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Kübler-Ross model
From Wikipedia, the free encyclopedia
en.wikipedia.org/wiki/Kübler-Ross_model
The Kübler-Ross model postulates a series of emotional stages experienced by survivors of an intimate's death, wherein the five stages are denial, anger, bargaining, depression and acceptance.
The model was first introduced by Swiss psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying, and was inspired by her work with terminally ill patients. Motivated by the lack of curriculum in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago medical school. Kübler-Ross' project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Since the publication of "On Death and Dying", the Kübler-Ross model has become accepted by the general public; however, its validity is not consistently supported by the majority of research.[citation needed]
Kübler-Ross noted later in life that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood. Rather, these are a collation of five common experiences for the bereaved that can occur in any order, if at all.
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Stages:
The stages, popularly known by the acronym DABDA, include:
Denial — The first reaction is denial. In this stage individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality.
Anger — When the individual recognizes that denial cannot continue, it becomes frustrated, especially at proximate individuals. Certain psychological responses of a person undergoing this phase would be: "Why me? It's not fair!"; "How can this happen to me?"; '"Who is to blame?"; "Why would this happen?".
Bargaining — The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise.
Depression — "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point?"; "I miss my loved one, why go on?"
During the fourth stage, the individual becomes saddened by the mathematical probability of death. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen.
Acceptance — "It's going to be okay."; "I can't fight it, I may as well prepare for it."; "Nothing is impossible."
.............................
In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.
Kübler-Ross later expanded her model to include any form of personal loss, such as the death of a loved one, the loss of a job or income, major rejection, the end of a relationship or divorce, drug addiction, incarceration, the onset of a disease or chronic illness, an infertility diagnosis, and even minor losses.
Both sufferers and therapists have reported the usefulness of the Kübler-Ross Model in a wide variety of situations. The subsections below give a few specific examples of how the model can be applied in different situations:
Situations:
.......................
> Children grieving in divorce <
Denial
Children feel the need to believe that their parents will get back together, or will change their mind about the divorce. Example: “Mom and Dad will stay together.”
Anger
Children feel the need to blame someone for their sadness and loss. Example: “I hate Mom for leaving us.”
Bargaining
In this stage, children feel as if they have some say in the situation if they bring a bargain to the table. This helps them keep focused on the positive that the situation might change, and less focused on the negative, the sadness they’ll experience after the divorce. Example: “If I do all of my chores maybe Mom won’t leave Dad.”
Depression
This involves the child experiencing sadness when they know there is nothing else to be done, and they realize they cannot stop the divorce. The parents need to let the child experience this process of grieving because if they do not, it only shows their inability to cope with the situation. Example: “I’m sorry that I cannot fix this situation for you.”
Acceptance
This does not necessarily mean that the child will be completely happy again. The acceptance is just moving past the depression and starting to accept the divorce. The sooner the parents start to move on from the situation, the sooner the children can begin to accept the reality of it.
.............................
> Grieving a lost amorous relationship <
Denial
The person left behind is unable to admit that the relationship is over. He/she may continue to seek the former partner's attention.
Anger
The partner left behind may blame the departing partner, or him/herself.
Bargaining
The partner left behind may plead with a departing partner that the stimulus that provoked the breakup shall not be repeated. Example: "I can change. Please give me a chance." Alternatively, he/she may attempt to renegotiate the terms of the relationship.
Depression
The partner left behind might feel discouraged that his or her bargaining plea did not convince the former partner to stay.
Acceptance
Lastly, the partner abandons all efforts toward renewal of the relationship.
.........................
> Grieving in substance abuse <
Denial
People feel that they do not have a problem concerning alcohol or substances. Even if they do feel as if they might have a small problem they believe that they have complete control over the situation and can stop drinking or doing drugs whenever they want. Example: “I don’t have to drink all of the time. I can stop whenever I want.”
Anger
The anger stage of abusers relates to how they get upset because they have an addiction or are angry that they can no longer use drugs. Some of these examples include “I don’t want to have this addiction anymore.” “This isn’t fair, I’m too young to have this problem.”
Bargaining
This is the stage that drug and alcohol abusers go through when they are trying to convince themselves or someone else that they are going to stop abusing in order to get something out of it or get themselves out of trouble (or to justify continuing their use of drugs and/or alcohol). Example: “God, I promise I’ll never use again if you just get me out of trouble.” “...If you let me stay here, i will never do drugs/alcohol again.”
Depression
Sadness and hopelessness are important parts of the depression stage when drug abusers are faced with the reality of living a life without their substance of choice. Most abusers experience this when they are going through the withdrawal stage quitting their addiction.
