Cancer & Emotions: A Guide for Patients and Family
Part II: Coping with Grief & “Why Me?”
Any article on grief when you’re coping with a cancer diagnosis and undergoing treatment would not be complete without the often-cited “Five Stages of Grief” by psychiatrist Elisabeth Kubler-Ross. Often cited is actually an understatement. The “Five Stages of Grief” model is discussed or mentioned in almost every article, blog post, book, or magazine publication on illness, death, loss, or any moment in life when things don’t go as we plan (i.e., the rug is pulled from under our feet or we fall smack down on our faces and don’t know what to do). It’s understandable, though, because Dr. Kubler-Ross definitely knew what she was talking about. Although the model was initially created to help people prior to death, it is now used to help people going through all sorts of issues, whether you’re dealing with an illness yourself or you’re supporting someone who is going through difficult times. Here I offer my spin on the “Five Stages of Grief”.
Stage One: Denial (“Who? Me?”)
When initially diagnosed with cancer, some people believe that it’s a mistake or that it can’t be happening to them. They might even put off beginning their treatment because of disbelief, but at a deeper level, they are really just overwhelmed with emotions, questions, concerns, and fear. When we’re stressed or scared, denial is our friend because denial is a survival instinct: It protects us from the potentially dangerous and damaging effects of stress. If you don’t believe that something is happening, then as far as your mind is concerned, it’s not happening. Denial kicks in when we need to process something new, unknown, and/or scary, but we need to process it slowly, at our own pace, so that it’s not so overwhelming.
Stage Two: Anger (“Why me?!”)
This stage is characterized by feelings of frustration, especially towards those closest to the grieving individual. Some people will enter the Anger stage immediately after diagnosis, while others will experience Anger after Denial. Feelings of Anger sometimes occur when the grieving person can no longer stay in the Denial stage (i.e., the diagnosis becomes too real). In this stage, a lot of blaming can occur. The grieving person wants to blame someone, anyone, for the illness. Some individuals feel they are being punished for some reason and will blame themselves.
Stage Three: Bargaining (“I’ll trade you.”)
Sometimes, people wish to try to avoid their illness and feel like they can still go back to the way things were before diagnosis. Individuals will promise themselves or others (or a sky-borne deity) that they will change their ways or sacrifice something in exchange for health. Bargaining involves a misplaced sense of responsibility or blame that the grieving person puts on themselves for the cause of their illness. They feel that if they become “a better person” then a miracle will occur or they will be given a second chance and they can be well again. This implies that the person feels as if they were “bad” before and the illness is their “punishment.”
Stage Four: Depression (“What’s the point…”)
Some individuals will enter a depression stage after they recognize that they can’t avoid their illness and that the illness is real. Just like in the Denial stage, they are overwhelmed with their circumstances, but unlike the Denial stage, they accept their illness (and feel like giving up). The thought of fighting the illness feels bigger than what they believe they can handle. Many individuals will withdraw from family and friends and demonstrate an “I don’t care” or “Leave me alone” attitude.
Stage Five: Acceptance (“Everything might be alright.”)
Many individuals come to the point where they accept their illness and even embrace it. They figure that there’s nothing they can do about it, so they may as well accept it and stop stressing. This stage involves the person having a more calm view of the illness and more stable emotions about their circumstances.
Research hasn’t supported Kubler-Ross’ model, but regardless, people like it and people can relate to it and I guess that’s important too. These stages can occur in any order and some people might skip some stages, repeat two or three of the same stage, or remain in only one stage. Grieving is a process that is so unique to every individual, but understanding the process makes us feel a sense of relatedness. A sense that we are not on this journey alone and that when we read things like this article or the numerous other self-help texts and advice on how to cope, we know that these things exist because others have gone through and felt what we are feeling. This is proof that we are not alone in our struggles.