Revisiting this complex topic for a third time, Mitch Ware takes a deeper look into the seven stages of grief and explores how we cycle through them. From shock and denial to rebuilding and acceptance, the journey through these phases can be exceptionally difficult to experience. Relating his personal experiences, Mitch offers insight into how to manage our lives while going through this process.
" When we stay in one of those first four stages denial, anger, bargaining, or depression, and we stay there too long, it affects our well being. That's a problem. And when we ignore this process of grieving a loss, that's not good either. It affects us in every single facet of our lives. "
Transcript:
Welcome to another episode of Living With Hospice. My name is Mitch Ware. And it's a distinct pleasure for me to be your host today.
I'm not a doctor, I'm not a Registered Nurse. I am a longtime hospice client and volunteer, I know hospice inside and out. I don't practice medicine, nor do I offer any medical advice. I do share my experiences and knowledge that I've gained firsthand over all these years.
It seems everywhere we turn, we find friends and family suffering from grief. We grieve when we lose a job or the loss of a business. we grieve over the loss of a relationship. And of course, we grieve when we lose a loved one. We all grieve loss, none of us are exempt. We just do it in our own way, our own unique way and in our own timing, and for the most part, that's perfectly okay.
We've addressed grief in two previous episodes. In episode eight, when and how do I start grieving? We discussed that the grieving process starts when we first get the news of the loss. For example, when we first find out that we're laid off, or when we first find out that our spouse is divorcing us, or when we first get that terminal prognosis. In Episode 22, we take a look at it from someone else's perspective, what and how do I talk to someone who's grieving. And as we all experienced some awkwardness, when we get into those situations, we suddenly discover, we don't know what to say. And we oftentimes say the wrong things. We're well intentioned. But when we open our mouths, somehow the wrong thing comes out.
Well, today, we're going to take a look at a little different perspective at grief and the ways to manage it. And yes, Virginia, there is hope. And there is a healthy solution to dealing in managing grief. We need to understand grief is a very, very, very deep emotion and it affects us not only mentally in our thought process and all that, but also physically, we also need to know that one day, you might feel okay, and you might have energy, and maybe that last for a few days, or even a couple of weeks, or it may only last a few hours, but we have that feeling of, "Okay, I feel better." And then you find yourself again, back into feeling sad, and wanting to withdraw, and just crawl back in bed or maybe never even get out of bed. Grief puts us on a very difficult emotional and physical rollercoaster. But before we go on, let's take a look at what the experts call the five stages of grief.
The first one is denial. The second one is anger. The third one is bargaining. The fourth one is depression. And the fifth one is acceptance.
When we stay in one of those first four stages denial, anger, bargaining, or depression, and we stay there too long, it affects our well being. That's a problem. And when we ignore this process, this grieving a loss, that's not good either. Many of you know what I mean by that. It affects us in every single facet of our lives. In fact, let's back up and say grief, and how we manage it can affect every facet of our lives, our jobs, our family, how we relate to neighbors, even how we perceive ourselves. You know, we can't manage what we don't fully understand. Let's look at grief in a little different way here.
Without getting, you know, too technical and medical and all of that. at first blush. Grief just sucks. It's painful. It's disruptive, and it often just can cause us to shut down. But mental health experts tell us it's necessary. It's necessary to deal with our losses. And it's necessary to do so in a healthy way.
Denial, anger, bargaining depression, and acceptance. Sound about right? Can you relate to any of these? Some medical practitioners actually break the first stage of denial into two separate stages in the first half of that would be shock. And then the second half is denial. You know, I like that idea. That makes perfect sense to me. When we find out some bad news, whether it's a loss of a loved one or like we get our pink slip or whatever. Anything that's a big loss that really impacts us. Our first instinct is what even for a few minutes It's like, 'What?!?!" You know, there's that shock there. Like, when the hijacked airliners hit the twin towers in New York City for those of you who were around at that time, you know, we were all in shock. America was in shock, the world was in shock, couldn't believe it. Or maybe you've been one of the unlucky ones that's going to be laid off or that was laid off. No warning, no clue. Your first instinct is typically one of shock, then for maybe only a split second denial might set in, like, you think, wait, this is a mistake. This can't be right. Or that's not true. No way.
Well, sometimes that denial, like an instance of hearing about a terminal disease, we might choose to deny it and say that that's not possible, he or she is very healthy. We play golf last week, or we just split wood, we put up two cords of wood last weekend, he's in great shape, no way he had a heart attack. Well, let's add shock to our first stage of grief. And let's call that first stage shock and denial.
Occasionally, once when the shock wears off, we realize we can't deny the reality and we just feel anger. Anger is a very powerful emotion. It often overrides our better judgment and common sense. Anger comes with some really bad side baggage too. It can bring a very unique, strong pain. For whatever reason we feel wounded, a sense of loss and an aching in our hearts and minds is there. Because of these feelings, we sometimes go into an alternate style of living our lives. For example, we may stop eating, or we may start overeating. Or we may not sleep, or we may sleep all the time. Or we may just make other people's lives miserable. Because we want company on that pain train. Unchecked, anger, like this is very destructive. It's very destructive to our loved ones, to our friends, well to everyone around us, as well as ourselves. Eventually, we realize that this anger really isn't going to help in any way. So we think about finding something that will and we move into the bargaining stage.