Acceptance
With substance abusers, admitting the existence of a problem is different from accepting the problem. When a substance abuser admits that he/she has a problem, this is more likely to occur in the bargaining stage. Accepting that he/she has a problem is when you realise that you have a problem and start the process to resolve the issue.
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As stated above, Kübler-Ross claimed these stages do not necessarily come in order, nor are all stages experienced by all patients. She stated, however, that a person always experiences at least two of the stages. Often, people experience several stages in a "roller coaster" effect—switching between two or more stages, returning to one or more several times before working through it. Women are more likely than men to experience all five stages.
However, the Kübler-Ross hypothesis holds that there are individuals who struggle with death until the end. Some psychologists believe that the harder a person fights death, the more likely they will be to stay in the denial stage. If this is the case, it is possible the ill person will have more difficulty dying in a dignified way. Other psychologists state that not confronting death until the end is adaptive for some people.
Pedagogical relevance
Pedagogical studies suggest that the stages of grief exemplify the basic process of integrating new information that conflicts with previous beliefs.
Criticism
In George Bonanno's book, The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss, he summarizes his peer-reviewed research based on thousands of subjects over two decades and concludes that a natural resilience is the principal component of grief. The logic is that if there is no grief, there are no stages of grief to pass. Bonanno's work has also demonstrated that absence of grief or trauma symptoms is a healthy outcome.
A 2000–2003 study of bereaved individuals conducted by Yale University obtained some findings consistent with the five-stage hypothesis and others inconsistent with it. Several letters were also published in the same journal criticizing this research and arguing against the stage idea. 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.
According to Baxter Jennings et al., Kübler-Ross did not adequately take the personal environment into consideration. If patients are surrounded by positive experiences, they will experience things differently from how they would if they were surrounded by negatives.
Grief communication
Grief communication occurs in grief-stricken people, through their emotions, actions, and words. Kübler-Ross placed much emphasis on communication. When a person is approaching death and is going through the five stages of her model she believed that person wanted to review his or her life, the illness he or she has, and his or her imminent death. When a patient and physician could discuss this courageously and candidly a good death would be possible. This model and her thoughts are influential to health care providers; it provides guidance to approaching and interacting with people experiencing grief.
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From "BusinessBalls":
elisabeth kübler-ross - five stages of grief
kubler-ross model for death and bereavement counselling, personal change and trauma
www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm
Elisabeth Kübler-Ross (which is the correct spelling; Elizabeth Kubler Ross is a common incorrect form and used above for search-engine visibility). Incidentally, 'counselling' is UK English and 'counseling' is US English.
Dr Elisabeth Kübler-Ross pioneered methods in the support and counselling of personal trauma, grief and grieving, associated with death and dying. She also dramatically improved the understanding and practices in relation to bereavement and hospice care. This is quite aside from the validity of her theoretical work itself, on which point see the note, right.
Her ideas, notably the five stages of grief model (denial, anger, bargaining, depression, acceptance), are transferable to varying degrees and in different ways, to personal change and emotional upset resulting from factors other than death and dying. See for example John Fisher's Personal Transition Theory.
We can often very clearly observe similar reactions to those explained by Kübler-Ross's grief model in people confronted with far less serious traumas than death and bereavement, such as by work redundancy, enforced relocation, crime and punishment, disability and injury, relationship break-up, financial despair and bankruptcy, etc.
This makes the model worthy of study and reference far outside of death and bereavement. The 'grief cycle' is actually a 'change model' for helping to understand and deal with (and counsel) personal reaction to trauma. It's not just for death and dying.
This is because trauma and emotional shock are relative in terms of effect on people. While death and dying are for many people the ultimate trauma, people can experience similar emotional upsets when dealing with many of life's challenges, especially if confronting something difficult for the first time, and/or if the challenge happens to threaten an area of psychological weakness, which we all possess in different ways.
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Note that the 'Five Stages of Grief' model, and Kübler-Ross's methods in developing and defining her ideas, are subject to debate and criticism. Some of this is reasonable and balanced; much is extreme and angry. The topic of death, including our reactions to death, attracts serious and passionate interest, and may be understood, rationalized, and 'treated' in many ways.
Accordingly, this article does not propose Kübler-Ross's ideas and the Five Stages of Grief as an absolute or wholly reliable scientific concept. The explanation here is offered as an interpretation and series of possibilities by which to appreciate situations involving traumatic loss.
Death, as life itself, means different things to different people.
Take from this what is helpful, and encourage others to treat this information in the same spirit.
