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Bereavement and grief counselling
Published in Chambers Mary, Psychiatric and mental health nursing, 2017
Elizabeth Kübler-Ross was strongly influenced by Bowlby and Parkes and her well-known model of grief appeared in her book On death and dying,6 which outlines five stages of grief: denial, anger, bargaining, depression and acceptance. These stages are usually remembered by the acronym ‘DABDA’. As with the previous model, these stages are not necessarily experienced in sequential order.
Self-directedness and adult learning
Published in Jenny Gavriel, The Self-Directed Learner in Medical Education, 2005
The five stages of grief were initially proposed by Kübler-Ross26 to describe the pattern of emotions experienced by terminally ill patients and those grieving for a loss (seeFigure 2.1). They are now widely used as a management tool to describe the impact of change in the workplace. The principle is that people experiencing a change will be, to some extent, grieving for the prior situation. Learners may be expected to go through similar stages (reduced to three below) when any change occurs at work or at home.
Managing care at the end of life
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
There are several theoretical models of loss and grief that have attempted to understand the complex nature of the emotions that we experience when we are bereaved. One such model was developed by Elizabeth Kubler-Ross in 1969 in her seminal work on the five stages of grief. Kubler-Ross worked with terminally ill people and noted that the medical profession was underprepared to care for them and their families who were experiencing grief. Kubler-Ross (1969) argues that individuals experience grief by going through five stages of emotion: Denial – ‘this isn’t happening to me’ – Individuals may disagree with a diagnosis they have been given or family members may refuse to accept that their loved one has died.Anger – ‘why has this happened to me’ – once individuals have accepted that they cannot stay in denial, they often elicit anger towards the situation or at others close to them.Bargaining – people will often struggle to find meaning in the situation, they may reach out to others for understanding. Feelings of guilt often prevail here, and bereaved individuals might ask ‘why them, and not me?’Depression – is often closely associated with grief; individuals may experience a number of overwhelming emotions such as sadness, emptiness, hostility, despair and hopelessness.Acceptance – this is where individuals enter a period of reality and understanding of the situation, whilst they may never accept their loved one has died; they learn to live with their loss and accept their new reality.
Developing a conceptual framework to identify and classify sources of parental stress following pediatric concussion
Published in Brain Injury, 2022
Elizabeth F. Teel, Jeffrey G. Caron, Isabelle J. Gagnon
Several conceptual models have been developed to better understand family burden and stress following TBI. Similar to the five stages of grief, the original developmental stage models were commonly comprised of an initial stage of shock, followed by denial, acknowledgment, bargaining, and acceptance (16–18). However, these models failed to capture a basic principle capable of explaining the variation in family adaptation following TBI (19). Thus, the Resiliency Model of Family Stress, Adjustment, and Adaptation was developed to understand ways that families can positively adapt following a family member’s injury (20). This model was tailored to patients with head injury and suggests that a family’s social support, injury appraisal, coping skills, and problem-solving abilities can influence family adjustment (21). More recently, Beauchamp et al. created a model to described how parent perceptions, attributes, and responses to post-injury symptoms can modulate recovery in young children (<6 years old) with concussion (22).
Transforming grief into peace: The normal grieving mind—Memory construction, deconstruction, and reconsolidation
Published in American Journal of Clinical Hypnosis, 2021
Grief is the natural response to loss, particularly to the loss of someone or some living thing that has died, to which a bond or affection was formed (Mughal, Azhar, & Siddiqui, 2021). Although conventionally focused on the emotional response to loss, grief necessarily has physical, cognitive, behavioral, social, cultural, spiritual, and philosophical dimensions. Grief is different from depression. Grief seems to be an emptiness with lots of memories, while depression is hollow emptiness (Robert Sachs, 2021, personal communication). Grief is an active mind, flooding with memories. Depression feels vacant. In some ways, they are opposite reactions to real or perceived loss. A set of grief guidelines created by Elisabeth Kübler-Ross (1969/2014), hypothesized five stages of grief designed for the dying and not survivors. I found that only acceptance applied to my situation. I had to uniquely create an atlas, a new roadmap to peace. I suspect this is true for others.
On Death and Dying at the Beginning of Life: Grieving the Stillborn Baby
Published in The American Journal of Bioethics, 2019
In her seminal work, On Death and Dying, Elisabeth Kübler-Ross wrote of the five stages of grief: denial, anger, bargaining, depression, and acceptance (Kübler-Ross 1969). People may not go through the stages in that specific order, and they may not go through all five stages. In a more specific application of Kübler-Ross’s stages of grief to miscarriages, and largely applicable to stillbirths (which differ from miscarriages in occurring beyond 20 weeks of gestational age), Dr. Carly Snyder writes that denial stems from losing a very real pregnancy by being told there is no heartbeat on the ultrasound. Anger comes from the unfairness of it all e.g. doing everything right, taking your prenatal vitamins and all following the precautions recommended to pregnant women. Anger can be self-directed, for doing or not doing something during the pregnancy, even while knowing the loss is not their fault. Anger can also extend to their partners, for not understanding their experience or for not grieving to the extent that they are, and also to their friends who are having babies, even though the grieving mother realizes it is an illogical reaction. While there isn’t bargaining in relation to the loss, there can be bargaining regarding the next pregnancy, as in wanting overly healthful behaviors to translate into a guaranteed healthy next pregnancy. Depression ensues from the knowledge that nothing can change the past nor ensure the future. This can be exacerbated by a tendency toward isolation, feeling that no one can relate to one’s grief, and by the presence of any underlying mental health illness. As the magnitude of the grief lessens with time, this can lead to a throwback to an earlier stage such as anger or guilt. Over time, the acuity of the pain decreases while the memory remains, allowing the loss to be a part of one’s life without remaining the defining feature (Snyder 2017).