美国著名的心理分析医生伊丽沙白.库伯勒.罗斯通过对大量晚期患者的访谈及研究患者临近死亡前的心理活动，将濒临死亡的过程分成五个心理阶段：拒绝、愤怒、挣扎、沮丧、接受。

第一阶段：Denial 否认与隔绝

大多数患者无论是在一开始就被明确告知病情或是起初不明真相、随后意识到自己患有绝症时，第一反应往往经历否认这一阶段，产生不同程度的否认情绪，会在心里想：不，这不可能。否认是暂时的自我防御机制，它的意义在于抗击痛苦，帮助重拾自我，激发出其他的、稍平和一些的心理防御机制，不久就转为在一定程度上的接受态度。

第二阶段：Anger 愤怒

当最初的否认无济于事，愤怒、狂燥、嫉妒、怨恨之情便开始出现，会自然而然的想：为什么会是我。愤怒的根源是由于生活秩序完全被打乱，无法充分享受生活、实现自己的人生计划等。常常把怨气撒在他人的身上。

第三阶段：Bargaining 交涉

这个阶段其实即是与残酷的事实讨价还价、做交涉和拖延时间，自我设定一个最后期限，在这个期限内实现一桩心愿、完成一件自我的承诺。

第四阶段：Depression 抑郁

当晚期患者对自己的状况再也无法否认，当他出现越来越多的征兆、变得越来越虚弱时，他无法做到一笑了之、无动于衷，也无法做到怨气冲天时，取而代之的将是一种强烈的失落感和焦虑，这种焦虑来自对生活、情感、工作等的焦虑，也来自病人在等待与这个世界永别的过程中产生的悲伤。

第五阶段：Acception 接受

经历了前面的几个阶段，最终进入到对死亡即不感沮丧又不感愤怒的阶段，这时候，不再惋惜自己将失去精彩的人生美景，而是开始默默守候离去的那一刻，睡眠也不再是为了逃避现实或是病痛折磨间隙的短暂休息，这一阶段的睡眠变得象婴儿一样单纯，对一切事物都不再有任何兴趣，重新找到了安宁。

心理分析医生伊丽沙白.库伯勒.罗斯的关于死亡几濒临死亡的论著，着重于更好的了解生命最后阶段及与之相随的一切焦虑、恐惧和希望，发现医院在照顾病人方面的优势与不足，以便在病人生命的最后之时伸出援助之手，她的工作推动了对弥留之际病人的临终关怀。

A Normal Life Process

At some point in our lives, each of us faces the loss of someone or something dear to us. The grief that follows such a loss can seem unbearable, but grief is actually a healing process. Grief is the emotional suffering we feel after a loss of some kind. The death of a loved one, loss of a limb, even intense disappointment can cause grief. Dr. Elisabeth Kubler-Ross has named five stages of grief people go through following a serious loss. Sometimes people get stuck in one of the first four stages. Their lives can be painful until they move to the fifth stage - acceptance.

Five Stages Of Grief

1. Denial and Isolation.
   At first, we tend to deny the loss has taken place, and may withdraw from our usual social contacts. This stage may last a few moments, or longer.
2. Anger.
   The grieving person may then be furious at the person who inflicted the hurt (even if she's dead), or at the world, for letting it happen. He may be angry with himself for letting the event take place, even if, realistically, nothing could have stopped it.
3. Bargaining.
   Now the grieving person may make bargains with God, asking, "If I do this, will you take away the loss?"
4. Depression.
   The person feels numb, although anger and sadness may remain underneath.
5. Acceptance.
   This is when the anger, sadness and mourning have tapered off. The person simply accepts the reality of the loss.

Grief And Stress

During grief, it is common to have many conflicting feelings. Sorrow, anger, loneliness, sadness, shame, anxiety, and guilt often accompany serious losses. Having so many strong feelings can be very stressful.

Yet denying the feelings, and failing to work through the five stages of grief, is harder on the body and mind than going through them. When people suggest "looking on the bright side," or other ways of cutting off difficult feelings, the grieving person may feel pressured to hide or deny these emotions. Then it will take longer for healing to take place.

Recovering From Grief

Grieving and its stresses pass more quickly, with good self-care habits. It helps to have a close circle of family or friends. It also helps to eat a balanced diet, drink enough non-alcoholic fluids, get exercise and rest.

Most people are unprepared for grief, since so often, tragedy strikes suddenly, without warning. If good self-care habits are always practiced, it helps the person to deal with the pain and shock of loss until acceptance is reached.

关于作者：

Elisabeth Kübler-Ross, M.D. (July 8, 1926 – August 24, 2004) was a Swiss-born psychiatristand the author of the groundbreaking book On Death and Dying, where she first discussed what is now known as the Kübler-Ross model. She is a 2007 inductee into the National Women's Hall of Fame.