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One person's despair (a job-change, or exposure to risk or phobia, etc) is to another person not threatening at all. Some people love snakes and climbing mountains, whereas to others these are intensely scary things. Emotional response, and trauma, must be seen in relative not absolute terms. The model helps remind us that the other person's perspective is different to our own, whether we are the one in shock, or the one helping another to deal with their upset.
The study of death and dying is actually known as thanatology (from the Greek word 'thanatos' meaning death). Elisabeth Kübler-Ross is accordingly sometimes referred to as a thanatologist, and she is considered to have contributed significantly to the creation of the genre of thanatology itself.
Elisabeth Kübler-Ross's seminal book was On Death & Dying, published in 1969, in which she explained her now classically regarded 'five stages of grief'. The book and its ideas were quite revolutionary at the time, reflecting Kübler-Ross's outspoken and bold approach, which is paradoxical given the sensitivity and compassion of her concepts.
Kübler-Ross was a catalyst. She opened up and challenged previously conservative (sweep it under the carpet, don't discuss it, etc) theories and practices relating to death and bereavement, and received an enormously favourable response among carers, the dying and the bereaved, which perhaps indicates the level of denial and suppression that had earlier characterised conventional views about the subject - particularly in the western world, where death is more of a taboo than in certain other cultures.
As stated, and important to emphasise, Kübler-Ross's five stages of grief model was developed initially as a model for helping dying patients to cope with death and bereavement, however the concept also provides insight and guidance for coming to terms with personal trauma and change, and for helping others with emotional adjustment and coping, whatever the cause. This has probably helped her ideas to spread and to enter 'mainstream' thinking.
Elisabeth Kübler-Ross and her ideas have now become synonymous with emotional response to trauma, and to grief support and counselling, much like Maslow is fundamentally associated with motivational theory; Kolb with learning styles, and Gardner with multiple intelligence.
As with much other brilliant pioneering work, the Kübler-Ross model is elegantly simple. The five stages of grief model is summarised and interpreted below.
The Kübler-Ross five stages and terminology are featured here with permission from the Elisabeth Kübler Ross Foundation, which is gratefully acknowledged. Please look at the website www.ekrfoundation.org, which enables and sustains Dr Kübler-Ross's values and mission, and extends help to those who need it. (Separate reference was made here previously to the www.elisabthkublerross.com website, which sometime after 2008 now re-directs to the EKR Foundation website.)
Please be aware that the interpretation and contextual material on this webpage represents my own thoughts on the subject. I would encourage you to develop your own ideas too - this is a deeply significant area and one that can be interpreted in many ways. My interpretation and associations are not an attempt to reproduce Kübler-Ross's thinking, they seek to provide a modern context, and to relate the basic model to the philosophies of this website.
Use of and reference to the Elisabeth Kübler-Ross five stages for commercial purposes, and publication of EKR quotations, require permission from the EKR Foundation. You can use freely the other aspects of this page subject to the normal terms for using this website, briefly summarised at the foot of this page.
elisabeth kübler-ross - five stages of grief
(I wrote this interpretation in 2006. As at 2011-13, this summary has been used on the Elisabeth Kübler-Ross [EKR] Foundation website as their main introduction to the Five Stages of Grief concept. I am grateful for this endorsement.)
Also known as the 'grief cycle', it is important to bear in mind that Kübler-Ross did not intend this to be a rigid series of sequential or uniformly timed steps. It's not a process as such, it's a model or a framework. There is a subtle difference: a process implies something quite fixed and consistent; a model is less specific - more of a shape or guide. By way of example, people do not always experience all of the five 'grief cycle' stages. Some stages might be revisited. Some stages might not be experienced at all. Transition between stages can be more of an ebb and flow, rather than a progression. The five stages are not linear; neither are they equal in their experience. People's grief, and other reactions to emotional trauma, are as individual as a fingerprint.
In this sense you might wonder what the purpose of the model is if it can vary so much from person to person. An answer is that the model acknowledges there to be an individual pattern of reactive emotional responses which people feel when coming to terms with death, bereavement, and great loss or trauma, etc. The model recognises that people have to pass through their own individual journey of coming to terms with death and bereavement, etc., after which there is generally an acceptance of reality, which then enables the person to cope.
The model is perhaps a way of explaining how and why 'time heals', or how 'life goes on'. And as with any aspect of our own or other people's emotions, when we know more about what is happening, then dealing with it is usually made a little easier.
Again, while Kübler-Ross's focus was on death and bereavement, the grief cycle model is a useful perspective for understanding our own and other people's emotional reaction to personal trauma and change, irrespective of cause.
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five stages of grief - elisabeth kübler ross
EKR stage Interpretation
1 - Denial
Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defence mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely.
2 - Anger
Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep detached and non-judgemental when experiencing the anger of someone who is very upset.
