Grief, Part 5

Grief, Part 5

If a patient has had enough time and has been given some help in working through the previously described stages, he will reach a stage during which he is neither depressed nor angry about his “fate”…He will have mourned the impending loss of so many meaningful people and places and he will contemplate his coming end with a certain degree of quiet expectation. Elizabeth Kubler-Ross, MD[1]

Swiss-American psychiatrist, Elisabeth Kubler-Ross, in her book On Death and Dying,[2] identifies five stages of dying, the first four of which I discussed in previous Life Notes. I place these stages in my section on Grief because the stages of grieving and the stages of dying are similar. Indeed, we grieve because we have or are about to lose someone or something precious. The final stage of dying is acceptance. It is not a stage everyone achieves.

Acceptance, when applied to dying and grief, is a form of surrender and brings a sense of peace. It is not a celebratory type of peace, but rather a quieter state that brings an end to the earthly-battling of the condition or situation. This is when Hospice is likely called for the terminal patient. Kubler-Ross described what she witnessed in her patients in this way: “Acceptance should not be mistaken for a happy stage. It is almost void of feelings. It is as if the pain had gone, the struggle is over, and there comes a time for ‘the final rest before the long journey’ as one patient phrased it.”[3] She points out that the patient’s family may need more support than the patient during this time since people seldom come to acceptance on the same timeline. Silence and, in some cases solitude, may become more important to the patient. They care less about what is going on in the world than they once did because an important part of acceptance is dissociating from this world and its many superfluous activities.

Some philosophers say the only part of us that dies, other than our body, is the ego – that self-centered, thinking and judging part of us that gets so wrapped up in and identified with the seductive pleasures of life on earth. This life, beautiful and painful as it can be, is a temporary stopping point for everyone because everything of the earth is subject to the law of birth, growth, decline, and death before being remade into a different expression of the Divine. This earthly life is a difficult place for the ego to leave because the ego finds meaning and purpose in the dualistic nature of life on earth, even though the meaning it finds is transient. As one nears death, it often happens that one’s thoughts and focus turns back toward that eternal part of us that existed before we were born and that will live on after we die. Our egos may have a place beyond this life, but it will not be the dominant role it learns to play here. In that sense, the ego must relent before we can reach a stage of acceptance.

In the context of grief, acceptance is a stage where we conclude, “Enough is enough. It is time to move on.” It does not signify hopelessness as much as a resignation that the path followed in the past is no longer an acceptable way forward. In the last weeks of my mother’s life, she seemed to have given up, at least from my view. She ceased cooperating with her therapists. She stopped eating and refused to allow us to feed her, clinching her jaw shut with all her remaining might. Her doctor proposed having a feeding tube inserted but she made her opposition clear. She was done. She spent an increasing amount of time sleeping and appeared at peace with the solitude. At this point in her life, she seemed unafraid of death, and whatever was on the other side of death was preferable to her post-stroke state of being. Mom had reached a state of acceptance and bided her time peacefully until she quietly slipped away.

Attaining acceptance allows for a smooth transition into the next stage of life. Some people receive glimpses of what is next, as I have described elsewhere, that may help ease the fear of death’s nearness. We cannot receive what is next with equanimity without first freeing ourselves from the bonds of this life. Acceptance is a choice, and not everyone choses to make it. Those who chose not to release this life willingly, however, will simply have it taken from them.

This is the 38th in the series of Life Notes titled, If I Should Die Before I Wake. I invite your thoughts, insights, and feedback via email at, or through my website, At the website, you can also sign up to have these reflections delivered to your Inbox every Thursday morning, if you are not receiving them in another manner. Prefer to listen? Subscribe to Life NotesPodcasts at

[1] Elisabeth Kubler-Ross, MD, On Death and Dying. Scribner, New York, 1969, pp. 109-110.

[2] Ibid.

[3] Ibid, p. 110.

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