By now, the Elizabeth Kübler-Ross Stages of Grief is a concept with which many people have some familiarity. In a sentence, the stages of grief describe the emotional process someone goes through when confronted with a loss. The stages – denial, anger, bargaining, depression and acceptance – encompass many of the feelings a person might grapple with when faced with the death of a loved one, a major illness, job loss or acute disappointment.
I know that this concept has gained coin in the wider world outside counseling because I first encountered it myself when I was about 19 years old while watching an episode of “The Simpsons” with friends. While I think it’s a good thing that people have a general idea now of what to expect while grieving, I’m a bit concerned that the grief stages are presented in such a neat package that it might oversimplify the experience. So, I’d like to spend some time going over the stages, taking a look at each of them in depth.
I’ve become something of a mini-expert in grief. I give the lecture on it when we train new volunteers at the crisis line. Why I always get tapped for this lecture, I don’t know. I jokingly say I’ve been typecast, but truth be told, it’s a lecture I like giving. I think a lot is misunderstood about grief. People put a lot of pressure on themselves to do it the right way, and worry if they’re grieving too long or not enough. Some judge others for not grieving appropriately, while other people may grieve unnecessarily in silence because they believe no one else could understand what they are going through.
So, let’s start with the first stage: denial.
In fact, let’s start before that. Because it’s been shown now that the familiar order of the stages of grief is not universal. While denial can be a protracted stage for some people, others might not experience it at all – or the same person may have no denial in one situation but a lot of it in another. It’s not a given that every person will experience every stage of grief in every situation.
It’s also not true that a grieving person marches through each of the stages in the same order. For example, upon hearing that one has terminal cancer, a person may initially be understandably depressed. But then they might think that something has been overlooked, that some treatment hadn’t been considered, or that another, and then another and another doctor, might reach a different conclusion. This is bargaining. When that fails, the person may become angry, and so on. Grief is an individual thing, there is no one way, much less no one right way, that it gets done.
So, denial. What is it? It’s the assertion that whatever horrible thing is happening simply cannot be happening. It’s the belief that there’s been a mistake. It’s the insistence that everything is fine when your world is actually in chaos.
To an outsider, this stubborn refusal to see things for what they are may seem utterly irrational. And, I suppose, it is. It can be frustrating to be with someone who refuses to faces up to what anyone else can plainly see is true. But there are reasons why this may be happening.
While denial isn’t present in every grieving process, it is listed first in Kübler-Ross’ list for a reason. Denial can act as a buffer between a person and disaster. Denial throws up a wall between a person and tragedy. Before the wall of denial is dissembled, a person has time to admit the reality of the loss. In this way, someone can ease into a situation they would otherwise be thrown headlong into.
There is a downside, of course. Because, obviously, as long as someone is entrenched in denial, they cannot start to take the actions they need to take in the wake of whatever has happened. How can you decide with your doctor how to handle a cancer when you can’t accept that you even have a tumor?
This business of denial – the upside and the downside – reminds me of something a dentist once told me. I was in his office after realizing a bite of carrot I’d taken earlier that day had become lodged inside a hole in a tooth. I was shocked that my tooth could have had so much damage without me feeling pain, but the dentist wasn’t surprised at all. Decay, he said, is an insulator. It prevents pain from being felt, but left unchecked, it makes the situation worse.
Denial, I think, works in much the same way. I know denial pretty well. I’ve held onto it too long in the past.
Several years ago, my marriage was falling apart. I didn’t know that at the time, however. I told my mother every time she asked – and she asked a lot – that things were just fine. She knew better, though, and that’s why she kept on asking. I would get irritated and insist that our marriage was great, and that she was worrying for no reason and wouldn’t she please just stop?
The denial fell apart one summer evening as I sat in a community agency counseling class. Our professor – and I can’t remember why – asked each of us to characterize our primary relationship. Who takes what role? I listened to people describe their lives: He takes care of the things that require physical work while I do most of the paper work; I’m not in a relationship but I have a son, so I’m the parent and he’s the child; We are equals. Then it was my turn.
I was startled by my own words as I spoke them. “I’m married to a 5-year-old.” Suddenly, I realized the situation for what it was. I had taken on all the responsibility while he worked as little as he had to and did nothing around the home. It had been that way for years, but until that night, I didn’t have the ability to see it for what it was, or to say it aloud. It was a catharsis. It was a revelation.
It brought pain, too. Actual, physical pain.
I brought myself into the emergency room with chest pains less than a week later. The dam that had held back all the anxiety and grief of a dying marriage had burst, and I was overwhelmed by a flood of feelings. With denial out of the way, anger and sorrow overflowed, along with the unsettling uncertainty of what would come next. A day later, they discharged me after deciding it had been nothing more than anxiety.
The end of denial isn’t usually that drastic for me, but it often does end in a storm of tears. I try now to be more cognizant of situations I find myself in. I sometimes ask myself what is truly going on, and what I truly feel.
But as I mentioned above, I don’t find myself in denial each time a loss rolls around.
Case in point: In my most recent grief, job loss, there was no denial at all. From the moment my editor tapped my shoulder and herded me into the executive editor’s office, I knew what was going on. There was nothing there to deny. Nor – I think – am I in denial about how this changes my life. This time around, denial just did not factor into the process. Perhaps it was because the newspaper business has been in the crapper for years now, and after three earlier rounds of mass layoffs it just wasn’t surprising anymore.
That wasn’t the case just a month earlier, when a doctor told me my Pap smear had come back with atypical endometrial cells and that I’d have to have a biopsy to see whether I had cancer. Even knowing what I know about the stages of grief and denial, I thought, “They must have mixed up the tests. That can’t be my result.” I knew this was nothing but denial, but still I clung to it. So, there you have it. The same person can grieve differently from one loss to the next.
Talking from the other side of the couch, I always find myself treading gingerly when I suspect a client is in denial about something or another. On the one hand, I recognize the protective shield denial can weave around a person who is not yet ready to face the facts. On the other, I also know that no real change can come while someone remains within that shield.
I also know that simply telling someone how things are isn’t the way to go – even though it can be tempting. I have listened to women describe horrifically abusive relationships, then dismiss the behaviors as unimportant. “He was just upset that day,” or “But he said he was sorry later.” I hate to hear these things for so many reasons. One, because I know the person saying them is hurting. Two, because I know that if I just say, “He’s abusing you,” it will either be rejected, or worse, I will anger the woman. She has to end her denial on her own.
How, then, can someone facilitate that?
Using the above example, I fetched a “power and control wheel.” This diagram lays out common abusive behaviors, such as isolating a partner from friends and family, constant belittling, economic control and physical violence. I put the chart in her hands and asked her to look at it. “I don’t know if your relationship is abusive or not, but some of the things you said reminded me of things on this chart. I’d just like you to look this over and tell me what you think.”
She did take a long look. And then the tears came.
“It really is that bad,” she finally said.
The end of denial can be excruciatingly painful. But without its end, there can be no change.