We don’t all process grief in the same way 

Many doctors, care workers, counsellors, social workers, therapists, teachers, nurses—and indeed men and women who have nothing directly do to with these areas of work—have been taught to think in terms of a model of grief and loss whereby an individual passes through specific 'stages' of emotions on their way to full recovery. Indeed, over the past 30 or 40 years training in grief counselling has tended to promote this same model.

There are said to be five stages – denial comes first; then emotions shift and the predominant feeling becomes anger; then comes bargaining; followed by depression; and then finally acceptance. 

Sometimes, people experiencing grief or loss – through bereavement, or divorce, or some other rupture in a close and important relationship – are said to become ‘stuck’ at one particular stage, and to need therapeutic help to move on. However, not everyone working in this field agrees that the model is accurate...or even safe.

No evidence for ‘stages’

Russell Friedman and John W James, who run the Grief Recovery Institute in California, write in the online journal Skeptic [1] that there has been far too much emphasis on ‘stages’, and that the evidence that stages exist is simply not there.

The idea began with Elisabeth Kübler-Ross, the world-renowned Swiss-born psychiatrist whose pioneering work on the emotions of people with terminal illness influenced the world-wide hospice movement.

Kübler-Ross and colleagues developed the five-stage model of people facing up to their own death, which in any case, say Friedman and James, was simply a result of observations, discussion and intuition, rather than any scientific research. Worse though, it was then taken up by others and applied to grief and loss…without any justification, and without even a good ‘fit’. 

Take the ‘bargaining’ stage of dying – when some sort of ‘deal’ is attempted in exchange for a cure, so the dying person will promise to God or some other force outside himself, that he will make some changes to his behaviour if only he gets a reprieve from death. This has no real equivalence in grief – and the usual replacement of ‘bargaining’ with ‘yearning’ is just not good enough.

Similarly, ‘denial’ – common enough in people who are dying and who take time to accept it – may not really apply in situations of loss. Grieving partners or others may know full well the loved one has died, for example.

Less rigidity

Friedman and James argue for a less rigid, approach to grief and loss counselling. ‘Since every griever is unique, there are no pat answers about grief’, they say. They indicate that Kübler-Ross herself expressed concerns about the way her work had been misinterpreted, in her work On Grief and Grieving [2]. ‘The stages have evolved since their introduction, and they have been very misunderstood over the past three decades,’ she wrote. ‘They were never meant to help tuck messy emotions into neat packages.’ 

Say Friedman and James, ‘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 [….] there are no stages of grief that fit every person or relationship.’

References

1. The Myth of the Stages of Dying , Death and Grief, by R Friedman, John W. James

2. On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, by Elisabeth Kubler-Ross, David A. Kessler