14 April 2012

Chronic Pain and Kubler-Ross' Five Stages of Grief

In my previous post, I wrote my way into an idea for this post while discussing acknowledging and allowing our feelings.  The idea is to relate our feelings about chronic pain to Elizabeth Kubler-Ross' Five Stages of Grief.  It has been explored before, here, here, and here, for example, but I found that I wanted more out of the discussions, so this is my attempt to add to what is already out there.

To begin, these are the Kubler-Ross Five Stages of Grief:

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Kubler-Ross said that these stages are fluid:

"Also known as the ‘grief cycle’, it is important to bear in mind that Kübler-Ross 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. There is a subtle difference: a process implies something quite fixed and consistent; a model is less specific – more of a shape or guide." (from the Elizabeth Kubler-Ross Foundation website)

There is enough information available at the click of a mouse that I do not need to go into basics about the Grief Cycle.  Using the links in the paragraphs above will get you good, basic information if you want it.

So, what about this Grief Cycle vis-a-vis the life of chronic pain?  It's different than grieving the death of a loved one because death is its own closure.  Like all humans, I have grieved death of loved ones.  But, like fewer of us, I have also grieved the debilitating presence of pain as well as the life changes it causes.  So I am going to make a comparison, but I am in no way saying that one kind of grief is worse or more noteworthy than another.  I just want to explore the grief cycle and the concept of closure together, as a way to enter into a discussion about the Five Stages model and chronic pain.

There is no closure with chronic pain: we cycle through bad days and not-so-bad days and celebrate the occasional good day; we try new medications or alternative therapies that do not deliver as promised; we hope for cure and suffer the inevitable disappointment.  Chronic pain doesn't die, obviously.  Its sneaky, beady little eyes peek out from behind every bit of relief we might find, assessing the optimal moment to pop up and smack us upside the head yet one more time.

When a loved one dies, there comes a point at which we are able to take comfort in the knowledge that the knife-edge of our suffering will be blunted.  (Others often try to force or coerce us to this point with well-meaning but maddening phrases like, "you'll feel better after a while," but that is another topic.)  Although we will never forget, never lose that core of sorrow, the intensity of our grieving will change, becoming more and more bearable.

The question is, how do we use the Five Stages when what we are grieving is an endless cycle?  The pain does not naturally, over time, become more bearable.  (It strikes me as I write this that there are other instances of endless grief: the disappearance of a child and the MIA soldier, for example.  Frankly, I would rather have chronic pain, the hell of that sort of limbo being unimaginable to me.)

Interestingly enough, I come, unexpectedly yet quite organically, back to one of the discussion points in my current series on Eckhart Tolle and his book, The Power of Now

This endless cycle of pain has one redeeming feature: it affords us the opportunity to come to terms with it and thus to accept and bear the reality of our lives.  It teaches us that what we can control is our reaction to the pain. 

In my next post, I will go further and more practically -- meaning less theory and more tools -- into the uses of the Five Stages of Grief in helping us come to the point of accepting and bearing our reality.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  Thank you.

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