“When someone you love dies, the world as you’ve known it is totally upended”.

Dr. Elisabeth Kübler-Ross

Dr. Kübler-Ross was credited with helping to open up discussions and the studying of death. She also contributed to better care of many terminally ill patients to make death less psychologically painful, not only for the dying, but also for their caregivers, families and friends. She was instrumental in creating a hospice system in the United States through which palliative care and psychological support are provided for many terminally ill people. She helped to turn thanatology, the study of physical, psychological, and social problems associated with dying, into an accepted medical discipline. Dr. Kübler-Ross is viewed as a true pioneer in raising awareness about the important issues surrounding death, dying and bereavement.

In 1969, Elisabeth Kübler-Ross and David Kessler co-wrote the book “On Death and Dying,” (later updated and released under the title “On Grief and Grieving”). The main contribution of the book was the discussion of a pattern of adjustment that people go through when a loved one dies. The pattern named the “Five Stages of Grief” consists of denial, anger, bargaining, depression, and acceptance (DABDA), to which a sixth stage “finding meaning” was later added. The research, on which the book was based, was initially done through discussions with terminally ill patients, but the pattern was found to also occur when people experience traumatic life changes like divorce or separation and can be applied to the family and friends who have lost someone they cared about. At Sonja Smith Elite Funeral Group, we feel that the work of Drs Ross and Kessler could have value in helping the bereaved to better process the loss of their loved ones, as long as we remember that everyone grieves in their unique way and heal in their own time.

  1. Denial

In this phase we try to register what has happened, spreading the total pain, shock, and disbelief over our loss over time, rather than being overwhelmed by it all at once. Denial is more an inability to comprehend the loss for a while than literally trying to convince yourself your loved one isn’t dead, which is not unhealthy or dysfunctional unless you continue struggling to accept the reality that you’ve been presented with for an extensive period.

  1. Anger

One can feel angry because of the reason someone had to die or be angry with the deceased (for dying and leaving you behind with the sorrow), or you can blame your God, yourself, or the universe in general. Anger is an emotion that is easier to express than pain, and can be an anchor when we are confronted with a void in place of the connection that we had with the person we have lost. You find temporary structure when you get angry at someone or something, rather than feeling frustrated, guilty, hopeless, or powerless. The reality that everyone is going to die eventually is something that we find difficult to accept.

  1. Bargaining

This stage typically entails feelings of guilt and conversations with yourself starting with “if only” or “what if I did/didn’t”. Bargaining rarely finds a permanent solution (because death is inevitable) but the negotiation process does help you to accept this truth on an emotional and psychological level. If the loss cannot be “negotiated”, the bereaved might move onto stage four, depression.

  1. Depression

An acute sadness can overwhelm you when the great loss begins to affect your life. Sadness hits people at different times because some people can maintain the illusion that their loved one is away on vacation and may be returning, only later accepting the reality of death. To cope with sadness, you can seek support from friends, family, or grief support groups and take care of yourself.

  1. Acceptance

This does not mean that you are OK with the death of a loved one, but that you are ready to accept the new reality of life. Acceptance does not mean that grief has ended, but rather that you are capable to remember the person with more love than pain. If you can’t get to this stage and if intense and persistent grief continues to interfere with your daily functioning a year after the death of your loved one, you could be suffering from “prolonged grief disorder” and should seek medical help. A symptom could be that you have stopped pursuing your regular interests or that you do not interact with your friends at all.

  1. Finding meaning, finding closure

To find meaning for someone’s death (especially if the death was unexpected) will not eliminate the pain of losing a loved one, but it can cushion it, according to David Kessler, whose son died at the age of 21. The meaning could be as simple as the mere realisation of the fragility of life, and this could help you to make changes in your life or be more appreciative of the everyday blessings that you have.

The DABDA pattern had much support since its inception. Criticism came from experts in grief, psychologists and academics, who believed that the pattern was not researched sufficiently and also that it was suggesting that grief should be handled sequentially or in a particular way. We agree with the argument that everybody experiences loss and death in their unique manner and that there is no right or wrong or better way to grieve. Grief is also not a linear process, and the different stages can be experienced out of order, all at once or in rotation. Dr. Kübler-Ross concluded in her studies that not all follow the same progression, but most people experience two or more stages.

The most beautiful people we have known are those who have known defeat, suffering, struggle, and loss, and have found their way out of the depths. These persons have an appreciation, sensitivity, and understanding of life that fills them with compassion, gentleness, and a deep loving concern.”

Dr. Elisabeth Kübler-Ross (1926 – 2004)

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