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2011年3月25日金曜日

Bereavement, Sorrow, Grief


Based on the book by Elisabeth Kuber-Ross and David Kessler
“On Grief and Grieving”

Also known as the 'grief cycle', it is important to bear in mind that Kübler-Ross (1) did not intend this to be a rigid series of sequential or uniformly timed steps. It's not a process as such it's a model or a framework. People do not always experience all of the five 'grief cycle' stages. Some stages might be revisited. Some stages might not be experienced at all. 

Denial
Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defense mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely. (1)
When person is in denial, he (she) may respond at first by being paralyzed with shock or blanketed with numbness. It is still not denial of the actual death, even though someone may be saying, “I can not believe”. They are saying this first of all because it is too much for their psyche. Denial helps to unconsciously manage their feelings. This first stage of grieving helps them to cope and make survival possibility. These felling are important; they are psyche’s protective mechanism. To fully believe at this stage would be too much. The denial often comes in the form of questioning reality: Is it true? Did it really happen? As denial fades, it is slowly replaced with the reality of the loss. (2)
 
Anger
Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep detached and non-judgmental when experiencing the anger of someone who is very upset. (1)
This stage present itself in many ways: anger at who person lost, anger at person did not take better care of whom has lost or anger at the doctor or nurse who could be able to be more attentive or kind, may be angry that bad things could happen to someone who meant so much to the person.
Anger does not to be logical and valid. Person may know something logically, but emotionally, all he (she) knows is that it was not supposed to happen or at least with him (her) and now.
Most of all, the person in lost may be angry at this unexpected, undeserved and unwanted situation.
Anger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. More the person truly feels anger, the more it will begin to dissipate and he (she) more will be heals.
There are many other emotions, but anger is the emotion we and most used to managing. We often choose it to avoid the feelings underneath until we are ready to face them. It is a useful emotion until you have moved past the first waves of it.
Anger has o limits. It can expend not only to your friends, the doctors, your family, yourself, to God, and your loved one who died. 
Anger is pain, grieving person’s pain, your pain. It is natural to feel deserted and abandoned, but we are live in society that fears anger. Some people may feel grieving person’s anger is harsh or too much. But grieving person’s job is firs of all to allowing themselves to be angry even scream if they needs. Anger can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea; no connection to anything. Than person gets angry at someone and suddenly has a structure – he (she) anger toward them. The anger becomes a bridge over the open sea, a connection from the grieving person and others. Even anger is the most immediate emotion, but as the person deals with it, then will find other feelings hidden. Anger means the grieving person are progressing and should not be criticized by anyone. (2)
There are some situation when anger are getting endless, then person should think how to deal with “permanent anger”.
 
Bargaining
Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death. (1)
“I will never hate my morning sickness again if my pregnancy, my baby will just back to me”. Guilt is often bargaining’s companion. The “if only” cause the person to find fault with him(her)self and what he (she) could has done differently.  
Bargaining can help grieving person’s mind move from one stage of loss to another; fills the gaps that strong emotions generally dominate, with often keep suffering at a distance.
After a death, bargaining often moves from the past to the future. We may bargain that we will see our loved ones again in the haven. (2)

Depression
Also referred to as a preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality. (1)
This depression is not a sign of mental illness; it is the appropriate response to a great loss. In grief, depression is a way for nature to keep the person protected by shutting down the nervous system so that he (she) can adapt to something they feel they cannot handle. 
When depression follows loss, there are specific sorrows that can be identified. In more serious and long-lasting depression, it is difficult to receive support. I this case antidepressant medications may be useful; to help lift someone out of what seems to be a bottomless depression. Some people feel that medications simply put a floor in for them to deal with their depression.
As difficult as it is to endure, depression has elements that can be helpful in grief. It slows us down and allows us to take real stock of the loss. It make us rebuild ourselves from the ground up. It clears the deck for growth.
A mourner should be allowed to experience his sorrow, and he will be grateful for those who can sit with him without telling him not to be sad. No matter what our surroundings may hold, we feel alone. This is what hitting the bottom feels like. (2)    

Acceptance
Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief. (1)
Acceptance is not of being all right or okay with what has happened. Most people do not ever feel okay or all right about the loss of a loved one. This stage is about accepting the reality that the person’s loved one is physically gone and recognizing that new reality is the permanent reality. This is the time to learn to live with it.
Healing looks like remembering, recollecting, and reorganizing. As we heal, we learn who we are and who our loved one was in life. In a strange way, as we move though grief, healing bring us closer to the person we loved.    
Finding acceptance may be just having more good days than bad. As the grieving person is begun to live again and enjoy the life, he (she) often feel that is betraying their loved one. The person who lost can never replace what has been lost, but can make a new connection, new meaningful relationships. (2)



2. On grief and grieving // Elisabeth Kübler-Ross and David Kessler, Scribner, 2005, 235 p.

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