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Kübler-Ross model

The Kübler-Ross model first introduced by Elisabeth Kübler-Ross in her 1969 book "On Death and Dying", describes, in five discrete stages, a process by which people allegedly deal with grief and tragedy, especially when diagnosed with a terminal illness. The stages are known as the Five Stages of Grief.

Stages

The stages are:

Denial:

Example - "I feel fine."; ''"This can't be happening."'Not to me!"

Anger:

Example - "Why me? It's not fair!" "NO! NO! How can you accept this!"

Bargaining:

Example - "Just let me live to see my children graduate."; "I'll do anything, can't you stretch it out? A few more years."

Depression:

Example - "I'm so sad, why bother with anything?"; "I'm going to die . . . What's the point?"

Acceptance:

Example - "It's going to be OK."; "I can't fight it, I may as well prepare for it."

Kübler-Ross originally applied these stages to any form of catastrophic personal loss (job, income, freedom). This also includes the death of a loved one, divorce, drug addiction, or infertility. Kübler-Ross also claimed these steps do not necessarily come in the order noted above, nor are all steps experienced by all patients, though she stated a person will always experience at least two.

Others have noticed that any significant personal change can elicit these stages. For example, experienced criminal defense attorneys are aware that defendants who are facing stiff sentences, yet have no defenses or mitigating factors to lessen their sentences, often experience the stages. Accordingly, they must get to the acceptance stage before they are prepared to plead guilty.

Additionally, the change in circumstances does not always have to be a negative one, just significant enough to cause a grief response to the loss (Scire, 2007). Accepting a new work position, for example, causes one to lose their routine, workplace friendships, familiar drive to work, or even customary lunch sources.

The most common factor is when the person doesn't have the capacity to change their situation, at least not without considerable loss to themselves, thus a person who would go through these stages would not need to continue if they found a way out of the situation: e.g., If a person losing their house was at the bargaining stage but then somehow found a way out of the situation, then they'd have no reason to become depressed. So the 'stages of grief' could be linked to a lack of control or ability, e.g., people who have lost limbs, people on the bad end of an ultimatum, people under threat, and so on.

Grief

In 1974, The Handbook of Psychiatry defined grief as "...the normal response to the loss of a loved one by death," and response to other kinds of losses were labelled "Pathological Depressive Reactions." This has become the predominant way for counsellors and professionals to approach grief, loss, tragedy and traumatic experiences. Kubler-Ross also viewed the various stages as equally valid coping mechanisms, allowing an individual to work through their disease process or loss over time.

Research

A February 2007 study of bereaved individuals, from Yale University obtained some findings that were consistent with the five-stage theory and others that were inconsistent with it. In 2008, Skeptic Magazine published the findings of the Grief Recovery Institute which contested the concept of stages of grief as they relate to people who are dealing with the deaths of people important to them.

Excerpts

On Death and Dying by Elisabeth Kübler-Ross

Notes

References

Kubler-Ross, E (1973) On Death and Dying, Routledge, ISBN 0415040159
Kubler-Ross, E (2005) On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, Simon & Schuster Ltd, ISBN 0743263448
Scire, P (2007). "Applying Grief Stages to Organizational Change."