Tuesday, September 05, 2006

Seeing the Stages of Loss in In Memoriam part 3

Kubler-Ross’ Stages of Loss

Two books comprise the soul of understanding of this thesis. Both were helmed by Elisabeth Kubler-Ross. The seminal 1969 work entitled On Death and Dying was a powerful work that affected all matters of research into not only dying patients but understanding how caretakers should take care of their patients. The 1969 book was published as an understanding of what terminally ill patients were going through. The other book, much more recent and co-authored by David Kessler, is On Grief and Grieving. This book makes much of an attempt to solve the problems that the general populace brought about by trying to apply the stages of loss applied to almost everything death-related. While a natural extension, it also paves the way for an understanding of how the human race copes with loss coming from the death of someone important to them.
The five stages of grief are the same in both circumstances. It is the assumption of the book, and thirty-seven plus years of research, that have given these stages credence in their applicability to the general populace. However, individuals will “witness and feel all those moments…at their own level” (On Grief 4).
Denial is the first stage. It is also called Denial and Isolation in On Death and Dying. This stage is often confused because of its title. “It means you come home and you can’t believe that your wife isn’t going to walk in the door at any minute or that your husband isn’t just away on a business trip. You simply can’t fathom that he will never walk through that door again” (8). Kubler-Ross notes that this stage is extremely important to help us “survive the loss…” and that “It is nature’s way of letting in only aw much as we can handle” (9). Denial allows the reality of the situation to sink in slowly as the griever can handle it.
Next, as denial fades, the stage of Anger sets in. There is the understanding that here, “Anger does not have to be logical or valid” (11). Comparisons here speak of a blurred line between intellectual and emotional thought. Sometimes they cannot coincide and feelings can lash out when these feelings do not reconcile with a new understanding of a world without a loved one. “There you sit, alone with your anger, wondering how to reconcile your spirituality and your religion with this loss and anger” (13). Kubler-Ross notes also the importance of this stage by the fact that a griever must allow it to happen. “But for now, your job is to honor your anger by allowing yourself to be angry. Scream if you need to. Find a solitary place and let it out” (15). It is understandable that Tennyson turned to his poetry in order to let it out and indeed did so for seventeen years as he wrote the poems of In Memoriam. “The more anger you allow, the more feelings you will find underneath,” says Kubler-Ross as she analyzes that a deeper understanding of the feeling involved is necessary for complete healing (16).
Bargaining is the third stage and can be somewhat short lived, depending on the griever. Here, you bargain with your faith, others, and anything as to letting your loved one remain. These what if scenarios are explorations into our understanding and need to be addressed. Even with bargaining, a griever will inevitably fall to “the tragic reality that our loved one is truly gone” (20).
Depression is the next stage and is needed as much as any of the other stages. Kubler-Ross notes that this stage is not a bad stage but absolutely necessary for a griever. “This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss” (20). It is important to note that people outside of the griever cannot force a griever to simply stop being depressed at this stage. It must work itself out. The author admits that there is no standard time for depression to last. “We must accept sadness as an appropriate, natural stage of loss without letting an unmanaged, ongoing depression leech our quality of life” (23). This is also a reason to understand these stages to allow a mourner sufficient individual time for his or her own grief.
Acceptance is the last of the five stages. It is not, however, forgetting the loved one or saying that the death is okay. “This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality” (25). It is part of the process, not an end point.
The article by Pass clearly elucidates the stages of grief through the actions of the character Sethe in the Toni Morrison novel Beloved. In it, she points out feelings and actions that directly correlate with the stages. The acceptance found at the end allows Sethe to “go forward to find a new life with Paul D, Denver, and the community surrounding the three of them” (Pass 124). She also says that while Kubler-Ross “literally delineates the steps,” Beloved “metaphorically illustrates the treacherous path” (124). This is exactly what Tennyson goes through in his writings for In Memoriam, a work that took seventeen years to complete and publish. In Memoriam is also a more autobiographical work than the fictitious Beloved. It is also important to note the publication dates of the two works. Beloved was first published in 1987 and In Memoriam in 1850. Whether Morrison was consciously or unconsciously aware of the findings of the 1969 work that had seeped into the general consciousness is unknown; In Memoriam was simply too far removed to be tainted by these concepts. Therefore, it is interesting to note that a work in 1969, about modern grieving, still adequately reflects a work published way back in 1850.
Critically, most psychologists and counselors have appreciated the five stages of loss derived by Kubler-Ross. In fact, the New York Times obituary of Kubler-Ross stated that the work was “pioneering.”
Dr. Kubler-Ross was credited with helping end centuries-old taboos in Western culture against openly discussing and studying death. She also helped change the care of many terminally ill patients to make death less psychologically painful, not only for the dying, but also for their doctors and nurses—and not least for the survivors” (Noble B8).

Quoting the president of the American Medical Association in 1998, Dr. Percy Wooten, the obituary also stated, “Dr. Elisabeth Kubler-Ross was a true pioneer in raising the awareness among the physician community and the general public about the important issues surrounding death, dying and bereavement” (B8).
Some of the dissenters to the Kubler-Ross model have cited errors in understanding some of the basic tenets of the stages. They call the five stages too general to fully count on. Also, they blame the misunderstanding on Kubler-Ross’ work when people do not go through the stages in order. Some of this criticism comes from an organization calling itself Counseling For Loss & Life Changes, and even at one point satirically uses the stages to complain about the loss of a car. Yes, it does fit in that respect, if forced, but Kubler-Ross identifies specifically that her stages are generalizations and these generalizations help us understand the process of grief on a wide scale.

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