Healing: Receiving Serious Health Diagnoses, Anger & Bargaining Responses

 Today we are briefly discussing the anger and bargaining phases of the grief model outlined by Elisabeth Kübler-Ross. 

Receiving Serious Health Diagnoses

When a person receives a cancer or aortic dissection or aneurysm diagnosis, after the initial shock and denial phase, they may experience the anger and bargaining phases. These stages are characterized by anger directed at various sources, manifesting in numerous ways and also often an attempt to negotiate, usually with a higher power, in a desperate hope to reverse or lessen the reality of their situation.

During the anger phase, it is crucial for the individual with the diagnoses and their loved ones to understand that this reaction is a normal part of the shock and grieving process. As we mentioned in the previous post, mental health professionals can provide essential support during this time, helping the individual express their anger in healthy ways and explore the feelings underlying their anger.

Some of the ways anger may be expressed by persons diagnosed with aortic dissection and/or cancer can include:

Anger at the Unfairness: After the reality of the diagnosis sets in, it is common for individuals to feel a deep sense of injustice. They may question, "Why me? Why now?" This anger can stem from the perceived randomness and unfairness of their situation, especially if they have been living a healthy lifestyle or are young with many unfulfilled plans. I personally have asked the ‘why me’ question time and time again.  This reaction is normal and I now acknowledge these feelings as valid when I begin to dwell on the ‘why me’ questions.

Anger at Physicians and Health Care Providers: Some people may feel anger towards their physicians or healthcare providers. This can result from frustration with perceived delays in diagnosis, dissatisfaction with the course of treatment, or simply as a transference of their fear and helplessness.  I personally am so over directing anger at my doctors.  After years of dealing with both my diagnoses and my doctors I am frankly just tired of blaming anyone, including my attending health care professionals. However for others, blaming doctors is a recognized emotional response.

Anger at God or a Higher Power: For those with spiritual or religious beliefs, anger may be directed towards God or a higher power. Individuals may feel abandoned or punished and may struggle with their faith during this challenging time.  I've been there done that with this type of anger.  Today my world view has more of a Daoist flavor so there aren’t really any ‘Gods’ or ‘Personal Higher Powers’ that could even hear me.  But for those with beliefs in a higher power, this avenue of blame is normal.

Anger at Oneself: There can be feelings of self-blame, especially if the individual believes their lifestyle choices may have contributed to their illness. They may also feel frustration at their body for "betraying" them.  Today, after many years, I’ve learned to love myself for whom I am, dissection and cancer and all.

Anger at Family and Friends: It's also common for individuals with a terminal illness to experience anger towards their family and friends. This can stem from a perception of being treated differently or from frustration over others' inability to fully understand their experience.  Caregivers, family and friends have it as hard as us, IMHO, in dealing with those of us that were diagnosed with these serious illnesses.

It's important for loved ones and caregivers to practice patience and empathy, avoiding taking any anger personally. Encouraging communication and providing a safe space for the individual to express their feelings can be beneficial. Over time, as individuals processes their anger, they may move towards the other stages of grief, such as the other phase we are going to briefly discuss here, the bargaining phase.

As for the bargaining behavior often experienced, here are some ways bargaining behavior may present:

Negotiations with a Higher Power: A person may seek to make a deal with God or a higher power, promising to live a better life, devote themselves to service, or make other significant changes in exchange for a cure or more time. 

Regret and Remorse: The individual may spend a lot of time thinking about what they could have done differently to prevent their illness. They may regret past lifestyle choices or not taking symptoms seriously earlier. This period is often characterized by guilt and self-blame.

Revisiting Past Choices: The person may start obsessively considering different scenarios in which their illness could have been prevented. They might think about what could have happened if they had made different decisions about their health, diet, or medical treatment.

Seeking Alternative Treatments: In their desperation to find a cure, the person might start exploring alternative treatments and remedies, often in cases where conventional medicine has provided no solution or hope.

It's important to note that, like all the stages of grief, both the anger and bargaining stages are not experienced by everyone, and can occur in any order. Additionally, these stages are not rigid categories, but rather part of a framework to help us understand the typical emotional process involved in dealing with terminal illness.

It's also crucial to approach a person in the anger and bargaining stages with empathy and patience. Many of us are grappling with the harsh reality of our imminent mortality and are seeking to exert some control over our situation. Mental health professionals can provide invaluable support during this stage, helping us process our emotions and gradually move towards acceptance of our diagnoses.  Like my mother used to say, “after ten years its not the first thing we think of when we wake in the morning”.

I’ve found that dealing with these serious medical diagnoses is a journey, one that has many twists and turns.  For me, acceptance of my diagnoses took time.  Today my understanding of the grief processes has led me to appreciate each and every breath and moment.  Next post we will discuss the last two remaining phases of diagnosis grief; depression and finally acceptance.  Many blessings as always, Kevin.