5 Stages of Pandemic Grief

“She’s in denial,” the doctor told me, “You’ve got to get her to face reality!”

I was a young chaplain in a local hospital, and this was the next task of the day. My job was to get a patient diagnosed with terminal cancer to “face” her diagnosis — to accept her death sentence from the doctor.

At that time, this was the task of “grief work.” We misunderstood the stages of grief. We assumed people needed to be dragged through the stages as quickly as possible. We needed to shove them into acceptance. It mattered little if the patient or family was ready or willing.

Let’s be honest — whether this woman accepted her diagnosis or not, the outcome was going to be the same. Acceptance seemed little comfort to her fears, to her new reality.

I was three years old when Elizabeth Kübler-Ross released her book on the stages of grief. They were well known and somewhat weaponized by the time I arrived on the professional scene as a hospital chaplain. Many professionals were dragging patients and families, kicking and screaming the whole way, from denial to acceptance (or so we thought). “Face reality” was the mantra, not because it changed the prognosis, but because… well, people need to face reality.

Kübler-Ross’s model came from her work with terminal patients. She noted that patients faced their death in five different stages: denial, bargaining, anger, depression, and acceptance. That did not mean that the patients had to get to acceptance. It was just one possible stage for people facing their own death.

Kübler-Ross meant these stages to be descriptive. People then used them prescriptively. Instead of describing the stage a person was in, the stages were used as the necessary path of facing a terminal illness. Which meant it was often a race to pull someone through the stages, so they could be accepting of their terminal diagnosis for as long as possible. I came to realize that this had more to do with the comfort (or discomfort) of the caregiver than a help to the patient. It can be tough to watch someone struggle through the stages — even frustrating to watch them stuck in a stage. But people could (and did) die in denial, still bargaining, angry, and even depressed.

Oh, and then there is that pesky little fact that people don’t simply move through. People bounce around, back and forth. One moment they were in denial, then bargaining, then denial, then angry, then bargaining, then… people move back and forth through any stage at any time. And even when they hit acceptance, they may “lapse” back into another stage.

Which brings us to this moment in time, as the world faces a pandemic. We are facing it collectively, and very personally.

Grief comes whenever our normal is disrupted. It is not just a factor of facing death. Grief is our response to disruption of what we want to have happen, of life as we want it to be. Grief is our response to loss. Not loss by death. Any loss.

And that is why it is important for us to note the grief of the pandemic. We are collectively in grief. But our particular response to grief is individual. While we are all in grief, we are individually in the different stages at different times.

This is reflected in the very different responses to the threat of the covid-19 virus showing up around us and within each of us. I have seen the stages within myself.

Denial. We started there, didn’t we? It’s “just like the flu.” It won’t be a danger, and it won’t get to “here.” It won’t spread. Those are all moments of denial. I was there, and I think most of us were there, however briefly. Some are still there! While fewer and fewer are claiming the virus is a hoax, many people move in and out of denial. It is how our mind copes with the unacceptable.

The new wave of denial is emerging in the midst of places trying to reopen. Folks who are out and about, returning to life and refusing to take precautions. They often say something to the effect of, “I just want to feel normal again, to act like nothing is happening.” In moments when we choose to pretend that things are normal again, we slip back into denial.

I do remember the response to trying to “help” someone out of denial during my chaplaining days. People actively resist, even angrily resist, attempts to pull them out of denial. I’ve noticed the reactions on social media, as people throw up undocumented and unreferenced memes on how overblown the pandemic is, even minimizing the known statistics on the virus. The “facts” on the memes are often demonstrably incorrect. Unless, of course, you want to stay in denial. Then, referenced sources are impugned and dismissed. The undocumented meme is accepted over the well-documented sources that challenge the preferred reality. It just makes life easier that way, although hardly any less dangerous.

Unfortunately, denial does have a danger. When in denial, we don’t do what we could do in order to avoid a faster (or certain) demise. While I was a chaplain, there was often a legitimate reason to try and move someone out of denial: if there was a treatment that was possible and the window was closing. Someone unwilling to see reality might miss the opportunity for a better outcome. In other words, when there was a possible treatment, denial could keep the person from getting treatment.

Steve Jobs did exactly this when he chose not to take aggressive steps to address his pancreatic cancer when it was discovered at an early stage. The window on potential treatment closed. Would it have made a difference? There is only one way to know if something would help… by trying. And denial can keep people from taking action.

In a pandemic, denial can be deadly. Denial exposes more people to the virus simply because denial keeps people from taking precautions that might prevent exposure.

Pandemic denial can change over the course of the pandemic. It starts with denial about the virus. Then, there is denial about the dangers of the virus. Then, there is denial about what can or can’t be done. Denial can appear at every stage.

