The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
1
The universality of grief often defined as the “normal and natural reaction to death”,
acknowledges that we are all grievers yet, “conflicting feelings caused by the end of or
change in a familiar pattern of behaviour” (James & Friedman, 2009: 3) can often result in
unresolved grief. Kubler-Ross (1969) attempted to address the societal constraint of grief as
an unspoken emotion in her study of terminally ill patients which emphasised the need for
individuals to address the fluid nature of loss. She suggested that this involved a grieving
process of five stages which includes denial, anger, bargaining, depression, and acceptance
(DABDA). Through the lens of the Kubler-Ross model, this essay will explore the personal
experiences of loss within my own family unit and will draw on its relevance to the work
carried out by social care practitioners.
According to Kubler-Ross (1969) grief is a multi-faceted response to loss which can be
described as the emotional suffering one feels when their meaning of the world has been
challenged. Historically, the model was only interested in death and dying but was later
expanded to apply to any form of catastrophic personal loss that an individual may
experience in their lifespan. She hypothesised that where someone experiences a life
threatening or life altering event, the grieving process can involve five stages but these stages
may not be complete or chronological in order (Kubler-Ross, 1969).
It is evident from my own personal experiences that where an individual becomes stuck in a
stage it can become unhealthy for the individual. Growing up with a brother that was
diagnosed with schizophrenia made it very challenging to openly grieve about him as a loss,
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
2
especially as the person you are mourning is still living. Doka (1989:4) refers to this as
disenfranchised grief, where a person experiences a “loss which cannot be openly
acknowledged or publicly mourned”. The diagnosis of a psychotic illness was not something
that was openly spoke about or acknowledged with the wider community and resulted in
family members becoming stuck in the denial stage of grief. This is the first stage of the
Kubler-Ross model and acts as a buffer, where feelings of hope are often visual. The
individual uses this stage as a defence mechanism and in my case allowed family members to
build a wall around their emotions. This manifested itself in an unhealthy way, resulting in a
refusal to accept the facts. As Kubler-Ross (1969) suggests this was a way my parents could
negate the pain while trying to accept the reality of the loss.
As a young child, I recall trying to speak to my parents about my brother’s illness and all the
questions I asked were ignored, or the subject was changed. This acted as a defence
mechanism, used to deny or ignore the diagnosis. The absence of communication impacted
on my own grieving process and caused a lack of understanding of the loss. Kubler-Ross
(1969) suggests that communication is an important factor when dealing with grief and the
ability to approach and interact with people who are mourning is paramount for social care
practitioners.
The stages of the Kubler-Ross model have also been used to explain the patient’s grief
reaction but this has caused much controversy. Individuals who have a mental disorder also
experience forms of loss, which include loss of identity and loss of social relationships.
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
3
Lewin (2004) would argue that schizophrenic patients must mourn losses engendered by the
illness and where this is not acknowledged it can result in denial. This supports the denial
stage
of the Kubler-Ross model and in the case of my brother suggests that denying his
mental illness acted as a defence mechanism, which allowed him too
consciously or
unconsciously evade the traumatic change that had taken place in him. The denial of his new
identity and reality led to avoidance and he became stuck which, exhibited itself in substance
addiction. On reflection, I question if the powerlessness to openly discuss his illness due to
disenfranchised grief (Doka, 1989) added to my brother denying who he had become and in
some way contributed to his addiction.
The second stage of the Kubler-Ross model is anger. With anger, the individual is unable to
remain in denial and this is replaced by misplaced feelings of anger, envy, rage, and
resentment. (Kubler-Ross, 1969) In a recent child protection placement I was working with a
young mother whose two young children had been placed in care due to mental health issues.
The social workers explained to me that she was very difficult to deal with and often blamed
“the system” for the situation that she found herself in. Unaware of this model, I did not
consider her anger as a reaction to loss and as suggested by Kubler-Ross, this may have been
a result of my inability to place myself in the position of the mother and discern the origin of
the anger. Kubler-Ross and Kessler (2005: 15) argue that “anger is a strength and can be an
anchor, giving temporary structure to the nothingness of loss”. As a social care practitioner it
may be difficult to support and care for an individual however, it is important to remain
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
4
detached and non-judgemental when dealing with a person experiencing anger from grief.
In the case of my brother, I recall my father blaming himself for the illness, questioning
whether he had done something wrong as a parent. This further manifested itself in anger
towards my brother “why had he not taken better care of himself”. Kubler-Ross argues that
the anger is just another indication of the intensity of love that exists, in this case between
father and son. However, as pointed out by Kubler-Ross (1969: 155), my father had to
explore the depths of his anger in order to heal as “should you shield the valleys from the
windstorms, you would never see the beauty of their canyons”.
