Psychological Point of View of Dying and Death
Death and dying have remained unclear over the years. No person has ever come back to life to tell the tale. There are different opinions that explain when death occurs, is it when the brain is dead or when the vital body organs refuse to function? Elizabeth Kubler-Ross a psychologist on her research on death, found out that there were five stages that most patients go through when diagnosed with a life-threatening disease. These stages do not necessarily follow a sequence. In this paper, we will look at the different views as to when death occurs. We will also look at the stages according to Elizabeth Kubler –Ross: denial and isolation, anger, bargaining, depression and acceptance and expand more on death is a task (Kubler-Ross, 1999).
In denial and isolation, an individual on receiving the news, denies that they have a fatal illness. They can insist that more tests be done just so the doctor is sure. Denial can also occur various times during the illness. The patient may refuse to mention the subject or divert to another topic once the subject is brought up. They may even express negative emotions and outburst. Some may even refuse any form of medication because they refuse to acknowledge that they are ill. Isolation is related to denial. An individual will reject any interactions with other people so as not to mention the subject of their illness. This stage however will not last long as individuals will either accept or pretend to accept until the end.
Anger will often arise because of the question, ‘why me?’ Patients will have a build up of annoyance, rage and bitterness as they try to understand why it had to happen to them. This anger will more often be transferred to other people regardless with their relation to the problem. The patient will find fault with the government, family, friends, and hospital staff. Some may even be in an awful mood all the time. This anger will mostly be triggered by resentment, when one realizes that they can no longer be able to do the things they once loved and adored. The bitterness can also be directed towards a superior authority for allowing them to depart this life. Depending on the religion one believes in, it can be God, Allah; Krishna etc. anger can be a way to seek attention and a reminder that one is still alive.
Bargaining occurs when a dying person tries to make an agreement with a higher power to get what they want. One will try to delay their demise as largely as possible. They can make promises so that this can happen. For example, they may want to spend one last Christmas with their families, or see the birth of their first grandchild. Bargaining is often linked with promises to be on the best behavior or to become a better person in return for more time to spend. The reason for bargaining is that the patient begins to appreciate life. One therefore has a desire to have more time.
Another stage is depression. This emotion is often expected considering the fact that a person is about to lose his life. Depression however is not so easy to understand when it arises in a dying man. There are two different types, from two diverse sources. The first kind is due to the tricky situation and aggravation. The patient is worried about the finances; probably they are already in debt. One can also think about the family: who will take care of young children or older people. Medications e.g. chemotherapy will the everyday life of a person, this can lower their self-esteem. All this will add to their rage and more often increase their misery. The other kind of despair a patient goes in to be due to anguish. The same sorrow that one would feel because of losing a loved one, is the same sorrow one feels when they are about to die.
Acceptance after going through all those stages (not necessarily in order) will finally come to terms with their situation. This does not mean that they are happy with the circumstance or giving up. Acceptance is where the patient is neither miserable nor in high spirits, but peaceful. The best type of therapy in this situation is to surround yourself with people who love and support you.
Identifying that a patient is about to depart this life is quite complex. It is difficult to determine that one is ailing and is about to recover, to being sick and not getting better. There is always a contention about whether the doctor should tell a patient that they are dying. Before, death was expected to follow an expected route. Where the heart stops, inhalation ends and the brain dies. James Naime in his book Psychology says that, “many psychologists find it more appropriate to talk about dying trajectories, which is the psychological path people travel as they face their impending death.” (Naime, 2008). Everyone has a different trajectory, which takes a different outline depending on the disease and his or her character.
In a society where technology is advanced it is not easy to tell exactly when a patient dies. There was a time when people used to believe that if the heart was beating a person was still alive. It did not matter whether they were conscious or not. It also did not matter whether their brains were functioning or not. The heart was the key determined (Kastenbaum, 2006). There is a controversy as to whether a parson on life-support, whose heart is still beating but who is in a vegetative state is dead or alive. An argument that is mostly used is does it consider the moral right of an individual. Currently, the focus is on whether brain death should take account of the entire brain or the core of the top functions.
Brutal accidents and abrupt illness will often take a different routine for the dying. The patient will not experience the different stages of anger, depression, bargaining, denial and isolation. The focus will be to rush to hospital. There is always hope that if they just get there they will survive. Despite how life threatening the situation may be, efforts will be on saving life. Treatments that save life even when death is foreseeable always pose a conflict between the right to live and the right to depart this life with poise. This often affects relatives and families who are torn between the choices to make.
The intensive care unit has become the new avenue for dying the contemporary death. These units mainly focus on critically ill persons. There are high chances of death or organ failure and doctors are always on the look out. This is another event where a person does not go through any stages of dying. Death is a constant threat. A person ends his life attaché to all sorts of machines. Once it has been ascertained that a patient will not live, their organs can now be considered for donation. Relatives usually have a hard time on this one. It is a very stressful and complex matter; this is because it is the first time their loved one is considered dead.
It has been said that we were all created differently. There are patients who prefer to die at home. This gives the family members a core role during the last days of the patient to look after them. Another reason is the lack of finances for treatment. Others enjoy the familiarity of their homes. This desire also comes with its disadvantages (Naime, 2008). The members of the family may not adequately provide all the required care that the patient requires. The relatives may also be overwhelmed with everything that they have to do; this may create strife or resentment, which is not good for the patient. This kind of death can be positive and negative to the grieving family.
Unanticipated death will seldom provide the same peace that expected death provides. Expected death allows people to say goodbye and help them to move on. When people die suddenly without saying goodbye, the family usually experiences shock, anger, rage. Sometimes it becomes a bit too much to take in and they enter into depression. According to Mary Bradbury in her book, the representation of death: a social psychological perspective being with the body, immediately after death, while it is still warm, is important to grieving relatives. This is because the body is still familiar. The scent is still the same. All this helps in the process of grieving.
Death on the other hand can mean different things to different people. For those who are religious and believe in life after death, death is an opportunity to meet their family and friends who went ahead of them. It is also a chance to meet with their maker and live happily. For the elderly it may mean the beginning of another life (Naime, 2008). For the young people, it may come as an interruption. For those who have been struggling, it may mean the end of a bad phase and hope that the next will be better.
On any discussion on death and dying, a question that is frequently asked is whether people should have the right to have power over the decisions to die when faced with immense pain. Is assisted suicide defensible? In case one is hooked to machines and most of their body organs are in vegetative state, are they allowed to continue living or can the machine be switched off. Religious opinions, the personality of an individuals and the fear of death will always affect these types of decisions.
In conclusion, there is not right and wrong way when it comes to dealing with death. Death remains ambiguous. It cannot be controlled and there is no way to prevent it. Everyone should be allowed to deal with death in his or her own way. Family and friends should provide their love and support those who are ill and those who are grieving. How everyone interprets, death will always control how he or she lives. It will also affect how they plan and even react to death (Naime, 2008). The issues about when to end life, in case there is no hope of recovery would have not been so major had it not been for the technological advances that have allowed for organ transplant. To make death less strenuous and complex, people should be advised to write wills. This is to help the people concerned.
Becker, E. (1997). The denial of death. New York, NY: Simon and Schuster.
DeSpelder, L. A. & Strickland, A. L. (2009). The last dance: Encountering death and dying. Boston, MA: McGraw Hill Higher Education.
Kastenbaum, R. (2006).The psychology of death. New York, NY: Springler publishing company.
Kubler-Ross, E. (1999). Representation. New York, NY: Routledge.
Naime, S.J. (2008).Psychology. Belmont, CA: Thompsonwadsworth.