3 - Bargaining
Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.
4 - Depression
Also referred to as preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality.
5 - Acceptance
Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief.
(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Kübler-Ross, 1969. Interpretation by Alan Chapman 2006-2013.)
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elisabeth kübler-ross short biography
Dr Elisabeth Kübler-Ross was born in Zurich, Switzerland, on July 8, 1926. She was one of triplet sisters. Kübler-Ross studied medicine against her father's wishes, at Zurich, later settling in the US in 1958 and becoming a US citizen in 1961.
Her experiences at the end of the Second World War, including the aftermath of the Majdanek (Maidanek) concentration camp at Lublin, Poland, as a member of the International Voluntary Service for Peace, reinforced her destiny to focus on the humanistic perspective of death and dying.
According to some accounts the young Elisabeth's childhood treatment by her father was very harsh, which might explain additionally how she became so intensely concerned for people's worst suffering.
Her seminal book On Death & Dying was published in 1969, in which she explained the process of dying in which she first described her now classically regarded Five Stages of Grief. The book, and the supporting publication of her ideas in Time magazine, achieved wide circulation, so that Elisabeth Kübler-Ross soon became known for her pioneering work with the terminally ill, and for her ideas in the counselling and support of those affected by death and bereavement.
Kübler-Ross spent much of the 1970s running workshops and speaking to audiences about her ideas, which quickly gained popular appeal and general acceptance among the caring professions, and which had significant positive influence over the development of hospice care and attitudes towards death and the care of the dying.
In the 1980s Kübler-Ross turned her attention to the plight of babies born with AIDS, and also founded a healing and workshop centre which she called Healing Waters, on a 300-acre farm in Virginia.
Kübler-Ross's work has not always been universally applauded. Detractors tend to focus on the 'vagueness' of the grief cycle model (which reminds us of the need to appreciate it as a guide, rather than a rigid process), and her interest in the after-life linked to near-death experiences also attracted mixed response, as one might expect given her iconic status, and the understandable scientific caution of much of her audience.
Whatever, Elisabeth Kübler-Ross was a remarkable woman who carved out unique reputation in her field - indeed she arguably defined the field itself.
Later in her life she suffered personal tragedy: a fire destroyed her Virginia home, and a series of strokes left her in ill health. She moved to Scottsdale Arizona and retired soon afterwards in 1996.
Other critically admired works include Living with Death and Dying (1981) and On Life After Death (1991) which are among more than 20 books that Kübler-Ross wrote or co-authored on subjects related to death and grieving, and caring for those affected by bereavement.
Elisabeth Kübler-Ross died on 24 August 2004. The Elisabeth Kübler-Ross Foundation (EKR Foundation) was formed in to keep Elisabeth's spirit alive. The EKR Foundation seeks to continue Elisabeth's life work through the education of bereavement carers, and to promote and enable the compassionate support of families affected by death across the world.
Elisabeth Kübler-Ross was inducted into the The National Women's Hall of Fame in 2007, a national nonprofit organization that annually recognizes the contributions to civilization of American women in a variety of disciplines.
"It's only when we truly know and understand that we have a limited time on earth - and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had."
(Dr Elisabeth Kübler-Ross, 1926-2004, psychiatrist, humanitarian, teacher, author, and pioneer of bereavement and hospice care. Used with permission, with thanks to www.ekrfoundation.org and http://www.elisabethkublerross.com.)
This quote is available with many other inspirational sayings on the posters section.
see also
Do Not Stand At My Grave And Weep
Inspirational and Amusing Quotes - it's good to have some light relief after a page like this..
John Fisher's Transition Curve - another wonderful perspective of emotional change
If
I am
Stress and Stress Management
Desiderata
Don Miguel Ruiz's The Four Agreements
Cherie Carter Scott - If Life is a Game
Emotional Intelligence
Ethical Leadership and Social Responsibility
Love and Spirituality at Work
Katherine Benziger's Thinking and Working Styles Theory
Maslow Hierarchy of Needs
Personality Styles Models
authorship/referencing
© Alan Chapman 2006-2013. The Elisabeth Kübler-Ross 'Grief Cycle' is © Elisabeth Kübler-Ross 1969, and permission for its use in the provision of commercial services must be sought from the EKR Foundation. Permission is also required from the EKR Foundation for use of Elisabeth Kübler-Ross quotations and extracts in the production or provision of commercial products and services.
Please see additional referencing/usage terms:
The use of this material is free for self-development, developing others, research, and organizational improvement. Please reference authorship and copyright of material used, including link(s) to Businessballs.com and the material webpage; see authorship/referencing above. This material may not be sold, published, or reproduced online. Disclaimer: Reliance on this material and any related provision is at your sole risk. Alan Chapman assumes no responsibility for any errors or damages arising. Seek qualified advice for any action entailing potential liabilities. Where appropriate retain this notice on copies. See about us for detailed terms.
