Friday, August 20, 2010

A Universal Course for Dealing with Death

Legions of mental and medical health professionals who work with the elderly memorize this acronym: DABDA. It stands for the five stages of coping with death popularized by Swiss-born psychiatrist Elisabeth Kübler-Ross in the late 1960s: denial, anger, bargaining, depression and acceptance. These stages describe a sequence of transitions that all people supposedly pass through on finding out they are about to die. According to Kübler-Ross, when we learn of our impending demise, we first tell ourselves it is not happening (denial), then become angry at the realization that it actually is (anger), next search in vain for a way to postpone the death, perhaps until we can accomplish a desired goal (bargaining), later become sad as the awareness that we are dying sets in (depression), and finally come to grips with our inevitable demise and accept it with equanimity (acceptance).

Many medical, nursing and social work students in North America and Britain learn about Kübler-Ross’s stages as part of their professional training. These stages also pervade our culture and now extend beyond death in the popular mind-set to the psychological processing of grief from any significant disappointment. In the sitcom Frasier, the main character passes through all five stages of grief after losing his job as a radio talk-show psychologist. And in The Simpsons, Homer experiences the same sequence of emotions in a matter of seconds after a doctor informs him (erroneously) that he is dying.

Despite its popularity, Kübler-Ross’s theory is surprisingly devoid of scientific support. Studies reveal that many dying patients skip one or more Kübler-Ross stages or even pass through the stages in reverse order. For example, some people initially accept their own deaths but enter denial later. Nor does research bear out the validity for these stages for grief. Not all people experience depression or marked distress after the loss of loved ones, including partners or family members to whom they were deeply attached, according to research by Columbia University psychologist George Bonanno and his colleagues. Moreover, in a 2007 study of 233 Connecticut residents who had recently lost a spouse, acceptance, not denial, was the predominant initial reaction following loss. Kübler-Ross stages may be appealing because they offer a sense of predictability over an event that is out of our control. The idea that the frightening experience of death can be boiled down to a set series of defined stages that culminate in tranquility is reassuring. In truth, however, the process of dying does not follow the same path for all of us, no more than does the process of living. We can all be fooled by psychomythology, because so many of its falsehoods dovetail with our intuitions, hunches and experiences. Thus, scrutinizing popular psychology claims can provide a new window onto our mental worlds and enable us to make better life decisions. As paleontologist and science writer Stephen Jay Gould reminded us, debunking a myth necessarily unveils an underlying truth, thereby allowing us to attune our expectations more squarely with reality. In this way, taking on psychomythology, example by example, can transform us into better informed and educated citizens.

Source of Information : Scientific American Mind March-April 2010

No comments: