, I will quote Kubler-Ross once again because, to me, what she says is absolutely beautiful. I hope you think so, too.

“How do these geese know when to fly to the sun? Who tells them the seasons? How do we, humans, know when it is time to move on? As with the migrant birds, so surely with us, there is a voice within, if only we would listen to it, that tells us so certainly when to go forth into the unknown.”
Elisabeth Kubler-Ross 

Photo from Alliance of Hope

1 comment:

  1. How long is's as individual as the way you breathe. You just have to remember to breathe. Anyone that knows you or has read your book knows that you have been carrying a big load for almost as long as you can remember. You are strong, stronger than you give yourself credit for sometimes. You will carry on just like you always have with memories of the advise, wisdom and 'twisted' humor that was your big brother. You have a huge support system of friends and family that love you and are always here for you. Lean on us until...long is long enough.


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