© Businessballs 2015
www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm
From Wikipedia, the free encyclopedia
en.wikipedia.org/wiki/Kübler-Ross_model
The Kübler-Ross model postulates a series of emotional stages experienced by survivors of an intimate's death, wherein the five stages are denial, anger, bargaining, depression and acceptance.
The model was first introduced by Swiss psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying, and was inspired by her work with terminally ill patients. Motivated by the lack of curriculum in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago medical school. Kübler-Ross' project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Since the publication of "On Death and Dying", the Kübler-Ross model has become accepted by the general public; however, its validity is not consistently supported by the majority of research.[citation needed]
Kübler-Ross noted later in life that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood. Rather, these are a collation of five common experiences for the bereaved that can occur in any order, if at all.
.................................
Stages:
The stages, popularly known by the acronym DABDA, include:
Denial — The first reaction is denial. In this stage individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality.
Anger — When the individual recognizes that denial cannot continue, it becomes frustrated, especially at proximate individuals. Certain psychological responses of a person undergoing this phase would be: "Why me? It's not fair!"; "How can this happen to me?"; '"Who is to blame?"; "Why would this happen?".
Bargaining — The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise.
Depression — "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point?"; "I miss my loved one, why go on?"
During the fourth stage, the individual becomes saddened by the mathematical probability of death. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen.
Acceptance — "It's going to be okay."; "I can't fight it, I may as well prepare for it."; "Nothing is impossible."
.............................
In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.
Kübler-Ross later expanded her model to include any form of personal loss, such as the death of a loved one, the loss of a job or income, major rejection, the end of a relationship or divorce, drug addiction, incarceration, the onset of a disease or chronic illness, an infertility diagnosis, and even minor losses.
Both sufferers and therapists have reported the usefulness of the Kübler-Ross Model in a wide variety of situations. The subsections below give a few specific examples of how the model can be applied in different situations:
Situations:
.......................
> Children grieving in divorce <
Denial
Children feel the need to believe that their parents will get back together, or will change their mind about the divorce. Example: “Mom and Dad will stay together.”
Anger
Children feel the need to blame someone for their sadness and loss. Example: “I hate Mom for leaving us.”
Bargaining
In this stage, children feel as if they have some say in the situation if they bring a bargain to the table. This helps them keep focused on the positive that the situation might change, and less focused on the negative, the sadness they’ll experience after the divorce. Example: “If I do all of my chores maybe Mom won’t leave Dad.”
Depression
This involves the child experiencing sadness when they know there is nothing else to be done, and they realize they cannot stop the divorce. The parents need to let the child experience this process of grieving because if they do not, it only shows their inability to cope with the situation. Example: “I’m sorry that I cannot fix this situation for you.”
Acceptance
This does not necessarily mean that the child will be completely happy again. The acceptance is just moving past the depression and starting to accept the divorce. The sooner the parents start to move on from the situation, the sooner the children can begin to accept the reality of it.
.............................
> Grieving a lost amorous relationship <
Denial
The person left behind is unable to admit that the relationship is over. He/she may continue to seek the former partner's attention.
Anger
The partner left behind may blame the departing partner, or him/herself.
Bargaining
The partner left behind may plead with a departing partner that the stimulus that provoked the breakup shall not be repeated. Example: "I can change. Please give me a chance." Alternatively, he/she may attempt to renegotiate the terms of the relationship.
Depression
The partner left behind might feel discouraged that his or her bargaining plea did not convince the former partner to stay.
Acceptance
Lastly, the partner abandons all efforts toward renewal of the relationship.
.........................
> Grieving in substance abuse <
Denial
People feel that they do not have a problem concerning alcohol or substances. Even if they do feel as if they might have a small problem they believe that they have complete control over the situation and can stop drinking or doing drugs whenever they want. Example: “I don’t have to drink all of the time. I can stop whenever I want.”
Anger
The anger stage of abusers relates to how they get upset because they have an addiction or are angry that they can no longer use drugs. Some of these examples include “I don’t want to have this addiction anymore.” “This isn’t fair, I’m too young to have this problem.”
Bargaining
This is the stage that drug and alcohol abusers go through when they are trying to convince themselves or someone else that they are going to stop abusing in order to get something out of it or get themselves out of trouble (or to justify continuing their use of drugs and/or alcohol). Example: “God, I promise I’ll never use again if you just get me out of trouble.” “...If you let me stay here, i will never do drugs/alcohol again.”
