The Kübler-Ross Grief Cycle

The Kübler-Ross grief cycle

DisciplinesChange Management > The Kubler-Ross grief cycle

Background | The Grief Cycle | Sticking and cycling | See also

Background

For many years, people with terminal illnesses were an embarrassment for doctors. Someone who could not be cured was evidence of the doctors' fallibility, and as a result the doctors regularly shunned the dying with the excuse that there was nothing more that could be done (and that there was plenty of other demand on the doctors' time).

Elizabeth Kübler-Ross was a doctor in Switzerland who railed against this unkindness and spent a lot of time with dying people, both comforting and studying them. She wrote a book, called 'On Death and Dying' which included a cycle of emotional states that is often referred to (but not exclusively called) the Grief Cycle.

In the ensuing years, it was noticed that this emotional cycle was not exclusive just to the terminally ill, but also other people who were affected by bad news, such as losing their jobs or otherwise being negatively affected by change. The important factor is not that the change is good or bad, but that they perceive it as a significantly negative event.

The Grief Cycle

The Grief Cycle can be shown as in the chart below, indicating the roller-coaster ride of activity and passivity as the person wriggles and turns in their desperate efforts to avoid the change.

The initial state before the cycle is received is stable, at least in terms of the subsequent reaction on hearing the bad news. Compared with the ups and downs to come, even if there is some variation, this is indeed a stable state.

And then, into the calm of this relative paradise, a bombshell bursts...

Shock stage: Initial paralysis at hearing the bad news.
Denial stage: Trying to avoid the inevitable.
Anger stage: Frustrated outpouring of bottled-up emotion.
Bargaining stage: Seeking in vain for a way out.
Depression stage: Final realization of the inevitable.
Testing stage: Seeking realistic solutions.
Acceptance stage: Finally finding the way forward.

Sticking and cycling

Getting stuck

A common problem with the above cycle is that people get stuck in one phase. Thus a person may become stuck in denial, never moving on from the position of not accepting the inevitable future. When it happens, they still keep on denying it, such as the person who has lost their job still going into the city only to sit on a park bench all day.

Getting stuck in denial is common in 'cool' cultures (such as in Britain, particularly Southern England) where expressing anger is not acceptable. The person may feel that anger, but may then repress it, bottling it up inside.

Likewise, a person may be stuck in permanent anger (which is itself a form of flight from reality) or repeated bargaining. It is more difficult to get stuck in active states than in passivity, and getting stuck in depression is perhaps a more common ailment.

Going in cycles

Another trap is that when a person moves on to the next phase, they have not completed an earlier phase and so move backwards in cyclic loops that repeat previous emotion and actions. Thus, for example, a person that finds bargaining not to be working, may go back into anger or denial.

Cycling is itself a form of avoidance of the inevitable, and going backwards in time may seem to be a way of extending the time before the perceived bad thing happens.

Bargaining stage
DisciplinesChange ManagementThe Kübler-Ross grief cycle > Bargaining stage
Symptoms | Treatment | See also
In the Kübler-Ross Grief Cycle, the fourth stage is one of desperate bargaining. In order, the stages are: Shock, Denial, Anger, Bargaining, Depression, Testing, Acceptance.
Symptoms
After the fires of anger have been blow out, the next stage is a desperate round of bargaining, seeking ways to avoid having the bad thing happen. Bargaining is thus a vain expression of hope that the bad news is reversible.
Bargaining in illness includes seeking alternative therapies and experimental drugs. In organizations, it includes offering to work for less money (or even none!), offering to do alternative work or be demoted down the hierarchy. One's loyalties, debts and dependants may be paraded as evidence of the essentiality of being saved.
Treatment
When people are bargaining, you should not offer them any false hope. Although there may be practical things they can do which you can offer them, never offer them something that cannot be fulfilled.
Sometimes the best you can do at this stage is point even more at the inevitable, even though this may well tip them into depression (which may well be a necessary move).
When they are in a bargaining mood, sometimes there are things you can offer them, such as support for change or new opportunities. In these cases you may be able to strike a win-win deal, where they get an improved deal and you get collaboration or some other contribution. In a business setting, this may include finishing off some important work before they leave and receiving a special bonus for doing so.
See also
Coping Mechanisms
Elisabeth Kübler-Ross, On Death and Dying, Macmillan, NY, 1969

