Research Paper: The 5 Stages of Grief in Recovery From Alcoholism.

Research Paper Assessment
Name: Shelley Breakell Date: 16.4.2012 Student ID: Email:shelley.breakell@sky.com
Complete your 2000 word research paper and insert it in the space below. Then email this document as an attachment to assessment@icoachacademy.com
Using the coaching process combined with the Kubler-Ross Model The 5 Stages of Grief in recovery from alcoholism
Table of Contents
Introduction3 Denial..3 Anger...5 Bargaining...7 Depression...8 Acceptance.10 Thoughts from an alcoholic in recovery - Anonymous.....11 Conclusion.12 References..14
Copyright 2006 International Coach Academy Pty. Ltd. Use is governed by the Terms and Conditions at http://www.icoachacademy.com Last updated Feb 2006
Introduction
My intention with this paper is to research and show how the coaching process can work alongside the 5 stages of grief as described by Elizabeth Kubler Ross. (Elisabeth KblerRoss, M.D. (July 8, 1926 August 24, 2004).
Her extensive work with the dying led to the book On Death and Dying in 1969. In this work she proposed the now famous Five Stages of Grief as a pattern of adjustment. These five stages of grief are denial, anger, bargaining, depression, and acceptance. (http://en.wikipedia.org/wiki/Elisabeth_K%C3%BCbler-Ross).
This model also applies to loss of all kinds including that of releasing or losing a substance that has become an essential part of someones life.
Denial:
Denial (also called abnegation) is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence. (http://en.wikipedia.org/wiki/Denial)
One of the fundamental aspects of alcoholism is denial; especially in the functioning alcoholic - a functioning alcoholic is someone who is able to maintain their daily
activities therefore maintaining the illusion of I dont have a problem. This person clings to the belief that if they can function like normal people they dont have a problem, saying If I was an alcoholic I wouldnt be able to get up and go to work would I? I wouldnt be a successful business man on a five figure income would I? I wouldnt be able to have the children up and dressed in clean, ironed school uniforms ready to go to school on time would I? Therefore appeasing themselves and others about how bad the problem really is.
It could be argued that if an alcoholic is in denial about their problem they would never seek out the help of a coach which is essentially true because why would they? However there are still those that may have been pressured into coaching by family, friends and loved ones for example and there are also those that arrive at coaching knowing they have a problem but still gripped by denial about the seriousness of it.
What is the client needing at the denial stage and can coaching answer those needs?
The main aim is to move from denial to acceptance; acceptance that there is a problem that can no longer be ignored.
The process of this is to help the alcoholic in denial to look at the facts. In Alcoholics Anonymous Step 1 is We admitted we were powerless over alcohol and that our lives had become unmanageable. And the process involved in that admittance is through a
thorough exploration of all of the events, circumstances, problems, pains, traumas, harm to others and ways they have tried to stop throughout their drinking.
By providing a safe, validating environment coaching can help the client to look at the reality of their drinking, to own the problem, offering perspectives and asking Is that true? If the client is willing and open to explore different perspectives they will begin to move towards a new view of the reality of the chaos their drinking has caused financially, physically, mentally, emotionally and spiritually.
This stage of the process would be designed to challenge present thoughts and beliefs in order to assist the client in reaching their own conclusions as to the exact nature of their problem. This may be a slow process and may be a case of two steps forward, three steps back as denial in alcoholism is chronic and powerful.
Anger:
The client may be stuck in denial, unable to face their reality yet paradoxically desperate to escape it, angry at people for suggesting they have a problem yet deep down fully aware that they do. This can manifest as anger, causing them to look outward for means of justification for their drinking i.e. the family in financial difficulties, the anger could be directed towards the spouse for not managing their money properly or spending too much on useless things. They may be stuck in the past, angry at a bad childhood. The anger they feel is
more often however a cover for what they are really suffering inside and that may be fear, guilt, confusion, hopelessness and despair but they are too frightened to see it.
Anger and rants such as Its not fair, why me? and blaming their childhood, their divorce, their circumstances are common. They may feel anger towards themselves, angry that they couldnt control it, anger that they didnt have the will power to stop, anger about the problems and pain they have caused people. There may be all of these aspects and although anger is a common emotion in alcoholism, it is often not true anger. What is meant by this is that the anger an alcoholic feels during their drinking is often in justification and blame, whereas when an alcoholic enters recovery many years of true repressed anger may surface alongside hostility and resentment towards themselves, other people, situations and life in general.
12 steps &12 traditions p.59, Step 5: "Anger and hurt pride might be the smoke screen under which we were hiding some of our defects while we blamed others for them.
What is the client needing at the anger stage and can coaching answer those needs? A coaching relationship offers the security for the client to lead the process without feeling they will be judged or criticized.
