Stages of Grief for Amputation

Dr. Elisabeth Kubler-Ross, a Swiss psychiatrist, pioneered studies on death. In 1969, she wrote the powerful book "On Death and Dying" which many grief counselors still use and which provided solid groundwork for understanding the stages of grief. Although her book specifically refers to the stages of grief as they relate to death, these stages can be applied to any type of loss, including amputation. However, all amputees may not go through each stage, and they may go through the stages in a different order.

Disbelief and Denial

• Initially, amputees typically respond with withdrawal, isolation, denial and disbelief. However, an amputee who has had some time to prepare for a surgical amputation may not experience denial. This stage gives the amputee time to develop better coping skills.

Rage and Anger

• The new amputee may vent rage or anger at anyone close to him. He may blame medical professionals or God for his loss. However, amputees can constructively channel this increased energy into productive projects.

Bargaining

• Bargaining occurs when the patient tries to make deals with God or her doctor. Typically she expresses it through such statements as, "If you heal my arm, I will feed the poor children in Africa forever." Many patients bargain privately. This is, in part, an attempt to postpone the reality of the amputation.

Discouragement and Depression

• The resulting sadness over the loss of a limb and worries over future losses can bring on depression. The amputee may sleep too little or too much, fixate on the future, feel hopeless or talk about death or even suicide. This stage of depression is not usually permanent but the amputee may need counseling or medical intervention to treat it.

Coping

• Although the amputee is never happy about the loss of a limb, she has now come to terms with her loss. A peer counselor can help the amputee work through this process.