The 5 stages of loss and grief

I’m sharing this article from http://psychcentral.com/lib/the-5-stages-of-loss-and-grief/000617

By JULIE AXELROD

The stages of mourning and grief are universal and are experienced by people from all walks of life. Mourning occurs in response to an individual’s own terminal illness, the loss of a close relationship, or to the death of a valued being, human or animal. There are five stages of normal grief that were first proposed by Elisabeth Kübler-Ross in her 1969 book “On Death and Dying.”

In our bereavement, we spend different lengths of time working through each step and express each stage with different levels of intensity. The five stages do not necessarily occur in any specific order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief.

The death of your loved one might inspire you to evaluate your own feelings of mortality. Throughout each stage, a common thread of hope emerges: As long as there is life, there is hope. As long as there is hope, there is life.

Many people do not experience the stages in the order listed below, which is okay. The key to understanding the stages is not to feel like you must go through every one of them, in precise order. Instead, it’s more helpful to look at them as guides in the grieving process — it helps you understand and put into context where you are.

All, keep in mind — all people grieve differently. Some people will wear their emotions on their sleeve and be outwardly emotional. Others will experience their grief more internally, and may not cry. You should try and not judge how a person experiences their grief, as each person will experience it differently.

1. Denial and Isolation

The first reaction to learning of terminal illness or death of a cherished loved one is to deny the reality of the situation. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.

2. Anger

As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us more angry.

Remember, grieving is a personal process that has no time limit, nor one “right” way to do it.

The doctor who diagnosed the illness and was unable to cure the disease might become a convenient target. Health professionals deal with death and dying every day. That does not make them immune to the suffering of their patients or to those who grieve for them.

Do not hesitate to ask your doctor to give you extra time or to explain just once more the details of your loved one’s illness. Arrange a special appointment or ask that he telephone you at the end of his day. Ask for clear answers to your questions regarding medical diagnosis and treatment. Understand the options available to you. Take your time.

3. Bargaining

The normal reaction to feelings of helplessness and vulnerability is often a need to regain control–

• If only we had sought medical attention sooner…
• If only we got a second opinion from another doctor…
• If only we had tried to be a better person toward them…

Secretly, we may make a deal with God or our higher power in an attempt to postpone the inevitable. This is a weaker line of defense to protect us from the painful reality.

4. Depression

Two types of depression are associated with mourning. The first one is a reaction to practical implications relating to the loss. Sadness and regret predominate this type of depression. We worry about the costs and burial. We worry that, in our grief, we have spent less time with others that depend on us. This phase may be eased by simple clarification and reassurance. We may need a bit of helpful cooperation and a few kind words. The second type of depression is more subtle and, in a sense, perhaps more private. It is our quiet preparation to separate and to bid our loved one farewell. Sometimes all we really need is a hug.

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5. Acceptance

Reaching this stage of mourning is a gift not afforded to everyone. Death may be sudden and unexpected or we may never see beyond our anger or denial. It is not necessarily a mark of bravery to resist the inevitable and to deny ourselves the opportunity to make our peace. This phase is marked by withdrawal and calm. This is not a period of happiness and must be distinguished from depression.

Loved ones that are terminally ill or aging appear to go through a final period of withdrawal. This is by no means a suggestion that they are aware of their own impending death or such, only that physical decline may be sufficient to produce a similar response. Their behavior implies that it is natural to reach a stage at which social interaction is limited. The dignity and grace shown by our dying loved ones may well be their last gift to us.

Coping with loss is a ultimately a deeply personal and singular experience — nobody can help you go through it more easily or understand all the emotions that you’re going through. But others can be there for you and help comfort you through this process. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.

I lost you.

I lost you and I never knew.

It’s taken me a few weeks to getting back to writing. It’s an ordeal that kept me adrift on memory, hormones and coping with it.

I had a week of cramps and most days, the cramps were awfully painful. I had to lie with a hot water bottle pressed against my left side of the tummy and uterus. I was still bleeding all this time…which means I’m bleeding for about 1.5 months now.

Daddy and I have huge fights and the pain gets worse after that. We are worried about you and Mommy feels crap about all of this. I feel so neglected, abandoned, challenged and I’m tired of explaining to Daddy. I’m tired of telling him the way I feel has nothing to do with him but I do need him to assure and calm me.

It’s not been easy for me. Perhaps it’s harder on Daddy.

When I went to the doctor on 11 Feb, the scan showed nothing. Dr turned the monitor to me and I saw the static noise of the monitor and the black hole in the middle that was my womb. That’s what I felt, a black hole, when he said ‘There’s no more heartbeat. It’s empty.’ and outlined my womb. I nodded and Daddy kissed me and held my hand. He said it’s alright and a tear slid out from  me. I said sorry and both Dr and Daddy said it’s ok. I felt numb. And that’s how I felt for a while.

I smile and I speak to people over the phone and I conducted training. But sometimes, I reminisce. I get a pang of black abyss that tugs at my heart. I try to ignore it. I go to the toilet and cry for a while. I feel better for a while but most times, I’m just numb.

I was in a lot of pain again on 16 Feb. Daddy and I fought because of my condition. I asked him to google possibilities of my bleeding, just wanting reassurance, but it set off a barrage of emotional questions that as usual, I couldn’t answer. I didn’t want to go to the doc because we were due for a checkup on 25 Feb anyway.

The Dr at KK sucked. She was curt, inattentive and asked me 3 times what was wrong with me, who told me I had a miscarriage, and asked such similar questions which I’ve answered before.

I had a vaginal scan where she probed around and I was thankful Daddy was with me. I was in pain and this irritating prick was testing whatever little patience I had left. I was put on antibiotics for a week due to a risk of infection. This meant that my womb is at risk and if I develop a fever due to the infection, I might not be able to have kids anymore.

I finally stopped bleeding on 23 Feb.

Today, 25 Feb, is the day of the cleanup. Dr said the womb is empty and there isn’t a need for a cleanup. When he said it, it brought back memories… the nurse at the payment counter asked why I have an ‘open date’ on my pregnancy booklet. She asked if we were going back to our country (assuming we are foreigners). There were 2 other nurses and a couple at the counter. I said there wasn’t a need for a follow up anymore and she asked again, oh how come? You going back to your country? When Daddy said we are Singaporeans, she asked again why we have an open date. I raised my voice and said bec there is no more baby. The couple and the other 2 nurses turned to look at us. I was flabbergasted that KK’s service staff are just useless, tactless and insensitive.

I only had ONE good experience out of the many visits with them. I like Dr Tan at AMK though. Just that the rest of KK staff… just sucked. Especially when something like this happens, you just don’t want to be reminded of it.

I broke down little one. I did. I have started insomnia a few days now. I lost my appetite but I force-feed myself so I can get better. I cried, knowing that I lost you. I cried, remembering the times I found out about you, the time that I found you were not growing and that you are no longer with us.

I cried a little, not fully. Just when it, whatever it could be, hits.

The pang of emptiness. The rhetorics. The abyss.

It hits you like a slow breath-taking icy wind and sucks the life out of you. No words to describe what you feel. No words.