Dr. Elizabeth Kubler-Ross, one of the world’s foremost authorities on the subject of death, describes the five universal stages of grieving: Denial, Anger, Bargaining, Depression and Acceptance (D-A-B-D-A) that people go through. How can DABDA help you, when you are coping with any severe loss, including facing your own death or the death of a loved one? Let us delve deeper into these different stages of grieving.
1. Denial
In the first stage, one denies the event altogether, refusing to accept reality due to the shock one is in. Typical responses are:
- ‘It can’t be … this is impossible.’
- ‘There must be a mistake.’
- ‘Nothing will happen, it’ll go away.’
2. Anger
In the second stage, one experiences a surge of anger. Angry responses can take many textures: some people explode, others implode and yet others suppress their emotion and maintain a neutral façade. Sadly and most often, anger is expressed and directed at those who are closest and safest ie, one’s family and friends.Typical angry responses are:
- ‘Why me?’
- ‘What have I done to deserve this?’
- ‘It’s so unfair!’
- ‘I hate being in this situation.’
3. Bargaining
Here, in the third stage, one tries to change – or at least postpone – the situation by striking a bargain; one is willing to bargain with oneself, with others, even with God. Some typical responses are:
- ‘If I behave as though nothing has happened, maybe no one else will notice.’
- ‘I’ll never touch another cigarette again. Can I have my health back?’
- ‘Please God, I’ll offer 24 rosaries in your praise, but take this suffering away from me and my family.’
- ‘Dear Lord, please take my life instead of my daughter’s.’
Bargaining techniques are not realistic or sustainable because they are usually based on a fantasy that one has cooked up in false hope. Many bargains are also difficult to spot because one makes them with oneself internally, and so they usually remain a secret.
4. Depression
In the fourth stage, everything feels wrong and one feels powerless to do anything about it. The grief is so deep that it turns into depression. One retreats into a dark cave, hoping that someone else will come and pull one out. Like anger, depression too can take many textures and may at times be hard to spot. Typical responses are as follows:
- ‘Nothing matters.’
- ‘I just don’t care anymore.’
- ‘Just assume I’m not here.’
5. Acceptance
In this stage, one becomes calm and peaceful; and can reconcile with both the event and its implications. Typical responses are:
- ‘So be it.’
- ‘Such is life.’
- ‘Normalcy is redefined forever for me.’
- ‘OK, what changes do we make now?’
- ‘Where do I go from here?’
- ‘I’m ready for the future.’
Of course, the human psyche is neither neat nor precise, so these five stages overlap considerably. They are not strictly linear either; people can travel back and forth between them. Different people respond differently, with some people spending more time at one stage and less in another, but broadly, the sequence outlined above holds for the majority and jumping stages or taking shortcuts just doesn’t work.
Reflections:
- As a caregiver, how can you gauge and then support your loved one on the journey on the rocky road to real Acceptance?
- As the patient, at which stage do you find yourself most often? What support do you need to break through to the next stage?
- Sometimes, even Acceptance doesn’t last … you may have to cycle back through DABDA repeatedly … how will you handle this?
More from this series
| Title | About the article |
|---|---|
| Part 1: Death Unites Us All | Traditional societies were closely connected with nature’s continuous cycles of birth-growth-decay-death, and marked these rites of passage with specific and well-established rituals and sacraments. Modern society seems to have lost this close contact with these natural cycles. |
| Part 2: Five Stages of Grieving | Dr Elizabeth Kubler-Ross, one of the world’s foremost authorities on the subject of death, describes the four stages of Denial, Anger, Bargaining and Depression that people pass through when coping with any severe loss, including their own death. |
| Part 3: Cancer’s Five Shocks | With cancer, there are five major ‘shocks’ that a person/ his family has to deal with. |
| Part 4: What Actually Happens at the Time of Death | Caring for a dying person, especially at home can be difficult and daunting. |
| Part 5: Top Five Regrets of the Dying | Every single patient found their peace before they departed though, every one of them. When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five. |
| Part 6: How to Die Before You Die | Perhaps the most exciting and empowering aspect of death is that it resets your clock to zero. By sharply ending what has gone before, it creates space for a new beginning – a rebirth of sorts. |
| Part 7: Quotes | We share some quotations (compiled by Arun Wakhlu) on the subject of Death |
| Part 7: Video (When I Die) | How do we approach death whilst embracing life? How can we change the conversation around death and palliative care for the terminally ill? |