Depression
Sadness and hopelessness are important parts of the depression stage when drug abusers are faced with the reality of living a life without their substance of choice. Most abusers experience this when they are going through the withdrawal stage quitting their addiction.
Acceptance
With substance abusers, admitting the existence of a problem is different from accepting the problem. When a substance abuser admits that he/she has a problem, this is more likely to occur in the bargaining stage. Accepting that he/she has a problem is when you realise that you have a problem and start the process to resolve the issue.
..........................
As stated above, Kübler-Ross claimed these stages do not necessarily come in order, nor are all stages experienced by all patients. She stated, however, that a person always experiences at least two of the stages. Often, people experience several stages in a "roller coaster" effect—switching between two or more stages, returning to one or more several times before working through it. Women are more likely than men to experience all five stages.
However, the Kübler-Ross hypothesis holds that there are individuals who struggle with death until the end. Some psychologists believe that the harder a person fights death, the more likely they will be to stay in the denial stage. If this is the case, it is possible the ill person will have more difficulty dying in a dignified way. Other psychologists state that not confronting death until the end is adaptive for some people.
Pedagogical relevance
Pedagogical studies suggest that the stages of grief exemplify the basic process of integrating new information that conflicts with previous beliefs.
Criticism
In George Bonanno's book, The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss, he summarizes his peer-reviewed research based on thousands of subjects over two decades and concludes that a natural resilience is the principal component of grief. The logic is that if there is no grief, there are no stages of grief to pass. Bonanno's work has also demonstrated that absence of grief or trauma symptoms is a healthy outcome.
A 2000–2003 study of bereaved individuals conducted by Yale University obtained some findings consistent with the five-stage hypothesis and others inconsistent with it. Several letters were also published in the same journal criticizing this research and arguing against the stage idea. 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.
According to Baxter Jennings et al., Kübler-Ross did not adequately take the personal environment into consideration. If patients are surrounded by positive experiences, they will experience things differently from how they would if they were surrounded by negatives.
Grief communication
Grief communication occurs in grief-stricken people, through their emotions, actions, and words. Kübler-Ross placed much emphasis on communication. When a person is approaching death and is going through the five stages of her model she believed that person wanted to review his or her life, the illness he or she has, and his or her imminent death. When a patient and physician could discuss this courageously and candidly a good death would be possible. This model and her thoughts are influential to health care providers; it provides guidance to approaching and interacting with people experiencing grief.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From "BusinessBalls":
elisabeth kübler-ross - five stages of grief
kubler-ross model for death and bereavement counselling, personal change and trauma
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Elisabeth Kübler-Ross (which is the correct spelling; Elizabeth Kubler Ross is a common incorrect form and used above for search-engine visibility). Incidentally, 'counselling' is UK English and 'counseling' is US English.
Dr Elisabeth Kübler-Ross pioneered methods in the support and counselling of personal trauma, grief and grieving, associated with death and dying. She also dramatically improved the understanding and practices in relation to bereavement and hospice care. This is quite aside from the validity of her theoretical work itself, on which point see the note, right.
Her ideas, notably the five stages of grief model (denial, anger, bargaining, depression, acceptance), are transferable to varying degrees and in different ways, to personal change and emotional upset resulting from factors other than death and dying. See for example John Fisher's Personal Transition Theory.
We can often very clearly observe similar reactions to those explained by Kübler-Ross's grief model in people confronted with far less serious traumas than death and bereavement, such as by work redundancy, enforced relocation, crime and punishment, disability and injury, relationship break-up, financial despair and bankruptcy, etc.
This makes the model worthy of study and reference far outside of death and bereavement. The 'grief cycle' is actually a 'change model' for helping to understand and deal with (and counsel) personal reaction to trauma. It's not just for death and dying.
This is because trauma and emotional shock are relative in terms of effect on people. While death and dying are for many people the ultimate trauma, people can experience similar emotional upsets when dealing with many of life's challenges, especially if confronting something difficult for the first time, and/or if the challenge happens to threaten an area of psychological weakness, which we all possess in different ways.
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Note that the 'Five Stages of Grief' model, and Kübler-Ross's methods in developing and defining her ideas, are subject to debate and criticism. Some of this is reasonable and balanced; much is extreme and angry. The topic of death, including our reactions to death, attracts serious and passionate interest, and may be understood, rationalized, and 'treated' in many ways.
Accordingly, this article does not propose Kübler-Ross's ideas and the Five Stages of Grief as an absolute or wholly reliable scientific concept. The explanation here is offered as an interpretation and series of possibilities by which to appreciate situations involving traumatic loss.
