For a long time doctors had had problems with persons with terminal illness. A dying person who could not be treated had always exposed the fallibility of the medical practitioners. This led to shunning of this lot as the dying and little to be done to save them. With this excuse doctors would move on more demanding cases that they believed could be cured. However, this was not the case with Elizabeth Kubler-Ross who was a doctor herself. Born in Switzerland, she was greatly disturbed by the numerous cases of patient neglect and unkindness by the hospital personnel.
She therefore decided to spend more and more time with terminally ill patients; comforting and studying them at the same time. It was after her numerous encounters with the dying patients that she wrote about the cycle of emotional states also referred to as grief cycle in her book On Death and Dying (Worth, 2004). In the later years, it became apparent that these emotional responses were not only applicable to the dying patients but also other persons affected by bad news like losing a love one, a job or generally being negatively impacted by a change.
The most important factor in the response is not whether the change is bad or good, but the perception of the change as a negative one. Kubler-Ross therefore came up with five stages of relief that includes anger, bargaining, denial, depression and acceptance (Kubler-Ross, 2005). It will be the objective of this paper to review these five stages as analyzed by Elizabeth Kubler-Ross in her book On Death and Dying. Denial: Denial can be defined as both conscious and unconscious refusal to admit or accept reality, information or facts that relates to a particular situation at hand.
It is normally employed by many as a defense mechanism which is perfectly natural to different and many situations that upset our emotional stability. Many times people find it hard to escape from this stage considering the magnitude of the traumatic change experience. And even in situations where a change can be easily ignored, a person may just be permanently locked in a state of denial. Of course death and dying is a change that we cannot easily avoid or dodge indefinitely but some people according to Kubler-Ross do not accept the fact that death is inevitable.
Nevertheless, denial is a temporary measure employed by individuals. The feeling is normally followed by a heightened consciousness of the situations and persons that will remain behind upon our death. This stage of grief is not only applicable to the traumas of death but also other perceived negative changes in our daily lives (Worth, 2004). Anger: The second stage of grief as identified by Kubler-Ross is anger. Anger can be manifested in various ways and forms as persons recognize the fact that denial cannot continue forever. It can be directed to one’s self or to others around us (Kubler-Ross, 1973).
Dealing with emotional upset may be tricky for some people. It is quite common to see those who are undergoing traumatic changes blaming others or themselves for their predicament. In such situations a person would either be angry with oneself and/or people around him or her. This is quite common in our daily emotional experiences. The important element at this stage is that we strive to find blame for the negative changes in our life – whether it is self inflicted or inflicted by others, we would direct our anger towards the cause and any other thing or person we deem to be causing further upset.
It is important that we know such persons who get angry the moment they are upset because this will helps us keep detached as well as non-judgmental when faced with the anger of those who are emotionally upset (Worth, 2004). Bargaining: Bargaining as one of the grief stages for the dying individuals can always involve trying to plead with whatever the higher being the person believes in as the savior. We plead with our gods to grant us more time to fulfill certain things we haven’t done at the time of our death.
The third stage of grief according to Kubler-Ross 1973) is based on the hopes that an individual may somehow delay or postpone death. The negotiated time in life is normally required with the promise to the higher being that we are going to live a reform life. Some people may ask to be granted eternal life by their deities if they actually cross over to the other word. However, for those experiencing less traumatic change, a bargain for a compromise may be quite in order. We may negotiate to be offered a second chance to redeem ourselves from our mistakes or to prove our worth.
For example, those faced with break-ups are fond of negotiating for a second chance or to remain friends with their ex-partners. Nevertheless, bargaining rarely offers a sustainable answer or solution to our problems, especially in matters of life and death (Kubler-Ross, 2005). Depression: Depression, which Kubler-Ross refers to as the preparatory grieving stage, is a form of acceptance veiled in an emotional attachment. At this stage, the dying individual starts to realize the certainty of death (Kubler-Ross, 1973). The patient may resolve to remain silent, turn away visitors or indulged in unending sobbing and grieving.
It is natural for many persons to experience sadness, regrets, uncertainty, fear, etc, when faced with a traumatic change. This according to Kubler-Ross is an indication that the person is beginning to come to terms with the reality and is on the path to accepting the change as it is. Normally depression is associated with an expression of total loss of control by the upset individual. This would be accompanied by withdrawal from activities and other members of the society. This process enables the dying person to disconnect him or herself from the things he or she loves or had adored (Worth, 2004).
Acceptance: The fifth stage according to Kubler-Ross’ five stages of grief is acceptance. Although the definition of acceptance do vary depending on an individual’s emotional situation, in broad terms it indicates that the upset person has developed certain emotional detachment and is objective of his or her situation. Those who are dying may long accept their situation and predicament before the bereaved ones because, according to Kubler-Ross, the bereaved must first undergo the various stages of grief in order to come to terms with the death of the loved one (Kubler-Ross, 2005).
The five stages of grief were originally applied to persons with terminal illness but later to various forms of traumatic losses or changes like loss of job, lack of freedom and loss of income. Included in this cycle of grief are significant upset in life like loss of a loved one, drug addiction, being diagnosed with infertility, chronic disease, onset of an illness as well as other life disasters and tragedies. The Swiss psychologist contended that the stages do not have to follow any particular order and that all patients do not necessarily undergo all the stages of grief (Worth, 2004).
However, she claimed that a patient always undergo at least two of the five stages. It is also normal that people may experience various stages simultaneously or may go through the all steps in a very short period and switch again from one to another before finally coming to terms with the reality of the situation. She also argued that the transition from one stage to another may be more of ebb and flow and not a linear progression (Kubler-Ross, 1973). These five steps are neither linear nor the same in experience; a person’s grief and all other emotional responses to trauma are as personal as fingerprints.
The model may beg questions at this point because of its variance from one person to another. A response according to Kubler-Ross is that the model takes into account the fact every one has an individual pattern of reacting to emotional changes affecting them like bereavement, death or any other great loss (Kubler-Ross, 2005). It recognizes that every person has his or her own individual path and journey through which he or she comes to terms with the realities of death or bereavement, which is then followed by the ultimate stage of acceptance that restores emotional stability in the grieved person (Worth, 2004).
This model perhaps helps in explaining how time heals and why life must go on. Knowing about our own aspects and other people’s emotional situations, we can be able to easily deal with our traumatizing losses or changes (Kubler-Ross, 2005). Again, while the focus of the five stages of grief was on death and dying, Kubler-Ross’ grief cycle model can be an important concept in understanding one’s self and other people’s emotional response to individual trauma and losses, irrespective of the cause.
Psychologists have used it to counsel individuals dealing with traumatic changes in their lives. Conclusion According to psychologists, it is important that any person undergoing these emotional changes do not force or rush the process. Just like Kubler-Ross, they believe that the grief process is personal and therefore it should neither be hurried nor lengthened based on an individual’s set opinion or time limits. Every person should know that all the steps will work themselves out and that the ultimate ‘acceptance’ stage will be reached.
Kubler-ross must be credited with providing insightful psychological thoughts derived from personal experience with the grieved persons. Because of her incisive analysis of the emotional reaction to traumatic changes, other psychologists have found the basis of furthering research on this subject. References Kubler-Ross, E. (2005) On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss, Simon & Schuster Ltd: New York. Kubler-Ross, E. (1973) On Death and Dying, Routledge: New York, Worth, R. (2004). Elisabeth Kubler-Ross: Encountering Death and Dying. Chelsea House Publications: London.
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Topic: Review of Elizabeth Kubler Ross’ Grief Cycle
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