Cycle of Acceptance
The first reaction on hearing the bad news is one of classic shock. This initially may appear as if there is no reaction at all to the news. The person may nod and accept the news without appearing to be troubled by it. Inside, they have frozen out the news that has not really taken hold yet.
This is followed by a more external shock, where there may be physical reactions such as paling of the skin, shortness of breath and physical freezing.
After the initial shock has worn off, the next stage is usually one of classic denial, where they pretend that the news has not been given. They begin to pretend that nothing has happened.
A classic behavior here is a ‘flight into health’, where previously-perceived problems are suddenly seen as having miraculously fixed themselves.
The next step after denial is a sudden swing into anger, which often occurs in an explosion of emotion, where the feelings of the previous stages are exploded into a flood of grief. Whoever is in the way is likely to be blamed. The phrase ‘Why me?’ may be repeated in an endless loop in their heads. A part of this anger thus is ‘Why not you?’, which fuels their anger at the those who are not affected, or perhaps not as seriously so.
After the anger has dissipated, the next stage is a desperate round of bargaining, seeking ways to avoid having the bad thing happen. Bargaining is hoping that the bad thing that is coming, won’t actually happen.
Bargaining in illness includes seeking alternative therapies and experimental drugs. In organizations, it includes offering to work for less money (or even none!), offering to do alternative work or be demoted down the hierarchy. One’s loyalties, debts and dependants may be thought of as ways of being saved.
After denial, anger and bargaining, the inevitability of the news eventually sinks in and the person reluctantly accepts that it is going to happen. From the animation of anger and bargaining, they slump into a depression. . In this deep depression, they see only hopelessness, with no end in sight.. In turning in towards themselves, they turn away from any solution and any help that others can give them.
Depression may be seen in a number of passive behaviors. The person may shy away from friends and family, they may begin to miss work more frequently, they may stop taking care of themselves physically. Depression can also be seen in some active behaviors such as crying for extended periods of time.
Even in the pit of depressive despair, reality eventually starts to bite and the person realizes that they cannot stay in that deep, dark hole forever. They thus start looking for realistic things that they can do. These may be taken on as ‘experiments’ to see if doing these things help the situation in any way. As this activity starts to work, at least in some ways, it is found to be preferred to the depression and so the person crawls out of that dark hole.
This escape is often done with the support of friends, family and professionals who specialize in helping people in whatever situation this is.
The final stage is back to one of stability, where the person is ready and actively involved in moving on to the next phase of their lives, no matter how short. The terminally ill person will be putting their life in order, sorting out wills and helping others to accept the inevitability that then now have countenanced and faced.
With people whom have chronic pain, like in the case of PN, a person might start making arrangements to find further treatments, like PT, Botox, PN injections etc.
Acceptance is typically visible by people taking ownership both for themselves and their actions. They start to do things and take note of the results, and then changing their actions in response. They will appear increasingly happier and more content as they find their way forward.