Five Stages of Grief

I recently completed a CBT (Cognitive Behavioural Therapy) course at the RNHRD (Royal National Hospital for Rheumatic Diseases) with the aim of find better ways of dealing with my emotions. Which I know I have a tendency to squash. I’ve found it extremely helpful, but now that I’ve come out the other end and have stopped trying to bury my feelings I have to deal with them instead. Something which is not at all easy.

The Kübler-Ross model or Five Stages of Grief suggests that when we grieve we go through five distinct stages. These are Denial, Anger, Bargaining, Depression and Acceptance. We experience these when we grieve for anything or anyone. Whether that is the loss of a friend or the loss of our life or just the loss of our life as it was.

Denial is the phase where you say ‘I’m fine’, and refuse to admit there is anything wrong. I think for me the denial phase was short lived.

Anger is when we ask ‘Why me?’ and start placing blame. I’m not too good at dealing with anger, of all the emotions, I find it the most difficult and I hid a lot of my anger in my mind in places where I didn’t have to see it.

Bargaining is where we try and change things: ‘I’ll do anything to change this’, personally I go through bargaining stages quite frequently, but they are usually short lived because I know the futility of it.

 
Depression is when we retreat into sadness. When people cry and grieve. In some ways I think this is the most important part of the process. This is the stage that you must participate in fully to move on to acceptance. The very fact that there are feelings of sadness shows the start of acceptance, the true realisation of loss. You wouldn’t stop someone grieving for the loss of some they love, and it is just as important not the stop yourself from grieving for the loss of your old life.

Finally there is Acceptance. The point where you are ok with it, whatever it is.

With CFS/ME there is a great sense of loss, or there was for me, particularly in the early stages. I felt very much that I was grieving for my old life which had disappeared or ended suddenly. I went through all the stages, some quicker than others, and reached a level of acceptance. What I did not fully understand is that this model is not linear; you can revert to earlier stages. It is only through CBT sessions that I have accepted that I am allowed to go backwards. And in fact, that I have lost the acceptance I had.

 
The part of my brain that wasn’t accepting my illness I’d buried carefully as dealing with it was too inconvenient. Now, having let it out I am now experiencing feelings of anger and depression again. Feelings that I have to allow myself if I am ever to move on to the acceptance phase again.

 
The sense of loss is not as immediate as it once was, time has softened it to something less sharp and painful, something blunter and duller, but it is still there nonetheless. I grieve for the loss of my independence, my career, my life as it was. I am angry with my body for letting me down. At the moment I cannot accept that I might never get my life back. Which is strange because I have accepted this in the past and been content with that, although I now wonder if this was a true acceptance.

 
I am at long last allowing myself to really grieve for what I have lost. Not forcing myself into acceptance and burying the parts of my mind that didn’t agree. I hope that true acceptance isn’t far away.