If the client is assured of confidentiality and understanding they will be more able to release this anger. The coach can help by encouraging the client to express their anger in
healthy ways, looking at the underlying reasons for the anger; where is the anger coming from? Who or what is the client angry at? How is the anger affecting the client on all levels i.e. emotionally, mentally, physically and spiritually? Can the client see how their anger may be holding them back from a life of peace and can they contemplate any ways of releasing the anger? The client needs to be allowed to be angry but the coach also needs to be able to help the client keep the focus on the future, helping the client to put their anger into context and gently reminding them to bring their focus to present time. Using gratitude as a healing tool is a strong base for coming to terms with and letting go of anger even if the client can only find minute things to be grateful for to begin with.
A large body of recent work has suggested that people who are more grateful have higher levels of subjective well-being. Grateful people are happier, less depressed, less stressed, and more satisfied with their lives and social relationships. Grateful people also have higher levels of control of their environments, personal growth, purpose in life, and self-acceptance (http://en.wikipedia.org/wiki/Gratitude)
Bargaining:
Essentials of intentional interviewing: Counseling in a multicultural world By Allen E. Ivey, Mary Bradford Ivey p.137 Bargaining occurs when patients engage in magical thinking If I lead a better life then God will let me live.
The bargaining stage is likely to be apparent before the sufferer truly makes the decision to stop. To bargain is to try to maintain control and continue to live without real change taking place. For addicts, this is the time for Just give me one more chance and I promise I will never kinds of statements. Rather than being fully surrendered to the problem, the addict is attempting to hold on to control by making up new excuses and promises, thereby avoiding the inevitable.
(http://www.sexualrecovery.com/articles/grief.php)
What is the client needing at the bargaining stage and can coaching answer these needs?
The client needs to see the truth but they have to arrive at that truth through their own assisted investigation. This is linked to denial and the process of working through it is to question the beliefs and bargains that the client holds and puts forward as valid asking questions such as Have you lived up to your bargains and promises in the past? to challenge the thinking of the alcoholic will help them to question these beliefs themselves and bring an inner awareness to the truth of what they are doing and the ultimate truth of the seriousness of their drinking.
Depression:
There is also the type of alcohol depression that comes with early sobriety. As the alcohol leaves the system and people begin to recover, the disease of alcoholism fights
with the brain, causing the phenomena of craving often associated with relapse. The alcoholic begins to be unable to imagine life with alcohol or without it, and the alcoholic depression that results can lead to suicide idealization or attempts.
(http://EzineArticles.com/?expert=Jonathan_P._Sapling)
Feelings and emotions are a part of life but this is a part of life that alcoholics havent been able to face. Their old method of dealing with intense emotions such as depression, anxiety, pain and stress is no longer there and they have no understanding of how to deal with them effectively.
What does the client need at the depression stage and can coaching answer these needs?
The coachs job here is to remind the client that what they are feeling is completely normal and it will pass and that the overwhelming grief they may be feeling is a natural response when letting go of something, even if that something is negative, as it has been such a major coping tool and friend to them, often for many years.
By being a gentle presence for the client to talk, cry and release emotions and using tools such as mindfulness and self-awareness exercises can help the client to feel the emotions without becoming overwhelmed by them. It is at the stage that the client is truly beginning to accept their disease and slowly with the coachs support begin to look at a new life in front of them. It may be daunting and scary at this point but with the sessions
being focused on positivity and encouragement, increasing confidence with small goals set and achieved the client will be able to progress to a true acceptance and hope.
At this stage it is important for the coach to be aware of the possibility of clinical depression and the need for possible referral.
Acceptance:
Acceptance in human psychology.is a person's assent to the reality of a situation, recognizing a process or condition (often a negative or uncomfortable situation) without attempting to change it, protest, or exit. (http://en.wikipedia.org/wiki/Acceptance)
And acceptance is the answer to all my problems today. When I am disturbed, it is because I find some person, place, thing, or situation--some fact of my life--unacceptable to me, and I can find no serenity until I accept that person, place, thing, or situation as being exactly the way it is supposed to be at this moment. Nothing, absolutely nothing happens in God's world by mistake. Until I could accept my alcoholism, I could not stay sober; unless I accept life completely on life's terms, I cannot be happy. I need to concentrate not so much on what needs to be changed in the world as on what needs to be changed in me and in my attitudes. From p. 449 of Alcoholics Anonymous, the Big Book of AA
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Some thoughts in response to one question I asked an alcoholic in recovery:
Can you explain how you felt at the beginning of your recovery and how do you think a coach could have helped you to arrive at acceptance?
