The 5 stages of grieving that affect chronic pain sufferers

From: Helen Dynda (
Sun Aug 26 14:03:33 2001

[]] The 5 stages of grieving that affect chronic pain sufferers by Rita Cowan, Ph.D.

In working with people with chronic pain over the years, I have noticed that the emotional ups and downs they display are very similar to those of people who have suffered a death or significant loss. It is no wonder that many chronic pain sufferers display a grief response to their pain. Professionals, who assist people in coping with grief, are aware of certain stages that these individuals proceed through as they begin the healing process after a loss. The five stages of the grieving process appear to apply well to chronic pain sufferers.

If you are a person, who suffers with chronic pain or knows someone who does, think about these stages and consider if you have or are experiencing any of them:

1 - The first stage is Denial and Isolation. When people learn or realize that they will be living with chronic pain the remainder of their lives, they often may deny it. "This can't be happening." "The doctor is wrong." "This pain will surely go away; they just haven't found out what to do." Denial is a normal initial response to loss. We want to believe that it is not happening. We often feel very alone in this stage.

2 - The second stage of grief is Anger. "How can this be happening to me?" "The stupid doctors messed me up!" There may be actual anger outbursts, often directed at the health care providers, family, or self. Many people with chronic pain are filled with rage over the substantial changes in their lives. Although this is a normal response to loss, when people get stuck here they create more stress which increases their pain. They may behave in a manner that isolates others more, which results in more anger.

3 - The third stage is Bargaining. Here the person makes "deals" with God, or believes that if they are "real good" this curse of chronic pain will go away.

4 - Depression is the fourth stage of grief. This emotion occurs when the individual begins to realize that they cannot bargain, that anger is counterproductive and that they certainly can't deny what they are physically and emotionally experiencing. There are very few chronic pain patients, that I have worked with, who do not have a degree of depression. How could they not?

5 - The fifth and final stage is Acceptance. At this point the person is not resigned to their life with chronic pain. Rather, they have realized that things are different and by accepting - not becoming their pain - they can obtain some control over their pain and their lives.

Each person experiencing the grieving process will go through these stages. Some stay stuck, and some move quickly through to acceptance. Each person is unique in their response; therefore, there is no "right" way of grieving the losses endured with chronic pain. This too is normal. Psychologists and other health care providers are trained to help chronic pain sufferers identify and cope with the special circumstances involved in each stage. Our goal is to help people gain acceptance so they can begin to take back their lives -- managing their chronic pain and not losing themselves to it.

Dr. Rita Cowan, Ph.D., is a Psychologist and Registered Nurse who specializes in Health Psychology at The Falls Pain Management Center, Cuyahoga Falls General Hospital. CPS

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