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Elisabeth Kübler-Ross

Elisabeth Kübler-Ross

Swiss-born American psychiatrist Elisabeth Kübler-Ross (born 1926) has pioneered the idea of providing psychological counseling to the dying. In her bestselling 1969 book, On Death and Dying, she describes the five mental stages that are experienced by those approaching death and suggests that death should be viewed as one of the normal stages of life.

Psychiatrist Elisabeth Kübler-Ross has dedicated her career to a topic that had previously been avoided by many physicians and mental-health care professionals—the psychological state of the dying. In her counseling of and research on dying patients, Kübler-Ross determined that individuals go through five distinct mental stages when confronted with death, a discovery that has helped other counselors to provide more appropriate advice and treatment to their clients. Her ideas have been presented to the public in a number of popular texts, including her groundbreaking 1969 work, On Death and Dying. She has also offered instruction and treatment at the seminars and healing centers she has run for the terminally ill and their caretakers.

Kübler-Ross had a unique childhood as one of three triplet girls born in Zurich, Switzerland, on July 8, 1926. Although the girls were all extremely small at birth, their mother, Emmy Villiger Kübler, closely attended to their physical needs and ensured their survival. Kübler-Ross, her sisters, and older brother grew up in a strict but loving household. Their father, Ernst Kübler, expected obedience from his children, but he also took them on hikes in the Swiss mountains, instilling a great love of nature in his daughter Elisabeth. One of Kübler-Ross's main concerns as she grew up was finding a way to distinguish herself from her sisters. This search for a unique identity was hampered by the fact that she was physically identical to her sister Erika, and the two were often mistaken for each other. She would frequently escape to a favorite spot in the woods to enjoy some time away from her sisters, and she also tried to develop interests that would set her apart. Seeking something completely different from her own experience, she began to study African history and one of her prize possessions was an African doll that her father gave her after she had been dangerously ill with pneumonia.

Developed Early Ideas on Death

In addition to her own brushes with death as a child, Kübler-Ross witnessed the death of others around her in a series of experiences that shaped her attitudes about mortality. When she was in the hospital at the age of five, her roommate passed away in a peaceful state. She also knew of a young girl whose death from an excruciating bout of meningitis was viewed as a release from suffering. In another childhood episode, she witnessed a neighbor calmly reassuring his family as he prepared for death from a broken neck. Such events led Kübler-Ross to the belief that death is just one of many stages of life, an experience that the dying and those around them should be prepared to encounter with peace and dignity.

Kübler-Ross excelled in science as a student and was determined to fill her life with meaningful work, but her parents were not very supportive of her goal of an advanced education. Although their son was expected to prepare himself for a business career, the triplets were sent to local schools to receive only the basic education that their parents thought was necessary for futures as wives and mothers. When Kübler-Ross was 13, World War II began with the invasion of Poland by German forces. These events provided her with a way to contribute to the well-being of others; she vowed to find some way to help the Polish people, and throughout her adolescence, she participated in numerous activities assisting victims of the war. She first worked as a laboratory assistant in a hospital that treated war refugees, and in 1945, she became a member of the International Volunteers for Peace organization. Her volunteer work took her to Sweden and the French-Swiss border, and finally, in 1948, to Poland. There she helped Polish people to rebuild their cities and lives after the war by serving in a variety of jobs, including cook, nurse, and carpenter.

Planned Career in Psychiatry

These experiences after the war convinced Kübler-Ross that her life's calling was to heal others. She firmly believed that spiritual and mental health was a necessary part of healing the physical body and incorporated these interests in her planned career as a psychiatrist. She enrolled in medical school at the University of Zurich in 1951 and graduated in 1957. For a short period after leaving school, she worked as a doctor in the Swiss countryside. In February of 1958, however, she married an American doctor she had met in medical school, Emanuel Robert Ross, and moved with him to New York. The couple would be married for 11 years. In New York both of them were accepted as medical interns at Community Hospital of Glen Cove, Long Island. After completing her internship, Kübler-Ross began a three-year residency in psychiatry at Manhattan State Hospital; during this time she also trained for a year at Montefiore Hospital in the Bronx. In her work at psychiatric hospitals, she was disturbed by the failure of staff members to treat the patients with sympathy and understanding. She attempted to use a more personal means of communicating in which she showed an obvious interest in the welfare of the patient, and her approach yielded improvements even in the cases of people suffering from acute psychoses.

