SayPro CONCEPTS AND PRINCIPLES OF SEPARATION AND LOSS

The Kübler-Ross model is popularly known as the five stages of grief. Even though it’s been represented in modern culture as model of depression, the model was originally designed to postulate a progression of emotional states experienced by terminally ill patients after diagnosis. The five stages are chronologically: denial, anger, bargaining, depression and acceptance.The model was first introduced by Swiss-American psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying, and was inspired by her work with terminally ill patients. Motivated by the lack of instruction in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago medical school. Kübler-Ross’ project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Although Kübler-Ross is commonly credited with creating stage models, earlier bereavement theorists and clinicians such as Erich Lindemann, Collin Murray Parkes, and John Bowlby used similar models of stages of phases as early as the 1940s.Later in her life, Kübler-Ross noted that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood. "Kübler-Ross originally saw these stages as reflecting how people cope with illness and dying," observed grief researcher Kenneth J. Doka, "not as reflections of how people grieve."Throughout life, we experience many instances of grief. Grief can be caused by situations, relationships, or even substance abuse. Children may grieve a divorce, a wife may grieve the death of her husband, a teenager might grieve the ending of a relationship, or you might have received terminal medical news and are grieving your pending death. In 1969, Elisabeth Kübler-Ross described five popular stages of grief, popularly referred to as DABDA. They include:

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

DenialDenial is the stage that can initially help you survive the loss. You might think life makes no sense, has no meaning, and is too overwhelming. You start to deny the news and, in effect, go numb. It’s common in this stage to wonder how life will go on in this different state – you are in a state of shock because life as you once knew it, has changed in an instant. If you were diagnosed with a deadly disease, you might believe the news is incorrect – a mistake must have occurred somewhere in the lab–they mixed up your blood work with someone else. If you receive news on the death of a loved one, perhaps you cling to a false hope that they identified the wrong person.In the denial stage, you are not living in ‘actual reality,’ rather, you are living in a ‘preferable’ reality. Interestingly, it is denial and shock that help you cope and survive the grief event. Denial aids in pacing your feelings of grief. Instead of becoming completely overwhelmed with grief, we deny it, do not accept it, and stagger its full impact on us at one time. Think of it as your body’s natural defense mechanism saying “hey, there’s only so much I can handle at once.” Once the denial and shock starts to fade, the start of the healing process begins. At this point, those feelings that you were once suppressing are coming to the surface.AngerOnce you start to live in ‘actual’ reality again and not in ‘preferable’ reality, anger might start to set in. This is a common stage to think “why me?” and “life’s not fair!” You might look to blame others for the cause of your grief and also may redirect your anger to close friends and family. You find it incomprehensible of how something like this could happen to you. If you are strong in faith, you might start to question your belief in God. “Where is God? Why didn’t he protect me?”Researchers and mental health professionals agree that this anger is a necessary stage of grief. And encourage the anger. It’s important to truly feel the anger. It’s thought that even though you might seem like you are in an endless cycle of anger, it will dissipate – and the more you truly feel the anger, the more quickly it will dissipate, and the more quickly you will heal. It is not healthy to suppress your feelings of anger – it is a natural response – and perhaps, arguably, a necessary one. In everyday life, we are normally told to control our anger toward situations and toward others.When you experience a grief event, you might feel disconnected from reality – that you have no grounding anymore. Your life has shattered and there’s nothing solid to hold onto. Think of anger as a strength to bind you to reality. You might feel deserted or abandoned during a grief event. That no one is there. You are alone in this world. The direction of anger toward something or somebody is what might bridge you back to reality and connect you to people again. It is a “thing.” It’s something to grasp onto – a natural step in healing.BargainingWhen something bad happens, have you ever caught yourself making a deal with God? “Please God, if you heal my husband, I will strive to be the best wife I can ever be – and never complain again.” This is bargaining. In a way, this stage is false hope. You might falsely make yourself believe that you can avoid the grief through a type of negotiation. If you change this, I’ll change that. You are so desperate to get your life back to how it was before the grief event, you are willing to make a major life change in an attempt toward normality. Guilt is a common wing man of bargaining. This is when you endure the endless “what if” statements. What if I had left the house 5 minutes sooner – the accident would have never happened. What if I encouraged him to go to the doctor six months ago like I first thought – the cancer could have been found sooner and he could have been saved.DepressionDepression is a commonly accepted form of grief. In fact, most people associate depression immediately with grief – as it is a “present” emotion. It represents the emptiness we feel when we are living in reality and realize the person or situation is gone or over. In this stage, you might withdraw from life, feel numb, live in a fog, and not want to get out of bed. The world might seem too much and too overwhelming for you to face. You don’t want to be around others, don’t feel like talking, and experience feelings of hopelessness. You might even experience suicidal thoughts – thinking “what’s the point of going on?”AcceptanceThe last stage of grief identified by Kübler-Ross is acceptance. Not in the sense that “it’s okay my husband died” rather, “my husband died, but I’m going to be okay.” In this stage, your emotions may begin to stabilize. You re-enter reality. You come to terms with the fact that the “new” reality is that your partner is never coming back – or that you are going to succumb to your illness and die soon – and you’re okay with that. It’s not a “good” thing – but it’s something you can live with. It is definitely a time of adjustment and readjustment. There are good days, there are bad days, and then there are good days again. In this stage, it does not mean you’ll never have another bad day – where you are uncontrollably sad. But, the good days tend to outnumber the bad days. In this stage, you may lift from your fog, you start to engage with friends again, and might even make new relationships as time goes on. You understand your loved one can never be replaced, but you move, grow, and evolve into your new reality.The Extended Grief CycleThe Extended Grief Cycle can be shown as in the chart below, indicating the roller-coaster ride of activity and passivity as the person wriggles and turns in their desperate efforts to avoid the change.

The initial state before the cycle is received is stable, at least in terms of the subsequent reaction on hearing the bad news. Compared with the ups and downs to come, even if there is some variation, this is indeed a stable state.And then, into the calm of this relative paradise, a bombshell bursts:· Shock stage: Initial paralysis at hearing the bad news.· Denial stage: Trying to avoid the inevitable.· Anger stage: Frustrated outpouring of bottled-up emotion.· Bargaining stage: Seeking in vain for a way out.· Depression stage: Final realization of the inevitable.· Testing stage: Seeking realistic solutions.· Acceptance stage: Finally finding the way forward.This model is extended slightly from the original Kubler-Ross model, which does not explicitly include the Shock and Testing stages. These stages however are often useful to understand and facilitating change.

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