Posted by: Darlene DeStefano on 08/31/2017

GRIEF & LOSS

GRIEF & LOSS

Loss of a loved one is likely one of the most traumatic events one will ever experience in their lifetime. For some, following the loss of a loved one they move through the stages of grief and are able to get on with their life. For others, it is not so simple. I know because I’ve been there. 


As a nurse settling in the field of geriatrics, I have consoled many of my patient’s family members. Near end of life, extending love and compassion while easing the atmosphere in the room can help all those affected by what will inevitably happen - the passing of a loved one. 


So many, many  time I had extended words of condolences, the offer of Hospice, local support groups, ministry, the mental health programs for bereavement, all services and programs available to help the ones staying behind. For many they find what they need, for those that don’t, most end up at their doctor’s office and are handed a prescription for antidepressants due to depression brought on by grief. Some are prescribed valium or a similar sedative to help calm themselves to better handle the stress offering an immediate escape delaying or eliminating the opportunity to begin the grieving process.  


For many years the only approach to possibly relieving any type of depression was clearly that of traditional medicine. While natural approaches may have been practiced readily in eastern countries, western civilization touted the scientific approach and downplayed eastern remedies. While meditation is acceptable in many of the world religions as the path to spiritual enlightenment, the idea of meditation healing depression, pain or any other conditions simply was not readily accepted in the traditional health care arena in the western hemisphere. The time is fast approaching whereby meditation as an effective natural alternative to handling stress and depression will become mainstream. 


The intensity of emotions is different for everyone who is grieving. I have learned that the grieving process cannot be rushed and, there is no set time for how long it takes for one to finish grieving, if in fact grieving truly ever ends. It may take months or years. It has been said that the grieving ends when the survivor accepts their loss, works through the pain of grief, adjusts to living without their loved one, and reinvests their emotional energy in other relationships. 


There is no timetable for grief to end. Awareness and understanding of the various stages of grief can be empowering for everyone. This brings me to Elisabeth Kübler-Ross. In 1969 her work on death and dying became a catalyst in the field of grief. Even today her model for grieving is taught the world over in medical fields and hospice centres. 


“The Way of the Wizard” by Deepak Chopra takes one through a transformation that spans the years of one’s life. His work assists one to discover a powerful source of love in spirituality. By renewing the spirit and gaining perspective on love and life, true transformation in relationships is achieved.


The healing that can be attained through Louise Hay’s treasury of inner wisdom in her book entitled “Heart Thoughts” is quite profound. Focusing on day-to-day experiences, the meditations and spiritual treatments offer guidance and assistance to discard old beliefs and habits, and make the necessary changes required in their life.  


Sigmond Freud had his own psychological theories of grief and depression. Of extreme interest was his theory of the grieving process including bargaining, anger, and depression. While his impressions have been rejected by many contemporary writers, some of his basic theories still have effect. It might even appear that some of his theories were a basis for the work of Elisabeth Kübler-Ross.


Traditional medicine has its various methods in treating depression. Usually the first offering will be that of antidepressant medication. Of course finding the right medication is truly a trial and error process. Psychotherapy on its own or in conjunction with medication is often prescribed. Then when they don’t work there is electroconvulsive therapy, followed by more medication and psychotherapy. 

   

Dr. Elisabeth Kübler-Ross stated, “The ultimate lesson all of us have to learn is unconditional love, which includes not only others but ourselves as well.”


It was back in nursing school where I had first heard of the five stages of grief also referred to as the grief cycle by Elizabeth Kübler-Ross through her book “On Death and Dying’ (1969). Commonly referred to as the Kübler-Ross model, the five stages of grief describes the process of grieving and how people deal with tragedy and grief. It is interesting to note that whether it is the person who is diagnosed with imminent death or the person who will be experiencing the loss, has lost someone, or experienced various levels of trauma, they all experience various stages of grief.


Not everyone experiences grief the same or in the same sequence and therefore Kübler-Ross did not intend these stages of grief to be in a particular order. Further, some may not go through all stages and some stages may be repeated. These stages are more of a model or framework - a process as such, for a process implies something consistent or fixed while a model is less specific - more of a guide. 


The five stages are not equal in their experience. Each person will experience grief and emotional trauma differently. Although the model of the five stages of grief may vary greatly from one person to another, there is a recognition that a person must move through their own journey of grief and come to terms with their loss and bereavement.  


Kübler-Ross's focus on death and bereavement, and the grief model has become a valuable roadmap for understanding one’s own and others emotional reaction to loss and change.  


The first stage is denial. Whether conscious or unconscious, the sense of feeling fine and not believing what is happening is a defence mechanism and is considered normal. However, this is just a temporary defence for the individual as this feeling is soon replaced by the awareness of the situation and the sense of loss to come, of being left behind after the death has taken place. 


The second stage is anger. The injustice of it all, the why it is happening, and who can be blamed. Here is the realization that one cannot continue to deny the situation and because of this anger, there are now misplaced feelings of rage, envy, resentment and even jealousy. When dealing with a person going through this stage it helps to stay detached to avoid emotional upset within oneself when at the receiving end of the anger. 


The third stage is bargaining. Here there is the attempt to bargain or negotiate with their Creator to live long enough to see something or finish something, with the promise to give something back for the extra time. Depending on the circumstance one may even try to extend a compromise.


