3. • Elizabeth Kubler-Ross in her book “On Death and
Dying” in 1969
• Stages are responses to loss, but there is not typical
response to loss as there is no typical loss (David
Kessler)
4. • Tools to help us identify what we may be feeling
• Do not proceed in a liner timeline
• Not everybody goes through them or in a prescribed
order
5. • Don’t last for weeks or months
• They are responses to feelings that can last for minutes
to hours
• Often slip in and out of them
6. Stage 1: Denial
• “No, not me, it cannot be true”
• Person who is dying: may look like disbelief
• Person who is grieving the loss of a loved one: more
symbolic than literal
7. • First reaction: to be paralyzed by shock or numbness
• Reassurance-seeking, doctor-shopping, seeking re-
evaluations
8. • Denial functions as a buffer after unexpected, shocking
news
• World seems meaningless and overwhelming
• Helps us to survive the loss, pace our feeling
• Nature’s way of letting in only how much we can handle
9. • Temporary defense to be replaced by partial acceptance
• As acceptance of reality sets in, healing process begins
• But as we proceed, feelings that we have been trying to
deny, begin to surface
10. STAGE 2. ANGER
• Anger can present itself in many ways – at yourself, lived
ones, doctors and the world
• It surfaces once you know that you are going to survive
whatever comes
• “Why me?”
11. • Feelings of sadness, loneliness, panic also appear, but
anger is at the forefront
• Unexpected, undeserved and unwanted situation
• Necessary stage of the healing process
12. • There are other emotions under this anger
• We are used to managing anger and we choose to avoid
feelings underneath until we are ready
• It gives temporary structure to the nothingness of loss
• Natural reaction to the unfairness of loss
13. • Difficult to cope with from the point of view of family and
hospital staff
• Anger is displayed in all directions
• Few people place themselves in the same position and
hence wonder where it’s coming from
14. STAGE 3. BARGAINING
• “if only…” or “what if…” statements
• We want life returned to what it was, our loved ones
back
• Go back in time, detect the illness earlier or stop the
accident from happening
15. • Associated with guilt
• Finding fault with ourselves and what we could have
done differently
• Even bargain with pain, trying to remain the past
• Most bargains are made with God
• Attempt to postpone the inevitable
16. STAGE 4: DEPRESSION
• Anger, rage, numbness get replaced by a sense of great
loss.
• Past loss and impending loss
• Added losses such as financial troubles
17. • Depression has elements that are helpful in grief
• Slows us down and helps us take stock of the loss
• Helps us rebuild ourselves
18. STAGE 5: ACCEPTANCE
• Often confused with the notion of being alright or okay
• Accepting the reality that a loved one is gone and this
new reality is the permanent reality
• Final healing and adjustment
• Awareness of the common-sense reasons of loss,
though we may not understand them
19. COMPLICATED GRIEF
• Intense longing and yearning for the deceased
• Intrusive thoughts or images of your loved one
• Denial of the death or sense of disbelief
• Imagining that your loved one is alive
20. • Searching for the person in familiar places
• Avoiding things that remind you of your loved one
• Extreme anger or bitterness over the loss
• Feeling that life is empty or meaningless