In 1962, after the birth of their first child, Kenneth, Kübler-Ross and her husband decided to leave New York City; they obtained jobs at the University of Colorado School of Medicine in Denver. The next year, Kübler-Ross began teaching at Colorado General Hospital. While in Colorado, another child, Barbara, was born to the family. In 1965, they moved again, traveling to Chicago, where Kübler-Ross became an assistant professor of psychiatry as well as assistant director of psychiatric consultation and liaison services for the University of Chicago. In the coming years, she increasingly turned her focus to the subject of psychological treatment for terminally ill persons suffering anxiety. She found that many doctors and mental health professionals preferred to avoid the topic, leaving patients with few resources to help them through the difficult process of facing death. Her interests were viewed with disapproval by medical school officials, who did not want to draw negative attention for focusing on death rather than recovery of patients. But Kübler-Ross went on with her work, organizing seminars to discuss the topic with a wide range of caregivers, including doctors, nurses, priests, and ministers. The seminars drew large numbers of interested people, demonstrating the need for information and ideas on counseling the dying. In these sessions, participants sat behind a one-way mirror and viewed Kübler-Ross interviewing terminal patients, discussing their fears and concerns.

Published Landmark Book on Dying

School administrators finally forced the psychiatrist to end her popular seminars. She continued her personal research, however, gradually discovering that all dying patients went through similar crises and discoveries. She organized her findings into five distinct stages of dying, which she identified as denial, anger, bargaining, depression, and acceptance. Her theory on the stages of dying and suggestions for how to use this information to treat patients were compiled in the 1969 book On Death and Dying. The book became a best-seller and was soon established as a standard text for all professionals who worked with dying patients and their families. Kübler-Ross's growing acclaim as an expert on the psychology of dying received an even greater boost when she was featured in a Life magazine article that described her frank discussions of death with terminally ill subjects. Overwhelmed by the tremendous public response to the article, Kübler-Ross decided to devote her career to helping dying patients and their loved ones.

While treating individuals on a case-by-case basis, Kübler-Ross also continued to put out more books. In 1974 she published Questions and Answers on Death and Dying, which was followed by two other books in that decade, Death: The Final Stage of Growth (1975) and To Live until We Say Good-bye (1978). During this time, she sought a way to reach more people with her counseling; the result was her creation of the Shanti Nilaya ("Home of Peace") healing center outside of Escondido, California, in 1977. In the 1980s, she began to focus on special themes within the topic of death, reflected in her books On Children and Death (1983) and AIDS: The Ultimate Challenge (1987). The early 1990s brought an apparent shift in her own philosophy of death. In the book On Life after Death she revises her earlier understanding of death as the final stage of life, stating that death is in fact a transition to a new kind of life.

Honored for Pioneering Work

In 1990, Kübler-Ross moved her healing center to her farm in Headwater, Virginia. After her house there burned down in 1994, she decided to hand over the operation of the center to an executive director, and she moved to Arizona to live near her son. She continues her work through ongoing workshops and lectures. Her groundbreaking career in the guidance of dying patients has been recognized with a number of awards, including receiving recognition as "Woman of the Decade" by Ladies' Home Journal in 1979 and honorary degrees from schools such as Smith College, the University of Notre Dame, Hamline University, and Amherst College. Such honors testify to the importance of Kübler-Ross's revolutionary approach of providing psychological support and comfort to the dying, an idea that has benefitted both doctors and patients.

Further Reading

Gill, Derek, "The Life of Elisabeth Kübler-Ross," Quest, Harper &Row, 1980.

Goleman, Daniel, "We Are Breaking the Silence about Death,"Psychology Today, September 1976, pp. 44-47.

Kübler-Ross, Elisabeth, On Death and Dying, Macmillan, 1969.

Wainwright, Loudon, "Profound Lesson for the Living," Life, November 21, 1969, pp. 36-43. □

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Kübler-Ross, Elisabeth

KÜbler-Ross, Elisabeth

Elisabeth Kübler was born on July 8, 1926, the first of three daughters born that day to a middle class family in Zurich, Switzerland. In her autobiography The Wheel of Life: A Memoir of Living and Dying (1997), Kübler-Ross commented: "For me, being a triplet was a nightmare. I would not wish it on my worst enemy. I had no identity apart from my sisters. . . . It was a heavy psychological weight to carry around." However, as an adult she concluded that the circumstances of her birth "were what gave me the grit, determination and stamina for all the work that lay ahead" and throughout her autobiography she describes herself as independent, unconventional, opinionated, and stubborn (Kübler-Ross 1997, p. 25).

"The first big decision I made solely by myself" involved defying her strong-willed father (who planned a secretarial career for her) in favor of her dream to become a doctor (p. 21). At school, Kübler-Ross was an excellent student, especially in math and languages, but not in religious studies. As her church, she preferred nature, pets, and animals of all kinds. One key childhood experience was a hospitalization in which an impersonal and uncaring environment isolated and separated her from her family. She often describes later encounters with conventional medical care in a similar way.

In the spring of 1942, the triplets completed their public schooling. Unwilling to become a secretary, Kübler-Ross took jobs as a maid and laboratory assistant. At the end of World War II, she volunteered to work in several areas of war-torn Europe. In Poland, necessity compelled her to practice rudimentary medicine and she was deeply moved by the concentration camp at Maidanek where more than 300,000 people had died.

