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Time to bury the ‘five stages of grief’ myth

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

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

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.”

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“[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.