As an example, apply the 5 stages to a traumatic event most all of us have experienced: The Dead Battery! You're going to be late to work so you rush out to your car, place the key in the ignition and turn it on. You hear nothing but a grind; the battery is dead.

DENIAL --- What's the first thing you do? You try to start it again! And again. You may check to make sure the radio, heater, lights, etc. are off and then..., try again.
ANGER --- "%$@^##& car!", "I should have junked you years ago." Did you slam your hand on the steering wheel? I have. "I should just leave you out in the rain and let you rust."
BARGAINING --- (realizing that you're going to be late for work)..., "Oh please car, if you will just start one more time I promise I'll buy you a brand new battery, get a tune up, new tires, belts and hoses, and keep you in perfect working condition.
DEPRESSION --- "Oh God, what am I going to do. I'm going to be late for work. I give up. My job is at risk and I don't really care any more. What's the use".
ACCEPTANCE --- "Ok. It's dead. Guess I had better call the Auto Club or find another way to work. Time to get on with my day; I'll deal with this later."

This is not a trivial example. In fact, we all go through this process numerous times a day. A dead battery, the loss of a parking space, a wrong number, the loss of a pet, a job, a move to another city, an overdrawn bank account, etc.

Handling Bargaining Behavior

Content:

What is bargaining when a loss is involved?
What are some irrational beliefs involved in bargaining?
How to cope with bargaining behavior

What is bargaining when a loss is involved?

Bargaining is:

Negotiating with God, others, and self to do or to stop doing a series of things in order to prevent a loss, hurt, failure, or uncomfortable circumstance.
Making resolutions to change a way of living in order to avoid the consequences of the current lifeBstyle.
Shopping for the guru, doctor, or belief system with the "answer'' for our life or the ``means'' to do away with our troubles.
Minimizing problems and the positing of quick solutions for them.
The unending quest for ``helping'' methods to change or improve our lives.
Chronic mistrust in established answers or methods of change required to help or to heal.
Resistance to trusting and to working closely with the helping agents in our lives who are willing to assist us in changing or improving our situation.
Loss of faith in the answers we are being given on how to treat or address our problems.
Lack of taking personal responsibility in addressing our problems.
"Looking good'' for helpers but ignoring and not cooperating with them in reality.
Convincing ourselves that ``others'' don't know what they are talking about and that we have the answers to our problems.
Ignoring those who confront us with our problems by explaining away our behavior and offering a variety of intellectual explanations for our motives and actions.
`Giving time'' and waiting for our problems to solve themselves with no direct intervention taking place.
Believing in the myth that ``more is better,'' and involving ourselves in a variety of different intervention and treatment modalities in order to make the problem go away ``as soon as possible.''
Handing over to others (e.g., therapists, counselors, doctors, friends) the responsibility for resolving our problems.
Exempting ourselves from any direct responsibility for the resolution or remediation of our problems.
Ignoring the advice of the professionals from whom we have requested help for our problems.
Second guessing the motives and advice of others as they attempt to help us address our problems.
Our unwillingness to admit that some problems are so great that we cannot solve them on our own and that we need help to work on them.
``Putting off the agony'' of facing the problems and the unwillingness to suffer the immediate pain in treating the problem. Putting off the pain to another time when we will be ``better prepared'' to handle it.
Asking for time so that we can prepare ourselves for the problem and its consequences.
The unwillingness to be ``prevention oriented,'' to look into the future and see what we could be doing today to prevent illness or problems from occurring.
Procrastinating in what we know we need to do while convincing ourselves that the problem will not recur or increase in magnitude.
Pointing out all of the good things we have or are doing in our life as a means of justifying our taking no action to resolve the current problem.
Grabbing onto a simplistic, minimally painful, quick solution to a complex problem.
Salving of one's conscience by taking some indirect action (e.g., contributing money to feed the hungry in Africa) in response to an immediate personal problem (e.g., a family member is involved in an unhealthy lifeBstyle and we are unwilling or unable to confront them on it.)
Giving a person with problems material things instead of our time and positive attention hoping that by this their problems will be resolved.
Convincing oneself that ignoring or using an indirect means of addressing another person's problems is the best way to help that person (e.g., let them know we love and care for them and that we are always there for them when they need us rather that confront them with the problem.)
Looking for the ``helper'' whose solutions to our problems are most palatable to us.
Doing ``good'' for others in the hope that such actions will solve our problems.

