Grief is an intricate and often overwhelming emotional experience that individuals face when dealing with loss. It's a natural response to losing something or someone we deeply care about, be it the death of a loved one, the end of a significant relationship, or even a major life change.
While everyone experiences grief differently, the Swiss-American psychiatrist Elisabeth Kübler-Ross famously outlined the five stages of grief in her groundbreaking work, "On Death and Dying." However, in recent years, experts have recognized that grief is a complex and multifaceted journey that involves more than just these five stages.
You might be familiar with grief's original “stages”: denial, anger, bargaining, depression, and acceptance. These stages are often referred to as a framework or scaffolding to help people understand the various emotional responses we can go through when experiencing grief.
While these stages can provide some insight into the grieving process, it's important to remember that grief is a highly individual and complex experience. Not everyone will go through these stages in the same order or experience all of them, and you could experience the same stage or wave multiple times in a cycle.
This is where the “wave” analogy can be helpful.
Think about your most recent trip to the ocean or any water that sees wind or wave action. Waves will crash on the shore depending on how windy or how many boats are on the water that day. It varies, just like grief and how we are experiencing it; it can change from day to day or experience to experience. The term "waves" metaphorically conveys that grief can ebb and flow, with periods of intense emotion followed by moments of relative calm during the process.
Why More Stages, Why Waves?
The idea of "new stages" or "waves" of grief represents an evolving understanding of the grieving process, and it doesn't necessarily replace or negate the traditional stages proposed by Elisabeth Kübler-Ross. Instead, these new models or concepts aim to provide a more comprehensive and nuanced perspective on how people experience grief.
Several factors contribute to the development of these new models of grief:
- Diverse Experiences: People's experiences of grief are incredibly varied and complex. The traditional stages, as proposed by Kübler-Ross, can oversimplify the grieving process. New models seek to acknowledge the diversity of emotions and responses individuals may have.
- Cultural and Individual Differences: Grief is influenced by cultural, societal, and individual factors. What may be considered a normative grief response in one culture may differ significantly from another. New models aim to be more culturally sensitive and inclusive.
- Long-term Grief: Grief doesn't have a fixed timeline. Some people experience grief long after the initial loss, which isn't fully captured by the original stages. New models may account for the long-term and evolving nature of suffering.
- Coping Mechanisms: Different people employ various coping mechanisms to deal with grief, such as humor, distraction, or seeking support. These mechanisms can influence individuals' grieving process, and new models aim to incorporate them.
- Research and Clinical Insights: Advances in psychology and grief counseling have provided a deeper understanding of how grief works. Researchers and clinicians have identified nuances that call for updated models.
- Holistic Approach: Many newer models of grief emphasize a more holistic approach to healing, considering not only the emotional but also the physical, cognitive, and spiritual aspects of grief.
While the "Five Stages of Grief" by Kübler-Ross remains a valuable framework for understanding the emotional journey of grief, newer models like the "Seven Waves of Grief" or other variations offer additional perspectives and insights. These models recognize that grief is a multifaceted, individualized process that can't be neatly categorized into fixed stages. They aim to provide a more comprehensive and compassionate understanding of people's challenges when dealing with loss and how they can find healing and resilience over time.
Bariatric Grief and Why It Can Be Triggered
Loss of connection to something we once had can trigger grief, and many stops along our bariatric journey can start the waves of grief. Let's explore some of these triggers.
- Loss of Identity: Before undergoing bariatric surgery, we may have lived with obesity for an extended period. Obesity can become part of our identity, and losing a significant amount of weight can lead to a sense of identity loss. This loss of the familiar self can trigger feelings of grief. Even if we don’t understand this before surgery, it can become known right after.
- Social Changes: Weight loss can significantly change one's social life and relationships. Friends, family, and acquaintances may treat the individual differently after weight loss. This shift in social dynamics can lead to feelings of loss, particularly if relationships change or there is a sense of isolation. People love us as we are, and when that changes, they grieve the “loss” of the person we once were. Their grief can trigger our grief, which can trigger or even add to your grief.
- Emotional Attachment to Food: Food often serves as a coping mechanism for many people with obesity. After bariatric surgery, our relationship with food changed dramatically and immediately. We may have to give up certain comfort foods or adjust our eating habits or social settings revolving around food, which can lead to feelings of grief and loss. Again, we might not understand food’s significant role before surgery. Right after, we can become immediately aware of its role and how surgery has changed it.
- Physical Changes: Rapid weight loss can result in significant physical changes, including loose skin, scars, and alterations in body shape. These changes can be a constant reminder of the past and may lead to feelings of grief over the loss of our former body.
- Complex and Unexpected Emotional Journey: Bariatric surgery is not a quick fix; it's a journey that involves both physical and emotional challenges. This emotional rollercoaster, including facing past traumas or emotional issues related to obesity, can trigger grief as we work through their feelings.
- Unrealistic Expectations: Sometimes, we have unrealistic expectations about the outcomes of bariatric surgery. When the results don't match these expectations, we can feel disappointed and grieve the loss of the envisioned outcome. When we don’t lose a certain amount of weight over a time we have deemed appropriate, we grieve that unmet expectation.
- Fear of Weight Reoccurance (aka Regain): There is a legitimate fear of weight regain after bariatric surgery. Scale fluctuations are normal but feel like a failure. This fear can be a source of ongoing stress and grief as we work hard to maintain our weight loss.
