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Grieving

Posted Sep 07 2008 8:01pm


I think maybe sometimes we may think that grief is reserved for a death of someone we love. But grief occurs for many other reasons. In my old job of a nurse in the neonatal ICU we commonly saw parents grieving the loss of their "healthy, normal" baby when they delivered a sick or premature baby instead. It doesn't mean they don't love their baby. It just means that the vision and idea of the healthy baby they had planned for and dreamt about is not going to happen and they need to grieve for that child before they can come to accept the reality of what they have now. This is a necessary process to go through and parents often feel so much guilt for feeling the way that they do.


Grief can also occur when one is diagnosed with a chronic illness. I know it has for me. I grieve the loss of the life I had planned out. I had a vision of my future for myself, my family and my children. Now that vision is different, it was shifted and that is a tough thing to deal with.


We are taught in nursing school about the 5 stages of grief first named by Elizabeth Kubler-Ross. They are Denial, Anger, Bargaining, Depression and Acceptance. Some go thru all the stages, some only go thru a few, some get stuck on one stage and some go round round. Everyone is different and there is no correct way to grieve. I think I got stuck on Anger. Partly b/c of the way I was treated by the first few doctors I went to. But I used the anger to my advantage and it fueled my efforts to find a diagnosis and a plan to get help.


I think I have finally moved to the stage of acceptance. I know that this has changed my life and my old life that I had planned out is dead. In its place is this new life and future and I find that I can see the positives in it. I am now home with my children full time. I have had to slow down and let go of activities that are just not important in the scheme of things. I have more time to spend with my husband and children and I treasure that time more than ever. I am more patient and compassionate to others than I ever have been. This are all major blessings and I am grateful that I have had this wake up call this early in my life so I have all this time ahead to really do important things and spend my time on things that matter.


I also think our families go thru stages of grieving too. It is a big change for everyone. I think my younger daughter doesn't fully comprehend what is going on but my 8 year old certainly does and she has had a lot of trouble in the last year coming to grips with the changes in all of our lives. Mommy can't do the things she used to do. I don't go to work anymore so our family income is less and there are things that we have had to cut out b/c they are no longer in the budget. She has been very angry at God and at me. She has also had a lot of fears about my future health and changes still to come. I think she is coming to terms with it and we have talked a lot in the last year. I have tried to instill in her all the blessings there are in our life instead of only looking at the bad things. I have also asked for a referral for her to the school consellor. I think it always helps to talk to someone when you are dealing with these types of issues. I have also seen a consellor when I was first dx and an impartial person can be just the thing to help you work thru some of these feelings.


I am going to include the 5 stages of grief that I found on a fibromyalgia website. I think these are applicable to any chronic illness. It has helped me to be aware that what I am feeling is "normal" and OK. There is no right way or wrong way to grieve. There is also no time limit.


Stage One: Shock and Denial
During stage one the individual will make such statements as:
“This can not possibly be happening.
This can not possibly be true.
The lab must have made a mistake.
This type of thing does not happen in our family.
How could this happen?
How will I cope?
What is going to happen to me/my family/my life?
I can’t think about this right now. I have too many other things to think about.
I will think about it later.”

Stage Two: Anger
There are various expressions of anger during this stage.
Anger at God – “How could You abandon me? How could You do this to me? Why me? I do not deserve this!” (think of the Book of Job)
Anger at Society – “How can the world just go on like this? My world is turned upside down and yet everything still goes on the same.”
Anger with Friends/Associates – “This is not fair. I take better care of myself than anyone else and yet they don’t have this diagnosis. Or, I am a nice person and there are lots of creepy people out there. Why is it me and not them?”
Anger with Self - " I knew I should have taken care of myself all those years ago. How could I have been so stupid not to listen about having a healthy diet, good exercise, not smoking, not living an excessive life etc. Well that's it then, I've really done it now and I don't even know what it is that I have done!"
What is important to realize in this Stage is that the anger is not rational. None of the above statements is rational. They are all anger statements which stem from frustrated emotion and fear of the unknown.

Stage Three: Bargaining
This is typically one of the shortest stages because the desired results do not come through therefore leaving the individual frustrated or depressed.
I will change my diet
I will give up smoking
I will stop drinking
I will go to Church/Temple, etc more
I will pray every day
I will learn to meditate
I will give to the poor
I will be more loving to my wife/husband/partner
I will stop yelling at my children
I will reconcile with my distant family member
I will “do anything” God – just tell me what you want me to do!
Needless to say, the above are healthy choices for anyone. The issue with stage 3 Bargaining is that those choices are conditional on God/the Divine/Life relieving the distress on condition of those actions happening.

Stage Four: Depression
Depression is characterized as a loss of interest in the events of daily living. We don’t care about meal planning, seeing friends/family, watching TV, world events, etc.
“I just don’t care anymore about anything.”
“Life is over as I knew it.”
During this stage individuals begin mourning the life they have lost and begin to recognize that their lives might never be the same again. Individuals are frequently frustrated and angry with anyone who tries to help them “feel better.”
“How do you know what I am feeling?”
“Sure, that is easy for you to say. You are not the one diagnosed with ______!”


Many people have the misunderstanding that depressed individuals are quiet and withdrawn. This is absolutely not true. Although silence and withdrawal are primary elements within depression – anger is very much present as well. This is what is occurring when the depressed individual “Lashes Out”.

Depressed individuals will lash out over issues which often appear trivial to those around them. Understandably in a family situation this can lead to some full-scale arguments/fighting and seriously hurt feelings. If it happens at the workplace, there is a potential for the individual to lose their job.

Depressed individuals will be just as frightened/upset by the episode as those around them.
“What’s wrong with me?”
“I must be losing my mind!”
“I can’t believe I did/said that.”
“I don’t even know who I am anymore.”
Again, this is because of lack of awareness of the depth of emotion within depression.

Stage Five: Acceptance
At some point, most individuals reach this stage but certainly not all will do so. In acceptance, there is a recognition and surrender to the reality that the individual can not change what has happened. In chronic illness many people will begin an earnest attempt to learn more about how to cope rather than “how to fight” what is happening in their bodies.


Acceptance does not mean Giving Up or Giving In. It does mean the ability to recognize and acknowledge that this diagnosis is truly a part of current life.

Individuals will understand that life patterns have shifted and may continue to shift unpredictably. The Stage Five Acceptance level does not mean people are now filled with Bliss and have no regrets. However, hopefully, at this stage, they are able to find some peace with life and able to move forward with new interests as appropriate to their energy level. Be mindful, that even when individuals are seemingly at the acceptance level that they can “slip back” to one of the other stages when a new occurrence has arisen.


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