Like the Kubler-Ross 5 Stages of Grief model, Expect These 5 Stages in Coming to Terms with a Pandemic:

As a psychotherapist, I commonly use, as applicable, several different models of grief, including perhaps the most widely referred to Kubler-Ross 5 Stages of Grief model. This is a tool, a roadmap, if you will, to help my patients through the death of a loved one or to help them come to terms with any other major change in their lives due to loss or trauma.  However, within the last few weeks of life in a global pandemic, I have adapted a model to allow people to identify where they are at in the process of experiencing both unthinkable change, and unimaginable loss.  If we allow for an updated model, one which is not necessarily linear and gives us license to move back and forth between the stages, we benefit in two ways: Firstly, if we initially view the stages sequentially, this helps us to identify where we are  both individually and collectively. We are comforted that our feelings are shared by others, completely normal and that whatever stage we are in now, we are engaging in a process that leads to adaptation and acceptance.Secondly, if we recognise that we may revisit certain stages, and they may revisit us, then we are less self-critical, and less traumatised by this movement. We will not chastise ourselves for ‘going backwards’ rather, we will recognise that we have revisited a certain phase because we left something behind that is critical to collect.  

 Stage 1: Denial  and Shock 

“This can’t be real. I don’t believe what I’m seeing, and I can avoid it by continuing to do what I have always done.” This is the Assault on Reality stage which means you will be resistant to accepting information.  It is also the Attempt to Avoid Pain phase. There is a sense that once you pass through this stage, you can never go back to who you once were and life will never be the same again. Hence, even though this is a place of tremendous pain and uncertainty, it is nonetheless easy to get stuck here as leaving this stage means leaving something or someone behind, including your sense of self or the only life you’ve ever known. This stage requires the biggest adjustment of them all. Remember that this is not a place of weakness - it’s ok not to just accept loss at face value. It’s ok to fight it at first. Some people will wake up every morning and find themselves momentarily back in Stage 1 before they readjust to reality and move back to the stage they had previously reached. Even some of our world leaders spent time in shock and denial despite having the benefit of experts at their sides. So don’t be hard on yourself if  you couldn’t accept what you were seeing at first - even people with the best eyes and ears struggled to comprehend what was happening. 

Stage 2: Assimilation

Acknowledgement and Absorption of a New Reality with a burgeoning understanding of impact - “I realise that the world and my life are changing right now even if I’m not ready to think about what comes next.”  Your brain has now stopped blocking information that it once found overwhelming and is starting to process reality. You utilise a new language here - terms and expressions that define the Pandemic landscape - you join in on using them. You now know, for example, what PPE stands for and you create a new mental space for relevant facts and science. Here is where you begin to follow new rules, absorb more news, and talk to other people about their experience. You expand your empathy, perspective and knowledge base and your brain opens to learning. You accept that you will have to participate and move forward even though you may not yet be prepared to think about long-term consequences. You are nonetheless familiarising yourself with a new world so that you will be able to know what action to take next. You may still shake your head at the weirdness of attending a video wedding, or be thrown off guard by quietness of your street - but you won’t feel crazy even if things look crazy.  

Stage 3: Acclimatization

“Everyone’s in the same boat and starting to row.  I’m on board with where this is taking me. Resistance to change is harder than change itself.” This is the stage where you move from comprehension to participation. You begin to modify your life and your day in order not to fight change but to adapt and facilitate it. You buy a mask and you put it on whenever you leave your home; you no longer have to remind yourself what the rules are; you automatically stand two metres away from the person in front of you. You now understand that not adjusting to your new environment will hold you back and so you develop a fluidity with regard to incorporation of new facts, expecting the situation to change quickly and customising yourself to uncertainty as opposed to relying on certainty. Once you are at this stage you will be ready to seek out information that applies to you and you will begin to come up with a plan, your Plan B. You may still feel panicky when you make calls you never thought you’d be making, e.g. mortgage breaks and furloughs. Though no longer frozen, you may still feel numb. 

Stage 4: Anger and Sadness 

“How could I have been left so unprotected in life by myself, my government…? People are losing so much, I don’t know where it will end, and meanwhile, I can’t even have a hug.”No matter how hard you’ve worked in life, whoever you are, you have just been introduced to the reality that you were never protected against this. Now, your basic human comforts and interactions have been taken away. Families are being kept apart, touching has become dangerous and you have been robbed of your independence on many levels.This is the stage that makes you human and you shouldn’t try to fight or suppress these feelings. It’s ok, it’s natural, it will awaken you, and at some point when these feelings (mostly) clear because they have had their day, the space they once occupied is where happiness, love and joy are rehomed. Bear in mind that this is a “Floating Stage” - it may wash over you without warning or invitation because these feelings slip through at unexpectedly vulnerable moments.Remember that when you experience sadness and loss, it means you appreciate what you once had. This is an acknowledgement of what you valued and is the first step toward having it again, even if it doesn't look exactly the same.  Your anger plays a critical role because it can both motivate and empower you. Don’t rush to push it away - feel it, and then use it to ask questions, protect yourself better in the future, and institute changes that will give you more control in the days to come. You have every right to be angry about suffering and change that is forced upon you.The goal is to exit this stage with a sense of both meaning and purpose. 

Stage 5: Acceptance 

“What’s happening is happening, I’ve reconciled myself to that fact that my perspective will determine my outcome”. You are now past ‘to Plan B or not to Plan B?’.  That is no longer a question. You can see yourself as part of a different world. Though you juggle both optimism and pessimism, as each day goes on - you hold on to more of the positive thoughts and drop more of the negative ones. You sustain yourself with thoughts of reunions with family and friends, and you promise yourself that what has happened will not discourage you but rather will encourage you to form deep bonds and take nothing for granted. Here you accept a reality that you didn’t create, a loss you didn’t anticipate, and you understand that stability comes from within. You recognise that certainty is an illusion and uncertainty is a conclusion that you make peace with.  Having learned that you are a survivor, you embrace life. 

Addendum on the Concept of Closure

Nowhere within these five stages will you find the expression, ‘closure’ because many aspects of dealing with a pandemic will remain open, ambiguous, unavoidable and irreparable. We will not commit the injustice of asking ourselves to ‘get over’ pandemic trauma by putting our experience behind us, rather we will gradually unburden ourselves as we learn to give meaning to it. Slowly, we will lighten the load.A pandemic creates complicated grieving, such as not being able to be with the person you love as they are losing their fight for life, or not hugging and being physically held on some of the hardest days of your life. Closure is better seen as survivorship which allows for a broader perspective. You should not be required to break down a bond or force your love for a person or a way of life to fade in order to complete a cycle of grief.  No good memories will be left behind. Grief will become a component of joy. 

https://www.health.harvard.edu/newsletter_article/beyond-the-five-stages-of-griefhttps://www.psychologytoday.com/gb/blog/mental-health-nerd/201911/the-4-tasks-grievinghttps://psycnet.apa.org/record/2008-13837-003https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806638