- Adapting to a New Lifestyle: Post-surgery, we often need to adopt a new lifestyle involving dietary restrictions, exercise, and medical follow-ups. Adapting to these changes can be challenging and may lead to grief over losing our old way of life.
- Positive Grief: We can experience grief when we reach milestones because now we wonder, “What’s next?” We might lose a sense of connection with our bariatric purpose or mission when we have met those goals we set for ourselves. This accomplishment can trigger grief for the task, for the goal met.
Experiencing grief during the bariatric journey is not a sign of weakness or failure. It's a natural and normal response to significant life changes and challenges that we all go through before and after the survey and rapid and extreme weight loss.
Recognizing and addressing these feelings of grief is the first step to moving through grief. Talking through your emotions in a supportive community like BariNation can be one of the best places to start moving through these waves of grief. Seeking the advice and support of healthcare professionals and therapists who specialize in grief and loss and bariatric life can also be essential for emotional well-being and long-term success in the bariatric journey.
Ready for some hands-on Bariatric Grief Learning and Support?
- Lora Grabow is leading a class on Growing Through Grief on October 17th at 4:30 p.m. PST / 7:30 p.m. EST.
- Timisha Malone, LICSW, has launched her Bariatri Grief Support Groups that will meet every other Monday in the BariNation Support Community.
As a member, we invite you to read more about these supportive events and RSVP if you think these could help you move through the bariatric grief you could be experiencing in your journey.
Learning About Each Wave of Grief
Let’s take a closer look at each wave to understand better what it could look and feel like as we move through each wave of grief. Remember, you might never experience waves; they could roll in in a different order than outlined below. Your grief can be different from other people's and can happen in a different order. What is important is that you know what each stage is and recognize the wave you are experiencing.
Wave 1: Shock and Denial
The first wave is often marked by shock and denial. When we receive news of a loss or realize we have lost a connection to something or someone, our immediate reaction is disbelief. We struggle to accept the reality of the situation, and it may feel like a bad dream. Emotions can be numbed during this stage as a protective mechanism, helping us cope with the initial impact of the loss of connection.
Wave 2: Pain and Guilt
The second wave brings intense pain and guilt as the shock wears off. This is when the magnitude of the loss truly sinks in, and we start to experience the emotional and physical toll. It's common to feel a deep sense of guilt during this stage, questioning whether we could have done something differently, made a different decision, or prevented the loss somehow.
Wave 3: Anger and Bargaining
During the third wave, anger and bargaining take center stage. We may become frustrated with the unfairness of the situation, directing our anger at ourselves, others, or even the person or thing we've lost. Bargaining involves making deals or wishing for things to return to how they were before the loss occurred, even though we understand it's impossible.
Wave 4: Sadness, Loneliness, and Reflection (Depression)
The fourth wave is marked by profound sadness and a sense of isolation. As the reality of the loss sets in, we may withdraw from others and sink into deep sadness. This is also a time for reflection as we begin to come to terms with the permanence of the loss and what it means for our lives moving forward.
Wave 5: Upward Turn, aka The Turnaround
The fifth wave represents a glimmer of hope. As time passes, we slowly start to adjust to life without what we've lost. The intense pain begins to subside, and we find moments of peace and acceptance. It's important to note that this wave doesn't necessarily mean the grief is over but marks the beginning of healing.
Wave 6: Reconstruction and Working Through
During the sixth wave, we focus on rebuilding our lives. We start to piece together a new reality, adapt to the changes brought by the loss, and set new goals and priorities. This phase involves finding a sense of purpose and rediscovering joy in life.
Wave 7: Acceptance and Hope
Acceptance and hope characterize the final wave. It's when we fully accept the loss and embrace the new life we've created or found ourselves in. While we never forget what or who we've lost, we find a way to move forward with peace, resilience, and hope for our future. This stage is not about forgetting but about building something new.
Thinking About The Road Ahead
Grief is not a linear process, and there is no right or wrong way to experience it. The concept of the Seven Waves of Grief offers a more nuanced understanding of this complex journey, highlighting the various emotional states and challenges that individuals may face when dealing with loss.
Grief is also not something we can experience once and never revisit. You might notice in a few months or a few years from now; you are grieving the same loss of connection along your journey, the familiar reliance on something.
We can grieve the same loss over and over again, but the loss is left in a new way or in a unique situation. The key to moving through grief is acknowledging that while some of this loss might feel familiar, this moment in your life is NEW. The situation is new; the surroundings are unique. The people might even be new.
This is an opportunity to grow, and grief is the tool that growth is using to get you to this new destination ahead. Embrace grief.
Lean into this community. Lean into the support groups, the classes, and the meetups. Lean into the safe spaces and places that exist in our digital home.
This is your place to practice this new life and move through grief safely. To explore your emotions without the fear or shame that may be keeping them buried.
Use BariNation as a flashlight and shine hope and faith on parts of your life that have remained hidden.
You’ve got this. You really do. And we’ve got you.
We'd love to have you in our BariNation community, where we have bi-monthly Bariatric Grief Support Group designed to help fellow patients understand grief, its many waves, and provide a safe place to practice the stillness needed to move through grief. Check out the community today.