Friday, 8 July 2022

Kübler-Ross model

It has been more than 50 years since Elizabeth Kübler-Ross wrote the book, On Death and Dying, sending her five stages of grief model afloat on the great sea of scholarship (1969). As a country doctor, Kübler-Ross felt that modern US society was attempting to wall off death, diverting us from a peaceful end at home by rushing people off to hospital; by 'keeping' the facts from the dying; by making people look as if they are asleep in a coffin (Kübler-Ross, 1969).

It is an interesting book, reading it 53 years on, with ideas that may still hold true for the US, but don't fit Aotearoa well in 2022. Some elements do, but others are quite uncomfortable. Of the elements which do fit, the five stages of grief are probably most recognisable. While we may not experience them all in the exact order, or feel them exactly as labelled (Stephens et al., 2021), they feel relatively 'right' to me. 

However, it is useful to remember that the Kübler-Ross model can be applied to any change, to anything that we hold onto (Connelly, 2020). To having to leave a job. To getting ill. To losing a relationship. To moving house. To having to making business changes (Stephens et al., 2021).

So let's run quickly through the stages (Connelly, 2020; Kübler-Ross, 1969; Stephens et al., 2021):

  1. Denial: This is our "this cannot be real", or "how is this happening?" stage. We are shocked, numbed, gob-smacked, pole-axed. This is our defensive posture, which allows us space to begin to digest this new situation before we can move on to the next stages. We may stall here, going blank, and trying to wall off what is inexorably coming at us. Buying time for our chewing work, perhaps: allowing our jaws to work at the initial breaking down of reality into smaller chunks, ready for further processing. 
  2. Anger: This is our "no!" or "this is not going to happen!" time.  We begin to understand that the situation is going to change our world. This may turn into anger, or be expressed as frustration, or as anxiety. We may seek to blame others: from the neighbour's cat, to the UN; to find fault with anything or anyone to try to ease our pain. Research has found that repeated knocks in business grieving tends to increase anger over time (Stephens et al., 2021). Now the acid in our stomachs is annihilating what we have eaten, making it unrecognisable. Furiously pounding the indigestible to mush.
  3. Bargaining: This is our "let me have two more days" point. We beg in the hope that we can postpone the inexorable, to put off the change or find a way out of the situation. Like rats in a maze, we are looking for a way out. The "If I do this, then you will do that" pleas, attempting to play dice with the universe. The indigestible has moved to the large intestine.   
  4. Depression: This is our "what is the point" moment. We now understand that the universe does not play dice, and the change is coming at us like a freight train. We are grieving for what we have to leave; our people, our certainty, our bedrock. We may be sad, demotivated or lacking direction. We are now well into digesting the indigestible: it is in our small intestine. 
  5. Acceptance: This is our "OK, let's do this" phase. We have moved past fighting into the future of it happening. This is likely to be a resigned stage, but usually becomes happier. We know we must just get on with life. We consider our options, we plan; we might be scared, but we know we can't hold this back the inexorable any more. Bowels, eh. And they have to move.

The Kübler-Ross model is a useful rule of thumb to help to guide us through the stages of grieving (1969), even after 50+ years.


Sam

References:

Connelly, M. (12 September 2020). Kubler-Ross Five Stage Model. https://www.change-management-coach.com/kubler-ross.html

Kubler-Ross, E. (1969). On Death and Dying: What the dying have to teach doctors, nurses, clergy and their own families. Macmillan Publishing Co., Inc.

Rothweiler, B. R., & Ross, K. (2019). Fifty Years Later: Reflections on the Work of Elisabeth Kübler-Ross MD. The American Journal of Bioethics, 19(12), 3-4. https://doi.org/10.1080/15265161.2019.1674551

Stephens, S., McLaughlin, C., & McLaughlin, K. (2021). Small business in a time of crisis: A five stage model of business grief. Journal of Business Venturing Insights, 16, e00282. https://doi.org/10.1016/j.jbvi.2021.e00282

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