Introduction
The Kübler-Ross model has shaped the ways in many psychologists and therapists think about grief, bereavement, and dying. The greatest appeal of this approach is that it describes the behavior of a person as a set of different reactions, namely denial, anger, bargaining, depression, and acceptance. By applying this framework, a therapist can believe that the behavior of a person can be more manageable and predictable. Thus, it has significant implications for the counseling of many patients. This paper will present a critique of this model. The main task is to show the main assumptions of this model can be over-simplified and misinterpreted even by practitioners. In particular, it is necessary to demonstrate that the stages identified by Elizabeth Kübler-Ross are not always consecutive as some people may believe. Secondly, some of these responses may not be present at all. Finally, the experiences of a person in such stressful situations cannot be reduced only to denial, bargaining, anger, depression or acceptance. To a great extent, they depend on the immediate environment of an individual. These are the main ideas that should be discussed.
Overview of the Kübler-Ross model
Overall, the use of Kübler-Ross model is an attempt to generalize or categorize the behavior of people who have to cope with grief or loss. It is largely based on the observations and interviews of terminally-ill patients1. This approach is premised on the idea that a person has to react to death or loss in certain ways. Yet, people should keep in mind that this model was not based on quantitative and longitudinal studies that can examine the changes in a patient’s emotional state. The absence of long-term empirical studies can be viewed as a limitation of this model.
The five stages are the most significant components of this approach. According to Kubler-Ross, the most immediate reaction is denial2. At this point, a person does not accept the idea that he or she is going to die or lose a loved person. Moreover, many people can reject every piece of evidence that can be presented to them, especially if it is related to the diagnosis of an incurable illness. The second reaction is anger. Under such circumstances, a person can blame oneself or others for the illness or any other catastrophic event. In some cases, people can vent their spleen in their closest friends or relatives. Later a person begins to think about bargaining of the ways in which he or she can delay death or loss.
At the stage of bargaining, people can believe that they can change their lifestyle and mitigate the effects of a loss. When a person understands that no bargaining is possible, he or she normally falls into the state of depression. At this stage, an individual realizes that death or loss is inevitable and comes to the conclusion that everyday life and its joys are pointless. In this case, he or she does not want to think anything else. The last stage identified by Kübler-Ross is acceptance. At this stage, people can act in different ways. They may try to reconcile themselves with others, settle their affairs or focus on the activities that they like most.
This may be a plausible description of how people can act when they have to cope with catastrophic news. However, this description is too speculative and it implies that the behavior of a person is predictable. This assumption seems to be flawed because there are many factors that can affect a person’s response to death or loss. For instance, one can mention the level of support offered by relatives, age, culture, or religion. Thus, the response to a loss does not always follow a particular pattern and it is by no means predictable.
It is worth noting that this model has often been applied not only to patients who are terminally ill. For example, it has been used to describe the behavior of children whose parents are going to divorce. Moreover, many people, who have just ended a relationship, are also believed to come through these five stages. Thus, this framework has the potential to describe people’s reaction to the possibility of a catastrophic loss. The main assumption is that the knowledge of these stages can help practitioners working with various patients. One should take into account that Elizabeth Kübler-Ross did believe that these stages were always chronological3. Moreover, she did not insist that each of them always had to be present.
She believed that the experiences of a person in such situations could complex or intertwined. Yet, a great number of people assume that a person passes through each of these stages in a chronological way. More importantly, every person who does not elicit one of the responses described by Kübler-Ross, is sometimes believed to behave abnormally. By accepting this assumption, practitioners can harm their patients, rather than help them. These are the dangers of taking the Kübler-Ross model for granted. This is why it is necessary to look at this approach more critically, especially at the way in which it can be misused. Such an evaluation can give better insights into this model of grief and loss.
Possible Limitations the Kübler-Ross model
One of the most important criticisms of this approach is that people do not usually pass through each of the stages identified by Elizabeth Kübler-Ross. In fact, many researchers believe that some of the reactions are not present at all. For instance, according to the qualitative study conducted by Russell Friedman and John James, people do not always become angry when some of their old relatives die as a result of a long-term illness4. More likely, they can feel relieved because the sufferings of their loved ones finally came to an end. Additionally, not all grievers pass through the stage of denial because when they seek the assistance of therapist they usually admit their loss.
These examples show that the behavior of people is more complex. First, it cannot be reduced only to five responses, described by Elizabeth Kübler-Ross. Secondly, some of these reactions do not always manifest themselves. The problem is that the therapists, who often work with grievers, can have preconceptions about the experiences of these people. For example, they can interpret every form of irritation as the sign that a person is at the stage of anger. In many cases, this irritation could have been caused by something else. This is why one should not try to apply this person to every individual irrespective of particular circumstances. The main danger is that the Kübler-Ross model can give practitioners an illusion of understanding the feelings of a bereaved or dying person. This is the pitfall that therapists should avoid.
Furthermore, according to the Kübler-Ross model, denial is one of the most common reactions to catastrophic news. However, one should note that to a great extent the reaction can be determined by the age of a person. For instance, elderly people are less likely to deny the possibility of their death. Therefore, therapists should take into consideration that the type of response may depend on the age of an individual. Secondly, the experiences of a person largely depend on his/her family and the support that they can offer. An individual, who feels the support of the dear ones, is less likely to suffer from depression.
