Stages of Acceptance

Stages of Acceptance
http://www.youtube.com/watch?v=ND6iSRlG5m0
Elisabeth Kübler-Ross, On Death and Dying, Macmillan, NY, 1969

In the Kübler-Ross [b]Grief Cycle[/b], the first stage is one of immobilized shock. In order, the stages are: [b]Shock, Denial, Anger, Bargaining, Depression, Testing, Acceptance.

Shock stage

Symptoms
The first reaction on hearing the bad news is one of classic shock. This initially may appear as if there is no reaction at all to the news. The person may nod and accept the news without appearing to be troubled by it. Inside, they have frozen out the news that has not really taken hold yet. To get the news through, they may need to be told several times.

This is followed by a more external shock, where there may be physical reactions such as paling of the skin, shortness of breath and physical freezing.

Treatment
When shock occurs, they may need to be sat down (to stop them falling) and given a drink of some sort (mostly as something to hold onto). Show them sympathy and acceptance. If the shock is not a short-lived one, help them get to a place where they can sit safely and let the news sink in.

You can pre-empt shock symptoms to some extent by taking the person to a place where they can safely hear the news. Especially if they are likely to move swiftly into more emotive stages, they will need to be in a private place, away from the embarrassment of public tears, and in the company of trusted friends or family.

Denial stage

Symptoms
After the initial shock has worn off, the next stage is usually one of classic denial, where they pretend that the news has not been given. They effectively close their eyes to any evidence and pretend that nothing has happened.

Typically, they will continue their life as if nothing has happened. In the workplace, they will carry on doing their job even if that job is no longer required.

A classic behavior here is a 'flight into health', where previously-perceived problems are suddenly seen as having miraculously fixed themselves.

Treatment
You can move a person out of denial by deliberately provoking them to anger. Hold up the future (sympathetically) so they cannot avoid or deny it. Tell them that it is not fair. Show anger yourself (thus legitimizing that they get angry).

This, to some extent, is done on daytime TV shows where people in precarious situations are prodded into emotional explosions that make good TV and (where sympathetically done) may even be good for them.

[b]Anger stage[/b]

Symptoms
The next step after denial is a sudden swing into anger, which often occurs in an explosion of emotion, where the bottled-up feelings of the previous stages are expulsed in a huge outpouring of grief. Whoever is in the way is likely to be blamed. In a company this includes the managers, peers, shareholders customers and suppliers. The phrase 'Why me?' may be repeated in an endless loop in their heads. A part of this anger thus is 'Why not you?', which fuels their anger at the those who are not affected, or perhaps not as seriously so.

Treatment
When they are angry, the best thing you can do is give them space, allowing them to rail and bellow. The more the storm blows, the sooner it will blow itself out.

Where anger becomes destructive then it must be addressed directly. As necessary, you may need to remind people of appropriate and inappropriate behavior. Reframe their anger into useful channels, such as problem areas and ways to move foreword.

Beware, when faced with anger, of it becoming an argument where you may push them back into denial or cause later problems. Support their anger. Accept it. Let them be angry at you.

[b]Bargaining stage[/b]

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.

[b]Depression stage[/b]

Symptoms
After denial, anger and bargaining, the inevitability of the news eventually (and not before time) sinks in and the person reluctantly accepts that it is going to happen. From the animation of anger and bargaining, they slump into a slough of despond. In this deep depression, they see only a horrible end with nothing beyond it. In turning in towards themselves, they turn away from any solution and any help that others can give them.

Depression may be seen in a number of passive behaviors. In the workplace, this includes physical absenteeism, long lunch breaks and mediocre work performance. It can also appear in tearful and morose episodes where the person's main concern is focused on their own world.

Treatment
The first thing you can do with people who are in depression is to be there with them, accepting them in all their misery. People who are depressed feel very much alone and you company, even though it may not seem that way, is likely to be welcome.

The second thing to do is to keep them moving. It is easy to get stuck in depression, and the longer they stay there, the deeper into the mud they are likely to slide. So keep up a steady stream of support, showing them that there is light ahead and encouraging them to reach towards it.

In the workplace, provision of professional coaching, counselling and other support can do a lot to help people recognize their depression and find a way to clamber out of the pit.

[b]Testing stage[/b]

Symptoms
Even in the pit of depressive despair, reality eventually starts to bite and the person realizes that they cannot stay in that deep, dark hole forever. They thus start looking for realistic things that they can do. These may be taken on as 'experiments' to see if doing these things help the situation in any way. As this activity starts to work, at least in some ways, it is found to be preferred to the depression and so the person crawls out of that dark hole.

This escape is often done with the support of friends, family and professionals who specialize in helping people in whatever situation this is. In medicine, hospices help the terminally ill face their short futures with courage. In organizations, counselors and outplacement consultants help individuals move on to other work.

Treatment
When they reach out towards the road to acceptance, they are at last on their way out of the mire. Help them try different solutions and to see that they can, after all, have an effect on their future. Hand as much control to them as possible, as this gives them a lifeline of stability on which to pull themselves forward.

[b]Acceptance stage[/b]

Symptoms
The final stage is back to one of stability, where the person is ready and actively involved in moving on to the next phase of their lives, no matter how short. The terminally ill person will be putting their life in order, sorting out wills and helping others to accept the inevitability that then now have countenanced and faced.

In the workplace, people who have lost their jobs will be actively seeking new work, whilst others who have had their work changed will be tidying up and getting ready to move on.

Acceptance is typically visible by people taking ownership both for themselves and their actions. They start to do things and take note of the results, and then changing their actions in response. They will appear increasingly happier and more content as they find their way forward.
Treatment

Help the person to establish themselves permanently in their new position. Fix them there, ensuring that there is no way back to the previous situation. Congratulate them on getting through the change. Celebrate the completion of their transition.

http://changingminds.org/disciplines/change_management/kubler_ross/shock_stage.htm