Dr. Elisabeth Kübler-Ross identified five stages of grief in her 1969 career-defining book, "On Death and Dying." Her grief model can be applied to various types of loss and trauma, including bereavement, divorce, disability and job loss. Grief is an individual process and differs significantly from person to person. Although the model presents a seemingly linear grief cycle, the stages may not occur in order, some may not occur at all and others may be repeated.
Denial
In this stage, a person denies the loss: "This can't be happening to me." A person might refuse to acknowledge the loss itself, for example, continuing to wait for a deceased spouse to come home. Denial may also occur in the form of denying feelings of grief. A person may fear that if she begins to experience emotion, then the feelings of loss will never stop. This may manifest as refusal to discuss the loss or refusal to cry. The presence of close friends is important during this stage to help the bereaved feel a sense of connectedness. Family and friends can offers assistance with day-to-day tasks to be helpful at this time.
Anger
This is the blame stage. A person may think: "Why me?" or "This isn't fair" or "Who's to blame?" A person in this stage expresses anger toward himself or toward others. Those close to a grieving person should be aware of this stage to help detach from the person's anger and to avoid permanent breakdown of a relationship. It is important not to tell a grieving person how he should feel. Instead, be a compassionate and non-judgmental listener.
Bargaining
This stage is about compromise. When accepting death, a person might attempt to bargain with God or another higher power to keep a loved one alive or to bring the person back. A person may request more time, or a loved one may ask to take the place of the dying. In a breakup, a partner may ask to remain friends. Talking to a trusted friend or writing in a journal can help a person to acknowledge and work through the desire to bargain.
Depression
This stage includes typical symptoms of depression, including hopelessness, fatigue, irritability, guilt, crying, loss of interest in once-pleasurable activities and thoughts of suicide. A person may also experience self-pity or feel lack of control or emotional numbness. She may have thoughts such as, "If ___ is going to happen, then why bother anymore?" or "Why should I go on?" Friends and family should refrain from attempts to persuade her not to be upset. Friends can help by being willing to grieve with a person, remembering with her and crying with her.
Acceptance
This final stage includes acceptance, objectivity and understanding. A person may think: "I'm ready to go" or "I will be OK." It is not unusual for a dying person to reach this stage before loved ones, which can result in a desire to be left alone, away from the continuing grief reactions of others. Reaching the stage of acceptance does not mean a person no longer feels a sense of loss, but it does mean he is able to move forward. Friends can help by being available to go out and spend time with the person as he discovers what it means to move on.
References
- "On Death and Dying"; Elisabeth Kübler-Ross; 1969
- "On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss"; Elisabeth Kübler-Ross & David Kessler; 2005
- Psych Central: The 5 Stages of Loss and Grief
