How We Got from Dying to Grief- in Five Stages

July 16, 2021

Nothing in my life ever prepared me for dealing with grief and loss. I just told you a non-truth. Everything that I had ever learned about my broken heart had prepared me for dealing with grief. The problem here is that the information I had learned was either incorrect or not useful.

Like the time I was kindergarten and I was bullied at school while in the restroom. An older girl slapped me across the face because she did not like the color of my skin. When I returned to the classroom my teacher announced to the entire class of five year-olds that we must all take a buddy with us when going to the restroom.

Never once did she address my broken heart. The pain on my face or the loss of trust that I was now left to deal with. As I tell this story I am reminded of the fact that I did have a buddy with me. But, she was also five years-old

Or the time when I was fourteen years old, and at 3:00 am the house phone rang uncontrollably. I ran into the kitchen to answer it. My uncle was on the other end and he asked my parents to come down to the hospital because my aunt was very ill. It was about three days after this call that my aunt passed away from a brain aneurysm. Bless my parents’ hearts; they did an incredible job of staying with my uncle for the next few days and helping him with all the arrangements.

I remember being so scared, but they did not come home and talk about death; what grief would feel like; what it means when someone dies. We just never spoke about it. I don’t blame them. They probably had no idea how to deal with it themselves.

Then there was the time I was eighteen years old and broke up with my first boyfriend. The love of my life. The man I knew I would marry and live the rest of my life with. My father told me not to feel bad; there are plenty of fish in the sea. You will fall in love many times before you end up with the man you will settle with. And so I was left alone to figure out my broken heart for myself. I cried myself to sleep every night for the next year.

When I was nineteen years old and in college, I learned about the “five stages of grief” in one of my classes. They are as follows:

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

These were the tools I drew upon when my next life-altering event occurred. That is one day that I will never forget. June 17, 2006; the day I got the call that my nephew Austin Tyler had drowned. He was with my family at the lake for the Father’s Day weekend.

In my very naive understanding about grief and loss, I truly though that only my sister Erica would grieve, and that I would be her support system. I was to be strong for her; the same thing that I had seen my parents do years earlier when my aunt died.

It was soon after his death that we realized that we had both learned the “stages of grief.”

I would call her every day to check up on her. The conversation would always go the same way. After listening to her repeat the story of how she found about Austin’s death, the conversation would come around to what stage of grief she was in.

One day she said to me, “Today I think that I am in anger.”

“Who are you angry with? Your husband?”

“No, I could never be mad at him. Maybe I am just mad that Austin is gone?”

 

I remember her saying, one day, that she thought she was in denial. “Denial?” I asked, “You know that he died, right? You do remember that we had a funeral?” “Yes,” she said. “I remember. But maybe I just can’t believe that this happened to me.”

We could never get the “stages” to fit. We had so many questions.

 

When do you enter the stages?

Does everyone enter each stage?

How long do the stages last?

Do you enter the stages in order?

Does everyone go through the stages?

 

It was about 8 months after Austin’s death that I was introduced to the Grief Recovery Program. On the very first day, Erica and I learned that there were no stages to grief. She and I both looked at each other. I do believe that if you were there, you would have heard our huge sighs of relief.

After taking the Grief Recovery Program and finally getting some closure on my relationship with Austin, I knew without a doubt that I had to help grieving people everywhere. I trained with the Grief Recovery Institute and became a Grief Recovery Specialist. I started working with grieving people eleven years ago.

It was through my personal journey that I started investigating the “stages of grief” for myself.

I learned that the stages were a powerful creation by Elizabeth Kubler-Ross, a psychiatrist. Dr. Kubler-Ross wrote a book titled On Death and Dying in 1969. It was only in the early 1970s that the stages of dying changed to be associated with stages of grief, which was mostly because the book was used for college-level courses.

Dr. Kubler-Ross interviewed over 200 hospice patients along with her intern staff. Upon the completion of the interviews she and the interns would meet to discuss the patients. To help her understand where each of the patients might be, she created a list of stages. She and the interns would place the clients under the stage that they best believed they best fit into.

Dr. Kubler-Ross used stage theory openly. She also warned that some stages may overlap, occur together, or be missed all together. She also has been known to state that the stages were not linear.

 

I personally believe that there is a lot to be learned from the subtitle that’s right on the cover of her book: What the dying must teach doctors, nurses, clergy and their families.

#1 On Death and Dying was never a study of grief and bereavement.

Even though grief was a part of the experience, it was never the totality of the experience.

#2 The “stage theory” described by Kubler-Ross warned that many of the stages overlapped, occurred together, and some were missed out altogether.

# 3 On Death and Dying is a discussion by a psychiatrist with over 200 dying patients and their psychiatrists.

 

My personal experience with the stages took place in 2014 when my father died. He was diagnosed with prostate cancer and fought for his life until the winter of 2013, when the doctors let us know that he had just over a year to live, and he had to be placed on palliative care. I believe that I truly saw him live through the five stages.

There were days when we would walk into the house and he was angry at every one; very snappy and biting everyone’s head off.

Depression: days where he was sad, not talking much, just starting off into space.

Bargaining: with my sister, allowing her to try every diet she could come up with to cure him.

Acceptance: there was the day we were talking about my daughter’s wedding and her plans. He was telling me what he was going to wear and then, in the lowest voice, he said, “Don’t wait for me.” I wasn’t sure that I heard him properly. We just sat together in silence. He died two months later.

I must admit that knowing the stages were helpful to me during this process. It was also helpful for me to have had some amazing conversations with him about death, dying, and our life together.

