The Five Stages of Grief

Tuesday, Feb 09, 2010

In 1969, the Psychiatrist Elizabeth Kübler-Ross wrote one of the most influential books in the history of psychology, On Death and Dying. It exposed the heartless treatment of terminally-ill patients prevalent at the time. On the positive side, it altered the care and treatment of dying people. On the negative side, it postulated the now-infamous five stages of dying—Denial, Anger, Bargaining, Depression, and Acceptance (DABDA), so annealed in culture that most people can recite them by heart. The stages allegedly represent what a dying person might experience upon learning he or she had a terminal illness. “Might” is the operative word, because Kübler-Ross repeatedly stipulated that a dying person might not go through all five stages, nor would they necessarily go through them in sequence. It would be reasonable to ask: if these conditions are this arbitrary, can they truly be called stages?...

As professional grief recovery specialists, we contend that the theory of the stages of grief has done more harm than good to grieving people. Having co-authored three books on the impact of death, divorce, and other losses, and having worked directly with over 100,000 grieving people during the past 30 years, our reasons for disputing the stages of grief theory are predicated on the horror stories we’ve heard from thousands of grieving people who’ve told us how they’d been harmed by them...

On February 21, 2007, The Journal of the American Medical Association (JAMA) published the results of the Yale Bereavement Study (YBS): An Empirical Examination of the Stage Theory of Grief...

The YBS begins: “The notion that a natural psychological response to loss involves an orderly progression through distinct stages of bereavement has been widely accepted by clinicians and the general public.” It concludes: “Identification of the normal stages of grief following a death from natural causes enhances understanding of how the average person cognitively and emotionally processes the loss of a family member.” We are troubled by the assumption that stages of grief are normal and distinct and progress in a specific order. We also wonder, when does “wide acceptance” equal scientific fact?

Contrast the alleged wide acceptance of an “orderly progression of stages” with this from the inside cover of Meaning Reconstruction & the Experience of Loss, edited by Robert A. Neimeyer: “Debunking the notion that an invariant sequence of stages of grief occurs among all who experience the death of a loved one, this groundbreaking volume clearly demonstrates that highly individual processes of meaning making are at the heart of grief dynamics.” Published by the American Psychological Association in 2001, Neimeyer’s book presents 26 academicians’ and clinicians’ non-stage methods for helping grieving people...

As much effort as we’ve put in to refuting the stages, Kübler-Ross herself rebuts them better than we can in the opening paragraph of On Grief and Grieving: “The stages have evolved since their introduction, and they have been very misunderstood over the past three decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grief is as individual as our lives. Not everyone goes through all of them or goes in a prescribed order.”

If there are no typical responses to loss and no typical losses, and not everyone goes through them or in order, how can there possibly be stages that universally represent people’s reactions to loss? The fact is, no study has ever established that stages of grief actually exist, and what are defined as such can’t be called stages. Grief is the normal and natural emotional response to loss. Stage theories put grieving people in conflict with their emotional reactions to losses that affect them. No matter how much people want to create simple, iron clad guidelines for the human emotions of grief, there are no stages of grief that fit every person or relationship.

The Myth of the Stages of Dying, Death and Grief, Russell Friedman & John W. James, Skeptic Magazine, 2008, http://www.grief.net/Articles/Myth%20of%20Stages.pdf.