Grief, Loss and Bereavement (part 2 Kubler-Ross)

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Grief counselling models

In the next two parts we are going to look at two well-known models that are associated with grief and bereavement counselling: the 5 stages of grief, theorised by Elizabeth Kubler-Ross, and J William Wordens 4 tasks of mourning.

Below we are going to look at Elizabeth Kubler-Ross’ 5 stages of grief:

Elizabeth Kubler-Ross is the author of On Death and Dying, published in 1969 and is based on exchanges between her and her patients about reactions to their impending deaths. Kubler-Ross theorised that when faced with the prospect of our own death we go through 5 stages of grief:

  • Denial: The first reaction to learning about the terminal illness, loss, or death of a loved one is to deny the reality of the situation. “This isn’t happening, this can’t be happening,” people often think. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock of the loss. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.
  • Anger: As the masking effects of denial begins to wear off, reality and its pain emerge. We are not ready. We deflect the intense emotion and redirect it, expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us angrier.
  • Bargaining: In this stage, people beg their “higher power” to undo the loss, saying things along the lines of, “I’ll change if you bring her (or him) back to me”. This phase usually involves promises of better behaviour or significant life changes which will be made in exchange for the reversal of the loss.
  • Depression: where they confront the inevitability and reality of the loss and their own helplessness to change it. During this period, grieving people may cry, experience sleep or eating habit changes, or withdraw from other relationships and activities while they process the loss they have sustained. People may also blame themselves for having caused or in some way contributed to their loss, whether or not this is justified.
  • Acceptance: where they have processed their initial grief emotions, are able to accept that the loss has occurred and cannot be undone, and are once again able to plan for their futures and re-engage in daily life.

Kubler-Ross’s theory has been widely criticised for suggesting that individuals must move through these stages, and it has been empirically rejected. Kubler-Ross does however state that her “stage theory” is not a map where the client transitions smoothly from one stage to the next, but that many of these stages overlap, occur together or even that some stages are missed out completely. I feel that her use of the term “stages” does suggest moving from one to the next, perhaps had she chosen to call it the “5 Aspects of Grief” people may have been more willing to look past the suggestion that you must move from one to the next.

Although the 5 stages model was originally developed to illustrate the process of grief associated with death it was later adapted by Kubler-Ross to illustrate any type of grief… in her own words “Grief is the price we pay for love and a natural consequence of forming emotional bonds to people” (Kubler-Ross, 1969). Despite the criticism, the 5 stages model remains one of the most famous grief models around, and is still used today.

References: Kubler-Ross, E. (1969). On Death and Dying. New York: Macmillan.