5 Stages of Dying

by Elisabeth Kubler-Ross M.D.

Most dying people, as well as their family and friends go back and forth among all the stages of dying. Shifting from anger to denial to acceptance to bargaining to depression.  These stages come many times, in no appropriate order or synchronicity.  The five stages of dying are denial, anger, bargaining, depression, and acceptance. 

DENIAL 

-may be the first response of shock or numbness

-the denial initially helps us to survive the loss, denial helps us to cope

-the refusal to accept, grows out of shock -denial can be expressed through actions

***DO NOT CHALLENGE THE DENIAL***

-denial can be a VERY powerful crutch that should not be yanked away unless you have something more powerful to put in its place

-as long as it’s not causing harm or damage to anyone, leave it alone

-if it is never given up, so be it

-it’s like taking a mini emotional vacation!! 

-when a care giver insists the dying person ‘keep trying to get better’, this can be adding guilt to a battle they have already lost

ANGER

-most anger will be expressed to those closest or safest to the patient or family

-anger doesn’t have to be logical or valid

-important to remember that the anger surfaces once you are feeling safe enough to know you will probably survive whatever comes

-anger is a natural response, closely followed by sadness, panic, hurt, and loneliness 

-anger is a necessary stage in the healing process

-the more you feel the anger, the more it will dissipate and the more you will heal

-underneath anger is pain, YOUR pain

-anger is strength and it can be an anchor, it can be something to hold on to

-anger means you are progressing and allowing feelings to come to the surface

-it is important to feel the anger without judging it. life is unfair.  death is unfair.

-anger is a natural reaction to the unfairness of the loss

-anger affirms that you CAN feel, that you did love, and that you have lost

BARGAINING

-like a child at bedtime, if a person needs to go there, just back them up

-guilt is usually bargaining’s companion

-we may even bargain with the pain, we will do anything not to feel the loss

-bargaining can be an important reprieve from the pain that occupies one’s grief

-we don’t really believe the things we bargain, it just creates momentary relief

DEPRESSION

-this stage can feel like it will last forever

-we may withdraw from life, or feel that there is no point in going on

-if you can get through daily activities they may feel empty and pointless

-if you did care about anything, it may actually feel scary to feel so it is safer NOT to care

-depression is a normal and appropriate response

-the heavy, dark feelings of depression are part of the healing process and very necessary. Welcome the sadness in and allow the sadness and emptiness to wake you up you and help you explore your loss in its entirety

-when you allow yourself to experience depression, it will leave as soon as its served its purpose in your loss

-our society often feels the need to ‘fix’ depression but depression is normal and should be viewed as the common cold of mental health

-treating depression is a balancing act and you need to be careful that you don’t use anti depressants to skip the process of grief 

-small simple activities, exercise, and connecting with others can help you work through the depression phase

-as difficult as it can be, depression slows us down and allows us to take real stock of the loss, it helps us rebuild ourselves

-depression clears out our previous idea of life and creates a place for growth. It takes us to a deeper place in our soul that we may not normally explore.

ACCEPTANCE

-often confused with the notion of being all right or okay with what happened

-acceptance is more about accepting the reality that our loved one is gone and recognizing that this new reality is permanent

-we do not have to like this reality to accept it

-we have been changed forever and and we must readjust

-in a strange way, as we move through grief, healing brings us closer to the person we loved

-as we start the process of reintegration we are trying to put back the pieces that have been ripped away

-acceptance may just be having more good days than bad ones

-when we begin to enjoy our life again it may feel like we are betraying our loved one

-instead of denying our feelings, we need to listen to our needs, move, adjust, readjust, change, grow, evolve through this experience

-we can begin to love again, but not until we have given grief it’s due time

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