Grief

I was honoured to be chaplain for the new Palliative Care Unit as it started at the Riverside Hospital in the late 70s and early 80s.  My mandate was to work closely with patients, their family members, hospital staff and volunteers.

Kubler Ross with her groundbreaking work described in the 1969 book ‘On Death and Dying’ brought us the Stages of Grief –
            Denial – This isn’t happening to me.
            Anger – Why is this happening to me? It’s not fair.
            Bargaining – I promise I’ll be a better person if only I live to see my children      graduate.
            Depression – I don’t care anymore. I’m so sad.  Why bother.
            Acceptance – I’m ready for whatever comes.  It’s going to be okay.

And yes, we as humans do indeed go through this roller coaster of emotions.  Not long after her book was released others were identifying other emotions:  numbness, disorganization, reorganization …  and the lists grew.  

Studies as recent as the 2007 one from Yale on the validity of this progression of stages are finding inconsistent results:  for some people it seems to hold true and not for others.

Over those years in Palliative Care, I had an up close look as some patients and their family members went from denial to bargaining to depression to anger to denial to ???  This was very confusing to a newcomer especially as I had been expecting them to do it ‘by the book’.  A patient could one moment be planning his memorial service, the next begging god for a little more time and then throwing things in anger. And I was seeing the same confusion of order in doctors, staff and volunteers.  

I even noticed folk who seemed to go through the stages in order Denial, Anger, Bargaining, Depression, Acceptance --- and then start over again!
Patients who dealt with all the issues around planning for death and surviving family members, closing a business, refining investments; then seemed to start all over on a strictly emotional level and come to a resolution, only to recommence again!
I was even seeing the same process happening in the, staff and volunteers.

So what was going on?  Why the difference in pattern?  Kubler-Ross had indicated that not everyone went through the stages in strict order   Why not?  What was happening?

After a while, I stood back and looked at the people I was working with and realized that the different patterns depended on the length of time.  Time?
When the dying process was fast with little time available – the stages were mixed up.
When there was a slower dying process and more time -- folk recycled through the stages more than once and very close to the order.

A person went through the stages the first time intellectually … planning … being logical… setting their affairs in order…
Then they went through all the stages again emotionally with a full roller coaster and range of reactions.
And the third time through,  at the deepest core level that most identified as spiritual.

At the time, I discussed my observations with staff and volunteers and it was helpful in enabling us all to better respond to the patients and their families..  Now its time to write about it.  

People in the world today face massive change, economic challenges, job uncertainties, other stresses and potential losses.  The process of dealing with all of these is the same as dealing with grief/loss/change.  Whether it is loss of life or loss of a job. Whether it is real - loss of mobility from a car accident.  Or imagined - the impact of a new computer system.  All loss real or perceived triggers a grief reaction.  Loss is pervasive in today’s society and the reactions of those affected surround us.