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Grief & Bereavement Resources

In her ground-breaking, classic book, On Death and Dying, Elizabeth Kubler-Ross (1969) identified fives stages of grief: 1) Shock and Denial, 2) Anger, 3) Bargaining, 4) Depression, and 5) Acceptance. These are not five distinct phases, but each stage of grief is predominantly characterized by one of these emotions. The person going through the grief process can bounce back and forth experiencing each of these emotions throughout their grief, but as they go through each phase, their emotional set will be dominated by the stage that they are in. Originally, Dr. Ross identified these five stages in her work with dying cancer patients. However, it was soon realized that the process of grieving could be applied to anyone suffering a significant loss.

After Dr. Ross introduced this conceptual framework, most therapists at the time seemed to feel that it was necessary for each client to emote each of these feelings so that the client wouldn’t get stuck in their grief process. However, we now know each individual has a unique style in their grieving process. For instance, individuals who predominantly process their emotions by thinking their way through their feelings will need to emote much less than individuals who are less inclined to this type of cognitive style. Essentially, while there is a general pattern to grief, there is no “right way” to grieve.

Stage 1: Shock & Denial

The first thing that someone undergoing a loss may feel is shock and denial. Typically shock is experienced as a sort of emotional numbness. The person who is in shock may feel as though their experience is unreal. The initial reaction by the person in shock is denial : “This can’t be happening.” The denial of the death might extend well past the feeling of shock. The death might feel so unreal in the first weeks that the person in grief might forget and set a plate at dinner for the deceased.

Stage 2: Anger

During this stage, the grieving person will experience the loss and the circumstances surrounding the loss as unfair. They will express their anger with the thing or the person they have lost or the people or circumstances surrounding the loss. This can be particularly distressing for people who had no previous awareness or occasion of being angry with the person who died. It is natural, even if it might not feel rational, for people to be angry with someone who has died.

Stage 3: Bargaining

The name of this stage is really a throw-back to Kubler-Ross’s work with the terminally ill. What it it refers to is the terminally ill patient bargaining with fate to vainly escape their predicament. Here the terminally ill person my say something like: “Just let me see my daughter’s wedding.” The Bargaining Stage manefests itself differently with someone who is grieving the death of a loved one. Here the bargaining person will say things like: “If only I had got him to the doctor sooner, he would have lived longer.” Or: “I should have never taken her on vacation, that’s where she got into the accident.” Or: “I could have been more loving at the end.

Stage 4: Depression

People often confuse sadness and depression. Sadness is a specific emotional state. Sadness will often accompany depression. Depression is not so much a feeling state as much as it is a state that suppresses emotion. Often people who are depressed will experience a depressed mood, a loss of their usual pleasures and interests, and fatigue. They might experience insomnia or over-sleeping. A depressed person also might lose their appetite to the extent that they lose weight. Someone in this stage might find their judgement affected by unreasonable feelings of worthlessness, hopelessness, nihilism, guilt and morbid thoughts.

Stage 5: Acceptance

The course of grief is not a linear one. As I mentioned, people tend to bounce back and forth throughout these five stages. However, after the roller-coaster ride of the shock, anger and bargaining, the bereaved settles down into a depression. Finally, the depression is worked through as the acceptance of the loss is integrated and accepted. The individual returns to functioning in their day to day affairs, they institute new routines and find ways of restablishing meaning, purpose and satisfaction in their lives.

Grieving Other Losses

The grief process can occur with other losses, not just the death of a loved one. Lost relationships, jobs, pets, and pretty much any significant loss can trigger a grief reaction. Even a positive loss, like the loss of a troublesome relationship or the loss of a problematic job can create a grief reaction. The depth of grief is usually related to the meaning and values the person places on what was lost.

What If You Get Stuck?

A grief reaction is not necessarily a bad thing. Grief and loss are natural parts of life. A grief reaction is the natural way we heal ourselves from loss. Complicated grief, multiple losses, the lack of opportunity to grieve or confusion about the grief process can create a situation where an individual gets stuck in their grief. Sometimes people do get stuck and that’s where grief counseling can help. If you would like to find out more about grief counseling or if you would like to schedule an appointment, please contact: Jacob Spilman @ (503) 227-3187 or jacobspilman@msn.com.

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Bereaved Adults:

Legacy Emanuel Hospital: http://www.legacyhealth.org/body.cfm?id=1127 A hospital-based professionally facilitated Grief Support Program.

Providence Hospital: http://www.providence.org/Oregon

Type in "Grief" in the search box to get to the "Bereavement Support" Link. This is a hospital-based professionally facilitated Grief Support Program.

Bereaved Children:

The Dougy Center: http://dougy.org/ Professional help for children, teens and their family.

Bereaved Parents:

The Compassionate Friends-Portland Chapter: http://www.tcfportland.org/ This is a layperson led self-help group offering support for parents who have lost a child.

Brief Encounters: http://www.briefencounters.org/ Support group for parents who are grieving the loss of an infant before, during or after birth.

Suicide Bereavement Support:

Suicide Bereavement Support: http://www.sbsgroups.org/indexHr.htm

Layperson led self-help group for family and friends of those who have committed suicide.

Grief & Bereavement