DYING, ILLNESS, AND AGING WITH GRACE

"I sat with my anger long enough, until she told me her real name was grief."

              ~Isaac Rowe

The Five Stages, or DABDA

You can expect a wide range – even a whirlwind – of feelings when someone important to you dies or is dying. It may be even worse if the death was sudden, unexpected, violent, or self-inflicted, or if it left you with a lot of unfinished business, emotional and otherwise. Don't feel bad about what you feel; it is a normal part of grieving. You may not experience all of the feelings typical of grief, or experience them in a fixed sequence. But avoiding uncomfortable feelings that do arise will only make things worse. The work of grieving, and the only way to get through mourning, is to experience your feelings fully. You may feel a strong desire to anesthetize your feelings (with food, drugs, alcohol, sex, work, or busyness) or stuff them. Doing so will only delay the experience of grief or push it underground; it will generally express itself anyway, in ways you'll have even less control over.

Elizabeth Kubler-Ross, in her book On Death and Dying, identified five stages of grief:
• Denial
• Anger
• Bargaining
• Depression
• Acceptance.

Colin Murray Parkes (in his book Bereavement) and psychologist John Bowlby suggest four stages:

• Shock and numbness (the emotions frozen, a self-defense mechanism to survive the loss)
• Pining (yearning and searching, wanting to bring back the lost),
• Depression and despair, apathy and anger (preoccupation with what's lost),
• Reorganization and recovery (Grief doesn't end, but feelings of sadness and despair lessen and positive memories of the decease increase).

Don't be surprised if you feel:

• Shock, numbness, dazed disbelief, a feeling of just "going through the motions," a sense that part of you is functioning but part of you is not.

• Laziness, fatigue, a sense of depletion.

• Bewilderment, confusion, indecisiveness, clumsiness, forgetfulness, inability to concentrate, a reduced attention span. Confusion is especially common.

• A whirlwind of changing feelings, unexpected surges of emotion, of mental chaos and disintegration, the feeling you might be going mad.

• Anger, at the person who died, at the medical establishment, at the people trying to help or console you, at the people who didn't die, at yourself, at whoever gets in the way when the anger feels like coming out; bitterness, hostility.

• Pain (both physical and emotional), sorrow, weepiness (tears you have no control over – they won't come when you want them, and then they'll come at times that are embarrassing), despair, intensely painful feelings of loss.

• Fear, anxiety, panic, agitation, hypochondria.

• A "selfish" preoccupation with your own feelings; a need to be babied, to regress.

• Depression, emotional flatness, apathy, defeatism, thoughts of suicide, a feeling of "What's the use?" "Why live?"

• Loneliness. A fear of being alone, yet a yearning to be left alone; a need for company, yet no desire to socialize.

• A yearning to see and feel the person who died.

• The sense of a void, a missing part, an enormous sense of loss and emptiness.

• A flood of memories, a restless search for the person who died, a feeling that he or she is nearby or visiting you.

• Guilt, regrets ("if only..."), ambivalence (especially if you had unfinished business with the person who died), feelings of shame about having "unacceptable" thoughts and emotions.

• A mental replaying of the illness, the death, or the life that preceded it; talkativeness, an urge to tell the story of what happened, to talk about the past.

• Sleeplessness, overeating or loss of appetite, weight loss or gain, and a wide variety of physical symptoms to which you are unaccustomed.

• Conflict with other survivors, or the resurfacing of conflicts from earlier in life – a common problem.

• An inability to remember what the dead person looked like; a tendency to idealize (or make a monster of) the dead person; eventually (when you’ve worked through some grief) the feeling that you are absorbing some of the dead person's personality, that his or her values, qualities, or behaviors are becoming part of you.

• Relief that a difficult time has ended.

• Acceptance, peace, joy.

• Dreams of the deceased; a sense of their presence nearby.

Copyright © Pat McNees. Reprinted from DYING: A Book of Comfort, which you can order here.

