Elisabeth Kubler-Ross’ groundbreaking 1969 book, On Death and Dying, quickly established the five stages of grief: denial, anger, depression, bargaining, and acceptance. In my early years as an oncology nurse and grief counselor, I too accepted these stages as grief gospel, and there’s no denying that Kubler-Ross’ work advanced the field considerably.
During these many years working with those overcoming their grief, I’ve identified two other stages to the grieving process: fear and forgetfulness. These two stages are experienced by everyone I have ever worked with. And fear always comes first, forgetfulness always last. This differs from Kubler-Ross’ five phases, which are not always experienced in the order she outlined.
The following is a brief breakdown of each of the seven stages of grief. Because there is ample information available for Kubler-Ross’ original five stages, the focus is on the stages I have identified: fear and forgetfulness.
Before any event even occurs, grief can kick in due to the fear of impending demise. The “demise” can be of anything – the loss of a job, the end of a relationship, the foreclosure of a home. In the fear stage, the individual imagines the worst possible scenario in a situation, which can sometimes do the individual the disservice of hastening an event that might not have otherwise occurred, or worsening the results. This fear can be your undoing, so working through it or living with it in a healthy manner is critical to making the subsequent events and grief phases easier to cope with.
Even in cases of a sudden loss, fear occurs. In fact, it’s the very first emotion that is experienced. The person who experiences the loss senses their mind racing out of control as they imagine all the changes that will befall them. As much as they miss the person or thing that they have lost, they are now afraid for themselves.
Acknowledging that you have a fear of a pending loss and examining the rationality of that fear can help alleviate overpowering emotions. When a client first comes to see me, I can tell right away if they are in the fear stage by the barrage of questions. What do I do now? How could this happen to me? What if I never recover? How will I possible get through this? There are so many questions, in fact, that they are often unaware that they are grieving.
Of course, some fears are reasonable, such as when you receive a negative prognosis from the doctor or if a loved one is put in a dangerous situation, such as a soldier being sent to the front lines. Such fears are very real and very, very rational. And there is no reason that these fears should be ignored. In fact, I encourage anyone in this stage to allow themselves to experience this fear, to acknowledge it and all of the emotion that comes with it. Too many times, people try to ignore this fear and pretend it isn’t happening, which may only prolong the whole grieving process.
We experience denial as a defense mechanism to buffer the shock of loss. During the denial phase, people tend to question their past actions, in which they usually find a great deal of fault. “I should have taken Spike to the vet sooner” is one such type of response, or even “This can’t be happening.” People who are grieving block out words. They hide the facts, because they don’t want to face the truth.
Near the end of the denial phase, you’ll find the conversation in your head start to change. Whereas at the beginning of denial, the devil on your shoulder dominated the conversation, the angel now has more and more say. “I’m too fat! I’ll never find someone new!” begins to morph into “My thighs aren’t so big. And anyway, I got a killer rack.” Even the worst denial dialogues begin to evolve. “She can’t really be dead” starts to change into “Oh yeah. He’s dead.” In my very scientific jargon, I call this getting a grip, and it’s a sure sign that you’re saying adios to denial.
Denial and isolation can wear on people, resulting in pain that manifests as anger. This anger can be aimed at inanimate objects, complete strangers, friends, family, or even someone who is deceased, whether recently or in the distant past. It’s human nature to resent someone who was caused you pain, which leads to your own feelings of guilt for being mad, which in turn makes you even madder. For these reasons, the anger phase tends to last longer than any other phase.
The depression phase requires the most cooperation from friends and family while the person grieving works through her emotions of sadness and regret. Many grievers choose to spend time alone, while others need that social structure to keep them afloat. Knowing exactly what each individual needs can be difficult to pin down, but often you can tell by how they behave at an occasion.
This is a normal reaction to the feelings of hopelessness and vulnerability. In the bargaining phase, the person grieving is trying to regain control of the situation. They make deals with God, with a higher power, or with themselves to try to postpone the inevitable – the divorce, the death, or what have you. They want to make that pending, painful event a non-reality.
Once a grieving individual accepts the loss, they’ll soon be back on the path to functioning normally. Although you are still in the grieving process, you are no longer mired in the muck of mourning and have begun to move forward. You’re proactive with taking care of your day-to-day responsibilities. People have careers, children, pets. They have laundry to do, groceries to buy, and rocking chairs to sit in for fifteen minutes each day to work through their emotions or simply to enjoy the change of the seasons. You’re able to do all of these things – responsibly and whole-heartedly – once you’ve reached the acceptance phase.
Kubler-Ross’s five stages ended with people still in the process of healing. But this final phase, which I have observed with every single one of my grief clients, is where I see individuals finally finding their way out of the woods.
The grief is always going to be there. It will always exist. However, once you have reached the forgetfulness stage, you’ve reclaimed the health you once had and can return to the normal functions of day-to-day life. When you have reached the forgetfulness phase, you still carry with you the remembrance of your loss, but you are not dwelling on the memory of that loss every second of every day.
What’s funny is that in this phase, just when the griever has allowed the healing process to be a regular part of life, he feels almost guilty for beginning to accept his loss – and the severity of the loss is often in direct correlation to the level of guilt. Although this may seem completely illogical, this guilt is completely normal, and it too will begin to subside as the griever completes this final stage of the cycle and rejoins the world as a happy, healing human being.