I used to think the stages of grief — denial, anger, bargaining, depression and acceptance — were about the loss of life, independence or freedom. Then, I met a patient that changed my point of view.
Before I met her, I assumed her grief was “normal” grief over the “normal” things.
Surprisingly, this was not the case with her. She had an uncommon, complicated grief that would require considerable help.
Our patient fully believed that God had spoken directly to her and told her that she will not be in heaven. She understood God to tell her that she is not forgiven — not loved by Him any longer.
This patient knew the Bible very well and would finish many of the quotes that chaplains and ministers use to help with these feelings. Indeed, she told me that she used these very Scriptures as she talked to God, and that he replied, “These Scriptures do not pertain to you.”
How do you help someone who has not only lost her faith but thinks deep down in her mind and heart that God has forbidden her to enter into heaven? The idea of the hospice peaceful death no longer applied to her because her lifelong religious beliefs caused her great distress.
During visits with her, we began to unravel where this thought of non-acceptance came from. She struggled at first telling the story because it brought tears and frustration. As time went on, the details became easier as she finally began to tell her story.
At first, no matter what Scripture I shared, she negated it. Then I talked about the Bible story of Jonah and the city of Nineveh and God’s forgiveness for them. She began to ponder and did not have an answer for that one.
But, the biggest turning point was when we talked about how Jesus was tempted in the garden and who tempted Him. We talked about how her set of beliefs concludes that Satan knows and understands the Scripture as well and uses it to cast doubt to God’s followers. She began to look at things from a different standpoint and began to be more relaxed and at ease.
So you see, grief consists of much more than the five stages. It can be a loss of faith, loss of direction or the loss of self. In these complicated cases, it takes more than conventional counseling. Rather, it takes time, building trust and creating relationships that begin to break down the barriers.
I would love to say that this patient is now completely at peace, but I cannot; she had lived many years thinking she was not welcomed in heaven. But I think we have moved her grief into doubt about her former beliefs, and that is a big step.
Mike Fritz, a bereavement coordinator for Compassus in central Texas, talks about guiding a patient out of deep grief.