The most familiar stages of grief were compiled by author and physician, Elizabeth Kubler-Ross. Each individual, however, grieves in a different way, and each stage is fluid. Although this list was created to describe the five stages of terminal illness for the dying patient, the stages also hold true for all losses in life:
1 - Denial. 2 - Anger. 3 - Bargaining. 4 - Depression. 5 - Acceptance.
The manifestations of normal grief include sadness, anger, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning, numbness, and sometimes relief, especially if a loved one has suffered with a long illness. For some, it is hard to comprehend that life goes on, and they feel as if they are watching a movie, detached from participating in life.
When we grieve after the death of a loved one, we not only grieve their loss. A part of our identity is missing as well. For example, when our parents die, we no longer identify ourselves as a daughter or son. After a death, we often reflect and reevaluate our lives, and many growthful opportunities may arise from that reflection. If we have experienced several profound losses, a recent death may cause the other losses to resurface.
Physical sensations of normal grief include hollowness in the stomach, tightness in the chest or throat, oversensitivity to noise, shortness of breath, depersonalization, weakness in muscles, a lack of energy, and dry mouth. Our bodies grieve as well as our minds and hearts. Many people feel the 'presence' of the deceased person, and this is also considered part of normal grief. There may be a preoccupation with the symptoms of the deceased before s/he died, and some people actually develop similar symptoms. There may be some suicidal thoughts, a need to join the deceased. Grieving people can become more absent-minded and socially withdrawn. They may develop problems with sleeping or appetite. They may have dreams of the deceased, or avoid reminders of that person.
In the book Grief Counseling and Grief Therapy, J. William Worden, Ph.D., discusses four tasks of mourning. They are:
1 - Accepting the reality of the loss.
2 - Experiencing the pain of grief.
3 - Adjusting to an environment in which the deceased is missing.
4 - Withdrawing emotional energy and reinvesting it in others, in one primary person, or in life itself.
The way we have grieved in the past has an effect on how we grieve in the present. Dealing with loss is unavoidable in life, and in every loss, there is an opportunity for growth.
Helping others to grieve can be upsetting. We often put pressure on ourselves to say the right thing, or to avoid the person involved. Helping can be very simple, though, as emphasized in this story:
A five year old child came to her mother after playing with a friend. The friend's doll had broken. The doll had a porcelain face. The child reported to her mother that she had helped her friend.
Mother: Did you help her put the doll back together?
Child: No, it was in a million pieces.
Mother: Then how did you help her?
Child: I sat down with her, and I helped her to cry.
Some important tasks for the therapist in treating the grieving person are to stay where the client is, to sit with silence, and to sit with tears. Therapy can be a safe place for a grieving person, as there is not much support in our culture regarding bereavement. At work, we get a few days of personal time to mourn. Often, the entire first year after a death is difficult, with all of the anniversaries, birthdays and holidays to get through. A therapist can help support you on the journey through your grief, and allowing yourself that connection can help with the healing process.