Finally, the Kübler-Ross model overlooks the idea that the response to death is culturally-determined. For instance, in Japanese culture, the idea of death is perceive with enormous amount of anxiety5. In fact, it is regarded as inevitability, and many people do not believe that it is horrifying. Thus, even if a practitioner applies the five-stage model, he or she has to make allowances for the cultural and religious background of an individual; otherwise, the attempts of therapists can be doomed to failure. The Kübler-Ross model has to be tested in different cultural environments.
The second important critique of the approach is that the five stages should not be regarded as a series of consecutive events. For instance, people cannot say that a person, who has entered the stage of acceptance, may never return to denial, anger, bargaining, or depression. These states often alternate with one another. People, who suffer from a terminal illness, can have brief intervals of acceptance, but a single word or image can make them deny the possibility of oncoming death6. Similar thing can be said about the loss of a relative. This idea can have profound implications for therapists who counsel such people. They should remember that the state of such a person is very volatile. Even if a patient has reached the state of acceptance, a therapist should think that the emotional state of this individual will remain unchanged in the near future. They should avoid the false sense of security that is typical in those situations when a patient shows the signs of improvement.
Additionally, the idea of five changes implies certain dynamics or the movement from one emotional state to another. Nonetheless, under such circumstances, peoples’ behavior has no patterns. For instance, some people can remain in the state of denial. Such a response is common among people who have received the news of their terminal illness. Some therapists may say that every person has to reach the state when he or she can come to grips with the possibility of death or loss. However, for some people this task is impossible, and it is unjust to blame them for their feelings and reactions. Certainly, there are some outcomes that a therapist should aim for, for example, the ability of a patient to lead a fulfilling social life. Yet, these outcomes can be achieved in different ways.
Apart from that, practitioners should take into account that the model of five stages is very difficult to verify. Psychologists cannot always measure the responses of individual who have to face catastrophic news in part because these people do not want to take part in any psychological studies. Moreover, it is practically impossible to establish the most widespread sequence of these responses because this task would require continuous observation and interviewing of many patients. Thus, researchers should still seek empirical evidence in support of Kübler-Ross model. Without it, one cannot argue that the notion of five stages is infallible. Thus, medical workers and counselors should take a more critical look at it.
Yet, these examples do not suggest that the Five Stages of Grief should be entirely rejected by psychologists. Elizabeth Kübler-Ross was able to pinpoint the most common responses to catastrophic news. Admittedly, some of these responses are not present, and they follow a certain order. However, therapists should know to help a patient who can be in the state of denial or depression. Thus, this knowledge can be used to teach a grieving person various coping skills that he/she can use to overcome the effects of a loss.
Conclusion
This discussion shows that the model developed by Elizabeth Kübler-Ross is often over-simplified or misinterpreted. The main mistake is to assume that a person always has to pass through specific stages in a certain order. Such an assumption completely overlooks the complexity of a person’s behavior. This approach can help medical workers and therapists better understand the challenges faced by patients or their relatives. However, it should not be seen as some postulate that is always valid irrespective of the situation. This model can be beneficial because with its help a therapist can better understand the experiences of a person at one particular point. However, one cannot assume that grieving always follows the pattern identified by Kübler-Ross.
Works Cited
Corr, Charles, C. Nabe, and D. Corr. Death and Dying, Life and Living. New York: Cengage Learning, 2012. Print.
Friedman, Russel, and James, John. “The Myth of the Stages of Dying, Death and Grief.” Skeptic 14.2 (2009); 37-41. Print.
Manis, Amie and Nancy, Bodenhorn. “Preparation for Counseling Adults with Terminal Illness: Personal and Professional Parallels.” Counseling and Values 50.3 (2006): 197-207. Print.
Tagaya, Akira, Okuno, Shigeyo, Tamura, Masae, and Anne J. Davis, et al. “Social Support And End-Of-Life Issues For Small Town Japanese Elderly.” Nursing & Health Sciences 2.3 (2000): 131-137.
Wright, Kristin. “Relationships with Death: The Terminally Ill Talk about Dying.” Journal of marital and family therapy 29.4 (2003): 439-454. Print.
Footnotes
1 Kristin, Wright. “Relationships with Death: The Terminally Ill Talk about Dying.” Journal of marital and family therapy 29.4 (2003): 440.
2 Charles Corr, Clyde Nabe & Donna Corr. Death and Dying, Life and Living. (New York: Cengage Learning, 2012), 152.
3 Amie Manis and Nancy Bodenhorn. “Preparation for Counseling Adults with Terminal Illness: Personal and Professional Parallels.” Counseling and Values 50.3 (2006): 201.
4 Russell Friedman and John W. James. “The Myth of the Stages of Dying, Death and Grief.” Skeptic 14.2 (2009); 40.
5 Akira Tagaya, Shigeyo Okuno, Masae Tamura, and Anne J. Davis, et al. “Social Support And End-Of-Life Issues For Small Town Japanese Elderly.” Nursing & Health Sciences 2.3 (2000): 135.
6 Amie Manis and Nancy Bodenhorn. “Preparation for Counseling Adults with Terminal Illness: Personal and Professional Parallels.” Counseling and Values 50.3 (2006): 197.