Friday, June 26, 2015

Feelings Friday: Kubler- Ross's Guide to the Grief Journey

Grief is a personal journey that takes time.

Are we there yet?

Losing a pet evokes the same emotions as other losses and for some children it is their first experience with the finality of death.  For the past seven years Suki has been a comfort to many children as they have done their "feelings work." This month I am helping those same children understand grief as they process Suki's death. Many of my clients have dealt with loss before, but Suki is a catalyst to talk it through again.

Grief work is good work.

Dr. Elisabeth Kubler-Ross was an innovative Swiss Psychiatrist who spent over thirty years studying grief in her work with terminally ill clients and their families.  She is credited for founding the Hospice Movement and her legacy includes a reliable guide to grieving.  I first learned about Dr. Kubler-Ross when I was an undergraduate and I still use her stage model in comforting children and adults. It is a useful tool to predict feelings at an otherwise unpredictable time.

Stage One: Denial.  Even if you are prepared for a death (due to illness or aging)  there will be some times when you forget or disbelieve that your loved one is dead. Thoughts of expecting to see them in the next room or waking up and questioning if it was a bad dream are common. Numbing and a sense of unreality are the feelings within this stage.

Stage Two: Bargaining.  This stage is marked by "What if . . ." thoughts.  What if the doctors had done tests earlier, what if we hadn't gone on that trip, . . . Feelings in this stage feel muted, as if in a fog. Anger, anxiety, sadness, and confusion are present but mild.

Stage Three: Anger and Guilt. For many people this is a tricky spot.  Either they are uncomfortable with anger- so they gloss over it- or they get way too comfortable with the anger and linger too long. Anger is directed at others who might have helped more, at self for not recognizing signs or for what was undone in the relationship, or at the deceased for dying. Angry or guilty feelings are powerful and unsettling. Some people describe their feelings in this stage as "restless."  

Stage Four: Sadness and Depression. The permanence of death is intensely sad and depressing.  At this point in grieving- the reality of death is internalized and the work of surviving the loss becomes a daily work.  The sadness of grief-work has a time table that is unique to each person and is not a symptom of mental illness.  Signs of concern are extended periods of lack of interest, withdrawal, poor eating and sleep, and a wish to die. 

Stage Five: Acceptance. A grieving person is always sad about the loss. Acceptance is finding a "new normal" of living without the loved one. The turning point is in the ability to develop a different loving relationship without a physical presence, learning to live with the separation. Ultimately resolution of loss involves memorial (traditions, memories, legacy), a full range of feelings, and hope for the future.

It is not uncommon within a family to see several different stages of grief, even though they experienced the loss at the same time. We have a guide but we don't all  follow the same path and sometimes we will re-experience the stages multiple times before we arrive at acceptance.  

As I process Suki's death with my clients who have come to expect her in my office on Wednesdays, I realize that Suki continues her work as a therapy dog even now. I am hearing incredible stories of loss and we are traveling together. It is nice to have a companion on our journey.

I hope this post helps you with loss and will be a tool for you in your walk with others on the the path.

Please share the link if you find it helpful. Thank you for reading.

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