In the early 1970’s Dr. Elisabeth Kὓbler-Ross and a team of medical grad students participated in a study. They wanted to learn how they could better meet the emotional needs of a person that was dying. The study took place at the University of Chicago’s medical school. For this study 100 patients were observed. They had been diagnosed with a terminal illness and given one year or less to live. Kὓbler-Ross and her team followed the medical staff around as they delivered the terminal diagnosis to the patients. They observed the patients’ reactions to the news of the terminal diagnosis. Her team then continued to regularly check in on those 100 patients. Talking with them and observing how they were handling the diagnosis of impending death. It was their observations and conversations with those dying that became the basis of her book “On Death and Dying”. Her findings were misinterpreted and became widely known as “the 5 stages of grief”.
One of the first things they observed when people were told that they had a year or less to live was – denial. As they continued their observations, they also witnessed anger, bargaining, depression and right before they took their last breath – most found acceptance that death was imminent. Kὓbler-Ross and her team never observed or studied the surviving family members – the spouses, the parents, the siblings. The study only focused on those that were dying. When her findings were published it was meant to be an observation of the emotions people battle while facing illness and dying. It was meant to be a resource to mental health professionals to aid them in knowing how to better assist those dying. Yet somehow it erroneously became a reflection of how people grieve. Later in life, she regretted the way the findings were reported and so easily misunderstood.
In her study, she reported emotions as they observed it, so it led people to believe that the grief process was linear. But anyone who has endured a season of grief, knows that emotions are anything but linear. You do not experience a singular emotion – you are more likely to experience a jumbled ball of emotions – helplessness, disappointment, bitterness, loneliness, dread, pain and rage – just to name a few. Her findings also led people to believe that the first year was the hardest and that most of the grief work was done within a year. This was based on the premise that all the participants in the study had died within a year – so their individual grief had stopped. Remember there was no one observing the family members – the ones left behind.
It has been my own personal experience that the second and third years were the hardest. Why is that? There are a few factors that contribute to that. One is simply because God in his infinite wisdom designed our bodies with a self-protective mechanism called “shock”. Without that protective mechanism of shock – none of us could survive the horrific realities of death. In his book “Surviving the Loss of a Child” Gary Roe states “when we first hear the news, time stops. It’s like someone pushed the pause button on the universe. Our hearts reel. Our minds spin. Shock is normal. The loss of a child is like being hit by an unexpected tsunami. It knocks us senseless.” Roe goes on to state “shock is not something we graduate from in grief. It is something that we move in and out of, numerous times, as needed. Our hearts need to grasp the enormity of what happened. Even years later, we might have trouble coming to grips with it.”
For much of the first year, shock is a large factor in our processing but as we are able to move in and out of the “shock” of the trauma, we are also left vulnerable to the rawness of the emotions. Another factor that makes the second and third year of grief harder is as times goes on, family and friends have usually gone back to their lives. The initial support group that was there in the early days, weeks, months is now gone. The one grieving is left on their own while facing the rawness of the emotions just as fresh as they were the first day it happened.
Acceptance was the final stage that was witnessed for many patients prior to their death. Acceptance for the surviving parent or family member takes on many different meanings. But it very seldom means that they have quit grieving. You can experience great peace while still experiencing great pain. Acceptance is much like shock. It’s not something you graduate you from – it’s something you flow in and out of it. It’s been twelve years since my baby boy left this earth. But it only takes a moment for my heart to find it hard to accept. Being on the campus of LU and hearing the drum cadence can crush me with emotions I thought I had long overcome. And the response is never the same. Some days I may hear the drum cadence from the marching band, and I am immediately filled with joy from all the wonderful memories I have of him and his marching band years. Another day I could hear the drum cadence and it quickly turns into an “ugly cry” because my heart aches with the memories of his funeral and the drum cadence being played. The cold realization that he is gone can come rushing at me like a freight train and I’m stuck on the tracks unable to move.
David writes in Psalm 31:10 “for my life is spent with grief, and my years with sighing: my strength faileth because of mine iniquity and my bones are consumed.” David realized how much the mental anguish had zapped his physical strength, he felt like a broken vessel and left all alone. Those are the sentiments shared by many grieving. It takes a physical and mental toll that is not mentioned in the 5 stages of grief. In fact, mothers who have lost a child are 40% more likely to die within 18 years of the child’s death. The chances increase if the child’s death was from unnatural causes (like a car accident/shooting/suicide). The stress of grief triggers numerous physical and biological changes in the body including increased susceptibility to the risk of cancer and heart disease.
As you can see this is a passionate topic for me, and one that I have lots more to write about. I’m still doing my own personal research on what I think more accurately reflects the complex process of grief. Grief never ends but how we process it changes from day to day.
For now, and for this months’ blog I’ll also add that I believe there has to be a place of finding purpose in the heart ache. Otherwise we just accept the loss and if we’re not careful we can become self-focused on our own pain. If we choose to find a purpose in the pain, it will push us out of our comfort zone to find a way to live again. And it takes a deep commitment to life to survive the horrific loss of a child.
My Hope Endures,
Laura Holmes
Director, Ephraim Ministries