Five stages of grief

According to the model of the five stages of grief, or the Kübler-Ross model, those experiencing sudden grief following an abrupt realization (shock) go through five emotions: denial, anger, bargaining, depression, and acceptance. Though widely used, the theory is empirically unsupported, potentially harmful, and of limited practical value.

Introduced as "The Five Stages of Death" by Swiss-American psychiatrist Elisabeth Kübler-Ross in 1969, this model has been known by various names, including "The Five Stages of Loss", "The Kübler-Ross Model", the "Kübler-Ross Grief Cycle", the "Grief Cycle", "The Seven Stages of Grief", and the "Kübler-Ross Change Curve".

The model was introduced by Kübler-Ross in her 1969 book On Death and Dying, and was inspired by her work with terminally ill patients. Motivated by the lack of instruction in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago's medical school. Kübler-Ross's project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Although Kübler-Ross is commonly credited with creating stage models, earlier bereavement theorists and clinicians such as Erich Lindemann, Collin Murray Parkes, and John Bowlby used similar models of stages or phases as early as the 1940s. In the foreword to the first 1970 English edition of On Death and Dying, Colin Murray Parkes wrote, "This book describes how some American individuals have coped with death."

In her book, Kübler-Ross states that the medical advancements of the time were the mark of change for the way people perceive and experience death. Due to this, pediatricians have been seeing fewer life-threatening ailments for their patients compared to one-hundred years ago.

In her 1974 book Questions and Answers on Death and Dying, Kübler-Ross had by then observed that the stages are not experienced in a strictly linear progression. She noted, "Most of my patients have exhibited two or three stages simultaneously, and these do not always occur in the same order." She later regretted writing them in a way that was misunderstood. "Kübler-Ross originally saw these stages as reflecting how people cope with illness and dying," observed grief researcher Kenneth J. Doka, "not as reflections of how people grieve." In the 1980s, the Five Stages of Grief evolved into the Kübler-Ross Change Curve, which is now widely utilized by companies to navigate and manage organizational change and loss.

As of 2019, On Death and Dying has been translated into forty-one languages, with the 50th anniversary edition published by Simon & Schuster. In December 2019, The American Journal of Bioethics published a special issue (Volume 19, Number 12) dedicated to commemorating the 50th anniversary of Elisabeth Kübler-Ross's work, On Death and Dying.

Kübler-Ross originally developed stages to describe the process patients with terminal illness go through as they come to terms with their own deaths; it was later applied to grieving friends and family as well, who seemed to undergo a similar process. The stages, popularly known by the acronym DABDA, include:

Kübler-Ross identified additional stages of emotional response beyond the five widely recognized stages of grief, illustrated in a full-page graphic on page 251 of the 50th anniversary edition of On Death and Dying. Alongside the well-known stages of denial, anger, bargaining, depression, and acceptance, Kübler-Ross detailed other "stages" such as shock, partial denial, preparatory grief (also known as anticipatory grief), hope, and decathexis, which refers to the process of withdrawing emotional investment from external objects or relationships. She also acknowledged other emotional responses including guilt, anxiety, and numbness.