Elisabeth Kübler-Ross was a prominent Swiss-born psychiatrist who pioneered studies on death, dying, grief and bereavement 1. Her stages of grief are outlined in her book, "On Death and Dying," and originally included five phases: denial, anger, bargaining, depression and acceptance. Today, the grief cycle can be thought of in six stages, the first stage now being shock, followed by the other five.
Shock is the initial reaction to a loss, whether in the form of death, divorce or any other form of loss that impacts an individual's functioning. Shock is the reaction that forms out of a feeling of disbelief, leaving a feeling of being temporarily numb. It is a defense mechanism that serves to protect the individual from being overwhelmed. This phase can last anywhere from a few days to a few weeks, depending on the gravity of the loss.
Denial is a defense mechanism that the individual employs to deny that the loss actually happened, whether the loss is finding out about the death of a loved one or finding out very bad news, such as learning that someone has a serious illness. The individual acts as though nothing has happened or denies that what she has heard is actually true. In effect, she closes her mind to what has occurred and continues her life for a certain length time, acting as though nothing has changed.
Anger typically occurs after denial in the grief phase, although it may occur at any point during the grieving process. Anger may be directed inward or outward, at others, a specific person or society in general. In this phase, emotions that may have been pent up for quite some time tend to erupt, and the frustration at having little or no control over circumstances may be directed toward anyone who gets in the way.
Bargaining is a form of desperation in which the individual tries to make deals to regain what he has lost. He may bargain with God or to himself in order to try to reclaim a loved one. In this stage, people try their best to cling to the things they have lost, even though they know the things will never come back.
When the individual accepts the inevitable and realizes that her efforts of avoidance are futile, a period of depression generally sets in. She finally realizes that she has no control in preventing the outcome, and she may turn away from loved ones, believing that there is no one who can understand what she is going through, or no one who can help her to feel better. She may cry frequently or appear despondent, and she may also alternate between the two.
Acceptance occurs when people learn to deal with the reality of the situation. They have passed through some or all of the previous phases of grief, and they now move on to this final phase where they take action to get closure with what has happened or with what is going to happen.
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