Five Stages of Grief

Swiss-born psychiatrist Dr. Elisabeth Kubler-Ross described the classic pattern of the coping strategies of  patients who know their diagnosis is terminal.

The first stage is denial

Upon hearing the diagnosis, the patient reacts with a shocked, "No, not me." According to Dr.Kubler-Ross, this is a healthy stage, and permits the patient and the family to develop other defenses.

Next comes anger or resentment

"Why me?" is the question asked now. "Why my child?" Blame, directed against the doctor, nurses and God often is a part of this stage. This outcry should be accepted, unjudged.

The third stage is bargaining

"Yes me, but-" "If you'll just give me five years, God, I'll . . ." This Dr. Kubler-Ross calls a period of temporary truce.

The fourth stage is depression

Now the person says, "Yes, me," with the courage to admit that it is happening; this acknowledgment brings depression. (Note: The family often goes through all the stages, along with the patient.)

Finally comes acceptance

A time of facing death calmly. This is often a difficult time for the family, since the patient tends to withdraw, to be silent.

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