Anger, bargaining, definitely denial: Our reactions change as we move through the pandemic
They may not be tidy, sequential stages, but it's only natural we react in different ways to COVID-19
You might have heard of the "five stages of death and dying" — denial, anger, bargaining, depression and acceptance. It's a model developed by the Swiss-born, American-based psychiatrist and author Elisabeth Kübler-Ross, and was the basis of her bestselling book On Death and Dying.
Kübler-Ross came up with the model from her work with terminally ill patients, and she presented it as the stages that people go through when they're confronted with their looming and certain mortality. The five-stage process was also used to describe what happens with the grieving and bereaved, and Kübler-Ross, late in her life, came to see applications in traumatic events.
Weeks ago, when the COVID-19 pandemic was upon us, my mind recalled the Kübler-Ross model, and it's been helpful in making sense of something that's so overwhelming, so staggering, it's almost beyond sense itself.
Rereading about Kübler-Ross, I learned that her popular model has very much gone out of favour clinically. No one has been able to prove that her five prescribed stages will clinically happen, while other researchers and therapists very much dislike the concept of sequential, linear, stages. Dying and grief, they say, are a bundle of emotions, and different people feel different things at different times. (Kübler-Ross herself, it's worth noting, came to have regrets about how strictly people came to interpret her model.)
Still, DABDA, as it's known, is still a popular concept, and few would deny that at least several of the individual stages can be commonly seen — not just during dying, but when something horrible is happening.
For me, they've been obvious in the pandemic — some more than others.
Outbreak? What outbreak?
Let's start with denial. Definitely denial.
A month ago, I wrote about being laid up with a broken leg, and how it had allowed me time to read a lot while I healed. I also talked about the weird feeling of healing, and focusing on the positive things in my life, while simultaneously watching COVID-19 burst into an inferno that seemed to be consuming the planet in stages.
Maybe because I had time to read, I got a bit obsessed with coronavirus. I also felt a disconnect: why was I not seeing the mounting dread I had outside my window?
The dread showed up, but the denial about outbreaks showing up in one country after another seemed just as startling, even though Canada became a coronavirus country in January.
Before the World Health Organization declared COVID-19 a pandemic on March 11, there was a a laissez-faire attitude across North America, and here. People flew from A to B (and to C through Z). COVID was a headline, a problem for others, not for us. Infamously, Donald Trump was still publicly calling coronavirus "a new hoax" as late as Feb. 28.
After the WHO's declaration, things changed, and quickly. But even then, denial seemed to be prevalent. How else, for instance, do you explain provincial cabinet minister Steve Crocker flying off for a Florida vacation the very day after the pandemic was declared? Crocker, who flew back home soon after and started a 14-day self-isolation, noted there were no travel restrictions at the time — and he has a point.
Then came anger. We saw it boil over on social media — where else? — when the pandemic was in our midst. There was anger about restrictions on shopping, about kids being forced to stay home from school, about loss of income, about too heavy a hand from government or not heavy enough … there was a red-hot poker to be wielded for every issue.
In terms of online rage, though, nothing seemed to be as torrid as the cluster of cases that involved Caul's Funeral Home in St. John's. The pitchforks were out for the … you know, I'm not going to use any of the nasty words used to describe the person who carried the virus. People topped each other for speculative details, even motives. (For another perspective, please read Ariana Kelland's reporting on the people who attended the funeral home.)
Similarly, I was horrified to see one Facebook thread that was identifying neighbours — by civic address — of who may have travelled where and when.
Anger has been evident as people lash out at what they perceive is happening that they don't like. Maybe sometimes it's justified, but I'm continually struck by people who are full of rage about those who, say, shop. One tweet I saw was about people going to a particular store four or five times a day. (Which made me think: "Um, how exactly do you know that?")
Bargaining? Let's make a deal
Health Minister John Haggie has frequently spoken out about those looking for a way out of the physical distancing and "stay at home" requests of the public health emergency legislation. While businesses can be ordered to close, what individuals do is voluntary, and government seems loath to that heavy-handed, for now.
So, Haggie says, people are looking for "not me" loopholes so they can travel, shop and live as they wish.
"For heaven's sake, what is it that I have to say to get people to understand that looking for loopholes like this may give you a short-term buzz and a feeling of getting away with something," Haggie said during an April 13 briefing. "But at the end of the day, you then take back everyone else's viruses to give to your loved ones and your family."
Depression is a tough thing to address, but it's real, and it clearly seems to be evident in the pandemic. I've read posts from friends who struggle with mental health issues at the best of times, and these last weeks have been very challenging indeed. Other friends are encountering overwhelming feelings that are new to them. That this is happening when there is restricted access within the health system to clinicians is concerning.
But there are broader mental health issues, too. I was reading research published just last month that noted in prior pandemics, health professionals on the front lines became at risk for significant mental health problems, including post-traumatic stress disorder.
Dealing with a new, changing reality
Kübler-Ross's fifth stage — I'm reluctant to call it the final one, because people experience different things at different times — is acceptance. In terms of terminal illness, this would be a feeling of putting affairs in order, making peace with mortality, even embracing where things stand.
Are we there yet? I'm not sure.
Our behaviours in our own house have been affected by the crisis Even though the number of positive cases in Newfoundland and Labrador has dropped significantly, we're being very strict with what we do — and what we don't do.
I was struck by the words of Bill Woolridge, who spoke at Thursday's COVID-19 briefing about he and others were infected because they attended Caul's Funeral home in St. John's in March. Woolridge, thankfully, has fully recovered, and so have all his family members and two close friends, one of whom was hospitalized.
"Coronavirus is not a hoax. Coronavirus is very real," Woolridge said.
"Coronavirus can make you very sick and even threaten your life. Please respect this virus."
Respecting the seriousness of COVID-19 is indeed acceptance.
We're not through this yet. No one knows how this will end — whether there may, for instance, be waves, perhaps one in the fall or another season in which countries around the world will again have to enact stringent rules. Perhaps it will be a seasonal health problem, managed like influenza. Perhaps it will be something else.
Let's accept that it's serious, that we don't know the outcome, and keep moving.