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Time to bury the 'five stages of grief' myth

Grieving family
REUTERS/Jonathan Ernst
Research shows that “we all grieve in our own way.”

The idea that we go through five stage of grief — denial, anger, bargaining, depression and acceptance — when we experience a major loss, particularly the death of someone we loved, has become deeply embedded in our culture.

A quick Google search turns up many current articles on death and grieving that refer to the stages. The pervasiveness (and usefulness to reporters) of this meme can also be seen, amusingly, in other types of articles, such as “The Five Stages of Conservative Grief,” “The Media’s Five Stages of David Petraeus Grief” and “NHL Fans Going Through Five Stages of Grieving.

There’s just one big problem: the five-stages-of-grief theory is not based on any kind of scientific evidence. In fact, it’s been completely debunked.

Instead, as Vaughan Bell, a psychologist at King's College London, notes in a recent article in the British newspaper the Observer, research shows that “we all grieve in our own way.”

“[C]ontrary to our long-help assumptions, there are no rules to grief, no stages except our personal journeys and no task except those we set ourselves,” he adds. “Normality is not what we return to; it is what we go through.”

Bell also emphasizes that our culture’s continued mistaken belief in the infallibility of the five stages — or other “universal” theories of grief — only adds to the emotional pain of individuals who are mourning a major loss.

Here’s an excerpt from his article (warning: British spellings and punctuation):

[P]sychologists have a sad tradition of seeing loss through their own cultural blinders and inventing supposedly "universal" theories. Even more regrettably, many have been at the forefront of encouraging people to think of their grief as having to conform to certain stages, feelings or phases to be considered "normal". Mourning has been framed as a problem, pain as something to be cured.

The idea that grief has specific stages is a popular belief and was given its most professional gloss by the Swiss psychiatrist Elisabeth Kübler-Ross, who is often cited as suggesting that mourners pass through stages of denial, anger, bargaining, depression, and acceptance. Not being able to "work through" a stage was considered a sign of psychological difficulty and therapists were encouraged to help people pass through each of the "phases". The fact that Kübler-Ross was talking about adjusting to your own impending death, not to the death of someone else, didn't seem to dull anyone's enthusiasm and her theories became wildly over-applied. But regardless of how accurately her ideas were used, the evidence for these stages evaporates under scrutiny — perhaps unsurprising considering they were based on little more than casual observation and creative thinking.

In contrast, psychologist George Bonanno has studied the course of grief by following people from before they were bereaved to months and even years afterwards. It turns out that there is little evidence for a progression through specific stages of adjustment, and even the belief that most people are plunged into despair and gradually "get better" turns out to be little more than cliché. This is not to say that sadness isn't a common response to loss, but an experience of deep debilitating anguish tends to be the exception rather than the rule. In fact, two-thirds of people are resilient in the face of losing a loved one — in other words, they are sorrowful but they are neither depressed nor disabled by their experience.

It is worth noting, however, that about 10% of people do suffer what is sometimes called "complicated" or "prolonged" grief, where the feelings of loss are intense, long-lasting and cause significant impairment, potentially needing help from mental health professionals. But in terms of the traditional concept of grief, most people experience their loss differently, something both important and liberating, in a sombre sort of way. We are left to wonder how many people have been stigmatised as being "in denial" because they are not experiencing what stereotype expects, or worse, have had their affection for their loved-one questioned due to their normal and non-catastrophic reactions.

You can read Bell’s article on the Observer's website. You can also follow his observations on the field of psychology through his always-interesting blog, MindHacks.

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Comments (2)

What about the original theory?

You state that Kubler-Ross originally theorized the five steps ONLY for a diagnosis of one's own impending death. Not grief for the loss of a loved one, which is the application that your article debunks. Are we to understand that the five stages of grief in addressing one's own imminent death still valid, or have they, too, been debunked by careful research (please cite that research, if so)?

I'd be surprised if they have been. I've seen those stages too often in real life, although maybe you would call that "casual observation" as you do with Kubler-Ross.

Do therapists really "push" these stages?

Having lost both of my brothers while in my twenties (many years ago), I saw several therapists for grief for a number of years. I don't recall any of them pushing this theory on me. (In fact, I didn't really get angry until about 15 years after the loss of my younger brother, and when I did, it was just a thought that occurred while doing housework.) They acknowledged that there are stages of grieving, but the overall message was always that "everyone grieves differently". My father died rather suddenly just days after this article was published and again the message I'm getting is that everyone is different when it comes to grief. I feel that the stages Kubler-Ross described do indeed exist, but the idea that they overlap and fluctuate seems to be more common (in my experience) than the rigid interpretation described above.

I find it ironic that a psychological theory is being called "unscientific". Don't many scientists consider psychology to be pseudo-science anyway? What would psychiatrists, who have more medical background than psychologists, say about the physical and emotional effects of grief? And is the opinion of one British psychologist really the basis for the "de-bunking"?

I think more substantial information would be helpful and provide more insight than what's written above. This article seems to be nothing more than a headline and a short blurb rehashing Mr. Bell's previously published article. Just a few thoughts from someone who's been there and disagrees with this "news-flash".