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

Grief

"Just get on with it."

I don't think so. Grief is as personal as the color of your eyes. Anyone in the throes of grief who hears 'just get on with it' must turn around and away from the person who speaks those words. They don't get it.

Grief visits after many traumatic events, not only the loss of a loved one, for we grieve the loss of many things including our health, jobs, friendships, divorce, and the family home whether taken away by sale or fire or flood. We grieve in stages, carefully described by psychiatrist Elisabeth Kubler-Ross, M.D. (July 8, 1926 – August 24, 2004) in her highly regarded work On Death and Dying. While Dr. Ross outlines five stages of grief, a friend has brought to my attention a different organization that honors the fluidity of grief as written by Dr. Ross, yet expands the concept to seven stages.

In both wonderful explanations for our feelings in a defined order, I find there truly is no timetable; nor is there a simple step-by-step guide. It's more like hopping across scattered stones in a pond because you can go through one stage just to revisit it again and again. Grief is simply total anguish - when we become awash with feelings that seem out of our control. They are out of our control.

There is also something called chronic or complicated grief. A 2008 UCLA study reveals that such grief actually stimulates pleasure centers in the brain - a kind of addiction to the good feelings one had with the person or thing that they lost. This type of grief can last for years. I guess that explains a co-worker I once knew back in 1984. She was talking to me about how much she missed her husband and how her divorce had been so hard on her. Thinking she had recently been divorced, I asked her how long ago it happened. She replied: 18 years. I was shocked at the time and thought poorly of her inability to move on but now I understand. I completely understand.

Another group brought to my attention is the Good Grief Center for Bereavement Support, an excellent resource for peer support, support groups, a library of publications, etc. My friend that relayed this information to me - and prompted me to write this blog post - lost a great friend and her husband within one month. It was just four months ago - four very long months. I suspect she will be in mourning for a good, extended time. As long as she needs. I'll say it again - as long as she needs.

Here's my dirty little secret: I was once hospitalized for four days for grief and grief alone. It was a culmination of several deaths and my declining physical health and I needed support 24/7. I asked for help and I got it. I am not ashamed. So there you have it - my simple musings for today. I sometimes feel like I am treading water when I discuss topics like these but, based on my readers' reactions, I am hitting some positive nerves with such topics and I hope it is not hurting or you will turn away when the topics get tough. We are all in this together. 

My memoir, DYING TO LIVE: Running Backwards through cancer, Lupus and other chronic illness, will be available soon. I am in the final stages of polishing and primping it for publication. I believe I will grieve when it is done; when I am no longer immersed in the written craziness of my childhood and the sickness of my adulthood and find my hands empty.

But following the advice of the excellent resources I've linked to above, I have a new goal, a plan, a dream. I will have something else to do. I hope you do, too.

The Black Hole

No matter how many years have passed, this time of year reminds me of my battle with "The Big C" and how I nearly died without an emergency tracheotomy and brutal chemotherapy. After my surgical biopsy revealed I had Stage IV Hodgkin's Lymphoma, a tumor lodged between my heart and lung and the ensuing days when, coupled with new-found Lupus, I descended into a hell unknown to me. Three years and many treatments and several near death experiences later, I emerged - new and naked. I had to recreate me.

But an amazing thing also happened when I ascended to Heaven for some moments, saw the light, and was able to look down on my own body on its gurney, the rushing doctors and nurses and my terrified husband. Briefly returning to my lifeless body, I told him to say goodbye to my sons and that I loved him. And then off I went to a peaceful, beautiful place until I woke in a trauma unit at another hospital with eyes swollen shut. Of course, when I was able to speak weeks later, I swore it never happened.

Then how would I have recognized the two nurses who tended to me? How did I 'see' my husband throw his trembling body over mine, screaming: "No, no! Amy! My soul mate!" Later, when I could read about such experiences, I learned I had entered a new club, if you will - those who are fortunate enough to visit Heaven and return. I haven't been afraid to die since.

The tears flow freely right now, not only from my memories but also from the tragic events unfolding all around us in this life; the grief, the misery, the sheer torture of it all for so many. And I felt it important that I write this down, perhaps selfishly because I still suffer from bouts of post traumatic stress disorder and to share one of my favorite quotes:

 “I have never met a person whose greatest need was anything other than real, unconditional love. You can find it in a simple act of kindness toward someone who needs help. There is no mistaking love. You feel it in your heart. It is the common fiber of life, the flame that heats our soul, energizes our spirit and supplies passion to our lives.

It is our connection to God and to each other."

Elisabeth Kubler-Ross

On Death and Dying

Let's stay connected, even if just through social media or email.

Let's remember those we miss so terribly. 

Let's wrap the holiday season around us in increments that we can manage, however big or small.

Let's feel our hearts heal and beat with love. 

I'm trying, God, I'm trying. 

Photo taken at Brookgreen Gardens, Murrells Inlet, S.C.