Jump to: Denial Anger Bargaining Depression Acceptance Symptoms Treatment

Grief Model Background

Throughout life, we experience many instances of grief. Grief can be caused by situations, relationships, or even substance abuse. Children may grieve a divorce, a wife may grieve the death of her husband, a teenager might grieve the ending of a relationship, or you might have received terminal medical news and are grieving your pending death. In 1969, Elisabeth Kübler-Ross described five popular stages of grief, popularly referred to as DABDA. They include:

Denial

Anger

Bargaining

Depression

Acceptance

A Swiss psychiatrist, Kübler-Ross first introduced her five stage grief model in her book On Death and Dying. Kübler-Ross’ model was based off her work with terminally ill patients and has received much criticism in the years since. Mainly, because people studying her model mistakenly believed this is the specific order in which people grieve and that all people go through all stages. Kübler-Ross now notes that these stages are not linear and some people may not experience any of them. Yet and still, others might only undergo two stages rather than all five, one stage, three stages, etc. It is now more readily known that these five stages of grief are the most commonly observed experienced by the grieving population.



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So, What Are The Five Stages?

Denial

Denial is the stage that can initially help you survive the loss. You might think life makes no sense, has no meaning, and is too overwhelming. You start to deny the news and, in effect, go numb. It’s common in this stage to wonder how life will go on in this different state – you are in a state of shock because life as you once knew it, has changed in an instant. If you were diagnosed with a deadly disease, you might believe the news is incorrect – a mistake must have occurred somewhere in the lab–they mixed up your blood work with someone else. If you receive news on the death of a loved one, perhaps you cling to a false hope that they identified the wrong person. In the denial stage, you are not living in ‘actual reality,’ rather, you are living in a ‘preferable’ reality. Interestingly, it is denial and shock that help you cope and survive the grief event. Denial aids in pacing your feelings of grief. Instead of becoming completely overwhelmed with grief, we deny it, do not accept it, and stagger its full impact on us at one time. Think of it as your body’s natural defense mechanism saying “hey, there’s only so much I can handle at once.” Once the denial and shock starts to fade, the start of the healing process begins. At this point, those feelings that you were once suppressing are coming to the surface.



Anger

Once you start to live in ‘actual’ reality again and not in ‘preferable’ reality, anger might start to set in. This is a common stage to think “why me?” and “life’s not fair!” You might look to blame others for the cause of your grief and also may redirect your anger to close friends and family. You find it incomprehensible of how something like this could happen to you. If you are strong in faith, you might start to question your belief in God. “Where is God? Why didn’t he protect me?” Researchers and mental health professionals agree that this anger is a necessary stage of grief. And encourage the anger. It’s important to truly feel the anger. It’s thought that even though you might seem like you are in an endless cycle of anger, it will dissipate – and the more you truly feel the anger, the more quickly it will dissipate, and the more quickly you will heal. It is not healthy to suppress your feelings of anger – it is a natural response – and perhaps, arguably, a necessary one. In every day life, we are normally told to control our anger toward situations and toward others. When you experience a grief event, you might feel disconnected from reality – that you have no grounding anymore. Your life has shattered and there’s nothing solid to hold onto. Think of anger as a strength to bind you to reality. You might feel deserted or abandoned during a grief event. That no one is there. You are alone in this world. The direction of anger toward something or somebody is what might bridge you back to reality and connect you to people again. It is a “thing.” It’s something to grasp onto – a natural step in healing.



Bargaining

When something bad happens, have you ever caught yourself making a deal with God? “Please God, if you heal my husband, I will strive to be the best wife I can ever be – and never complain again.” This is bargaining. In a way, this stage is false hope. You might falsely make yourself believe that you can avoid the grief through a type of negotiation. If you change this, I’ll change that. You are so desperate to get your life back to how it was before the grief event, you are willing to make a major life change in an attempt toward normality. Guilt is a common wing man of bargaining. This is when you endure the endless “what if” statements. What if I had left the house 5 minutes sooner – the accident would have never happened. What if I encouraged him to go to the doctor six months ago like I first thought – the cancer could have been found sooner and he could have been saved.



Depression

Depression is a commonly accepted form of grief. In fact, most people associate depression immediately with grief – as it is a “present” emotion. It represents the emptiness we feel when we are living in reality and realize the person or situation is gone or over. In this stage, you might withdraw from life, feel numb, live in a fog, and not want to get out of bed. The world might seem too much and too overwhelming for you to face. You don’t want to be around others, don’t feel like talking, and experience feelings of hopelessness. You might even experience suicidal thoughts – thinking “what’s the point of going on?”



Acceptance

The last stage of grief identified by Kübler-Ross is acceptance. Not in the sense that “it’s okay my husband died” rather, “my husband died, but I’m going to be okay.” In this stage, your emotions may begin to stabilize. You re-enter reality. You come to terms with the fact that the “new” reality is that your partner is never coming back – or that you are going to succumb to your illness and die soon – and you’re okay with that. It’s not a “good” thing – but it’s something you can live with. It is definitely a time of adjustment and readjustment. There are good days, there are bad days, and then there are good days again. In this stage, it does not mean you’ll never have another bad day – where you are uncontrollably sad. But, the good days tend to outnumber the bad days. In this stage, you may lift from your fog, you start to engage with friends again, and might even make new relationships as time goes on. You understand your loved one can never be replaced, but you move, grow, and evolve into your new reality.



Symptoms of Grief

Your grief symptoms may present themselves physically, socially, or spiritually. Some of the most common symptoms of grief are presented below:

Crying Headaches Difficulty Sleeping Questioning the Purpose of Life Questioning Your Spiritual Beliefs (e.g., your belief in God) Feelings of Detachment Isolation from Friends and Family Abnormal Behavior Worry Anxiety Frustration Guilt Fatigue Anger Loss of Appetite Aches and Pains Stress

Treatment of Grief

The prescription of medication and engagement in counseling have been the most common methods of treating grief. Initially, your doctor may prescribe you medications to help you function more fully. These might include sedatives, antidepressants, or anti-anxiety medications to help you get through the day. In addition, your doctor might prescribe you medication to help you sleep. This treatment area often causes some differences in opinion in the medical field. Some doctors choose not to prescribe medications because they believe they are doing you a disservice in the grieving process. That is, if a doctor prescribes you anti-anxiety pills or sedation pills – you are not truly experiencing the grief in full effect – you are being subdued from it – potentially interfering with the five stages of grief and eventual acceptance of reality.

Counseling is a more solid approach toward grief. Support groups, bereavement groups, or individual counseling can help you work through unresolved grief. This is a beneficial treatment alternative when you find the grief event is creating obstacles in your every day life. That is, you are having trouble functioning and need some support to get back on track. This in no way means it “cures” you of your loss, rather, it provides you with coping strategies to help you deal with your grief in an effective way. The Kubler-Ross Model is a tried and true guideline but there is no right or wrong way to work through your grief and it is normal that your personal experience may vary as you work through the grieving process.

If you or a loved one is having a hard time coping with a grief event, seek treatment from a health professional or mental health provider. Call a doctor right away if you experience thoughts of suicide, feelings of detachment for more than two weeks, you experience a sudden change in behavior, or believe you are suffering from depression.