And right on the heels of denial is bargaining. People bargain to find exceptions to a situation. Someone might try to strike a bargain with God or the Universe to get around a diagnosis: “If you cure me, I will become a missionary to the other side of the world, or give my money to the poor, or live a good life.” Or might be just a request for a change in timing: “Please let me live until….” The “until” might be a big event in life or the life of another, a wedding or birthday or birth. It’s just an attempt to make it past the stated prognosis.

But you don’t have to be sick to bargain! During this pandemic, people have lurched from one hope to another for a quick fix, a cure or treatment. We might not all get pulled into any one miracle cure, but we all want one to exist. One that will cut this pandemic short and allow us to just return to normal.

And that really is the struggle of grief — the space between wanting to go back to normal and knowing there is no going back to that normal… it has already ceased to exist. We grieve when we can’t wait out a return to normal.

But that doesn’t mean our mind doesn’t try to find some path, some way, some exit back. Let’s be clear, the pandemic will end. How is the question. We already live with many viruses around us. Ones that are no longer so virulent or dangerous. Ones that we know how to treat. History shows us a pattern of pandemics. They either burn through the vulnerable or we learn to manage illness when it does hit the vulnerable.

We bargain as a way of shortcutting our way through, a way back to normal. Which is different than staring down a (I know, you are as tired as I of hearing it) “new normal.”

In fact, contemplating what the future (even the near future) holds can make anyone angry. Which is another stage of grief. Anger comes when we realize there is a threat and we can’t find a shortcut.

Sadly, the anger is often misguided and misdirected. It is not focused on the cause (the virus), but on those who note the implications. Doctors, politicians, concerned family members, cautious citizens, uncautious citizens — they become the focus of the anger. And then, angry people become the focus of anger.

Unfortunately, anger causes us to forget we are in this together. It has us lashing out at fellow humans who are equally (but differently) scared. It breaks us from one group and bonds us to another group. Those who disagree are seen as the enemy and the threat. Those who agree are comrades in arms against the scourge. Even if the scourge is now fellow humans.

It’s important to note that some people never leave a certain stage of grief. There is no requirement to work through to another stage. Nor is there a requirement to move beyond grief at all. When I was a chaplain, I watched people die, still in anger or bargaining or anger or depression. Their diagnosis never waited for acceptance.

And that can be depressing to consider. Which, by the way, is another normal stage of grief. Depression is a loss of energy in the face of the threat. It can feel like giving up or not caring. It can look like defeated acceptance. When there appears to be no way through, no way back to normal, it can feel defeating and overwhelming. That sucks the energy right out of anyone. Pulling up the covers and letting time pass by certainly seems the best option. And anyone who tries to suggest something be damned!

“I deserve to feel this way, and you can’t change it!”, marks the stage of depression. And that is fair! Any stage is just where someone is. It is where they are, even if it is different than where I or you are. It isn’t right or wrong. It simply is. The stage of grief where you find yourself is where you find yourself.

Years ago, I remember having a recurring discussion with folks where acceptance was lurking just around the corner. But they didn’t want to step into that stage, mostly because they misunderstood that stage. They believed that acceptance meant giving up; acceptance meant giving in and accepting their future fate.

Acceptance, though, is not giving up. It is not oriented toward the future at all. Instead, it is accepting where you are right now, in this moment. It is looking at the facts, brutal or not, of where we are. While where we are might affect where we can go, it is not an acceptance of what might happen that matters. It is about where we are in this moment.

If you were hiking in the woods and you got lost, continuing to wander around, aimlessly trying to find a shortcut is not considered the best idea. Nor is it helpful to pretend you are not lost. Nor is it productive to yell at the path or the trees around you. Nor is it particularly helpful to curl up under a tree and wait out fate. All are responses. Just not necessarily the productive responses.

Accepting where you are — lost in the middle of the woods — can start the process of choosing the better response. In many ways, acceptance is the balance of the rational with the emotional. The four stages of grief — denial, bargaining, anger, and depression — are all rooted in an emotional response to the existential threat. Acceptance is a return to the rational, asking “so, what do we do now?”

As I have moved through the pandemic and my responses to the pandemic, it has been helpful to note the stage I am swirling in at that time. There have been times of denial, bargaining, anger, and depression. They come as I note the growing implications of this pandemic. It helps me to be able to label a moment and note the stage I am in. Even if it does not move me out of the stage. At least I can see my reaction and say to myself, “Oh, okay, this is _______”, noting the stage I am in. That has often given me just enough space to decide if I am responding in the way I really want. Or am I stuck in a stage that is less helpful (not wrong, but less helpful) than where I want to be?

The goal is not about moving through the stages. It is more about moving toward where I would rather be, functioning in a way I would rather function. It gives me the place to start, a place to move from.

About the Author: Lee Baucom is a Thriveologist, specializing in how people thrive. He is the author of several books on thriving, and host of the Thriveology Podcast. Learn more about Lee at his website.