Denial – the first of the five stages of grief.

denial

We know what has happened, why denial?

Whether you have received a diagnosis or lost a loved one, the temporary defense we use to dull the blow is called denial. It is seen most vividly in the patient who goes from one doctor to another, believing that a mistake has been made in the unwanted diagnosis, requesting tests to be repeated and repeated.

Last year I read Ingrid Poulson’s book ‘Rise’. It was about her journey of recovery following the murder of her two little children and father at the hands of her ex-husband. I could not fathom that this was something anyone could recover from; it is the extreme of loss and suffering.
In it I discovered that she did recover, by her own unique path of grief, living and breathing one day after another, developing such powerful resilience that her life was forced on a trajectory of healing others as well as herself in the process. I was amazed and inspired by her, and I was educated by her more than anything I have ever read on what grief is about.
She said of the early days: ‘I can’t believe that the world continues, a world without them in it…my entire body has been hollowed out and it’s not substantial enough to hold all this pain…’
Denial is necessary in the first instance to cope with the pain. People may talk briefly about what has happened and then be completely unable to.

Elisabeth Kubler Ross introduced us to the stages of grief.

The nature of human experience following tragedy or loss was first introduced to us by Elisabeth Kubler-Ross (‘On Death & Dying’ Scribner 1968) While we may have some idea of the stages, it is more helpful to see that they are, as Elisabeth says: a loose framework which encompasses grieving in general, and this is because we are all so unique.

First described as Denial, the initial stage of grief encompasses the profound impact of shock. The finality of death of a loved one, even when it is expected at the end of a long illness can still deliver a significant shock, even more so if the conditions of death were particularly unpleasant.

Denial is a shield we use against pain.

Denial and the shock we feel is a protective, self-coping mechanism…a ‘shutting down’ to give our mind and soul time to take in the changes that have occurred. Just as the act of going to sleep at night allows the brain the time-out which is an essential aspect of how we process information on a sub-conscious level. We are beings comprised of many layers, most unseen. Denial is knowing what has occurred, but the knowledge sits like undigested food in our stomachs. The time may be brief or prolonged depending on how much a person has suffered and how they have learnt to recover from that suffering.

This stage allows stronger feelings and thoughts to remain buried until you are ready for them. Each subsequent day and night allows these raw emotions to soak through the layers of your soul, like a watercolour seeps and spreads into the absorbant white paper, each stage revealing more of the true colour and image.
As the picture of your new reality emerges with greater clarity, it can be disconcerting to realise that your body still needs to be fed and that you are required to carry out the mundane tasks of everyday life.

What is normal?

Everyone behaves differently, there is nothing to expect which can be called normal. You are normal as you experience your own grief. If you haven’t cried… that’s your way. If you have thrown yourself into work, that is your way. There is no judgement. Denial happens because it is unbearable pain……which eventually becomes bearable.

Elisabeth Kubler-Ross found in relation to patients, that denial was more important to them at the beginning of their illness than at the end. Towards the end, she noticed that patients used isolation more than denial.

Experience of previous loss may provide recovery prompts.

Depending on how much knowledge people were given, how much time they had to absorb and understand, but also importantly how they were prepared through-out their life to cope with stressful situations…..all impacted on the moving away from denial towards acceptance.
If life had been relatively comfortable and stress-free and they had been sheltered as children from death in the family, it is likely that denial in these people would be felt more strongly and take longer to move beyond.

I did notice that Ingrid Poulson had already suffered the loss of her brother years before the tragedy of her own family. She had learnt something of grieving and recovery already.
Regardless, denial is still a natural coping mechanism from the onset of great loss or bad news. It is more about moving on from denial that is impacted by skills we may have acquired through other difficult life experiences.

Stuck in Denial

If you know someone who is in the denial stage of grief, they are unable to bear their pain.
When it is protracted, help is available through specialist grief counsellors. A gentle and understanding approach is required from family and friends. And occasionally as Elisabeth Kubler-Ross found out, there will be patients who remain in denial of their illness right to the end.

How can you help someone in grief?

A simple offer of love and support, active listening and just being present can help. An opinion isn’t necessary, and acknowledging that you don’t know what to say is ok; they appreciate your honesty. You could bring over a meal, offer to take them for a walk or a drive through the hills.
The Mt Lofty Botanical Gardens are a lovely walk. Men in particular benefit from a walk and talk, side by side. It’s more comfortable than sitting with someone looking at you, particularly if you feel awkward. Or go to the beach, have an ice-cream while you walk on the sand and breathe in the negative ions which are so beneficial for everyone. These are the times when talking comes more naturally, and in the silence there is the beauty of the natural world to provide it’s own reassurance.

Counsellors and services available in South Australia

www.adelaidecounsellingpractice.com.au Ph 0407 405 733

Loss and Grief Counselling from Anglicare SA
www.anglicaresa.com.au/support-disability/loss-grief/

www.beyondblue.org.au/grief+loss

The University of Adelaide has a grief counselling service available in the city:
Ph 08 8313 5663

http://www.grieflink.asn.au/coping-with-grief-aspx

Lifeline is available 24 hours a day: 131 114

And just as an aside, I was watching ‘The Project’ last night when they interviewed a lady who had been diagnosed with terminal cancer and required very expensive drugs unavailable on the PBS. She said that if you have been diagnosed with a terminal illness as a younger person, you are allowed to access your Superannuation to fund your medical costs. I wasn’t aware of this, and thought there may be others who would like to know this if they missed the segment.

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