Grief and loss are common human experiences that touch us all at some point in our lives. Death is one of the universal givens of life, and no-one is immune from the pain and sorrow of bereavement. Likewise, we all face a myriad of losses as we journey through life – the loss of health, of a job or of the hopes and dreams we had, for example.
In the first of five blogs, we considered some of the forms grief can take, as well as the impact and effects of loss for many people. In this second blog, we look at one of the models or frameworks often used to help explain grief and loss. We will look at other models in subsequent blogs. These models can be helpful in making meaning of the experience of loss. That said, they never eradicate or remove the pain of grief. Grief and loss remain one of the biggest hurdles that, as a human being, we all face.
Death in the Sickroom.
Before we dive into the first of models of grief, let’s take a moment to pause and consider how grief has been expressed through the medium of art. Perhaps you are familiar with the Norwegian painter, Edvard Munch? His best-known work, The Scream, is one of the art world’s most iconic and recognisable images. Edvard’s mother died of tuberculosis when he was 5 years old. His older sister Sophie also died from the same illness in 1877, when Munch was a teenager. A number of his paintings touch upon the theme of grief and loss – in particular, his 1893 work, Death in the Sickroom. This painting was produced 4 years after Munch also experienced the death of his father. It portrays a family overcome by the death of Munch’s sister, Sophie. In it, we see the raw pain of loss, as each of the characters seem frozen and lost in their own inner world, silenced by grief. One figure, with hollowed eyes looks pale, drawn and almost ghost-like. Heads bowed, each of the characters refrain from connection and eye contact, and some even seem to need support to stand as they lean against a chair, a wall. This painting, for those familiar with grief, helps to convey something of the loneliness and agony of loss. This image is a helpful reminder that grief and loss are debilitating and impact us, no matter our age, economic status or privilege.
The Kübler-Ross Model of grief.
And, so, how to make meaning from grief? Is there any way that we can find some structure, some explanation that provides a framework to explain the grief experience? This is what various thinkers have tried to do, in an attempt to being some containment to grief. Whilst no one model provides clear answers, or a simple “aha” moment – each model does offer something that can help to make some sense of the grief experience. Let’s look at one of these models – often the model that most people are familiar with – the Kübler-Ross Model.
The five stages of grief model was developed by Elisabeth Kübler-Ross and became famous after she published her book On Death and Dying in 1969. Kübler-Ross’ model was a way of explaining the common processes experienced by people with terminal illness facing their own death. But it was soon adapted as a way of thinking about grief and loss in general. That can include the grief we feel with any form of loss: loss of status, retirement, loss of income, loss of social contact etc.
Is it helpful to think in terms of stages?
Whilst it can be helpful to recognize common phases within the grieving process, it is also important to recognize grief is rarely a predictable journey. Everyone is unique and everyone’s grief is unique too. There are no set stages of loss that everyone passes through, no neat way to move through grief. That said, there are often common themes, and these are the five stages represented by Kübler-Ross’ model.
Denial after loss can present itself as a numb feeling. It may involve a person carrying on as if nothing has happened. Even though we logically understand a loss has occurred, denial makes it hard to believe this in our hearts. We might feel as if soon we will discover it was all just a bad-dream of that there has been an error or mistake. With loss that involves death, it’s also very common to feel the presence of someone who has died, hear their voice or even see them. These experiences can be a form of denial.
The short-term benefits of denial.
Other people may not understand your denial. However, denial is a helpful short-term coping mechanism that gives you time to adjust to distressing situations. If you’re in denial, you’re trying to protect yourself by refusing to accept the truth about the loss that’s happening in your life.
Whilst denial can offer short-term benefits, it is also perfectly normal to not experience denial after a loss. Remember, everyone’s journey and process through loss is different.
Anger is a completely natural emotion that humans experience as part of life. In life, we often get angry when we can’t control what’s happening to us. Anger can be expressed in ways that are productive and cathartic – such as speaking with a supportive person. Anger can also be dealt with I ways that are less helpful – such as taking out our anger on others, using violence or turning our anger inwards and attacking ourselves.
Anger after loss.
Anger is common response after a loss, in that loss often involves a situation that we don’t have control over. Whether that is a death, a redundancy or loss of social connection due to the pandemic. These are all things we have little or no control over, and that can lead to intense feelings of anger. Loss can seem cruel and unfair and impacts our plans and hopes for a dreamed for future. We may look to blame or direct our anger towards someone or something – God, the person who has died, the NHS, the Government etc. We may feel intense anger towards ourselves and direct that anger inwards.
Anger isn’t always understood.
Feelings of anger as part of the grieving process are common. Anger was identified as one of the stages of grief in Kubler-Ross’ model. Yet, feelings of anger can be misunderstood by others, and can be difficult to talk about. Perhaps people around us expect us to feel sad, lonely or tearful. They may be confused or frightened if we express feelings of anger.
Expressing anger after loss.
If you feel anger after loss, the following considerations may be helpful:
- It’s common to feel angry and ask why you face this loss?
- It’s possible you may find yourself taking out your frustration on family and friends.
- You may feel overwhelmed with a deep sense of resentment.
- In the case of death, your anger might be directed at the person who’s died for leaving you.
- You may feel anger towards family members, medical staff, God or even yourself.
- Anger can be experienced at any point during the grieving process.
- If you’re unable to express your feelings in a way which feels safe, feelings of anger may increase.
- Even the most supportive people around you may not expect anger as a part of grief, and might not know how to deal with it.
- A grief counsellor or supportive listener may be able to help you to acknowledge and explore your feelings of anger.
Bargaining to try to reduce the pain of loss.