What are some irrational beliefs involved in bargaining?

It should not hurt to solve a problem.
Solutions to problems should be simple and straightforward.
In getting help for problems there should be no cost in terms of time, resources, or energy.
There should be a solution for all problems.
There should be an answer or diagnosis for all problems.
There should be a cure for all ills.
If I look hard enough I'll find an answer or solution to my problems.
Living a good, clean life should result in my problems being small or nonexistent.
People should recognize their own problems and work them out on their own.
People will not like or accept me if I confront them with their problems.
They are constantly finding new cures; therefore, they'll find one for my problem.
If I ignore a problem it will go away.
If I am hurting from my problem, everyone in my life should respect my feelings and avoid causing more problems for me.
All helpers should be kind, gentle, considerate, and successful in helping me solve my problems.
A helper is responsible for solving my problem.
Change should come easy.
Since I am motivated to work on solving my problem, then my problem should be solved easily, immediately, and completely.
Once you solve a problem you should never have to solve it again.
The more I pay in resources, time, and energy to solve a problem, the better the solution should be.
Why worry about tomorrow? Relax and enjoy life, and don't concern yourself with the possible aftermath of your behavior.
No one understands me or my problem.
I am the only one with this problem.
If I am quiet about what I am currently experiencing in my problem, it will eventually go away.
How can this problem ever be resolved?
I must face this problem on my own.
I must never burden anyone else with my problems.
It is a sign of weakness to ask others for help in dealing with a problem.
If you ask someone for help and they give it, you will always have to perform some type of payback.
I must have done some awful things in my earlier life for this problem to happen to me.
You must accept any problem that comes your way as a sign of your innate evil; you must accept it as the penance or retribution for your badness.
If I get help the problem will go away, and I won't need anymore help.

How to cope with bargaining behavior

Step 1.When you recognize bargaining behavior being used in dealing with a problem or loss, you need to stop that behavior immediately, or confront the person with the bargaining behavior and ask him to stop.

Step 2.Identify the irrational beliefs underlying the bargaining behavior.

Step 3.Systematically begin the process of refuting the irrational beliefs by asking the following questions:

Are the beliefs I am (or you are) working under reasonable and rational considering the nature, scope, and intensity of the problem involved?
What would be a more reasonable set of beliefs to work with when addressing the problem(s)?
What would happen if I (or you) should begin to follow these new ``rational'' beliefs in addressing the problem(s)?
How is the problem being resolved by my ( or your) operating under the current beliefs?
What is self-defeating in my (or your) current beliefs?
What is self-enhancing in my (or your) new set of beliefs?

Step 4.Once you (or the other) have decided upon a new set of rational beliefs to use in addressing the problem or loss, begin to put the problem-solving techniques into operation.

Step 5.As you (or the other) begin the process of problem solving, be alert to the re-introduction of any irrational beliefs that might lead you to use bargaining behavior again.

Step 6.If you identify any bargaining behavior, go back to Step 1 and begin again.