Elisabeth Kübler-Ross

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Elisabeth Kübler-Ross

Elisabeth Kübler-Ross, M.D. (July 8, 1926 – August 24, 2004) was a Swiss-born psychiatrist and the author of the groundbreaking book On Death and Dying, where she first discussed what is now known as the Kübler-Ross model. Kübler-Ross was born in Zürich, Switzerland, one of a set of identical triplets. She graduated from the University of Zürich medical school in 1957. She moved to the United States in 1958 to work and continue her studies in New York.

As she began her practice, she was appalled by the hospital treatment of patients who were dying. She began giving a series of lectures featuring terminally ill patients, forcing medical students to confront people who were dying. Her extensive work with the dying led to On Death and Dying in 1969. She wrote over 20 additional books on the subject of dying.

She also proposed the now famous Five Stages of Grief as a pattern of phases, most or all of which people tend to go through, in sequence, after being faced with the tragedy of their own impending death. The five stages of grief, in sequential order, are denial, anger, bargaining, depression, and acceptance. The five stages have since been adopted by many as applying to the survivors of a loved one's death, as well.

She did not found the hospice care movement, but its adherents credit her with encouraging it. Kübler-Ross completed her degree in psychiatry at the University of Colorado in 1963 and has also received 23 honorary doctorates.

In later life, Kubler-Ross became interested in out-of-body experiences and mediumistic attempts to contact the dead. This led to a scandal connected with one medium, as well as attacks on her healing centers.

Kübler-Ross suffered a series of strokes in 1995 which left her partially paralyzed on her left side. In a 2002 interview with The Arizona Republic, she stated that she was ready for death. She died in 2004 at her home in Scottsdale, Arizona.

The Kübler-Ross model describes, in five discrete stages, the process by which people deal with grief and tragedy. Terminally ill patients are said to experience these stages. The model was introduced by Elisabeth Kübler-Ross in her 1969 book On Death and Dying. The stages have become well known, and are called the Five Stages of Grief.

Enumeration of stages

The stages are:

1. Denial : The initial stage: "It can't be happening."
2. Anger : "How dare you do this to me?!" (either referring to God, oneself, or anybody perceived, rightly or wrongly, as "responsible")
3. Bargaining : "Just let me live to see my son graduate."
4. Depression : "I'm so sad, why bother with anything?"
5. Acceptance : "I know that I will be in a better place."

Kübler-Ross originally applied these stages to any form of catastrophic personal loss (job, income, freedom). This also includes the death of a loved one and divorce. Kübler-Ross also claimed these steps do not necessarily come in order, nor are they all experienced by all patients, though she stated^{[citation needed]} a person will always experience at least two.

Others have noticed^{[citation needed]} that any significant personal change can follow these stages. For example, experienced criminal defense attorneys are aware that defendants who are facing stiff sentences, yet have no defenses or mitigating factors to lessen their sentences, often experience the stages. Accordingly, they must get to the acceptance stage before they are prepared to plead guilty.^{[citation needed]}

Additionally, the change in circumstances does not always have to be a negative one, just significant enough to cause a grief response to the loss (Scire, 2007). Accepting a new work position, for example, causes one to lose their routine, workplace friendships, familiar drive to work, even customary lunch sources.

Grief

In popular culture these stages are almost exclusively applied only to news of one's own impending death. The notion that to resolve grief they must all be followed, in order, is also common.

Although, in 1974, "The Handbook of Psychiatry" defined grief as "...the normal response to the loss of a loved one by death," and response to other kinds of losses were labeled "Pathological Depressive Reactions," this has become the predominant way for counselors and professionals to approach grief, loss, tragedy and traumatic experiences.[1]

Further, many psychiatrists believe real grieving begins after the stages are over, and that "grief work", involving its own set of stages, begins with acceptance, where the Kubler-Ross stages end.

Research on the theory

A February 2007 study of bereaved individuals, from Yale University obtained some findings that were consistent with the five-stage theory and others that were inconsistent with it [2].

Criticism

The original Kübler-Ross model did not identify five stages of grief. It identified what Kubler-Ross called "the Five Stages of Receiving Catastrophic News" [3].

There exists no real evidence that stages are present in coping with death: Using the terms stages implies that there is a set order of set conditions, meaning that everyone will go through each stage at the same time while confronting impending death. The order of the stages, as well as the amount of time each stage lasts can vary. Also, the definition of each stage is not clear, and some stages can be combined.

More specifically, there is no real evidence that people coping with their impending death move through all of the five stages. The path through the stages is not a one-way street: they can repeat, occur out of order or not at all. It is highly dependent on other qualities, such as emotional ties to family, and other relationships. These stages can also occur in a repetitive, spiral-like fashion where the individual is re-working and re-experiencing various grief stages over time. "Real events", such as moving, getting rid of the loved ones clothing or objects, etc. tend to trigger a grief regression in which the grieving individual may re-experience anger or shock or depression.

The way in which the particular loss is experienced may strongly influence how grief is played out. A sudden loss or violent loss in which one is "blind-sided", caught unaware and unprepared, may create a traumatic loss which is probably more difficult to process and work through.^{[citation needed]}

In popular culture

• In the TV show Frasier, when Frasier is unemployed, there is an episode where he cycles through the stages. (Season 6)

• In the TV cartoon show The Simpsons, the 5 stages were also shown in 'One Fish, Two Fish, Blowfish, Blue Fish', where Homer discovers he will most likely die after eating a poisonus fish. Dr Julius Hibert tells him the 5 stages of grief, to which Homer replies instantly after each one (although fear/depression and bargaining are a different way around.

• In the TV cartoon show Robot Chicken, the 5 stages are cited by a giraffe when it is sinking in quicksand.

• In the TV show House, the 5 stages are referenced to by Dr. House when he criticizes Cameron's attitude toward diagnosing one of her patients. (Season 2)

• In the TV show Scrubs a patient goes through the 5 stages of grief and gets help from the hospitals grief counselor Dr Hedrick in the episode My Five Stages.

• In the TV show Monk, Adrian Monk cycles through the stages repeatedly.

• In the TV show Dead Like Me, George Lass notes that dead people go through the same cycle, as she does moments after her death. Her acceptance takes a little longer to accomplish than the other four which she passes through rapidly for comedic effect.

• In the Comic series Fallen Son: The Death of Captain America. Following the assassination of Captain American, the five part mini-series "Fallen Son" had chapters entitled: Denial, Anger, Bargaining, Depression, and Acceptance.

• In the 1979 Film All That Jazz, stand-up performer Davis Newman, commenting on the impending/happening death of the main character, says, "This chick, man, without the sole benefit of dying herself, has broken down the process of dying into five stages: anger, denial, bargaining, depression and acceptance. Sounds like a Jewish law firm. 'Good morning, Angerdenialbargainingdepressionacceptance!'

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