The Five Stages of Grief are based on a theory developed by psychiatrist Elisabeth Kübler-Ross that suggests people go through five distinct stages of grief after the loss of a loved one. The five stages are denial, anger, bargaining, depression, and eventually, acceptance. While the theory was based around the loss of someone close to you, it has been posited that workers injured on the job may also go through a similar process after a serious accident.
There are certainly strong parallels in the comparison. Consider these stages both for the loss of a loved one and a serious injury that leaves someone with an impairment. Denial is an attempt to understand the loss, while often initially refusing to believe it is possible. Anger follows shortly behind, when reality has set in, and a person may realize that their life has been significantly changed by the loss, but they refuse to accept the outcome. Bargaining often is directed to a higher power and includes a commitment or promise in exchange for relief of suffering. Depression can set in when, after the denial, anger, and unrequited bargains, the reality of the permanency of loss sets in. Acceptance is when a person realizes that life has indeed changed, and they stop struggling to reverse or undo the event.
Acceptance is also the stage that some injured workers never really reach. And to that end, the Five Stages of Grief may not be a perfect comparison for the emotional journey of people in the workers’ compensation system. It is a critical problem, and likely a great contributor to negative outcomes for our industry. Without acceptance, healing at the emotional level can never really occur. The cycle of anger leading to depression can be all-consuming. The person who is incapable of understanding their reality and adjusting properly is destined for greater issues down the road.
Professional Surfer Bethany Hamilton, who lost an arm in a shark attack at the age of 13, tells the story of the doctor informing her of the amputation after her surgery. He told her, “I am going to give you a list of things you will no longer be able to do. It will be very, very short. I am also going to give you a list of things you can still do, you just may need to change the way you do them. That list will be much, much longer.” That doctor was helping her set a path to acceptance, by letting her know that, while life had certainly changed, it was by no means over.
Acceptance doesn’t mean the pain or sadness vanishes. It does mean, however, that the person has decided not to let the event define their future self. Acceptance brings ownership, and ownership brings healing. As we’ve written in these pages before, for a seriously injured worker this means that they must own their disability, or otherwise, their disability will surely own them.
Professionals in the industry working with these injured employees can make a difference in this process. We can help people get to the point of acceptance of their situation. Clear communication that sets reasonable expectations and outcomes is critical. Listening to the injured worker and understanding where they are in the process is also important. People left with impairment naturally would like to once again be the person they were before the accident. Acceptance is realizing that may not be possible and understanding that they must work from the point of their new reality in order to return to normalcy. Our job should include helping them get to that final stage.
There is no doubt that this theory can be applied to the process of healing for injured workers. Ushering them across the finish line, to that point of acceptance, will help in achieving positive outcomes. The Five Stages of Grief is a good principle to understand. If we don’t, we risk it being the Five(ish) Stages of Grief, and the omission of that final stage can be costly indeed.