The pain of loss and grief can leave us feeling desperate. It is a common experience for people experiencing grief to express that they’d be willing to go to great lengths if it means they no longer had to experience the pain of loss. If you are facing loss, you may feel willing to do almost anything to alleviate or minimize the pain. We can make bargains with ourselves to try to avoid the pain we are experiencing.
People can begin to make “promises” as a form of bargaining, that include:
- “I’ll never argue again with my Mum if she recovers from her terminal illness”.
- “I will never get angry again if it means the pain will go away”.
- “I’d do anything just to see my family members”.
Bargaining with a Higher Power.
Bargaining can be directed towards a Higher Power, and many people report questioning their faith or religious beliefs after experiencing a significant bereavement. Their world view and belief system may adapt and change as a result of the loss. For example, they may have prayed:
“God – if you can heal this person, I will never sin ever again.
Yet, now they are experiencing the ultimate loss of the person they love, they may then question their faith or belief in a Higher Power.
Such thoughts can help us to deal with the sense that we are human and there is nothing we can do to influence change or a better end result. This feeling of helplessness can cause us to react by bargaining, which gives us a perceived sense of control over something that feels so out of control.
“What if” questions.
Another aspect of bargaining includes asking “what if” questions that center around our personal faults or regrets. “What if I’d never said that….”, “What if I’d made different financial choices…”. Guilt and bargaining often go hand in hand. We may wish we could go back and behave differently. We might ask “what if” to express the assumption that if we had acted differently, we would not be experiencing this pain now.
Some of the “what if” questions you may find yourself answering in this bargaining stage include:
- “What if I hadn’t said that?”
- “What if we never visited that place on that night?”
- “What if I’d managed to get her to the hospital sooner?”
- “What if I’d saved more money before the Pandemic?”
- “What if I’d never let my family move away from the local area?”
- “What if I’d worked harder, or put in longer hours at work?”
The sadness of loss.
Loss involves sadness. We grieve because we have lost something important and significant to us, and that involves sadness and longing. Many people also become more acutely aware of their own mortality, which can also prompt sadness. Sadness is an emotion that many people anticipate and expect during the grieving process. Of course, that doesn’t mean it is easy to experience.
The Kübler-Ross Model includes depression or sadness as one of the five stages of grief. Such grief can be both reactive or anticipatory. We can react to losses we have experienced. We can also anticipate loss and experience grief as we prepare to face such loss. This is common when we are anticipating our own death, or the death of someone we love who has a terminal illness, or some degenerative condition such as dementia.
For some people, a journey through loss can involve both reactive and anticipatory loss. For example, if you are living with someone with dementia, you will experience a number of reactive losses as you adapt to their many changes and loss of abilities. You will also be aware of their eventual demise and death as a result of the dementia. If you are facing the loss of retirement, you may begin to feel a sense of loss months before the actual date of retirement.
The difference between grief and depression.
Although the Kübler-Ross Model speaks of depression, some people note that the sadness associated with loss is not necessarily the same as clinical depression. There are many similarities, but also differences between grief and depression.
Grief is an entirely natural response to a loss, while depression is an illness. People who are grieving find their feelings of sadness and loss come and go, but they’re still able to enjoy things and look forward to the future. In contrast, people who are depressed constantly feel sad. They find it difficult to enjoy anything or be positive about the future. Remember that if you do feel depressed, it’s important to seek medical help. Talking therapies are available on the NHS, via Cruse Bereavement Care, or you can seek support via a private counsellor.
Losing a sense of purpose.
The sadness and depression associated with loss can be very intense and come in waves over many months or even years. Whatever the form of loss, if we have loss something important to us, it is normal and natural to feel sadness. Life can feel like it no longer holds any meaning or purpose. In this way, we can lose touch with our own joy and vitality in our loss. To engage in activities that we enjoy can evoke feelings of guilt. Our loss is now present and unavoidable.
The isolation of sadness.
People experience sadness and low mood as a result of loss may seek to retreat from the world. Socializing can feel very difficult in this stage. This stage of grief can feel very isolating.
Acceptance in the Kübler-Ross model.
Acceptance is one of the five “stages” of in the Kübler-Ross model. When Kübler-Ross first created her model to explain the process that people with terminal illnesses often faced, she noted that some people were able to come to terms with the prospect of their own death and felt a sense of peace about the future.
Acceptance of other forms of loss.
Nowadays, the Kübler-Ross model is used to help make sense of other forms of loss. When we think about the grief and loss we face after the death of a loved one, a retirement, or other form of loss, the idea of peaceful acceptance can feel appealing. It may also seem like an impossible dream.
A gradual process.
For many people, grief comes in waves, and it can feel like nothing will ever be right again. Whilst we may idetify with some of the themes in Kübler-Ross model, it would be unusual if we experienced our grief in a way that neatly follows the five-stages in the order in which Kübler-Ross presented them. Grief can be messy and confusing. However, gradually – over time, many people find that the pain eases to some degree, and it is possible to accept what has happened. We may never ‘get over’ the loss, but we can learn to live again. It is possible to feel that you have begun to accept the loss one day, and then feel sadness, anger or some other emotion another day. Remember, everyone’s journey through loss is unique.
The mourning process can be helpful in supporting people to begin to move to acceptance. In time, many people do reach a state of acceptance of their loss. Some people find creative ways to express their experience of loss, as Edvard Munch did through his painting. Some people benefit from additional support from a grief counsellor or other professional to help them in the process.
In subsequent blogs, we will consider other models of grief and also look at support for the experience of loss and grief.
If you have been impacted by any of the themes or topics in this blog, please reach out for support. One of the ways you can do this is by speaking to a bereavement counsellor via the free webchat service provided by Cruse.