• Finding Joy in My Father’s Death (Ann Patchett, The End, NY Times Opinionator, 2-27-15) "I was glad for my father, the end of his suffering, his ticket off the raft, but it was more than that."
• Life After Tim, by Janet Burroway (St. Petersburg Times), in which Burroway describes what she learned about grief after her son Tim Eysselinck, a former Ranger and Army captain, committed suicide after finishing work in Iraq.
• The Task. An 8-part series about grief, mourning and memory after a father's death (Olivia Judson, Opinionator, NY Times, 2014).
--- 1.Home, Dismantled (Olivia Judson)
--- 2. Scenes of Confusion (2-16-14)
--- 3. Stalin and Soap (Olivia Judson 2-17-14)
--- 4. 54 Drawers (Olivia Judson, 2-18-14)
--- 5. A Piece of DNA (2-19-14)
--- 6. Weighing the Ice Cream (2-20-14)
--- 7 To Read or Not to Read?
--- 8 The Memory Stone
---The entire series

• Getting Grief Right (Patrick O'Malley, Opinionator, Couch, NY Times, 1-10-15) The story of a woman's loss of her child and her inability to get through her grief. "Based on my own and my patients’ experiences, I now like to say that the story of loss has three “chapters.” Chapter 1 has to do with attachment: the strength of the bond with the person who has been lost. Understanding the relationship between degree of attachment and intensity of grief brings great relief for most patients. I often tell them that the size of their grief corresponds to the depth of their love.
Chapter 2 is the death event itself. This is often the moment when the person experiencing the loss begins to question his sanity, particularly when the death is premature and traumatic. Mary had prided herself on her ability to stay in control in difficult times. The profound emotional chaos of her baby’s death made her feel crazy. As soon as she was able, she resisted the craziness and shut down the natural pain and suffering.
Chapter 3 is the long road that begins after the last casserole dish is picked up — when the outside world stops grieving with you. Mary wanted to reassure her family, friends and herself that she was on the fast track to closure. This was exhausting. What she really needed was to let herself sink into her sadness, accept it." And support groups can be helpful: " the relief she felt in the presence of other bereaved parents, in a place where no acting was required. It was a place where people understood that they didn’t really want to achieve closure after all. To do so would be to lose a piece of a sacred bond."
• Braving the Fire: A Guide to Writing About Grief and Loss by Jessica Handler (author of the memoir Invisible Sisters, about being the "well sibling" of two younger sisters who die)
• A new approach to complicated grief (Karen Kersting, American Psychological Association, Nov. 2004) Better assessments and treatments lead to a brighter outlook for people with severe grief, according to a report from an APA group.
• No Stages of Grief (Russell Friedman, Psychology Today, 9-25-09) There never have been stages of grief. "Kübler-Ross' feelings were processed through the filter of her life-long unresolved grief and retained anger....Had she stuck with the phrase catastrophic news, perhaps the mythology of stages wouldn't have emerged and grievers wouldn't be encouraged to try to fit their emotions into non-existent stages....Elisabeth Kübler-Ross' herself constantly stated that the stages didn't all happen and not necessarily in order, if at all." See also The Myth of the Stages of Dying, Death and Grief by Russell Friedman and John W. James.
• How Grief Works (Alia Hoyt, How Stuff Works,
• The Four Phases and Tasks of Grief (Angela Morrow, RN, VeryWell Health, 12-6-18) In 1982, American psychologist William J. Worden published his book Grief Counseling and Grief Therapy, which offered his concept of the four tasks of mourning: 1. Accept the Reality of the Loss. 2. Accept the Reality of the Loss. 3. Adjust to an Environment in Which the Deceased Is Missing. 4. Find an Enduring Connection With the Deceased While Embarking on a New Life.
• The Process of Grief (PDF, Tip sheet, Resolutions RTK, Australia) The grief and loss curve (portrayed as a big narrow U): Shock, denial, bargaining/guilt, anger, depression, acceptance, planning, new beginnings. A fuller explanation than most. Among mportant points made: 'Negative terms are often used if you get upset (Breaking down, falling apart, cracking up, not coping). Positive terms are often used if you demonstrate restraint: Brave, strong, courageous, holding yourself together, coping well. "Our culture with grief and choice of language around grief and loss may prevent you from expressing your feelings."'