Life Lessons

Christian Century, May 23, 2001 by Lucy Bregman

Life Lessons. By Elisabeth Kubler-Ross and David Kessler. Scribner, 224 pp., $24.00.

FOR THOSE OF US who associate Elisabeth Kubler-Ross with the death awareness movement she initiated 30 years ago, her subsequent work and writings are a puzzle and a disappointment. Why did she abandon the communal world of research and clinical work to assume the isolated position of a death-and-dying guru? This move was accompanied by a spiritual perspective that many consider eccentric at best and profoundly misguided and denial-oriented at worst. The aspect of her work that has remained alive for people is her description of the "five stages of dying," a model for coming to terms with loss which seems applicable to just about any kind of loss.

Today professionals such as those in the Association for Death Education and Counseling (ADEC) deny that anyone dies or grieves "in five stages," and ignore Kubler-Ross's later work on such topics as near-death experiences. Her latest book will be no exception; it is easy to categorize as a New Age inspirational potboiler, uncritically filled with rhetoric from the 1970s human potential movement.

Are the professionals correct? Is Kubler-Ross ignored because she deserves to be? I recently reread On Death and Dying (1969), the book which brought her fame, and found it remarkably fine. But what makes it fine is not primarily the "five stages" theory, but the many perspectives and voices Kubler-Ross presents. The Freudian beginning insists that our unconscious minds find our own deaths "inconceivable," although the point of the book is to show that true acceptance of death is indeed possible, even amid the dehumanizing milieu of a large research hospital. Though the patients interviewed for the book are long dead, they speak memorably through these pages. They do not confirm that there are a neat five steps on the way to the acceptance of death. Rather, they stammer and contradict themselves and the interviewer. Their continued vitality as they move closer and closer to death is what makes them real to us.

The book's underlying plot pits Kubler-Ross, the champion of the dying and their families, against powerful doctors. Recognizing fear and denial in herself and others, she works to change hospitals and American society. The book is awash in nostalgia for a lost rural past when death was "a natural part of life." It is also marked by an antiwar ethos that makes the military imagery used by hospitals to describe their combat with death look as warped and misguided as America's involvement in Vietnam.

Perhaps it is a tragedy that the changes Kubler-Ross worked for more than 30 years ago have not occurred. Bill Moyers's recent PBS documentary on the plight of the dying, On Our Own Terms, makes one wonder why so much remains as it was in 1969. Or perhaps the original critique, with its vision of death as psychologically "acceptable," was itself so flawed that it's no surprise things have not moved in the direction that Kubler-Ross and many others had hoped they would.

But On Death and Dying did help to start a movement and a popular language in which the very, phrase "death and dying" became a catchword. College courses, workshops, sections in bookstores and endless writings by counselors, pastoral caregivers, American Buddhists, freelance inspirational authors and others rely on Kubler-Ross's model of dying as a process of coming to terms with loss. Hospice care and the rise of such professional specialties as "grief counselor" have professionalized this movement, but its breadth and importance are also revealed in the proliferation of autobiographies whose major plots concern life-threatening illness, dying and bereavement.

Kubler-Ross has framed for us what the experience of dying is about and how to respond to it. Categories such as "denial," "anger," "depression" and "acceptance" are the dominant organizers of such contemporary inspirational literature as books of meditations for those facing death. Add "forgiveness" and "surrender," which were not in the original 1969 book but are included in Life Lessons, and we have a kind of basic core of topics constituting a "spirituality" of the death awareness movement. The ADEC professionals, now focused on cultural construction, narrative and a relational vision of identity, may slowly have moved away from this original framework, but many still are rooted in it.

Life Lessons both assumes and proclaims some specific beliefs about self, society and ultimate reality. According to Kubler-Ross, there is a "core self," a real and eternal "you," who is not identified with actions, social roles or history. Happiness is its natural state. This self is good and pure but always learning; its experience is to be seen as "lessons." Because it learns from its mistakes, "guilt feelings" about the past are burdensome and unnecessary. Kubler-Ross believes that "the world is set up to work; it is coded in a way that brings us to our lessons. ... There is a reason for every experience, even if we don't see it."