The forth stage is depression. The sadness sets in along with the lack of desire to do much of anything. There is the desire to be alone and spend most of one’s time crying and grieving. Thus begins a total disconnection from self and others. This stage is different for everyone. It can be short or long, it can be anticipatory grieving prior to the actual event taking place. Regardless of the when, where, and how long, each individual is different and this stage be different for them. The time one requires to move through depression is an important part of the process.  


The final stage is acceptance. The realization that one cannot change what is happening. Therefore the one dying must accept and prepare for it. For the one who will be left behind it may take longer to get to and to go through this stage. There is a point however where peace and understanding prevail. This last stage has often been described as the end of the struggle.


This training of the Elizabeth Kubler-Ross model on death and dying delivered into the mainstream an awareness to the sensitivity required for better treatment of individuals who are dealing with a fatal disease. Kübler-Ross originally applied these stages to people suffering from terminal illness, and later to any form of loss. 


Kübler-Ross claimed these steps do not necessarily come in the order noted above, nor are all steps experienced by all people, though she affirmed a person will always experience at least two. 


While this model has been accepted into mainstream practice there would appear to be some considerations that were not identified. The most obvious of these would be the level of relationship support, the overall effects of the illness and how these might affect each of the stages and in fact the cycle as a whole. Then there is the unanswered question of how the dying person deals with fear and despair in their own approach to death and whether they felt their life had meaning and purpose, and even whether they were spiritual or not.  


Grief or loss is directly associated with mind, body and soul. Therefore, in addressing the whole or holistic self we can identify five Human Holistic Domains. These are the physical, mental, emotional, social and spiritual well being of the individual. Each of the five human holistic domains can be directly linked to one or more of the stages of grief.

In the physical domain, the person who is going through the stage of depression often will neglect themselves in the areas of nutritional intake, exercise, rest, cleanliness, dress, and overall image. One may experience fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia. There may be a few tears, an overabundance of tears, or no tears at all. The person may continually clench their fists, avoid eye contact, have their head lowered most of the time, or may clearly show through body contact their lack of interest in anything going on around them. They may continue this downward trend until they become either extremely ill requiring medical attention or hospitalization, or until they come to terms with the stage of acceptance. It is important to recognize that the mind and body are connected. One can improve the physical domain during grieving by getting enough sleep, eating right, and exercising. After all, when one feels and looks good physically, one feels well emotionally and will be better able to handle this stress without resorting to drugs or alcohol to numb the pain of grief or to artificially lift one’s mood.  

  

During the mental domain the stages of denial, bargaining, depression, and acceptance can come into play. As the physical and mental are connected through mind and body it come down to not just whether but how one is or is not dealing with the loss. Mentally coping with the loss has as much to do with mental attitude as does the physical appearance. Yet, when the mind does quiet enough for the grief to lessen and it feels like it is too much to bear, one should seek help. Help is available to work through the mental anguish in the area of mental health professionals, facilitators of energy healing or through the self help process by learning to meditate, thereby overcoming obstacles to grieving. 


Facing your feelings relates to the emotional domain which connects with the stages of anger, depression and acceptance. Mentally one knows they are not coping when the emotions are out of sorts. For instance, one may bury their feelings showing no outward signs of emotional distress. This can be due to a cultural or gender issue, the way one was raised. However, the question of why, invariably comes to most people. Whether one exhibits a tough or sensitive exterior everyone goes through emotional trauma of some kind when experiencing loss. 


It is important then to face one’s feelings. Once one acknowledges the pain, one can begin to heal. Avoiding feelings of sadness may prolong the grieving process, yet unresolved grief can lead to serious complications. In dealing with emotions during times of loss it would then be prudent to plan ahead for the triggers of grief such as birthdays, anniversaries and special holidays that reawaken memories and feelings. Perhaps planning a celebration to honour the loved one with friends and family, talking about the good times, sharing the memories and taking a truly joyful approach may prove very helpful in moving forward. This may now offer new memories to reflect on over the coming years. 


The stages of depression and acceptance are associated with the social domain. This domain may exhibit a lack of participation in previous activities, not going out as much, partial to total withdrawal from society, to the more critical failure to thrive. Differentiating between grief, feeling depressed, or clinical depression brought on through grief can be difficult as many of the symptoms are the same. There are ways to tell the difference. Grief can be likened to a roller coaster, involving a wide variety of emotions with a mix of good and bad days. With grief and feeling depressed, one will have moments of pleasure or happiness, while with clinical depression the feeling of emptiness and despair are constant. Furthermore in clinical depression there are usually intense feelings of guilt, inability to function normally, feelings of worthlessness, and thoughts of suicide. The single most important factor in healing from loss is having the support of other people. Talking about one’s feelings and sharing one’s loss makes the burden of grief easier to carry. It is better to accept wherever the support comes from and not grieve alone. Connecting to others will help one heal. This connection through meditation provides profound help with one’s inner world, while connection with others helps with the outer world. This outer world connection may be to join a support group such as hospice or just start getting back together with friends and family by dining out, going for a walk, playing cards, or just having a chat about topics besides the loss. 


As with the social domain, the spiritual domain can also be related to the stages of depression and acceptance. It helps if one is better educated about death and dying, the stages of grief, and the differences in mild depression and clinical depression. In coming to terms with the loss and finding acceptance one can draw solace from one’s faith while embracing its mourning rituals. The spiritual activity of prayer and/or meditation offers comfort on a level that is much harder to put in words. It really is about going within and finding peace.  

New ebook on moving through grief to be launched in October 2017. Order yours today. https://talkandgrow.ca/

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