Back in Switzerland, Kübler-Ross resumed working as a lab assistant and studying for the medical school entrance examination, which she passed in September 1951 with the intention of becoming a country doctor. In 1957 she passed her medical board examinations and became a physician. In February 1958 she married a fellow medical student from America, Emanuel ("Manny") Ross, and the couple moved to the United States. Becoming pregnant disqualified Kübler-Ross from a residency in pediatrics so she settled for one in psychiatry. There were problems of adapting to a new culture and eventually four miscarriages; as she later wrote, "You may not get what you want, but God always gives you what you need" (p. 111). A son, Kenneth, and a daughter, Barbara, were born in the early 1960s.

A new position brought Kübler-Ross to Billings Hospital of the University of Chicago. There, in 1965, four students from Chicago's Theological Seminary approached her to seek assistance in understanding death as the ultimate crisis in life. She offered to help and search out dying patients for interviews. Many physicians at the hospital were critical of Kübler-Ross for what they viewed as "exploiting" vulnerable patients, and the story of her difficulties in locating suitable interviewees is well known. Nevertheless, by early 1967 Kübler-Ross was leading an unorthodox but popular weekly seminar in which she would interview a patient behind one-way glass with a subsequent discussion with students and medical professionals after the patient had left.

An offer of a book contract from a publisher led to the international best-seller On Death and Dying (1969). This book developed Kübler-Ross's now well-known theory of five stages in dying: denial, anger, bargaining, depression, and acceptance. As a result of this book, together in an interview with a twenty-one-year-old patient published in Life magazine on November 21, 1969, Kübler-Ross received numerous requests for interviews and lectures. Still, her hospital was not pleased with her success and she transferred to LaRabida Children's Hospital to work with ill and dying children. Finally, at the age of forty-six, she quit that post to do research on what death is like and to conduct weeklong workshops on life, death, and the transition to afterlife.

Kübler-Ross's research had convinced her that there was an afterlife. She was intrigued by stories of near-death experiences and experienced her first apparition about this time. As a result, she concluded that death does not exist in its traditional definition; rather it occurs in four distinct phases: (1) floating out of one's body like a butterfly leaving its cocoon, assuming an ethereal shape, experiencing a wholeness, and knowing what is going on around oneself; (2) taking on a state of spirit and energy, not being alone, and meeting a guardian angel or guide; (3) entering a tunnel or transitional gate and feeling a light radiating intense warmth, energy, spirit, and overwhelming love; and (4) being in the presence of the Highest Source and undergoing a life review.

At about this time, Kübler-Ross became convinced of the reality of her own spiritual guides and she eventually moved to California in early 1976 to pursue these inquiries. There, she founded a healing center (eventually called Shanti Nilaya, a Sanskrit phrase that she understood to mean "the final home of peace") where she could have a base for her workshops, explore out-of-body experiences, and develop a new lecture entitled "Death and Life after Death." Unfortunately, Kübler-Ross eventually lost confidence in some of her California colleagues and the center's property was sold.

In July 1983 Kübler-Ross purchased and later moved to a 300-acre farm in Head Waters, Virginia. There she built her house and a healing center for workshops. Around this time, the situation of persons with AIDS (acquired immunodeficiency syndrome) attracted her attention. However, when in 1985 she announced her intention to adopt AIDS-infected babies, she became, in her words, "the most despised person in the whole Shenandoah Valley" and could not get the necessary zoning approvals to carry out that plan. On October 6, 1994, her house was set on fire and burned to the ground with the complete loss of all her papers and possessions.

In the meantime, she experienced heart fibrillations and an eventual stroke. Again, Kübler-Ross had a low opinion of the medical treatment she received. She refused to give up smoking, coffee, and chocolate, and checked herself out of the hospital. After moving to Scottsdale, Arizona, Kübler-Ross experienced a massive stroke on May 14, 1995, that left her paralyzed on her left side and no longer able to live alone. While writing in January 1997, Kübler-Ross said she was enduring a "miserable" life resulting from pain and the limitations of her paralysis. Although she was "anxious to graduate" she remained opposed to efforts to foreshorten life (p. 280). Instead, she asserted that "our only purpose in life is growth" and that her task in these circumstances was to learn patience even as she was totally dependent on others for care (p. 281).

On Death and Dying and other books by Kübler-Ross have earned her a worldwide reputation. In addition, large numbers of people have been attracted to her many lectures, presentations, and workshops. Many have credited her with helping to draw attention to problems encountered by dying persons and to their needs as living human beings, thus tending to normalize and humanize such experiences. In all of this, she was an early and important contributor to the death awareness movement. The stage theory of dying that she proposed is simple and easy to learn. Its author and many others have since applied this theory to a wide variety of losses, even while some professionals have criticized its limitations. Her views about the afterlife, spiritual guides, out-of-body experiences, and near-death experiences have been consoling to some, but sharply criticized by others from both scientific and theological perspectives.

