Is the theory of the five stages of the inevitable true?

On the Internet, one can often find the mention of the five stages of acceptance of the inevitable (grief, loss): denial, anger, bargaining, depression, acceptance. We decided to check if this theory has a scientific rationale.

Five stages of acceptance of the inevitable are remembered in relation to anything: economy, HR, management, changes in the profession etc. Articles about this model can find In female magazines, publications About palliative care, on medical resources, V Blogs And Media. Sometimes this model Use in a humorous manner, even Replacing Stages for any others.

For the first time, five stages of acceptance of the inevitable (otherwise called the Kybler Ross model) appeared in the 1960s. They were highlighted by a psychiatrist Elizabeth Kybler Rossworking with incurably sick patients. She was horrified, since most of the hospitals of hospitals did not understand what these people were experiencing and how to communicate with them to facilitate their condition. This inspired her to study the theme of dying. Kybler-Ross spoke with inconspicuously ill patients, watched their experiences, talked with their relatives and friends, held seminars for medical students to increase awareness in this area. And in 1969, the psychiatrist collected its observations and wrote a book "About death and dying"where the first five stages of acceptance of the inevitable were first fixed.

Stages that Kybler Ross identify:

• Denial and isolation. Patients claim that an error occurred, that the tests mixed up, that the doctors are not competent enough, tried to pretend that nothing was happening.
• Anger. Patients ask the question “Why did this happen to me, and not with someone else?”, Begin to be annoyed and tear off anger at doctors, nurses and their loved ones, subconsciously accusing them of what happened.
• Bargain. Patients are trying to agree with fate, God or illness, giving various promises to delay the inevitable.
• Depression. When the previous stages do not work and the disease does not retreat, the dying fall into depression, which is aggravated by poor health, loss of attractiveness due to operations, and cash expenses for treatment.
• Acceptance. The patient is no longer angry and does not blame anyone, does not try to agree with fate. Often this stage is mistakenly considered positive changes, something joyful compared to previous stages. According to Kubler Ross, this is just a stage when the patient no longer has the strength to fight.
• Hope. This component, which is usually forgotten about, is present at all stages of grief.

A few years later, a psychiatrist joined Kybler Ross in the study of grief David Kessler, in collaboration, they wrote another book about ways to survive the loss. It was published after the death of Kybler Ross. Subsequently, Kessler Highlighted Another stage:

• Search for meaning. A person begins to look for what happened to him, a deep meaning, tries to make his death (loss, grief) not in vain.

Kessler celebratedthat the stages of adoption of the inevitable are also observed in people who experience the pandemic of coronavirus. About this They wrote and other psychologists.

It is worth noting that Kybler-Ross herself never claimed that her model is the only true or that all incurably ill or experiencing grief should necessarily pass all five stages and precisely in the sequence she bred. These were only her observations based on a relatively small sample.

Over the past decades, the Kubler Ross model has been criticized from other psychiatrists more than once. First of all It is noted The absence of any long and representative empirical studies, as well as the fact that the model is based on representatives of only one culture in a fairly short time period and can be not applicable to people of another culture after several decades. 

Expert in the field of gerontology, aging and death Robert J. Castaum celebratedthat the existence of these stages as such is not proven, as well as the fact that the dying or people who experience grief really live all five stages. In addition, Castasbaum believes, the model does not take into account the influence of the nearest environment on the studied.

Scientists of Yale University for three years talked with people who survived the loss of a loved one, and published in 2003 results this study. Some of the people really experienced grief according to the Kubler Ross model, but a significant part of the results did not correspond to it completely.

George Bonnano, a professor of clinical psychology of Colombian University, summarized existing studies based on thousands of subjects in 20 years, and introduced Conclusions in his book "The other side of sadness." He claims that there are no stages of grief, everyone experiences the loss or expectation of the inevitable differently. Moreover, the absence of any symptoms is also the norm.

Thus, the five stages of acceptance of the inevitable are only one of the options for how people can experience grief that is rather controversial from the point of view of other researchers. In addition, this model is often distorted by people who did not read the work of Kybler Ross, but only heard something about it.

Half truth

What do our verdicts mean?

Read on the topic:

1. Elizabeth Kybler Ross. About death and dying
2. Is it true that any habit is formed in 21 days?
3. Is it true that psychosomatics do not exist?
4. Did Sigmund Freud say: “Sometimes a cigar is just a cigar”?