THE FIVE STAGES, or DABDA

 THE FIVE STAGES OF…. Popularly known by the acronym DABDA Loss of a Loved One (person or pet), Diagnosis of a Chronic Illness, Divorce, Death, or Grief The Kübler-Ross model, or the Five Stages Of Grief, postulates a series of emotions experienced by terminally ill patients prior to death, wherein the five stages are denial, anger, bargaining, depression and acceptance. The model of the Five Stages Of Grief was first introduced by Swiss psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying, and was inspired by her work with terminally ill patients. Kübler-Ross was motivated by the lack of curriculum in medical schools on the subject of death and dying.  Her project at the University of Chicago evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Since the publication of On Death and Dying, the Kübler-Ross model has become accepted by the general public. Kübler-Ross noted later in life that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood. Rather, they are a collation of five common experiences for the sad/frightened/mournful/bereaved that can occur in any order, if at all.

Denial – The first reaction is denial. In this stage individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality.

Anger – When the individual recognizes that denial cannot continue, they become frustrated, especially at proximate individuals. Certain psychological responses of a person undergoing this phase would be: “Why me? It’s not fair!”; “How can this happen to me?”; “Who is to blame?”; “Why would this happen?”.

Bargaining – The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise. For instance: “I’d give anything to have him back.” Or: “If you take this diagnosis away, I promise to be a better person!”

Depression – “I’m so sad, why bother with anything?”; “I’m going to die soon, so what’s the point?”; “I miss my loved one, why go on?” During the fourth stage, the individual despairs at the recognition of their mortality. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen.

Acceptance – “It’s going to be okay.”; “I can’t fight it; I may as well prepare for it.” In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions. Kübler-Ross later expanded her model to include any form of personal loss, such as the death of a loved one, the loss of a job or income, major rejection, the end of a relationship or divorce, drug addiction, incarceration, the onset of a disease or chronic illness, an infertility diagnosis, and even minor losses, such as a loss of insurance coverage. Even sports fans go through such a process if their favorite team loses an important game, and also supporters of a losing candidate in an election.