In the 1970’s as an undergraduate, I spent much of my time studying the work of Dr. Elizabeth Kübler-Ross whose seminal book On Death & Dying was all the rage in my mental health and psychology program. Her book was one of the first to broach the topic of death, openly reminding all of us that death is part of life. We all die. Her work has positively advanced the hospice movement in the United States and abroad.
Kübler-Ross brought to the fore 5 stages of grief. However, she never intended for these to occur in numerical order, i.e. first denial, then anger, then bargaining, then depression and then at last the finish line–acceptance. This, however, was how her work was first interpreted.
We now know that there is a beehive of emotions related to death and loss, many of the feelings overlapping and repeating themselves.
Over the decades since Kübler-Ross’ work first appeared, there have been many models developed for those in mourning. Others are created all the time. Since people’s style of grieving is so relative, I believe the more variety the better. Yet, even today, On Death & Dying is used in high schools, universities and even medical schools as THE textbook on the subject. While Kübler-Ross’s work is foundational to what is being done today in the field of thanatology, it is by no means the final word. Starting and stopping with Kübler-Ross leaves all the advances made in the past thirty years unrequited.
Kübler-Ross’ work was widely accepted because it had a logical sequence and was easy to teach. People felt like they knew what was coming next. Today we understand that grief is not linear. It comes at us from all directions. We might think we are doing fine one day, and the next day a lava flow spews forth in uncontrollable streams. Our bodies need breaks from grieving. We can’t contain that much emotion 24/7, so there will be moments here and there when we find ourselves in relative peace. Over time, these moments will increase in duration, until one day, we find ourselves learning to live again without our loved one physically present. Grief, however, never leaves us completely. There will always be times of sadness. Perhaps we’ll hear a familiar song, one that reminds us of our loss; or smell something, visit a place, see a face and it all comes rushing back, as if it were lying in wait.
A model for grieving developed by Dr. J. William Worden in his book Grief Counseling and Grief Therapy is one I personally relate to. However, as I’ve said, there are others just as useful. Worden talks about the tasks involved in grieving. Task 1: Accept the Reality of the Loss. Even when we expect someone to die, the finality of death smacks us in the face. The fact that the person is gone forever is a hard one to wrap our minds around and it takes time to assimilate its significance. If the death is sudden, unexpected, traumatic or self-inflicted accepting the reality of the loss is even more complicated because we try to make sense out it, but it’s impossible.
Task 2: Processing the Pain of the loss. There is both physical and emotional pain involved in grieving. It also affects our behavior. Without working through this process, the person might carry the pain of their loss for the rest of their lives, never fully living themselves. One of the reasons for grief counseling is to assist the person in the difficult task of facing their pain with someone who will stay with them through the process. Additionally denying our pain at the time of loss can lead to addictions, life-threatening illnesses, and ongoing emotional problems.
Task 3: Adjusting to a World without Our Loved One in it. The more roles the person played in our lives the more difficult the adjustment, just as the greater the attachment we have with the deceased the greater our pain. Death affects our sense of self-efficacy, self-definition and self-esteem. Sometimes widows or widowers feel like they are only half of who they previously were. It is a time of learning who we are as individuals apart from our loved one/s. It might become a time of spiritual adjustment and re-evaluation of all of our beliefs.
And finally, Task 4: Finding an Enduring Connection with the Deceased in the Midst of Embarking on a New Life. As mourners, we never forget or lose our connection to the person who has died so we are still emotionally invested. We must find a place in our minds where we can place our loved one so we can revisit them from time to time. A place that also has room for others to enter. We do this through our thoughts, memories and dreams. This allows us to move forward in our lives after the loss. Sometimes, I suggest to my clients that they decorate a room in their minds-eye, a room where they will be comfortable meeting their loved one in memory. An effective place where they can visit from time to time..
We will always be influenced by the inspiration, values, beliefs and meaning our loved one had in our life. Even though we shed our physical bodies our relationships never die; they live on in memory. Most people have the resilience to overcome the pain of loss and move on, others need a bit of professional help, but eventually, I believe we can all learn to live meaningful lives again and find a place in memory to keep our relationship with those who’ve gone before us fresh and secure.
For more information and reference books visit: www.HospiceFoundation.org/