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elisabeth kübler-ross - five stages of griefkubler-ross model for death and bereav
ement counselling, personal change and trauma Elisabeth Kübler-Ross (which is the
correct spelling; Elizabeth Kubler Ross is a common incorrect form and used abov
e for search-engine visibility). Incidentally, 'counselling' is UK English and '
counseling' is US English.
Dr Elisabeth Kübler-Ross pioneered methods in the support and counselling of perso
nal trauma, grief and grieving, associated with death and dying. She also dramat
ically improved the understanding and practices in relation to bereavement and h
ospice care.
Her ideas, notably the five stages of grief model (denial, anger, bargaining, de
pression, acceptance), are also transferable to personal change and emotional up
set resulting from factors other than death and dying.
We can clearly observe similar reactions to those explained by Kübler-Ross's grief
model in people confronted with far less serious traumas than death and bereave
ment, such as by work redundancy, enforced relocation, crime and punishment, dis
ability and injury, relationship break-up, financial despair and bankruptcy, etc
.
This makes the model worthy of study and reference far outside of death and bere
avement. The 'grief cycle' is actually a 'change model' for helping to understan
d and deal with (and counsel) personal reaction to trauma. It's not just for dea
th and dying.
This is because trauma and emotional shock are relative in terms of effect on pe
ople. While death and dying are for many people the ultimate trauma, people can
experience similar emotional upsets when dealing with many of life's challenges,
especially if confronting something difficult for the first time, and/or if the
challenge happens to threaten an area of psychological weakness, which we all p
ossess in different ways. One person's despair (a job-change, or exposure to ris
k or phobia, etc) is to another person not threatening at all. Some people love
snakes and climbing mountains, whereas to others these are intensely scary thing
s. Emotional response, and trauma, must be seen in relative not absolute terms.
The model helps remind us that the other person's perspective is different to ou
r own, whether we are the one in shock, or the one helping another to deal with
their upset.
The study of death and dying is actually known as thanatology (from the Greek wo
rd 'thanatos' meaning death). Elisabeth Kübler-Ross is accordingly sometimes refer
red to as a thanatologist, and she is considered to have contributed significant
ly to the creation of the genre of thanatology itself.
Elisabeth Kübler-Ross's seminal book was On Death & Dying, published in 1969, in w
hich she explained her now classically regarded 'five stages of grief'. The book
and its ideas were quite revolutionary at the time, reflecting Kübler-Ross's outs
poken and bold approach, which is paradoxical given the sensitivity and compassi
on of her concepts.
Kübler-Ross was a catalyst. She opened up and challenged previously conservative (
sweep it under the carpet, don't discuss it, etc) theories and practices relatin
g to death and bereavement, and received an enormously favourable response among
carers, the dying and the bereaved, which perhaps indicates the level of denial
and suppression that had earlier characterised conventional views about the sub
ject - particularly in the western world, where death is more of a taboo than in
certain other cultures.
As stated, and important to emphasise, Kübler-Ross's five stages of grief model wa
s developed initially as a model for helping dying patients to cope with death a
nd bereavement, however the concept also provides insight and guidance for comin
g to terms with personal trauma and change, and for helping others with emotiona
l adjustment and coping, whatever the cause. This has probably helped her ideas
to spread and to enter 'mainstream' thinking.
Elisabeth Kübler-Ross and her ideas have now become synonymous with emotional resp
onse to trauma, and to grief support and counselling, much like Maslow is fundam
entally associated with motivational theory; Kolb with learning styles, and Gard
ner with multiple intelligence.
As with much other brilliant pioneering work, the Kübler-Ross model is elegantly s
imple. The five stages of grief model is summarised and interpreted below.
The Kübler-Ross five stages and terminology are featured here with permission fro
m the Elisabeth Kübler Ross Foundation, which is gratefully acknowledged. Please l
ook at the website www.ekrfoundation.org, which enables and sustains Dr Kübler-Ros
s's values and mission, and extends help to those who need it. (Separate referen
ce was made here previously to the www.elisabthkublerross.com website, which som
etime after 2008 now re-directs to the EKR Foundation website.)
Please be aware that the interpretation and contextual material on this webpage
represents my own thoughts on the subject. I would encourage you to develop your
own ideas too - this is a deeply significant area and one that can be interpret
ed in many ways. My interpretation and associations are not an attempt to reprod
uce Kübler-Ross's thinking, they seek to provide a modern context, and to relate t
he basic model to the philosophies of this website.
Use of and reference to the Elisabeth Kübler-Ross five stages for commercial purpo
ses, and publication of EKR quotations, require permission from the EKR Foundati
on. You can use freely the other aspects of this page subject to the normal term
s for using this website, briefly summarised at the foot of this page.

elisabeth kübler-ross - five stages of griefAlso known as the 'grief cycle', it is

