Stages of Grief or the Five Stages of Dying
DABDA—Dr. Elisabeth Kubler-Ross' Model of Coping with Dying
Oct 5, 2009
In 1969 Dr. Elisabeth Kubler-Ross published her classic, groundbreaking book, On Death and Dying. Included in the book was a model, the Model of Coping with Dying, which was based on her research and interviews with more than 500 dying patients.
As part of the model, Dr. Kubler-Ross identified five stages of coping with dying. These stages describe the psychological and emotional responses that many people experience when dying from a terminal illness.
The Model of Coping with Dying
Although there have been other models developed to try and explain how people cope with grief and loss, the five stages of the Kübler-Ross model are the most recognized by the lay public.
The five stages of coping with dying is abbreviated DABDA. The stages include:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
The DABDA acronym is taken from the first letters in the words, denial, anger, bargaining, depression and acceptance. DABDA has become an expression used in popular culture even finding its way into the Urban Slang dictionary as the five stages of loss: denial, anger, bargaining, depression and acceptance.
These stages of coping with dying are also referred to as the Kubler-Ross model, the "Stages of Dying," the "Five Stages of Dying," and the "Stages of Grief," the "Five Stages of Grief" or the "Stages of Loss" or the "Five Stages of Loss."
The model of coping with dying has also been used to describe the psychological and emotional responses that many people experience when facing a life-threatening illness or life-changing situation.
The Stages of Dying
According Dr. Kubler-Ross in her 2005 book On Grief and Grieving, "the stages have evolved since their introduction, and they have been very misunderstood....They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have." A key point Dr. Kubler-Ross made about the stages of dying is that they were not meant to describe a typical response to a loss, because there is not typical loss. Every person's reaction to a loss is unique, just as every loss is unique.
Over the years since the model was introduced the "Stages of Dying" were also used to explain the grieving response to a loss. As such this model is often referred to as the "Stages of Grieving." In On Grief and Grieving, Dr. Kubler-Ross acknowledged the "Stages of Grieving."
The Stages of Grieving
The five stages of grieving are the same as the five stages of dying: denial, anger, bargaining, depression and acceptance. A key point made by Dr. Kubler-Ross in On Grief and Grieving, is that the five stage model is meant to be used as a tool to help "frame and identify what we may be feeling."
It is important for people to realize that these models are not meant to be absolute stages that everyone who experiences a life-changing loss progresses through in a stepwise manner. The stages are not designed to be chronological or complete responses. They are a way of putting categories and words to emotions that may be difficult to express.
It is also important to realize that not everyone goes through all of the steps or goes through them in a linear fashion. Some steps may be missed entirely, others may be experienced in a different order, some may be re-experienced again and again.
The Legacy of On Death and Dying
On Death and Dying was groundbreaking at the time because the book was written on a topic that most people did not want to deal with at the end of life, namely death and dying. It became the first bestseller on the subject of death and dying and remains a best selling book in the fields of Psychology and Thanatology.
What began as one physician's quest to help improve care for those who are dying turned into a clinical model still taught to health care providers and counselors. Kubler-Ross model has also become a popular cultural expression, DABDA to describe the dying and grieving process.
The "Stages of Dying" and "Stages of Grieving" are best viewed for what they are, models to help explain one of the most difficult emotional situations people must cope with in life, navigating the journey of grief.
Resources
Kubler-Ross E. 1969. On Death and Dying. New York, NY: Scribner Publishers.
Kubler-Ross E and Keller D. 2005. On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. New York, NY: Scribner Publishers.
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