The well-known pioneer researcher Dr. Elisabeth Kubler-Ross identified five states through which the dying patient goes. It is also true that the recently bereaved and the about to be bereaved evidence the same stages. Kubler Ross has labeled the 5 stages denial, anger, bargaining, depression, and acceptance. People do not necessarily go through these stages in any set order or over a set length of time, nor does the individual necessarily pass through each of the stages. Most controversial is the final stage of acceptance. Kubler-Ross believes that all of us come to accept death as it approached, but other researchers do not agree. Westberg, for example believe, as do the writer, that we come to a point of living with the loss. Let’s now review the 10 stages of grief as defined by Westberg. If you have or can access his tiny book entitled, Good Grief, it would help you to understand each stage in more depth than the writer will go.

10 Stages of Grief According to Granger Westberg (Good Grief):

1) shock – numbness, denial, disbelief
2) emotional releases – tears, cursing
3) physical manifestations – loss of sleep, eating
4) depression, panic –how do I go on, detachment
5) guilt – if only
6) anger – god, self, deceased, blame
7) idealism – halo effect, past was perfect
8) realization – past not perfect, maybe a future
9) new patterns – begin again, let go of past images
10) living with the loss – live, love. Laugh again, adjusting

Another valuable resource is Catherine Sanders book, The Mourning After. Taking an integrative approach, she identifies 5 primary phases of the grief process:

5 Phases of the Grief Process According to Catherine Sanders (The Mourning After)

1) shock – disbelief and denial, confusion, restlessness, state of alarm

2) awareness of loss – separation anxiety, conflicts, prolonged stress, acting out emotional expectations

3) conservation/withdrawal – despair, withdrawal, diminished social support, helplessness

4) healing – turning point, assuming control, identity restructuring, relinquishing roles

5) renewal – new self-awareness, new sense of freedom, accepting responsibility, learning to live without

In summary, it should be understood that the numbness and sense of unreality when first hearing about the death of a loved one is both a gift and an adaptive response which prepares one to deal with the loss. Statements expressing this surreal phase includes: "I don't believe it," or "It can't be."

It is common to lose a loved one and feel angry about the death and consequences. Since anger needs a target, it is frequently directed at the self, doctor, nurse, funeral director, clergy person, family member, friend or God. Since anger is a choice, it is important for the bereaved to recognize and acknowledge the fact that they are angry.

It is said that actress Elizabeth Taylor, speaking about the death of her husband, Michael Todd, and her subsequent depression, stated: "I didn't think I would survive and I didn't much care. To this day my feelings about him are so strong that I cannot speak about him without being overcome with emotion." For the majority of people in grief, feelings of emptiness and sadness generate feelings of depression.

"My husband died after a long illness. Several times I lost my temper and said some cruel things to him, but when I realized he couldn't get well, I took loving care of him until God called him home. Now I regret all the wrong things I did." Like many who have experienced a loss, this woman is tortured by regrets. While feelings of guilt are quite normal, they are usually not very realistic.

Sometimes anxiety and frustration are connected to the fear of being alone and without a loved one. There may be concern about the future and fear about losing someone else to death. There is no timetable for grief. No one need feel ashamed while getting over a traumatic loss. It is a long complex business. it is the process of grief.

The day will come when grief softens and even dissipates. Usually the recovery is so gradual that the bereaved is not even aware that healing is, in fact, taking place.

Rev. Saundra L. Washington, is an ordained clergywoman, social worker, and Founder of AMEN Ministries http://www.clergyservices4u.org. She is also the author of two coffee table books: Room Beneath the Snow: Poems that Preach and Negative Disturbances: Homilies that Teach. Her new book, Out of Deep Water: A Grief Healing Workbook, will be available soon.

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