I’m sure some of you have heard of the five stages of grief developed by Elizabeth Kübler-Ross. Kübler-Ross developed these stages to explain the process individuals go through who are near death. But did you know that these five stages can be used to explain the process people go through when diagnosed with a chronic illness or chronic pain? Below, I will explain how these stages relate to those of us with chronic illness or chronic pain. Along with the “depression” stage, I have added anxiety because I think this is common in most of us who experience a chronic illness or chronic pain. As you read these, think about which stage you may currently be in. Remember, these stages are not linear. You can jump back and forth between stages depending on where you are at in your diagnosis.
In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We wonder how our life is going to change and how we are going to live with those changes. Denial and shock help us to cope and make survival possible.
This stage can be dangerous for people with chronic illness/pain because at this stage if they are in denial about their illness or pain, they may not take the necessary steps to get themselves the treatment they need.
Example: “It’s not a big deal, it will go away”
Anger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal. There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing. Your anger has no limits and it may extend not only to your friends, doctors, your family, yourself and your loved ones.
Example: “This isn’t fair! I didn’t do anything to deserve this!”
This is the stage where we want more than anything for life to be what it once was. We become entrenched in “if only” or “what if” statements. Guilt is often bargaining’s companion. The “if only’s” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain or illness because we would do anything not to feel it anymore.
Example: “Please just don’t let this ruin my life”.
Depression (and/or Anxiety)
After bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It is important to understand that this depression is not a sign of mental illness. It is the appropriate response to a loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on. Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. Being diagnosed with a chronic illness or experiencing chronic pain is a loss – a loss of the life you once had. Depression is one of the many necessary steps along the way toward healing.
Having a chronic illness or chronic pain also may bring up feelings of anxiety; anxiety about what the future holds, anxiety about not being able to live up to expectations now that this illness or pain is present, anxiety about social situations, anxiety about medical bills, etc.
Example: “I’m going to be in pain forever so why even bother”.
Acceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Many people don’t ever feel OK or all right about having to live with pain or an illness for the rest of their lives. This stage is about accepting the reality of your situation and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live life with it. It is the new norm with which we must learn to live. We must make adaptations and alterations to our lives. We must find new things that bring us joy.
Example: “I’m not going to let this define me. I will learn to deal with this the best I can”.