By Trudy Lechner, RN, BA, CDE, Medical and Bereavement Counselor
Trudy is a Registered Nurse and Bereavement Counselor who has worked in the field of Death and Dying for 26 years. The theory referenced below was established by Dr. Elisabeth Kübler-Ross.
I am a lung cancer survivor. I was diagnosed in 2013 after my twin sister nagged me to get a low dose CT scan. I had been a smoker, but stopped 18 years earlier. I recall being shocked and numb when I received the news, but I think I reacted more emotionally when my twin told me that she had also been diagnosed with lung cancer a few months earlier.
My father died when I was 21. I received plenty of advice at that time about grieving and loss. It was all wrong. Ten years later, I found myself gravitating towards the field of Death and Dying and Hospice, allowing me to offer sound advice (not old wives tales) to others suffering a loss.
Grief is an emotion that we may feel every day. It can be as minor as losing your keys or as life-altering as a cancer diagnosis. With any change or life transition there is always a sense of loss, which is accompanied by an array of emotions. From both my personal and professional experience, I have found that most people undergo all or some of the following stages of grief, established by Dr. Elisabeth Kübler-Ross. Here’s what to expect and how to deal.
STAGE 1: DENIAL
Denial is the psyche’s way of protecting you and allowing only little bits of reality to sink in. This is why when someone hears, “You have cancer,” they rarely hear the words that follow. It is important that another person is there to support them or that the conversation is taped so they can refer to it later. The initial reaction tends to be tears, which often give way to numbness.
Tip: Some people will tell family and friends immediately and receive the emotional support that they need. Others will wait until they have digested the information and have made a treatment decision. There is no right or wrong.
STAGE 2: ANGER
Anger usually follows denial. The anger can be seething or violent. Anger can be dissipated by using your hands, mouth or feet. For instance, when I was a nurse on an Oncology Unit and a patient was really angry and would throw the food tray, that was a good sign that this person had the energy and power to get better.
Tip: I often suggest hitting a rug with a tennis racquet or broom, pounding your feet into the ground when taking a walk or getting in the car and singing or screaming at the top of your lungs. Even scribbling on paper is helpful, but taking that anger out on another person is not acceptable.
STAGE 3: BARGAINING
Bargaining is when one promises to be a better person or to be more charitable, etc. to change their diagnosis. If you are a spiritual person, the conversation is often with a higher being. This stage does not last too long.
STAGE 4: DEPRESSION
Often the person will turn inwards by avoiding communication with loved ones, rejecting visitors, avoiding food or crying all day.
Tip: Sometimes a therapist, family member or friend is helpful so that the person can start to share their feelings with someone. If these feelings persist and last over time, it is important to seek out professional assistance.
STAGE 5: ACCEPTANCE
Acceptance does not mean that the person feels good or right. This stage is about accepting the fact that a new reality cannot be changed. It is about seeing how the new reality will impact life and relationships.
Tip: Most will start to feel ready to reach out to friends at this point. Go at your own pace and be kind to yourself through this process.
Although these are the common stages of grief, they do not always follow this set pattern. Many people switch back and forth in the stages; some never reach acceptance or some get stuck in a particular stage.
The important take-away is that managing emotions plays a significant role in dealing with cancer or any life-altering condition. There are many professionals in the community, as well as those who care about you, to help you through this difficult time. Please think seriously about using their talents because quality of life is the ultimate goal. You’re not alone.
Check out CancerCare for online tools to find support groups, counseling or community programs near you.
If you have further questions about lung cancer, please contact our Support Team at 1-800-298-2436 or email support@go2.org.
Excellent article and VERY accurate. Biased though, because I am the twin sister who was diagnosed first. Because of Trudy and her daughter I did not go through most of these stages.