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“Meaningful Reflections” Helping Individuals Create Meaningful Life Reviews Client : Sarah, a 67-year-old female Stage 1: Trust vs. Mistrust. Sarah was hospitalized for the first two months of her life. Her mother was with her almost all the time she was hospitalized and would not leave her side unless nurse Phyllis was on duty. Her mother trusted Phyllis because she treated her as her own. Her father seemed like a stranger to her because she rarely saw him, however her mother had the freedom to take as much time off work and was present for all appointments and doctor visits. Sarah bonds quickly, but has to see the genuineness in a person to really believe that they are of good character. Stage 2: Autonomy vs. Shame and Doubt . Sarah’s toddler years were a time of curiosity and independence. She stated that she went through a ‘Purple Green phase’ in which she only wore purple and ate green food, which her mother would dye to appease her. Her parents were incredibly supportive, she re- called them letting her explore, playing in the mud, going in woods and being active. She stated that in the

pictures they looked happy watching her but she does not recall them ever partici- pating in these activities. Stage 3: Initiative vs. Guilt . Sarah spoke about wanting to be inventive and proactive at this stage, which de- notes a successful resolution. She had happy memories of doing different things and asking her parents for permission, indicating healthy initiative growth. However, Sarah de- scribed times when she felt guilty because her parents had prevented her from engaging in cer- tain habits. Stage 4: Industry vs. Inferiority. Sarah mentioned her middle school years, scholastic and extracurricular successes. She took satisfaction in her accomplishments. She also admitted to self-doubt, particularly when comparing herself to others. It is possible that these unresolved inferiority com- plexes had an impact on her adult self-concept. Stage 5: Identity vs. Role Confusion. Sarah investigated her concept of self throughout this phase. She discussed her life goals, personal values, and work, demonstrating a successful resolution. However, she also spoke about periods of uncertainty that prompted some self-exploration and questioning. These

unresolved issues aided her personal development but occasionally made her vul- nerable. Stage 6: Intimacy vs. Isolation . When Sarah discussed her marriage, friendships, and important relationships, she completed this step. She expressed happiness with her close relationships and the emotional closeness she had. However, she also admitted to having certain insecurities and reluctance to open up to people due to prior traumas, showing issues with intimacy that have not yet been healed. Stage 7: Generativity vs. Stagnation . Sarah displayed generativity by talking about her contributions to her community and family. She appeared content in her role as a mother and not making the same mistakes as her parents. However, she also voiced worries about regrets and squandered possibili- ties, implying unresolved sentiments of stagnation. Stage 8: Ego Integrity vs. Despair. Sarah expressed a sense of contentment and acceptance with her life. She talked about her successes and the lessons she had learned, demonstrating a successful ego in- tegrity Resolution. However, she occasionally expressed sadness and worry about becom- ing older,

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exposing some unresolved components of despair, such as not being able to travel the world with her husband when they retired because of his untimely passing. Kubler-Ross: Stages of Grieving (Define each stage; describe how Sarah dealt with each stage; provide 2 tips per stage to help Sarah cope with her loss). Denial: Sarah first found it difficult to accept her husband’s death, trying to escape the truth of his absence. She could find solace in cherishing the memories they shared and looked at the as she suffered by thinking back on their past together. I would suggest that she take the trips t hey had planned before his death as a solo trip or with her kids in commemoration of her late husband and or picking up an old/new hobby as a distraction. Anger: As the shock subsided, Sarah became irate and frustrated by her loss. She relied on the support of her friend group. I would suggest that Sarah take up exercising/yoga and participating in the arts. Bargaining: To find comfort, Sarah thought back on the times she might have had with her hus- band and envisioned alternative outcomes. She also spoke to her God trying to negotiate for her

husband to stay alive a little longer for them to do all that they had planned and in return would do whatever just to have that outcome. I would suggest that she writes down her thoughts and shift her focus on something more positive. Depression: Sarah was filled with deep sadness and emptiness. She dealt with it by talking hon- estly about her feelings with close friends and family members and going to a professional counselor . My tip for Sarah is to continue seeing her therapist as well as getting back into a rou- tine at home. Acceptance: Sarah gradually came to the realization that loss is an inevitable part of life. She overcame by concentrating on creating deep bonds with her loved ones and taking part in ac- tivities that made her happy. I would suggest that she keeps looking forward with purpose, accept that her life has changed and seek out a new meaning. The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in

grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief ‘s terrain, making us better equipped to cope with life and loss. At times, people in grief will often report more stages. Just re- member your grief is as unique as you are.

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References Samsanovich, A. (2021). Theory and diversity: A descriptive study of Erikson’s psy- chosocial development stages. Tyrrell, P., Harberger, S., Schoo, C., & Siddiqui, W. (2023). Kubler-Ross Stages of Dy- ing and Subsequent Models of Grief. In StatPearls [Internet] . StatPearls Publishing.

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