On Life and Living: Cancer and the Stages of Grief: Part 1

"The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of those depths." - Elisabeth Kubler-Ross

In 1969, Elisabeth Kubler-Ross gave us the groundbreaking book, "On Death and Dying." In it, she outlines the five stages of grief — denial, anger, depression and acceptance — as normal reactions to any loss. When one explores the depths of her teachings, it becomes clear that the title of her book could easily have been, “On Life and Living.” Far from prescribing a resistance to suffering, up to and including death, she proclaimed, “It is not the end of the physical body that should worry us. Rather, our concern must be to live while we're alive — to release our inner selves from the spiritual death that comes with living behind a façade designed to conform to external definitions of who and what we are.”

Those of us touched by cancer know all too well that the stages of grief are not linear and not steps we move along with the precise choreography of ballet dancers. No, these stages represent the roller coaster that has, as an added unnerving thrill, the ability to move in reverse. Thus, today’s bargaining gives way to tomorrow’s anger, only to be met by yesterday’s depression with acceptance waiting patiently on the horizon.

As a therapist, I’ve found that telling my clients that grieving is essential to their recovery helps eliminate concerns that there is something wrong with being in denial, depressed or angry regarding their illnesses. I try to assist them in finding ways to honor each stage, rather than eliminate it. Knowing that a cancer diagnosis can bring a sledgehammer to the façade that is our self-image, I consider myself both a demolition and hazardous material expert as I join them in the release of inner-self.

When it comes to the stages of grief, my advice to clients has always been that, while there is little we can do to speed up process, there are numerous things that we do to slow it down. These include:

• Lingering too long in any stage on our way to acceptance, and having it become our primary mode of operating.
• Taking on unhealthy coping skills that only reinforce denial, anger and depression.
• Thinking that we have to rush through the stages as if it were a race.
• Trying to reach the peak of acceptance without having traveled through the foothills of resistance.
• Confusing acceptance with “being OK with” or “happy about.”

Kubler-Ross wrote, “Those who learned to know death, rather than to fear and fight it, become our teachers about life.”

It would be great if we were able to choose both the timing and nature of the lessons that life is trying to teach us. Many of us, however, receive a nudge, push or shove toward the knowledge of our inner selves and thus the meaning of life and death. This suggests there is a natural force working beyond the limitations of our personal understanding. If this is the case and the course in life and living is mandatory (not an elective) then not only am I sitting in the front of the class, I’m taking notes.