Moving From the 5 Stages of Grief to the 5 Stages of Action

Change, even for the better, involves loss, and we grieve our losses. Almost fifty years ago, psychiatrist Elisabeth Kübler-Ross proposed a model of five stages of grief in response to the death of a loved one: Denial, Anger, Bargaining, Depression and Acceptance. Her model found wide public acceptance and since has been generalized and applied to other forms of loss.

Although it’s not 100% supported by research, or universally agreed upon by the scientific community, I think the Kübler-Ross model received public acceptance because the average person can see the basic truth in it. Which of us hasn’t had those feelings in response to some loss in our lives? And doesn’t their general order also ring true? It does for me.

Major necessary personal and organizational changes also seem to involve loss and grieving. In healthcare, many organizations are moving away from older, successful business models into an uncertain but hopefully better future. As individuals, many of us are trying to leave behind old lifestyles and adopt new habits, habits that will allow us to enjoy robust good health.

In my view as a healthcare insider, most often, both the organizations and individuals start in denial and do move through at least some of the five stages of grief related to their respective losses. In the case of a business this might be loss of income, culture, authority, autonomy, or market share. For individuals it might be loss of pleasurable activities or friends. In both cases, human egos will take a hit as people admit that they have been in denial, which is very hard on the self-image.

Feelings aside, change involves action. So, how do we move from grief to action? I’ve been thinking a lot about that lately. Observing organizations and individuals in change processes, I propose that there are five stages of action which may be taken based on the circumstances and emotional state of the individuals/organizations facing the need for change. These five stages are:

  1. None
  2. Forced
  3. Reluctant
  4. Willing
  5. Enthusiastic

I’ll explain my thoughts on each in turn.

None – Very simple, no action. The individual or organization chooses to do nothing. Think: avoidance, stonewalling, and procrastination.

Forced – Actions as required by circumstances. This is action taken under compulsion. Examples could include an example an employee facing termination under a corrective action plan, or a drug addict going to rehab to avoid jail time. Think: resentment, passive aggressiveness, and a “bad attitude.”

Reluctant – Action by the intellectually willing but not emotionally willing. Change because, “I have to change. I see the need. I’ll do it but I don’t like it.” May ultimately be ineffective, or less than fully effective or necessary action. Think: basic compliance programs, half-hearted, self-defeating or self-sabotaging behaviors, and low volume complaining.

Willing – Action with good feelings. Emotional assent along with intellectual assent. Change because, “I want to change.” Effective action. Think: solid action plans, full compliance, and clear views of the path ahead.

Enthusiastic – Inspired, aggressive action. Change because, “I am excited to build the future.” Beyond effectiveness, this is action for greatness. Think: inspiring vision, meaningful mission, transcendent purpose.

Here’s how I see the five stages of grief relating to the five stages of action

You can’t get far down on the right side without progressing to the bottom of the left side.  Assuming that we’d all like to get to effective action in our personal or organizational change efforts, we need to manage our emotions and arrive at true acceptance of the need for and desirability of change. That will at least get us to “Willing.” If we can then connect the change to our larger mission and purpose in life, and create a compelling vision for ourselves/our organizations, we are set for greatness.

And who doesn’t want to be great?