Date of Submission:
1st March 2012
Human Development & the Ageing Process
Grief & Grieving
Outline of the 5 stages of grief (Kubler-Ross 1970)
The 5 stages of grief or the Kubler-Ross model is a theory first put forward by Dr.Elisabeth Kubler-Ross in her 1969 book On Death & Dying. Dr Kubler-Ross was a psychiatrist who had a particular interest in end of life care and the book & theory came as a result of discussions and interviews with over 500 terminally ill patients which took place at the University of Chicago Billings Hospital between 1965 and 1968. This theory was initially formulated to describe a series of stages that can occur in a person on discovering that they had been diagnosed with a terminal illness and have a finite amount of time to live. It was later expanded to describe the feelings experienced by anyone suffering a significant loss or traumatic change in their life such as the death of a close friend or relative, going through a divorce or losing a job.
The 5 stages of grief are namely:
(Also known by the acronym DABDA)
A common misunderstanding of this model occurs when people assume that this is a linear process and people experience every stage in a set order moving from one to the next in a particular sequence. In reality each person reacts uniquely in such situations. Some people can move forwards and backwards through the stages while others can experience 2 stages at the same time or even skip stages all together. Some stages may only last for a few seconds or minutes as the person’s moods alter throughout the process.
First Stage – Denial
Denial is a very common initial reaction in terminally ill patients. On discovering their unfavourable diagnosis some people can react by denying such a possibility outright saying that such a thing cannot be true. In On Death & Dying Kubler-Ross gives the example of one of her patients who reacted in such a way.
‘She was convinced that the X-rays were mixed up and she asked for reassurance that her pathology report could not be back so soon and that another patient’s report must have been marked with her name’ (1)
The initial denial or shock is likened to a control mechanism which a person can use to control their real emotions until they are ready to face reality. This is seen as a healthy way of processing the information until the person is prepared to deal with their own mortality
Second Stage – Anger
Anger is the 2nd stage in the grief process but can also occur at any time through the grieving process or in conjunction with other stages. It is natural to feel anger at the world when faced with your own impending death. A common refrain mentioned by terminal patients is looking at themselves and asking “Why me” or deflecting their anger onto other people and asking “Why not you”. This can be a particularly difficult stage as emotions run unchecked and people involved in the grieving process such as family or staff can be hurt very easily. The best thing to do in this scenario is to allow the person to be angry and vent all their frustrations which will help dissipate their anger and aid their progress through the grieving process.
‘The more the storm blows, the sooner it will blow itself out’ (2)
Third Stage – Bargaining
Dr Kubler-Ross describes the bargaining stage as:
‘an attempt to postpone and it has to include a prize offered for good behaviour’ (3)
People in this stage make themselves promises or set themselves deadlines which they believe can delay the inevitable. Many people might also try to bargain with a higher power offering their eternal gratitude if they can just be spared this...
References: 1. Kubler-Ross E (1969) On Death & Dying p.31
3. Kubler-Ross E (1969) On Death & Dying p.67
5. Clane College (2011) Human Development & the Ageing Process course notes p.49
7. Kubler-Ross E (1969) On Death & Dying
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