Kubler-Ross and the “Five Stages of Grief”

Grieving is hard work. It is exhausting, both mentally and physically. People who are depressed and grieving often have a hard time getting out of bed in the morning, and find themselves going back to bed, or at least to the couch, early in the evening. When you do sleep, it can be restless and hard to catch quality sleep, meaning you wake up just as exhausted as you were the night before.

One of the hardest things to do when grieving is to devote enough time to the work of grief. And it is work. Many employers only grant a few days off for grieving a family member, something that is woefully inadequate. But it can be hard holding down a full time job and work through your grief as well.

The temptation is there to put it off, to throw yourself back into your life and avoid the uncomfortable feelings that grief brings. Elisabeth Kubler-Ross was one of the first researchers to take a serious look at grief, and she described it as a five-stage process. However, grief isn’t a linear process, and we can find ourselves repeating stages, moving from one to the next, and back again, as our circumstances allow.

Kubler-Ross described the first stage as denial and isolation. This can be asking for second opinions (or third, or fourth) from medical staff. It can be the way I felt disconnected from myself during the first few days after my boys died. It was as if it was happening to someone else. Pretending this isn’t really happening can be a way to shield yourself from painful emotions. It can be the way you simply don’t want to go out, don’t want to see others, don’t want to have to explain where your baby has gone.

The second stage is anger. This can be directed inward, at yourself, or outward at others. You can even feel angry at your baby. You might be angry at the doctor for making a mistake, even if no mistakes were made. You might be angry at yourself for not recognizing ‘signs’ your baby was in distress, even if those signs were all in your head. You can be angry at your partner too, for not grieving in the same way you are, or for not being supportive enough of your concerns. You can be angry at other pregnant women, for having healthy babies even though they don’t deserve them.

The third stage is called bargaining. This is where we try to take our loss and regain control over our world. We might make promises to ourselves or to God that this time will be different. “If I have a healthy baby, I promise I will…” This can often be done to hide guilty feelings about things that happened in your last pregnancy. If you’ve felt guilty over the loss of your baby, it can be hard to let those feelings of guilt go. Forgiving yourself is an important step to feeling better.

The fourth stage, and for many of us the one that has the longest impact, is depression. Depression is more than sadness. It hurts. This is where you can’t get out of bed, where you get little pleasure out of life. There is nothing that can be said or done to cheer you up. Depression has been described as a black dog that follows you around, as a cloud, or a filter that leaves the whole world grey.

The final stage is acceptance. Acceptance is not the same thing as happiness. It is the point where you have incorporated the death of your baby into your life. Where it becomes a part of you and who you are. Thinking about your baby will still be sad, but not painful in the same way as it was during the earlier stages.

New pain can bring up old grief. A friend once told me about how he couldn’t cope when his dog died. It left him with a deep and mystifying depression. As a minister, he was used to being the one to hold it together at funerals, to be the one who could step in and take charge, but here he was, almost paralyzed for months by the death of a dog, who admittedly had been sick for some time. Finally, his wife helped him realize the obvious. He wasn’t just grieving his dog, but all the other friends who had died. He hadn’t allowed himself to grieve before because he was busy keeping busy. When his dog died, no one looked to him for answers, no one expected him to perform the funeral or to help wrap up the estate. He was free to grieve, and so he did. And it hurt.

Keep working on your grief. It can and will come back to you when you least expect it. Work with a grief counselor (you can ask your doctor for a recommendation). Devote the time you need to doing ‘grief work’. You’ll still see reoccurrences of grief throughout your life. We all do. It is part of the cycle of our lives. But postponing the hard work of grief will only make things harder later on.

This post first appeared on Still Standing Magazine.

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