The best example of this is when my son got sick, he had brain cancer at the age of 24. I remember my wife and I both wishing it was one of us. After all, he had his whole life ahead of him. We pray, dear Lord, take me not him that was bargaining with God. In a divorce setting, one party may say, Well, just wait, let's hang on back up. Before we finalize this, let's go to counseling one more time. Let's try to work through our issues here together. Even though the other party is determined to go ahead with a divorce. There's bargaining that's taking place.
Many times once we realize that our anger and our bargaining are fruitless, we just get depressed. We think well, gosh, this is a lost cause, then we self doubt, we see nothing but dark and gloom and hopelessness. This reality we're in is happening whether I want it to or not, and I can't do anything to stop it. The company's shutting down, the company is moving overseas, I have this prognosis. It's terminal, there is no cure. Whatever the loss is, we get to the point where we see that it's it's hopeless, and our minds quiet down from all the denial, all the anger, and all the bargaining. Depending on our overall mental state, we might begin to see things more clearly at this point, at least we see them for what they really are, and not what we want them to be or wish they were. That's the first huge step and taking control of our future and our feelings about it. Rather than focusing on the anger and fighting with ourselves and our friends, or God,or everybody around us,rather than telling ourselves we can fix this, if we only do this, or that we can begin to wrap our minds in our energies around finding the best way to proceed. Now that we can see things clearly, we can develop a plan we can see a path. Someone told me getting to this stage was rather cathartic because they knew all along. They would get here after all of the anger and denial and bargaining and they knew that sooner or later, they would get to the point where they would accept the reality. Ultimately, it feels normal to actually be in that place mentally.
This state of mind then takes us to a sense of what the experts call acceptance. That's where we begin to deal with our new reality in a productive and positive way. Some medical practitioners call it the upward turn, and to add it to stage five, which is acceptance. And I like that idea to just like we put shock in the first step, let's put upper turn in the last step, stage five, most of us with some coaching from others can find a way to actually look at our new reality in a way where we begin to reconstruct our lives.
A good example of this is a patient of mine. He told me that after he dealt with the shock of a terminal prognosis that he decided to go on a cruise to Alaska, he and the Mrs. They'd always wanted to go. So they said no better time than the present, and understanding their new reality. They worked through their new lifestyle issues, and went on the trip of a lifetime. And they had the trip of lifetime. When they returned, he went into hospice home care, and she was his caregiver. And that is where I had the pleasure of meeting them in forming a great and meaningful relationship, a wonderful friendship with them and the entire family.
So there are five steps of grief.
What if we shortcut or bury or ignore these feelings? if we're honest, we've kind of all done that at one time or another. The human psyche is wondrous in how it works. We're all wired to have certain responses to different experiences in our lives. And one of those is grieving when we have a loss. Failure to do so is often ugly and very painful. In my experience, blocked and locked away feelings tend to impact us in many ways that we don't foresee. And many times in ways we don't even realize. From the obvious physical under the surface, grouchiness to a state of depression, blocked feelings, or denied feelings - things we don't want to deal - with can cause episodes of PTSD. They can cause us to be frozen and no longer able to function normally. Even though we try to forget, and we put our loss out of our minds, we bury it deep in the back dark corners of our minds.
It's still there.
And those percolating feelings of anger and denial and bargaining and depression and guilt, and they're just sitting there, just smoldering, and building up pressure, and someday, they boil over. And in the meantime, they'll affect your worldview. They'll affect everybody around you. They'll affect how you think and how you behave. And none of this is positive.
I recall when my son was first diagnosed with brain cancer, you know, he just finished college he had his whole life ahead of him graduated with honors from a prestigious engineering school. Upon completion of the brain surgery that he had to have. The neurosurgeon gathered us into a small room, off from the main waiting room, close the door, he said, in a very soft tone that, "folks, we did not find the news that we wanted. What we found was a glioblastoma, it's a brain tumor. And you can Google that and find out more about it. This type of tumors very serious will refer you to an excellent oncologist that specializes in these types of tumors."
I recall he avoided the trigger words cancer and terminal. Going in, we knew that it certainly could be a cancerous tumor. We were hoping for something else, like an infection or something non terminal. And I remember when we got that news, for sure. We were in shock. The surgeon dismissed itself so we could have some time together. With tears in our eyes, my wife and I knew that what we had heard was probably correct. That MRIs that were taken made it abundantly clear.
When Matt came out of surgery and woke up he asked me well, "Dad, what's going on up there?" And I told him it was a tumor, and that we're going to get the best neuro oncologist on the planet to help us take care of it. We chose our words carefully, as if to almost be in denial, and that maybe it would not be as bad as we He really thought it might be at the time.