The third stage deals with bargaining, where individuals become lost in a web of what if and
if only statements. Kubler-Ross (1969) suggests that this stage may involve bargaining with
God, if God did not respond to my anger, then maybe he will postpone the inevitable if asked
nicely. In my own personal experience it is difficult to attain if my father experienced this
stage. I reminisce making promises to God that if he let my brother be free from his illness
and the depths of his addiction then I would live a life free from all temptation.
Kubler-Ross (1969) suggests that promises that are made are generally ones that cannot be
kept and are usually associated with an unconscious guilt. On reflection, I feel that the
unconscious guilt of seeing my father suffer after losing another child to addiction resulted in
me making pleas to God to not let this happen again. In questioning my reasoning for
wanting to become a social care practitioner, it could be argued that this was another form of
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
5
bargaining, vowing to help so that others do not experience the same suffering.
The fourth stage deals with depression, also referred to as preparatory grief. Once it becomes
clear that anger and bargaining are not going to reverse the loss, according to Kubler-Ross
(1969) individuals may then sink into a depression stage where they confront the inevitability
and reality of the loss and their own helplessness to change it. As a social care practitioner it
is vital to recognise the signs and symptoms of this stage. The emotional attachment of the
loss and the accepting of the reality can result in addiction, self-harming and suicidal
thoughts. In the case of my brother, he became locked in a cycle of depression and used drugs
as a way of escaping from his reality. I believe that it was at this point that my father began to
accept the reality of the loss through anticipatory grief, mourning “the impending loss of all
the love objects, in order to facilitate the state of acceptance” (Kubler-Ross, 1969: 99).
The final stage deals with acceptance. This stage may vary according to the person’s situation
and Kubler-Ross would argue that this is where emotional detachment and objectivity takes
place. In my own personal experience of growing up as a child with a brother who has
schizophrenia, it was much easier for me to accept his reality as I only vaguely remember
who he was before the illness. This supports Kubler-Ross (1969) hypothesis that
the stages
are not linear in fashion, allowing me as child to feel one, then another and back again to the
first. Kubler-Ross (1969) suggests that.
individuals may forget that the stages are responses to
feelings that can last for minutes or hours and we all have an innate ability to flip in and out
of one and then another.
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
6
In the case of my father, I feel that it was much more difficult for him to reach acceptance
and readjust and reorganise his role as a father. As Williams (2000) suggests the social death
of an individual is often more difficult to grieve as the individual is not gone physically but
the loss occurs in the emotional connection. This can impact on the grieving process. As
social care practitioners, we have a duty of care to individuals to empower them to reach
acceptance, to support them to grow and evolve. This model is useful in understanding the
vulnerabilities of the individual who is mourning a loss.
The stages of the Kubler-Ross model has been used and widely accepted by practitioners in
social care settings. The model has been useful in grief counselling however, some criticisms
do exist. Kastenbaum (2003) argues that the stages place schedules on the grieving process
and that individuals may experience emotions that are not mentioned in the model. However,
it must be acknowledged that Kubler-Ross (1969) advocated that there is no typical loss and
loss is unique as the person experiencing it. She further argues that the grief stages were
“never meant to tuck messy emotions away into neat packages” (Kubler-Ross, 2005: 7).
James and Friedman (2009: 14) further suggest that “there are no stages of grief but people
will always try to fit themselves into a defined category if one is offered to them. Sadly, this
is particularly true if the offer comes from a powerful authority such as a therapist,
clergyperson, or doctor”. This is an important factor to consider in your work as a social care
practitioner.
In conclusion, grief and loss is a very unique journey that all individuals will travel and
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
7
experience and while “death and dying is reviewed as a taboo subject” (Kubler-Ross, 1969:
44) it is an important concept to consider when working with vulnerable people in society.
Kubler-Ross (1969) suggests that one cannot become a teacher of grief where they have not
confronted their own emotions of loss and accepted the destructive nature of death. Social
care practitioners will become a source of support for an individual who has experienced loss
where they have the strength to “sit in the silence that goes beyond words” knowing that “this
moment is neither frightening nor painful, but a peaceful cessation of the functioning of the
body.” (Kubler-Ross, 1969: 252).
The Kubler-
Ross Model of
Grief: A Journey
of Unique
Experiences
8
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Ross Model of
Grief: A Journey
of Unique
Experiences
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