(Anonymous) I was in complete denial, I kept saying Ill quit next week, Ill just have one, its everyone elses fault for years and then when I entered sobriety I was so angry I couldnt bare it, sadness, grief, despair, joy, hopelessness and a total lack of anything worthwhile, one minute I was high as a kite, the next I was sobbing into my bed sheets. I guess if I had found a space or a person who could have just listened to me it might have helped. I was facing emotions I hadnt even banked on and they were terrifying. I had massive surges of energy and then days I was exhausted. I think having a coach would have helped me to make sense of those emotions by helping me to put them in their place.
I didnt know who I was, it was as if I was in a body I didnt recognize with thoughts and feelings I didnt recognize. I felt lost and alone. I couldnt comprehend a life without drinking because I had so little confidence, everything I ever did like meals out, parties, even cooking revolved around drink and everything I ever felt like happiness, excitement, sadness, anxiety, anger, stress.everything revolved around drink. I could not get my brain around the thought of never having another drink. I just kept thinking this is so unfair. If I had had a coach that could help me to work through the mess my brain was
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in by asking me to look at my own lies, the pain I had caused and the truth of my disease I may have arrived at acceptance quicker.
I had no idea how to look at my future and what to do with it, I was a mess and couldnt find any clarity in my brain because it felt like a washing machine in there. Sometimes I just wanted someone to talk to, to help me unscramble everything, put it into perspective and help me to see that the future wasnt as scary as I believed it was.
In Conclusion:
Coaching an addict in recovery through the 5 stages of grief to a place of acceptance can be effective in assisting them on their path to recovery by creating the safe space, challenging distorted thinking within that space, posing reflection questions, supporting them through pain and helping them to explore themselves and develop a self-awareness that will help them to stay aware of their triggers.
By having a coach that the client trusts, all of the overwhelming thoughts, fears and emotions can be addressed whilst keeping the present and future at the core of the focus.
If the 5 stages of grief are kept at the forefront of the coaching process the coach and client will be more able to gauge where the client is and decide on the most beneficial, productive and pro-active ways to be working together in order to keep the client on a
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strong road to recovery with goals and strategies being decided upon to enable to client to begin the process of creating the future they desire.
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References
Websites
Change Management Coach. (2008). Kubler-Ross 5 stage model. Available: http://www.change-management-coach.com/kubler-ross. Last accessed 13th April 2012.
Emily Battaglia . (2008). Overcoming Denial: The first step to recovery. Available: http://www.drugalcoholaddictionrecovery.com/?p=21. Last accessed 12th April 2012.
Gigi Veasey. (2012). Managing addiction recovery is important when overcoming grief. Available: http://www.ahwatukee.com/community_focus/article_da3d09c0-63f5-11e1-
b75a-0019bb2963f4.html. Last accessed 10th April 2012.
Jonathan P Sapling. (2010). Alcohol Depression - How To Get Through It. Available: http://ezinearticles.com/?Alcohol-Depression---How-to-Get-Through-It&id=3740407. Last accessed 12th April 2012.
Michael M. Stuart. (2005). Denial Is Not A River In Egypt. Available: http://www.mikestewartseminars.com/PDF_Files/A-DenialIsNotARiverInEgypt.pdf. Last accessed 13th April 2012.
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Sexual Recovery Insitute. (2012). The role of grief and loss in addiction recovery. Available: http://www.sexualrecovery.com/articles/grief.php. Last accessed 14th April 2012.
Signs Of Alcoholism. (2011). Recovering from Alcoholism:Preventing Relapse. Available: http://signsofalcoholism.org/recovering-from-alcoholism-preventing-relapse/. Last accessed 10th April 2012.
Wikipedia,
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(2009).
Denial.
Available:
http://www.wikipedia.org/wiki/Denial. Last accessed 13th April 2012.
Wikipedia,
the
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encyclopedia.
(2004).
Kubler-Ross
model.
Available:
http://www.http://en.wikipedia.org/w/index.php?title=Kbler-Ross_mode. Last accessed 13th April 2012. Books
Allen E. Ivey, Mary Bradford Ivey, Carlos P. Zalaquett, Kathryn Quirk (2007). Essentials of Intentional Interviewing: Counseling in a Multicultural World. USA: Wadsworth Publishing Co Inc. p37.
Anonymous (2002). Alcoholics Anonymous - Big Book. 4th ed. New York: Alcoholics Anonymous World Services Inc. 417.
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AA Services (2002 (edition unknown)). Alcoholics Anonymous - twelve steps & twelve traditions. 4th ed. New York: Alcoholics Anonymous World Services Inc. 59.
Harold C. Urschel, III, MD (2009). Healing The Addicted Brain. USA: Source Books Inc. p119 - p121.
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Research Paper: The 5 Stages of Grief in Recovery From Alcoholism.

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Research Paper Assessment

Name: Shelley Breakell Date: 16.4.2012 Student ID: Email:shelley.breakell@sky.com

Some thoughts in response to one question I asked an alcoholic in recovery:

b75a-0019bb2963f4.html. Last accessed 10th April 2012.

http://www.wikipedia.org/wiki/Denial. Last accessed 13th April 2012.

http://www.http://en.wikipedia.org/w/index.php?title=Kbler-Ross_mode. Last accessed 13th April 2012. Books

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