Death, as life itself, means different things to different people.
Take from this what is helpful, and encourage others to treat this information in the same spirit.
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One person's despair (a job-change, or exposure to risk or phobia, etc) is to another person not threatening at all. Some people love snakes and climbing mountains, whereas to others these are intensely scary things. Emotional response, and trauma, must be seen in relative not absolute terms. The model helps remind us that the other person's perspective is different to our own, whether we are the one in shock, or the one helping another to deal with their upset.
The study of death and dying is actually known as thanatology (from the Greek word 'thanatos' meaning death). Elisabeth Kübler-Ross is accordingly sometimes referred to as a thanatologist, and she is considered to have contributed significantly to the creation of the genre of thanatology itself.
Elisabeth Kübler-Ross's seminal book was On Death & Dying, published in 1969, in which she explained her now classically regarded 'five stages of grief'. The book and its ideas were quite revolutionary at the time, reflecting Kübler-Ross's outspoken and bold approach, which is paradoxical given the sensitivity and compassion of her concepts.
Kübler-Ross was a catalyst. She opened up and challenged previously conservative (sweep it under the carpet, don't discuss it, etc) theories and practices relating to death and bereavement, and received an enormously favourable response among carers, the dying and the bereaved, which perhaps indicates the level of denial and suppression that had earlier characterised conventional views about the subject - particularly in the western world, where death is more of a taboo than in certain other cultures.
As stated, and important to emphasise, Kübler-Ross's five stages of grief model was developed initially as a model for helping dying patients to cope with death and bereavement, however the concept also provides insight and guidance for coming to terms with personal trauma and change, and for helping others with emotional adjustment and coping, whatever the cause. This has probably helped her ideas to spread and to enter 'mainstream' thinking.
Elisabeth Kübler-Ross and her ideas have now become synonymous with emotional response to trauma, and to grief support and counselling, much like Maslow is fundamentally associated with motivational theory; Kolb with learning styles, and Gardner with multiple intelligence.
As with much other brilliant pioneering work, the Kübler-Ross model is elegantly simple. The five stages of grief model is summarised and interpreted below.
The Kübler-Ross five stages and terminology are featured here with permission from the Elisabeth Kübler Ross Foundation, which is gratefully acknowledged. Please look at the website www.ekrfoundation.org, which enables and sustains Dr Kübler-Ross's values and mission, and extends help to those who need it. (Separate reference was made here previously to the www.elisabthkublerross.com website, which sometime after 2008 now re-directs to the EKR Foundation website.)
Please be aware that the interpretation and contextual material on this webpage represents my own thoughts on the subject. I would encourage you to develop your own ideas too - this is a deeply significant area and one that can be interpreted in many ways. My interpretation and associations are not an attempt to reproduce Kübler-Ross's thinking, they seek to provide a modern context, and to relate the basic model to the philosophies of this website.
Use of and reference to the Elisabeth Kübler-Ross five stages for commercial purposes, and publication of EKR quotations, require permission from the EKR Foundation. You can use freely the other aspects of this page subject to the normal terms for using this website, briefly summarised at the foot of this page.
elisabeth kübler-ross - five stages of grief
(I wrote this interpretation in 2006. As at 2011-13, this summary has been used on the Elisabeth Kübler-Ross [EKR] Foundation website as their main introduction to the Five Stages of Grief concept. I am grateful for this endorsement.)
Also known as the 'grief cycle', it is important to bear in mind that Kübler-Ross did not intend this to be a rigid series of sequential or uniformly timed steps. It's not a process as such, it's a model or a framework. There is a subtle difference: a process implies something quite fixed and consistent; a model is less specific - more of a shape or guide. By way of example, people do not always experience all of the five 'grief cycle' stages. Some stages might be revisited. Some stages might not be experienced at all. Transition between stages can be more of an ebb and flow, rather than a progression. The five stages are not linear; neither are they equal in their experience. People's grief, and other reactions to emotional trauma, are as individual as a fingerprint.
In this sense you might wonder what the purpose of the model is if it can vary so much from person to person. An answer is that the model acknowledges there to be an individual pattern of reactive emotional responses which people feel when coming to terms with death, bereavement, and great loss or trauma, etc. The model recognises that people have to pass through their own individual journey of coming to terms with death and bereavement, etc., after which there is generally an acceptance of reality, which then enables the person to cope.
The model is perhaps a way of explaining how and why 'time heals', or how 'life goes on'. And as with any aspect of our own or other people's emotions, when we know more about what is happening, then dealing with it is usually made a little easier.
Again, while Kübler-Ross's focus was on death and bereavement, the grief cycle model is a useful perspective for understanding our own and other people's emotional reaction to personal trauma and change, irrespective of cause.