So he went through all his radiation and chemo treatments. And I recall a few days before Christmas, we got news that the treatments were working, and that his tumors had actually shrunk to almost being invisible on the CT scans. We were so thankful to Almighty God for this good news. It was, if God has gifted us this good news for Christmas, we still are thankful for that news to this day. And that Christmas was amazing. Even though we all knew in the back of our minds, that this might just be a reprieve, a temporary deal, we still had a wonderful family Christmas, we focused on our new reality.
As Matt's journey went on, as you can imagine, we had good times and bad times, we were on that emotional rollercoaster that we all go through in this grief cycle. We finally got to the point where the chemo and the radiation no longer worked. And well, we were out of options. He had a stroke from all of the radiation and his brain and lost part of his functionality on the right side of his body. He was on steroids. So he ballooned up. This was our new reality. And so we made plans, we tried to figure out okay, what can we do? What do we want to do?
We decided to live in a series of 24 hour lifetimes. We didn't worry about tomorrow, didn't care about yesterday. We just looked at today. What can we do today. And some of those day trips and things that we did are, were fabulous, just awesome, and made awesome memories. As his disease progressed, I left my employment and was his full time caregiver along with his mom. And I recall how difficult that was, he was still 200 and something pounds, he couldn't stand on his own. And he was pretty much in a wheelchair all the time. And the things that we did for him when he was a, an infant and a toddler, we begin to have to do again. And all of this takes a toll on you emotionally. And when you think of this varsity letter winner, athlete, now having to be helped to the bathroom and had to be bathed, and all these things that we thought were way behind us. It takes its toll on on how you perceive your reality.
And we tried to stuff a lot of that away and put it in the back of our minds as we moved forward to put our best foot forward. And Matt did the same thing. He kept his chin up. And he tried to put a good smile on his face. Finally, one of the nurses came to visit us and it man's house where we were taking care of him. And she said "You guys look terrible. It's time for respite." And we all looked at each other, like what is that? And she explained how we could go to an inpatient facility they have, and Matt would be pampered. And we could get a good night's sleep, and not have to worry about him not being in good hands. And it was wonderful. So in the midst of this battle, going through the grieving cycle, we find ourselves in acceptance, and in hospice care in trying to do the very best we can. And this angel came to us in the form of a hospice nurse, and actually gave us five days where we could just be mom and dad, and we didn't have to be caregivers.
As I got rested, I began to think, what is our firstborn going through? Why him in this anger and depression washed over me. And to the point I couldn't breathe, and I cried out, Lord, take me in and leave my son. But that wasn't God's plan. I began to realize that Matt and all of us, well, there's nothing we can do about this, and put everything in God's hands, and that no matter what we're going to be okay.
Now, for those of you who don't have faith in God, this might be a very hard thing for you to understand. But I can tell you as one who's been involved with death of loved ones, and death of many good friends for many, many years working in hospice, it's true. We all need to find a respite when we're in the midst of this grief cycle. We all need a timeout. We all need to get to the point in our minds, to have grace with ourselves to the point where we don't have to try and keep pushing through, we shouldn't pressure ourselves, we should allow ourselves to grieve. And if we need help, if we need someone to come in alongside us, which we all do, by the way, it's okay to let go of the reins for a while, it's good to sit back and reflect on where am I, what's really going on here. It's good to get a good night's sleep and wake up with perspective of this new reality that we find ourselves in. And it's good to allow other people to help.
And when you're on the outside looking in, it's good to help others. And if you find yourself or someone else in one of these stages too long, that it's becoming destructive or harmful to them, and you see it in their, in their face, you see it in how they behave and how they relate. Remind them that it's not good to be at this point forever. Oh, it's good to be in all five of these steps. I guess we've made them seven now, haven't we, but there's going to be times where we have a foot in one and a foot in the other.
And like we said at the beginning of this episode, there's going to be times when we've advanced and we think Well, okay, we're doing good. And maybe that goes on for months, and then all of a sudden, something else happens. And we start going through this grieving process again, and then again, and then again. And even though these are new events, those old emotions are still there. And so instead of moving the rock pile out of the way we're adding to it or adding to adding to it.
So it's important that we understand how to deal with each of these events, and this grief process, and know that we can manage through it through self care through awareness of what actually what's going on, and why. And getting help and relying on our faith. Accepting our feelings seems to be the express route to being better into being healthier, ignoring them only makes matters worse.
As always, I highly recommend joining a local grief support group. Like most support groups, these are usually facilitated by a highly trained and very dedicated individual that has walked the same journey that you're walking right now. Online groups are good, don't get me wrong. But in my opinion, they're not as good as the in person ones. So call your hospice agency or shop around in your community for a good grief support group, you will certainly be a blessing to them. And you'll find comfort and encouragement there.
I want to thank you for taking time to be with us today. If you'd like to comment on this or any of our episodes, please visit us at www.livingwithhopsice.info. And you can leave us a note there while there you can also subscribe to our podcast, and then that way you won't miss any of the new episodes. Please share us with your friends. we're eager to help as many people as possible. Until next time, this is Mitch Ware for Living With Hospice. Have a blessed day.