 

 

Here are some truths that I have learned about grief through my Grief Recovery Program:

  1. Grief is a normal and natural reaction to a loss of any kind.
  2. Grief is the conflicting feeling caused by the end of or a change in a familiar pattern of behavior.
  3. Grief is individual and unique.
  4. There are over 13.5 million grievers a year.
  5. There are over 43 known kinds of losses that can cause a grieving experience. Death and divorce are just the most popular, and that’s what we all talk about.

The following are some of the causes of grief:

Adult:

  • Retirement
  • Change in health
  • Loss of a pet
  • Financial changes
  • End of an addiction
  • Finishing school

Teen/Children

  • Losing a pet
  • Moving (leaving friends or a childhood home)
  • Changing schools
  • Bullying
  • Death of a pet

Here are some intangible examples of grief:

  • Loss of trust
  • Loss of safety
  • Loss of control
  • Loss of faith

Typically, these intangible grieving experiences are felt along with other losses in our hearts.

I want to give you an alternative to the five stages that we are still stuck on. There are some typical responses associated with grief:

  1. Reduced concentration
  2. A sense of numbness
  3. Roller-coaster of emotions
  4. Change in eating habits
  5. Disruptive sleep patterns

Grief is loss. Grief is the emotional incompleteness that takes places here (point to heart). Grief does not happen here (point to head).

85% of what we hear immediately following a grieving experience is not helpful:

  • Don’t feel bad (often interpreted as: just don’t feel anything)
  • Time will heal your wounds. Just give it time. (How much time? 10, 20, 30 years?)
  • Grieve alone
  • Be strong
  • Keep busy (the sister of “be strong”)
  • Replace the loss

As a society we truly believe in these myths. We not only believe them, we say them to grievers in an attempt to help them with the pain in their hearts.

  1. Loss is cumulative, and it is cumulatively negative. It builds up in our heart.
  2. Grievers need to be heard and listened to with respect.
  • Don’t try to fix the griever
  • The number one thing you can do for them is listen
  • If you can imagine a heart with two big ears hanging off the end, that is what we all need to be to the griever.
  1. Grievers need to talk. They need you to listen. They need to know that you have heard them respectfully.

 

So now that we have got this great awareness, let’s talk about grief and recovery. I want you all to consider this: recovery from a broken heart is possible.

  1. We must first do a complete inventory of all the losses that are in our heart.
  2. Acceptance and awareness are key tools. Before now many of you have thought that grief was only for death. Or maybe many of you believed in the five stages of grief and loss.
  3. Talk with safe people. People that will listen to you without judgement or the need to fix you. Talking will help you process what you are feeling.
  4. Grievers are not broken. They do not need to be fixed.

 

Breaking-through the idea of five neat and clean stages of the grieving process will take time. In April of 2018, my sister was in her nurse-practitioner class and she sent me a text message saying, “Look at what I am learning.” (slide here)

We have to do better as a society and as medical professionals when it comes to dealing with grief and loss.

As of 2017, the annual number of United States deaths almost reached three million. For each one of these deaths the National Institutes of Health (2009) reported that four to five grievers remained to cope with and mourn the loss. Due the essential provision of services required to recover from the experience, grief has become a public issue that has necessitated a population-wide approach.

We have to change the way we look at grief in our life. Now that we are aware that we will all experience some sort of loss in our hearts over our lifetimes, is it possible to do a better job of dealing with the pain?

I want to leave you with the thought that we can each start to bring this change in our lives; right now; from today after we leave this area or are done listening to this talk. This change needs to start with our children while we wait for the medical community to catch up.

 

  • Please raise your hands, and keep them up, if you have children.
  • Raise your hands, and keep them up, if you are a grandparent.
  • Please raise your hands, and keep them up, if you are an aunt or uncle.
  • Please raise your hands if there are children in your neighborhood.
  • Please raise your hands if you know that children exist.

 

Okay, that is all of us. Thank you. Take a look around. We can start the change with what we are teaching our children about grief.

This change will be an amazing gift for your child. When talking to your child about loss or a grieving experience here are some simple tips:

  • Do remember that grief is emotional, not intellectual, and that it will take place in our hearts.
  • Always tell the truth.
  • Do go first when talking to your children about loss.
  • Do use the words death or dying.
  • Be honest.
  • Use emotional words when talking to your children.
  • Do remember that every child is unique and will have their own personal relationship with their own grief and loss.
  • Be patient.

I am going to make this even more simple for you. Here is list of six simple words that we should always be using when talking to our children about this:

  1. Mad
  2. Sad
  3. Glad
  4. Angry
  5. Afraid
  6. Embarrassed

“I was thinking about Grandma today and I got very sad”.

  • Don’t say – Don’t feel scared.
  • Don’t say – Don’t feel sad.
  • Don’t – Ask your child how they are feeling.
  • Don’t – Compare them to other children.
  • Don’t – make promises you cannot keep. For instance, “I promise I will never leave you.”
  • Don’t – forget that your children are smart and watching you.

Remember that they are watching everything that you are doing. Do cry in front of them. We have a responsibility to show our children how to grieve.

They will also need a safe place to talk about the pain that is in their hearts. You are their safe place and their heart with ears.

I want to take you back to the beginning of my talk with you. What if, way back, when I was five years old and in kindergarten, I was bullied in the bathroom when a mean girl slapped me across the face because she did not like the color of my skin.

Let’s imagine that I went to my teacher crying in pain, and she stopped what she was doing to give me a hug. What if she got all my friends in the classroom to come and listen to what had just happened to me?

What if she sat us all down in a circle and where we could all talk about fear, pain, and our broken hearts?

What if we used this grieving experience to talk, teach, and learn?

Thank you.

 

 

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