Grief becomes a roller coaster for those who experience it (Karawi, 2019). Whether it's a romantic breakup, a significant life change, or the loss of a loved one, everyone has faced in some way the complexities of grief. This process is triggered after a painful loss, completely transforming life, taking on a different hue, and plunging the person into the most painful depths of the soul. According to Karawi (2019), moments of calm intertwine with anger, sadness, and confusion as the person struggles to restore normalcy without realizing that perhaps the very concept of normalcy has changed irreversibly.
Swiss-American psychiatrist Elisabeth Kübler-Ross presented her work "On Death and Dying" in 1969, outlining for the first time the five stages of grief (Martin, 2021). This description was based on her work with terminally ill patients at the University of Chicago (Martin, 2021). However, it is crucial to clarify that these stages do not follow a linear path, and each individual experiences them with different intensity, influenced by the strength of the bond, the circumstances surrounding the loss, and psychological, emotional, and mental factors (Karawi, 2019). According to Karawi (2019), understanding these stages can provide people with the certainty that they are not alone, that their experience is entirely normal, and that, inevitably, they will overcome this challenging process.
Denial
This is supposed to be the first stage (Karawi, 2019). Initially, people find it profoundly painful to accept reality, which can lead to a conscious or unconscious rejection of what they are experiencing at that moment. Denial can be a strategy to survive and cope with the emotions that arise when facing the idea of losing something beloved forever. When someone learns about the loss of a loved one or understands that the loss will permanently change their life, they may question why it has happened, and reality itself may lose its meaning (Karawi, 2019). Consequently, according to Karawi (2019), the person may feel that they cannot go on like this.
Although this stage of grief sometimes involves strict denial of the loss, it is not always the case; it can manifest in a more diffuse or abstract form (Martin, 2021). For example, one might deny the significance of the loss or its definitive nature, rather than denying the fact that it has occurred (Martin, 2021). As the person goes through this stage, they adapt to the new reality they face (Karawi, 2019). According to Karawi (2019), it is entirely normal for memories of what happened to come back to life repeatedly at times, as it is the way the mind processes the fact that the situation truly happened.
Rage
The end of denial is filled with feelings of frustration and helplessness regarding one's ability to change the consequences of the loss (Martin, 2021). This frustration, in turn, leads to the emergence of anger (Martin, 2021). This is because the person feels that life has let them down, taking away something that was very important (Karawi, 2019). On the other hand, death is perceived as the result of a decision, and that's why blame is sought (Torres, n.d.). Thus, in this phase, what dominates is disruption, the clash of two ideas with very strong emotional charge. That's why a strong feeling of anger appears that is projected in all directions, unable to find a solution or someone to fully blame for the death. Torres (n.d.) states that, even though a part of the person knows it's unfair, the anger is directed against people who are not at fault, or even against animals and objects.
Finally, it is crucial for the grieving person to understand that it is normal and healthy to experience and express all emotions that arise during this process (Karawi, 2019). This is because, through anger, situations can be processed much better, so it is crucial that those around the grieving person allow them to express themselves fully. In line with Karawi (2019), uncontrolled anger can trigger various deeper problems, both physical and mental or emotional.
Negotiation
In this stage, the word "hope" takes on an essential role as grieving individuals, amid all their emotions, seek to make religious promises, lifestyle changes, or emotional exchanges, with the fantasy that their loved one will remain (Karawi, 2019). This constitutes a defense mechanism that, in turn, aims to safeguard the person from fully experiencing the painful situation they are facing. At that moment, the person may experience great frustration upon realizing that the relationship with their loved one or the situation will never be the same again. Similarly, the person is filled with questions, wondering if things could have been different or if they really did enough or not. Multiple scenarios are contemplated as a last attempt to mitigate the pain caused by the loss (Karawi, 2019). However, according to Torres (n.d.), this stage is brief because it does not align with reality, and moreover, it is exhausting to constantly think about possible solutions.
Depression
During this period, the person begins to accept the reality of the loss, giving rise to feelings of sadness and hopelessness, accompanied by characteristic symptoms of depressive states such as social isolation or lack of motivation (Martin, 2021). Similarly, they experience a void, helplessness, and absolute exhaustion (Karawi, 2019). The loss of a loved one, facing one's own mortality, and other causes of grief can lead to the sense that life lacks meaning, at least temporarily (Martin, 2021). However, this stage is crucial and necessary as it allows people to confront reality, even though it involves a higher degree of suffering (Karawi, 2019). Consequently, many individuals choose to avoid discomfort or even falsely recover to evade a genuine connection with the pain. Perhaps, according to Karawi (2019), they feel the need to display strength to others, preventing them from fully experiencing the various emotions trying to emerge.
Acceptance
After the phases of denial, anger, bargaining, and depression, the acceptance of loss and the arrival of a state of calmness are associated with the understanding that death and other losses are natural phenomena in human life (Martin, 2021). In this stage, people allow themselves to continue enjoying life, even though what they love so much is no longer present (Karawi, 2019). Living from acceptance does not imply that people are completely okay or that they no longer care about what they experienced (Karawi, 2019). Instead, this stage is about making peace with the idea that this process they went through will always accompany them; it is about saying yes to life with all that it has brought; it is about honoring the destiny of that loved one. Finally, in line with Karawi (2019), guilt, doubts, and helplessness gradually disappear, bringing a new sense of tranquility where the person knows that there are things that cannot be controlled, and that the cycle of life is precisely that, a cycle.
Referencias
Karawi, S. (2019). ¿Qué es el duelo y la importancia de vivir su proceso?. Discovering Therapy. Recuperado 29 August 2021, a partir de https://www.discoveringtherapy.com/blog/es/que-es-el-duelo-y-la-importancia-de-vivir-su-proceso/
Martin, E. (2021). Las 5 fases (o etapas) del duelo: la teoría de Kübler-Ross. Centro Psicología Integral MC. Recuperado 29 August 2021, a partir de https://centrodepsicologiaintegral.com/las-5-fases-o-etapas-del-duelo-la-teoria-de-kubler-ross/
Torres, A. Las 5 etapas del duelo (cuando un familiar fallece). Psicologiaymente.com. Recuperado 29 August 2021, a partir de https://psicologiaymente.com/clinica/etapas-del-duelo
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