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Dealing with Your Own Imminent Death - Theories on Acceptance of Impending Death

Kathryn Patricelli, MA

Research suggests that when considering our own death, we are most concerned about potential pain, helplessness, dependency, and the well-being of our loved ones. Other common concerns include fear of a painful or unpleasant afterlife, fear of the unknown, and fear of a loss of dignity or individuality. While we certainly do not have the answers about unknowable issues, we hope that the following information can help you to prepare for this final chapter in your life.

man grievingProbably the most famous model of the stages of grieving our own impending death was presented by Dr. Elizabeth Kubler-Ross in her book "On Death and Dying." Dr. Kubler-Ross's stages have also been borrowed by the larger grief community as a means of describing the grief process more generally. Coming to terms with dying is certainly a loss experience and an occasion for grief, so there is merit to this borrowing and reason to become familiar with Dr. Kubler-Ross' stages. Not everyone will experience all of these stages, or, if all are experienced, they won't necessarily occur in this particular order.

Kubler-Ross' first stage is Denial. In this stage, you may feel unable or unwilling to accept that the loss of your life will shortly take place. It can feel as though you are experiencing a bad dream and you are waiting to "wake up," expecting that things will be normal and that your diagnosis is a mistake.

After you have passed through denial and accepted that death will occur, you may begin to feel Anger at the unfairness of it. You may become angry at yourself for the disease and at your higher power for allowing it to happen. Feelings of abandonment may also occur and religious beliefs may be severely tested during this stage.

Next comes Bargaining. In this stage, you may beg your higher power to change the diagnosis, saying things like "I'll change if you allow me to live." This phase usually involves promises of better behavior or significant life changes, which will be made in exchange for the reversal of the diagnosis.

Once it becomes clear that Anger and Bargaining are not going to change the situation, you may then sink into a Depression stage where you confront the inevitability and reality of death and your own helplessness to change it. During this period, you may cry, experience sleep or eating changes, or withdraw from relationships and activities while you process the impending death. You may also blame yourself for having caused or in some way contributed to the diagnosis, whether or not this is justified.

Finally (if all goes according to Dr. Kubler-Ross's model), you will enter a stage of Acceptance where you have processed your initial grief emotions, and are able to accept that the death will occur and cannot be stopped. At this point, you are able to plan for your impending death and re-engage in daily life.

Although Dr. Kubler-Ross' theory is very popular, it has been criticized by researchers and others who have worked extensively with the dying. Scientific research has not provided support for this model; it is not clear that the stages exist as Kubler-Ross described them. For example, some people experience several stages simultaneously or fail to experience certain stages at all. Also research has not found that everyone goes through all five of these stages in the order specified. Critics also charge that the five stages are insufficient to reflect the full range of human reactions to death and dying. Still others worry that using the term "depression" for stage four is confusing; is this a healthy, normal way to respond to dying or instead, maladaptive psychological and physical symptoms?

People in the field of thanatology (death studies) have moved away from viewing grief as a series of predictable stages to seeing it as a stage of live with associated tasks. For example, theorists such as Charles Corr have suggested that dying is a uniquely individual experience that does not fit into neat stages. His research suggests that those who are coping with dying will react in their own individual ways to the unique challenges that confront them, such as dealing with unfinished needs in physical, psychological, social, and spiritual domains.