It is now commonly accepted that grief involves a five stage cycle of denial anger, bargaining, depression and finally acceptance. Often this five stage cycle is referred to as the Kubler-Ross cycle or the Kubler-Ross model, after Elizabeth Kubler-Ross, the doctor who investigated this cycle in people grieving over the loss of a loved one. This cycle can be experienced either by those who have suffered a loss, or those who have been informed that they themselves are terminal and may die soon.
Denial, the first stage of grief, occurs when an individual refuses to accept that their loss, or the news of their impending loss, is true. At this time they often simply ignore all evidence to the contrary and continue on as if a loved one will be coming home soon or they will not be facing their own death. Denying the truth may be a conscious or unconscious choice, and may last for varying degrees of time. However, particularly when presented with the body and burial or cremation, individuals often have no choice but to pass into the next stage: anger.
It is very easy for individuals who have suffered a loss or been informed of their own terminal illness to become overwhelmingly angry. They may be angry at their doctors, angry at the wider medical community, angry at themselves, angry at other relatives or friends, angry at the deceased or even angry with their religious deity for allowing this situation to occur. This anger is rarely rational, but it can be overwhelming and consuming. Often, however, this anger burns itself out eventually and this emotion may be replaced with the next stage: bargaining
Particularly for individuals who have been diagnosed with a life threatening illness, a period of bargaining will likely occur in which the individual attempts to wheedle a deal with their religious deity. They may attempt such bargains as If you take away the pain, then I will… or If you let me live, then I will… Individuals watching a loved one suffer may also attempt such bargains, such as If you just let my sister live, I will… Sometimes this bargaining may also occur irrationally after a death, in which an individual begs for their loved one to be returned to life in exchange for whatever price such a bargain would demand. When this bargaining does not work, the result is often the next stage of grief: depression.
When an individual is facing death, the depression that is experienced often stems from the first steps in accepting their own mortality. At this time the individual may feel sad, anxious, scared and even a certain amount of regret or guilt. In individuals who have lost a loved one, depression may include the same emotions as they will just be beginning to realise that their situation is irrevocable and they really must continue to live without the presence of the deceased in their lives. These first hints at acceptance then lead into the last stage of grief: acceptance.
Individuals approaching their own deaths may come to accept this fact long before their relatives and friends do so. This acceptance may come many months or even years before their death will occur, and it will often prompt the individual to examine their current way of life and decide what is truly important to them. These decisions sometimes influence the individual to change their way of living, such as moving to an area that they have always wanted to live, take a trip that they have always wanted to take, change careers to a sector in which they have always been interested, or stop working all together. Individuals who have recently lost a loved one will likely come to the acceptance stage after they have become comfortable with the fact that the deceased will not be returning to them. This may also spark life changes, though major decisions such as to move houses, change careers or have a baby should be put off for at least a year until the individual is certain that this is rationally the best decision.
Grief can be overwhelming, and in general the Kubler-Ross model of the five stages of grief is experienced by most of the bereaved and those who have been advised of their own impending death. However, the way each stage is experienced is often unique to the individual. If at any time grief becomes overwhelming, the individual suffering should consult a medical or mental health professional for further support, information and advice.