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five stages of grief - elisabeth kübler ross
EKR stage Interpretation
1 - Denial
Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defence mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely.
2 - Anger
Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep detached and non-judgemental when experiencing the anger of someone who is very upset.
3 - Bargaining
Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.
4 - Depression
Also referred to as preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality.
5 - Acceptance
Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief.
(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Kübler-Ross, 1969. Interpretation by Alan Chapman 2006-2013.)
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elisabeth kübler-ross short biography
Dr Elisabeth Kübler-Ross was born in Zurich, Switzerland, on July 8, 1926. She was one of triplet sisters. Kübler-Ross studied medicine against her father's wishes, at Zurich, later settling in the US in 1958 and becoming a US citizen in 1961.
Her experiences at the end of the Second World War, including the aftermath of the Majdanek (Maidanek) concentration camp at Lublin, Poland, as a member of the International Voluntary Service for Peace, reinforced her destiny to focus on the humanistic perspective of death and dying.
According to some accounts the young Elisabeth's childhood treatment by her father was very harsh, which might explain additionally how she became so intensely concerned for people's worst suffering.
Her seminal book On Death & Dying was published in 1969, in which she explained the process of dying in which she first described her now classically regarded Five Stages of Grief. The book, and the supporting publication of her ideas in Time magazine, achieved wide circulation, so that Elisabeth Kübler-Ross soon became known for her pioneering work with the terminally ill, and for her ideas in the counselling and support of those affected by death and bereavement.
Kübler-Ross spent much of the 1970s running workshops and speaking to audiences about her ideas, which quickly gained popular appeal and general acceptance among the caring professions, and which had significant positive influence over the development of hospice care and attitudes towards death and the care of the dying.
In the 1980s Kübler-Ross turned her attention to the plight of babies born with AIDS, and also founded a healing and workshop centre which she called Healing Waters, on a 300-acre farm in Virginia.
Kübler-Ross's work has not always been universally applauded. Detractors tend to focus on the 'vagueness' of the grief cycle model (which reminds us of the need to appreciate it as a guide, rather than a rigid process), and her interest in the after-life linked to near-death experiences also attracted mixed response, as one might expect given her iconic status, and the understandable scientific caution of much of her audience.
Whatever, Elisabeth Kübler-Ross was a remarkable woman who carved out unique reputation in her field - indeed she arguably defined the field itself.
Later in her life she suffered personal tragedy: a fire destroyed her Virginia home, and a series of strokes left her in ill health. She moved to Scottsdale Arizona and retired soon afterwards in 1996.
Other critically admired works include Living with Death and Dying (1981) and On Life After Death (1991) which are among more than 20 books that Kübler-Ross wrote or co-authored on subjects related to death and grieving, and caring for those affected by bereavement.
Elisabeth Kübler-Ross died on 24 August 2004. The Elisabeth Kübler-Ross Foundation (EKR Foundation) was formed in to keep Elisabeth's spirit alive. The EKR Foundation seeks to continue Elisabeth's life work through the education of bereavement carers, and to promote and enable the compassionate support of families affected by death across the world.
Elisabeth Kübler-Ross was inducted into the The National Women's Hall of Fame in 2007, a national nonprofit organization that annually recognizes the contributions to civilization of American women in a variety of disciplines.
"It's only when we truly know and understand that we have a limited time on earth - and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had."
(Dr Elisabeth Kübler-Ross, 1926-2004, psychiatrist, humanitarian, teacher, author, and pioneer of bereavement and hospice care. Used with permission, with thanks to www.ekrfoundation.org and http://www.elisabethkublerross.com.)
This quote is available with many other inspirational sayings on the posters section.
see also
Do Not Stand At My Grave And Weep
Inspirational and Amusing Quotes - it's good to have some light relief after a page like this..
John Fisher's Transition Curve - another wonderful perspective of emotional change
If
I am
Stress and Stress Management
Desiderata
Don Miguel Ruiz's The Four Agreements
Cherie Carter Scott - If Life is a Game
Emotional Intelligence
Ethical Leadership and Social Responsibility
Love and Spirituality at Work
Katherine Benziger's Thinking and Working Styles Theory
Maslow Hierarchy of Needs
Personality Styles Models
authorship/referencing
© Alan Chapman 2006-2013. The Elisabeth Kübler-Ross 'Grief Cycle' is © Elisabeth Kübler-Ross 1969, and permission for its use in the provision of commercial services must be sought from the EKR Foundation. Permission is also required from the EKR Foundation for use of Elisabeth Kübler-Ross quotations and extracts in the production or provision of commercial products and services.
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