20 April 2012

Elizabeth Kubler-Ross' Five Stages of Grief and Pain Management

In my previous post, I discussed how Elizabeth Kubler-Ross' Five Stages of Grief might be applied to living with chronic pain.  Specifically -- and in conjunction with my current series on Eckhart Tolle and his book, The Power of Now -- how this model might be of use in helping us come to the point of accepting and bearing our reality.

The first step is to see the relevance of Kubler-Ross' teachings to living the life of chronic pain.  They help us name and acknowledge our natural emotions.  In this discussion of the Stages, you will notice that I am not giving examples of each one, but instead examining how they relate to my theme, accepting and bearing reality.

1. DENIAL: We all have times when we pretend the pain is not affecting us physically, mentally and emotionally, and spiritually as much as it is.  This leads us to keep working (as I did) long after we have lost our effectiveness; to act as if our mental faculties are not affected by the pain and thus to make poor decisions for ourselves and others; to die a small spiritual death because we have not understood the toll denial takes on our spirits.

2. ANGER: If we do not allow our anger to surface to our awareness in order to be dealt with, it's inevitably going to come out in other ways.  And thus cause us stress: "In terms of physical health, it doesn't matter if you tend to lash out in rage or repress your anger."  Without going into all of the ways that lashing out and repressing affect our health, let's just say that unless we are honest about our anger and willing to assess its affect on us, we are raising our stress levels and making our health -- and thus, our pain -- worse.

3. BARGAINING: For me, bargaining has affected my ability to accept and bear the reality of living with chronic pain by making it harder for me to keep to practices I know are good for me.  I say to myself: "I have been strict in my diet and so confined for the past months: I can just drink this glass of wine for once."  But the glass of wine does not really help me to feel better, and often enough there soon comes a migraine because of it.  It's the same with certain foods I know I should not eat: fresh, warm yeast bread, for example.  "Just this once," becomes a day in bed with the blindfold on.

4. DEPRESSION: One of the side effects of many medications is depression -- it also is reality for anyone living with chronic pain.  Compounding the difficulty is that other therapies for depression -- such as exercise, a regular sleep schedule, get out with friends -- are made problematic or even impossible by our chronic pain.  We lose perspective, we retreat, we have no ability to see the beauty or joy in life.  Even writing about it is depressing. 

5. ACCEPTANCE: It is important to honestly, and with just the appropriate amount of whining, admit that pain has taken a good deal away from us.  We have died many little deaths in our relationships, our inability to hold a career, and greatly restricted lives, even aside from the sheer physical misery of chronic pain.  To accept these hard truths as facts of our lives keeps us out of what I call "victim mode", which is its own small death in and of itself.  With acceptance, we regain control.  We can choose whether or not to wallow in self-pity.  We can learn how far we can go before we have stepped over the line between healthy honesty and unhealthy self-pity.

Okay, so this post is a quick assessment of what the Five Stages might look like for someone with chronic pain.  In my next post, I will take the discussion further into more constructive, practical tools.

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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