important to bear in mind that Kübler-Ross did not intend this to be a rigid seri
es of sequential or uniformly timed steps. It's not a process as such, it's a mo
del or a framework. There is a subtle difference: a process implies something qu
ite fixed and consistent; a model is less specific - more of a shape or guide. B
y way of example, people do not always experience all of the five 'grief cycle'
stages. Some stages might be revisited. Some stages might not be experienced at
all. Transition between stages can be more of an ebb and flow, rather than a pro
gression. The five stages are not linear; neither are they equal in their experi
ence. People's grief, and other reactions to emotional trauma, are as individual
as a fingerprint.
In this sense you might wonder what the purpose of the model is if it can vary s
o much from person to person. An answer is that the model acknowledges there to
be an individual pattern of reactive emotional responses which people feel when
coming to terms with death, bereavement, and great loss or trauma, etc. The mode
l recognises that people have to pass through their own individual journey of co
ming to terms with death and bereavement, etc., after which there is generally a
n acceptance of reality, which then enables the person to cope.
The model is perhaps a way of explaining how and why 'time heals', or how 'life
goes on'. And as with any aspect of our own or other people's emotions, when we
know more about what is happening, then dealing with it is usually made a little
easier.
Again, while Kübler-Ross's focus was on death and bereavement, the grief cycle mod
el is a useful perspective for understanding our own and other people's emotiona
l reaction to personal trauma and change, irrespective of cause.
five stages of grief - elisabeth kübler ross
EKR stage Interpretation
1 - Denial Denial is a conscious or unconscious refusal to accept facts, informa
tion, reality, etc., relating to the situation concerned. It's a defence mechani
sm and perfectly natural. Some people can become locked in this stage when deali
ng with a traumatic change that can be ignored. Death of course is not particula
rly easy to avoid or evade indefinitely.
2 - Anger
Anger can manifest in different ways. People dealing with emotional upset can b
e angry with themselves, and/or with others, especially those close to them. Kno
wing this helps keep detached and non-judgemental when experiencing the anger of
someone who is very upset.
3 - Bargaining
Traditionally the bargaining stage for people facing death can involve attemptin
g to bargain with whatever God the person believes in. People facing less seriou
s trauma can bargain or seek to negotiate a compromise. For example "Can we stil
l be friends?.." when facing a break-up. Bargaining rarely provides a sustainabl
e solution, especially if it's a matter of life or death.
4 - Depression
Also referred to as preparatory grieving. In a way it's the dress rehearsal or t
he practice run for the 'aftermath' although this stage means different things d
epending on whom it involves. It's a sort of acceptance with emotional attachmen
t. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows tha
t the person has at least begun to accept the reality.
5 - Acceptance Again this stage definitely varies according to the person's situ
ation, although broadly it is an indication that there is some emotional detachm
ent and objectivity. People dying can enter this stage a long time before the pe
ople they leave behind, who must necessarily pass through their own individual s
tages of dealing with the grief.
(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Küb
ler-Ross, 1969. Interpretation by Alan Chapman 2006-2009.)

elisabeth kübler-ross short biography Dr Elisabeth Kübler-Ross was born in Zurich, S

witzerland, on July 8, 1926. She was one of triplet sisters. Kübler-Ross studied m
edicine against her father's wishes, at Zurich, later settling in the US in 1958
and becoming a US citizen in 1961.
Her experiences at the end of the Second World War, including the aftermath of t
he Majdanek (Maidanek) concentration camp at Lublin, Poland, as a member of the
International Voluntary Service for Peace, reinforced her destiny to focus on th
e humanistic perspective of death and dying.
According to some accounts the young Elisabeth's childhood treatment by her fath
er was very harsh, which might explain additionally how she became so intensely
concerned for people's worst suffering.
Her seminal book On Death & Dying was published in 1969, in which she explained
the process of dying in which she first described her now classically regarded F
ive Stages of Grief. The book, and the supporting publication of her ideas in Ti
me magazine, achieved wide circulation, so that Elisabeth Kübler-Ross soon became
known for her pioneering work with the terminally ill, and for her ideas in the
counselling and support of those affected by death and bereavement.
Kübler-Ross spent much of the 1970s running workshops and speaking to audiences ab
out her ideas, which quickly gained popular appeal and general acceptance among
the caring professions, and which had significant positive influence over the de
velopment of hospice care and attitudes towards death and the care of the dying.
In the 1980s Kübler-Ross turned her attention to the plight of babies born with AI
DS, and also founded a healing and workshop centre which she called Healing Wate
rs, on a 300-acre farm in Virginia.
Kübler-Ross's work has not always been universally applauded. Detractors tend to f
ocus on the 'vagueness' of the grief cycle model (which reminds us of the need t
o appreciate it as a guide, rather than a rigid process), and her interest in th
e after-life linked to near-death experiences also attracted mixed response, as
one might expect given her iconic status, and the understandable scientific caut
ion of much of her audience.
Whatever, Elisabeth Kübler-Ross was a remarkable woman who carved out unique reput
ation in her field - indeed she arguably defined the field itself.
Later in her life she suffered personal tragedy: a fire destroyed her Virginia h
ome, and a series of strokes left her in ill health. She moved to Scottsdale Ari
zona and retired soon afterwards in 1996.
Other critically admired works include Living with Death and Dying (1981) and On
Life After Death (1991) which are among more than 20 books that Kübler-Ross wrote
or co-authored on subjects related to death and grieving, and caring for those
affected by bereavement.
Elisabeth Kübler-Ross died on 24 August 2004. The Elisabeth Kübler-Ross Foundation (
EKR Foundation) was formed in to keep Elisabeth's spirit alive. The EKR Foundati
on seeks to continue Elisabeth's life work through the education of bereavement
carers, and to promote and enable the compassionate support of families affected
by death across the world.
Elisabeth Kübler-Ross was inducted into the The National Women's Hall of Fame in 2
007, a national nonprofit organization that annually recognizes the contribution
s to civilization of American women in a variety of disciplines.

"It's only when we truly know and understand that we have a limited time on eart
h - and that we have no way of knowing when our time is up, we will then begin t
o live each day to the fullest, as if it was the only one we had."
(Dr Elisabeth Kübler-Ross, 1926-2004, psychiatrist, humanitarian, teacher, author,
and pioneer of bereavement and hospice care. Used with permission, with thanks
to www.ekrfoundation.org and www.elisabethkublerross.com.)
This quote is available with many other inspirational sayings on the posters sec
tion.