Wednesday, June 1, 2011

The Grief Process

I've done a lot of reading about grief since my dad died in January and have learned a lot, but I am still trying to figure things out (if that’s even possible).  I’ve come across two “models of the grief process,” the first one being far more well-known:

The Kubler-Ross Model, commonly knows as The Five Stages of Grief.  I remember studying this is psychology classes in college and reading Kubler-Ross’s book On Death and Dying back then, before I had any kind of personal reference or experience.  I remember memorizing the stages and thinking I had an understanding of what each was like.  However, like lots of things I thought I knew back then, I was actually far from knowledgeable (and, despite what my family has been through over the past 7 months, I still am).

The stages of grief are generally described as steps that people go through as they cope with loss and tragedy.  Kubler-Ross said that the emotions identified in these stages are not complete or necessarily chronological; grieving often involves many other feelings that can surface or re-surface at any point in the process.  Some steps may be missed entirely by some people, and sometimes a person may get “stuck” in one of the stages for different reasons.  The five stages are as follow:

*Denial – usually a temporary defense but can be very useful at times because it gives the person time to process.  (I can't believe he died.  I keep thinking if I call his cell phone and leave him a message, he'll call me back.)

*Anger – Lots of questions surface during this stage, which may also involve rage and envy. (Lots of this for me is not based on reality, I know, but I'm still really pissed off!)

*Bargaining – The negotiation offers begin, sometimes for a longer life for oneself or for their loved one or even just a desire for something to hold onto, such as a dream or contact with the loved one who has passed away. (I recognize now that lots of bargaining took place before Dad died, mostly in the form of accepting the changes in him and his abilities without missing a beat, as long as we still had him around.)

*Depression – The understanding of the certainty of the loss begins to set in, which often results in feeling extreme sadness, crying, and disconnecting from others, which can serve to allow the person time to process.  (Yeah, I've got some of that going on, too.)

*Acceptance – The last of these stages during which the individual comes to terms with what is happening or has happened.  (Nope, not even close to being there yet, and in a way I don't ever WANT to get there because I'm afraid it will mean I am "getting over" what happened and forgetting him or things about him.)

The second model I’ve seen in the literature is the “Grief Spiral,” which involves many more stages and emotions, all of which are shown to overlap at times.  I like that this one is more visual and seems more descriptive.  It starts with the death/loss and then progresses through shock, numbness, disbelief, avoidance, confusion, anger, longing, searching, intense sadness, apathy, sadness, detachment, hope, less pain, more energy, and personal growth.  It ends with “New Life.”  The information that this model includes says that grief should be viewed as a healthy reaction to a loss and that it can even “set us on the road to healing.”  It reiterates the fact that each person’s grief is individualized and explains that the initial feelings are part of denial and bargaining, which help us to adjust to the loss at our own pace, as we can tolerate it.  It says emotions in the anger phase may be overwhelming as the significance of the loss is realized and the depression stage often causes the grieving person to want to withdraw, which can serve as a “time out” so that the healing can begin.  In the last part of the model, hope is said to return along with more positive feelings that eventually lead to a “new normal.”  (I hate the term "new normal!"  I want my "old normal" back!  I also hate the term "healing" when it is applied to grief.  I think people CHANGE as a result of loss instead of healing, and I don't think grief should be looked at like an injury or an illness that would necessitate healing.)

I’ve heard lots of metaphors used to describe the grief process.  I am a big fan of metaphors in general, and so some of these are helpful and/or interesting to me.  The two things I’ve heard grief compared with the most are a body of water like the ocean or a river and a roller coaster.  I've been told that after a period of time, emotions associated with grief and loss tend to be less intense with the pain being more spread out, much like waves breaking at the shore, rapids that are rough to cross but then lead to calmer waters, or the roller coaster ride that is rough in the beginning but easier as the ride goes on.  I hear people who are more experienced than I am say that even years after a loss a certain event or memory can trigger a flood of emotions again but that over time it is easier to focus on the good memories more than the pain.  I’ve heard that grief is like the ocean, with waves that are manageable one minute and knock you down the next but that eventually the waves get smaller and are spaced further apart.  (I also think grief is endless, like the ocean, and that it holds the potential for drowning, like water in general.)  I’ve heard it’s like navigating in a canoe down a river in that at times you are just being pulled along by the current but at other times you will have to face the rapids.  (And maybe even a waterfall or a huge boulder, fallen tree, or snake!)  I’ve heard that grief works like a magnifying glass in that someone’s “pre-loss” personality and habits become intensified under the stress of coping with loss.  I've read that a person usually copes with loss based on how he/she functioned before that loss.  I’ve also heard that grief blurs the lines (or filters) on one’s perspective and hardens one’s tolerance to many things, at least for a while, and I personally have found this to be true.

For me, grieving seems like building a house of cards.  As I go through my daily life five months after my dad went on ahead, most of the time I am stacking and balancing cards; however, at least once a day the cards get bumped over, resulting in partial destruction of my card house or even a total knock-down.  And then I rebuild again, even though I don't really feel like it and I don't have the energy for it most of the time.  It’s also like a tornado.  Maybe there is an eye of the storm that comes into play sometimes, but the rest of the time everything is swirling around, powerful and threatening and threatening to touch down.

I want to tell this story to be sure we recognize and remember it all, not just Dad’s illness or his dying, but his whole life, his presence, his impact, his personality, him before he got sick.  I’m afraid if I start writing I may not be able to stop, or worse – that I will, and then I will be done grieving/processing/remembering which is what I think is keeping him with me.  I don’t want to be a me without my dad.  I know I am not technically "without" him, but that doesn't help my heart from hurting from missing him.

When I read about grief, some of it helps me to think or to process what’s going on inside me, but some of it pisses me off.  “Embrace your grief” and “Grief is a journey.”  WHAT?? It’s more like being burned or beaten.  While I appreciate offers and gestures of support, I can't take advice from someone who doesn't have first-hand experience with losing a loved one, and even when that is the case it PISSES me off when others assume (or even SAY) they understand what I'm going through or that they know how I feel.  See?  I told you that anger stage is in full force.

When we honestly ask ourselves which person in our lives means the most us, we often find that it is those who, instead of giving much advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a gentle and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares. ~ Henri Nouwen