Psychiatrist Elizabeth Kübler-Ross was the first person to define clearly the five stages of grief that you experience when you are diagnosed with a terminal illness. These stages, or steps, are the most common progression of emotions when given devastating news. They are:
- Denial, or “no, this must be a mistake. You’ve mixed up my lab results with someone else’s.”
- Anger and frustration at hearing such bad news. “This is completely unfair. Why me? I don’t deserve this!”
- Bargaining, trying to see if doing an act of redemption could save you. “If I return to my faith, will God spare me?”
- Depression, as the news sinks in. “What’s the point, I’m going to die soon.”
- Acceptance, or the last stage in the process, where you understand that there is no avoiding this and you might as well live your last months/days/moments peacefully and lovingly.
These stages are not a neat, linear progression. People going through the five stages of grief may move back to an earlier stage from time to time, and also move forwards skipping a stage but then returning to it.
There is no set timeframe for the movement through the stages, and some people will stay in a certain stage longer than others.
Let’s examine these stages, and the reasons they are commonly felt by people going through a grieving process.
Denial is the brain’s way of allowing our minds to process horrible news in a way that is easier on our mental state. So denial serves a purpose: it allows us to filter this news in a more palatable, gentle way. It helps us survive the brutal information initially, allow us to pace the input process so it is not more than we can handle.
Depending on the person, the denial stage can last anywhere from 24 hours to…forever.
Most people move out of this stage eventually as they come to terms with the news and feel strong enough to let it all in.
It is rare if a person does not feel angry when receiving terrible news. Anger is a normal reaction and nothing to be ashamed of. Do not let anyone tell you not to be angry, that it is a waste of energy because “you can’t do anything about the situation.”
Accept your anger, and feel it wholly. Do not push it aside. You have the right to be angry; life has dealt you an unfair hand.
Anger is masked pain. When the anger lifts, you will be left with the pain, which is also a very natural reaction to your situation. How do you deal with this anger? Remember, it is good to just sit in it and feel it. It will not hurt you. If you feel the need to speed through this stage, you might try meditation, prayer, some gentle sport such as yoga to quiet your mind.
Trying to bargain your way out of a bad diagnosis is a natural reaction, even if logically you know it is magical thinking. But you’ve read about people being miraculously cured by going to Lourdes, or eating a special diet that will cure, say, cancer, or making amends to people they may have hurt in life.
We focus on “if only” or “what can I do to reverse this news?” or try to negotiate something with God if only we can be spared.
In this stage, we also tend to blame ourselves for somehow bringing on this disease. We will relive the past and wish we had never smoked, eaten junk food, or that we should have practiced veganism.
We try and find a reason for our misfortune. Finally, we understand the reality of our medical condition and that if this our path in life, so be it.
Everyone faced with a terminal diagnosis will spend a while in this stage. This is the deepest stage of grief, and when we are here it means we have given up on the magical thinking of the bargaining stage and are moving towards facing our reality.
This type of depression is situational depression, and not to be confused with clinical depression or depression that is free-floating and without any identifiable cause.
Depression is a perfectly normal and legitimate response to this situation.
We might ask ourselves what is the point of doing this or that since we will be leaving this earth soon. Why bother taking care of our physical self? Why go on? We might even have suicidal thoughts, thinking ending everything now will spare our family great pain, as was the case with comedian Robin Williams and his fatal illness.
The final stage of grief is acceptance. It is in this stage that we begin to realize what is at stake and that we need to prepare for it.
Acceptance does not mean we are fine with the situation.
It merely means we have integrated the news and are now going to get our affairs in order. This is our new normal. Many of us will begin to reach out to our loved ones and yearn to spend quality time with them at this point.
Our relationships will strengthen and we won’t “sweat the small stuff” for we know what is now important. People in this stage often feel their connections to others quite deeply, voicing that the only thing that is important in life is the love you give and the love you receive.