Grief Therapy When You’re the One Dying
Most grief resources are centered around the people who have lost a loved one. But much of the original grief research was based on the process of the person who was dying. The 5 Stages of Grief? Yeah, that was written for you. They’re actually the five stages you go through after getting the news that you don’t have much longer to live.
Processing End of Life with Grief Therapy
Most people have mixed feelings about getting a terminal diagnosis. On the one hand, you’re probably going to die. On the other hand, having a potential deadline can offer you an opportunity to switch from a focus on treatment to a focus on making the most of the time you have left.
Therapy at the end of your life is more existentially focused. What did you accomplish with your life? What regrets do you have? What is the legacy you want to leave?
Unfortunately, it can be difficult to have these discussions with friends and family when you’re dying. They are in the middle of trying to process their own grief and sadness. They might not be able to discuss these big questions objectively, or they might feel like they have to give you a positive perspective rather than having a rich conversation.
End of life therapy is more conversational and touches on these deep questions of purpose, meaning, life, and death. We can talk about anything. No topic is off the table. We often focus on unfinished business- the things you want to do, relationships you want to repair, and pain you want to heal before you die. We can also get into practical matters like financial issues, funeral arrangements, and personal loose ends.
Living with Death Awareness
Death awareness means recognizing that every person has limits. None of us will live forever, even if the current issue is miraculously healed. The immediacy of a terminal diagnosis forces you into awareness of your own mortality and offers you an opportunity to clarify your values and purpose.
In therapy, we’ll focus on that sense of opportunity and talk about ways you can live out your values with the time you have left. Depending on your capacity and limits, you may not be able to do anything about your big regrets, but you can always make the most of what you do still have. My goal is that you’re able to live as full a life as you want to in the face of death.
Processing Fear of Death
Impending death is incredibly stressful. Most people’s biggest fear is the pain and suffering that comes along with death. Depression, anxiety, and anger are the most common ways that you might experience fear of death.
Meditation, relaxation training, and cognitive therapy can help with the fear of pain. EMDR and Brainspotting can also help with intense emotions, anger, anxiety, and depression.
Depression
Let’s be real. Very few people are happy to hear that they’re dying. Sadness is an appropriate reaction to bad news.
It’s also normal to feel like a line has been drawn between you and everyone around you. You have a death sentence and they get to keep living. It’s normal to feel a sense of alienation and want to withdraw from others and their normal life.
Depression becomes a problem when it pushes you into a state of despair, hopelessness, and demoralization. This kind of depression can keep you from actually getting to live the rest of your life with the time you do have left.
In therapy, we’ll leave room for your sadness while giving you practical skills and tools to keep depression from consuming your life.
Anxiety
There are two main reasons that people feel anxiety when they’re dying. First, you might be worried about what might happen to your loved ones after you die. Second, nobody knows what happens after death, and you might feel anxious about what you will experience.
If you have children, parents, or others who depend on you, the prospect of your death is worrying. What’s going to happen to them? What, if anything, can you do ahead of time to keep them from suffering after you die? You might also worry about how they are going to handle their grief based on how well they took the news that you’re dying. And depending on your diagnosis or medical treatments, you might feel anxious about going through the pain, physical changes, and loss of independence that’s ahead of you.
No matter what your religious or spiritual beliefs are, it’s normal to question everything when you’re actually facing the possibility of afterlife, reincarnation, or nothingness. Friends and family are often frightened or unsettled if you start questioning the beliefs you’ve held. It’s okay to have doubts, questions, and concerns about what comes next after death.
Therapy can help you process your anxiety, work through religious questions, and learn how to manage anxious feelings when they come up.
Anger
Anger can turn outward (hostility, irritability, frustration), inward (self-blame, guilt, regret), or existential (injustice, absurdity, unfairness).
Your anger is valid and normal, but it can also be unhelpful when it’s turned against yourself or others. Therapy can help you learn how to process and hold your anger in appropriate ways.
The Five Stages of Dying
Denial
A terminal diagnosis can feel like it’s coming out of left field. You may have had some intuitive sense that things were serious, but it’s hard to accept that there’s nothing that can be done. Denial often feels like a rejection of the diagnosis, the sense that it can’t be real or happening to you.
Anger
Death is an injustice. It’s not fair, and it doesn’t affect people according to what they deserve. Anger is a healthy, normal response to hearing that your life will be cut short.
Bargaining
When you feel totally out of control, it’s normal to want to try to make a deal. This could be praying to God, promising to live a better life to try to get karmic justice, or suddenly trying to be healthier to stave off illness.
Depression
After the bargaining doesn’t change your situation, depression can set in as you are fully aware that there may not in fact be anything you or others can do to fix the fact that you’re dying.
Acceptance
This doesn’t mean that you love what’s happening or that you’re looking forward to dying, but it does represent a new phase where you’re able to admit to yourself honestly that you are going through this right now.
Obligatory disclaimer: these stages are not meant to rigidly apply to everyone in every situation. The stages are fluid, and you might not experience all of them. You may find that you hang out in some stages more than others or that you cycle through them regularly.
Therapy for the dying
I offer online therapy for people who are dying and want to process the end of their life. I work with people of all ages- children, teens, adults, and elders. Schedule a consultation here.
If you are a friend or family member grieving the death of someone close to you, click here to learn more about grief therapy for the people left behind.