See also: Dying, Process of; Near-Death Experiences; Stage Theory


Gill, Derek. Quest: The Life of Elisabeth Kübler-Ross. New York: Harper and Row, 1980.

Kübler-Ross, Elisabeth. The Wheel of Life: A Memoir of Living and Dying. New York: Charles Scribner's Sons, 1997.

Kübler-Ross, Elisabeth. On Life after Death. Berkeley, CA: Celestial Arts, 1991.

Kübler-Ross, Elisabeth. AIDS: The Ultimate Challenge. New York: Macmillan, 1987.

Kübler-Ross, Elisabeth. On Children and Death. New York: Macmillan, 1983.

Kübler-Ross, Elisabeth. Living with Death and Dying. New York: Macmillan, 1981.

Kübler-Ross, Elisabeth. Death: The Final Stage of Growth. Englewood Cliffs, NJ: Prentice-Hall, 1975.

Kübler-Ross, Elisabeth. Questions and Answers on Death and Dying. New York: Macmillan, 1974.

Kübler-Ross, Elisabeth. On Death and Dying. New York: Macmillan, 1969.


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Kübler-Ross, Elisabeth (1926-)

Kübler-Ross, Elisabeth (1926-)

Contemporary physician who has become a world authority on the subject of death and after-death states. Born in Switzerland on July 8, 1926, she worked as a country doctor before moving to the United States. During World War II she spent weekends at the Kantonspital (Cantonai Hospital) in Zürich, where she volunteered to assist escaped refugees. After the war she visited Majdanek concentration camp, where the horrors of the death chambers stimulated in her a desire to help people facing death and to understand the human impulses of love and destruction. She extended her medical background by becoming a practicing psychiatrist. Her formal work with dying patients began in 1965 when she was a faculty member at the University of Chicago. She also conducted research on basic questions concerning life after death at the Manhattan State Hospital, New York. Her studies of death and dying have involved accounts by patients who reported out-of-the-body travel. Her research tends to show that while dying can be painful, death itself is a peaceful condition. Her 1969 text, On Death and Dying, was hailed by her colleagues and also became a popular best-seller.

In 1978 Kübler-Ross helped to found Shanti Nilaya (Final Home of Peace), a healing and growth center in Escondido, California. This was an extension of her well-known "Life-Death and Transition" workshops conducted in various parts of the United States and Canada, involving physicians, nurses, social workers, laypeople, and terminally ill patients. Much of Kübler-Ross's later research was directed toward proving the existence of life after death. Her publication To Live Until We Say Good-bye (1979) was both praised as a "celebration of life" and criticized as "prettifying" the real situation. She has also dealt with issues such as AIDS and "near death" experiences. In the mid-1980s Shanti Nilaya moved from San Diego County, California, to Head Waters, Virginia, where it continues to offer courses and short-and long-term therapeutic sessions.


Berger, Arthur S., and Joyce Berger. The Encyclopedia of Parapsychology and Psychical Research. New York: Paragon House, 1991.

Gill, Derek L. T. Quest: The Life of Elisabeth Kübler-Ross. New York: Harper & Row, 1980.

Kübler-Ross, Elisabeth. AIDS: The Ultimate Challenge. New York: Macmillan, 1987.

. Coping With Death and Dying. Edited by John T. Chirban. Lanham, Md.: University Press of America, 1985.

. Living with Death and Dying. New York: Macmillan, 1981.

. On Death and Dying. New York: Macmillan, 1969.

. Questions and Answers on Death and Dying. New York: Macmillan, 1974.

. To Live Until We Say Good-Bye. Englewood Cliffs, N.J.: Prentice-Hall, 1978.

, ed. Death: The Final Stage of Growth. Englewood Cliffs, N.J.: Prentice-Hall, 1975.

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Kübler-Ross, Elisabeth

Elisabeth Kübler-Ross (kōō´blər-rôs´), 1926–2004, American psychiatrist, b. Switzerland. After studying medicine at the Univ. of Zürich (M.D. 1957), Kübler-Ross became a pioneer in the field of thanatology, the study of death and dying. Her influential On Death and Dying (1969) mapped out a five-stage framework to explain the experience of dying patients, which progressed through denial, anger, "bargaining for time," depression, and acceptance. Kübler-Ross was the author of a number of other books on the subject, and her work has had lasting significance among the medical community, who have generally become more responsive to the needs of dying patients and their families. She was also a powerful force behind the movement for creating a hospice care system.

See her memoir, Wheel of Life (1997).

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