Thursday's Therapy - Ways We Grieve, Part Three: 5 Stages of Grief + Debunking the 5 Stages of Grief

Thursday's Therapy

Ways We Grieve

Part Three

5 Stages of Grief

+

Debunking Stages of Grief

The following are two articles, Article One describing Kubler-Ross' 5 stages of grief and Article Two describing debunking the stages of grief:

Article One:

Stage of Grief Models: Kubler-Ross

Mark Dombeck, Ph.D. Updated: Dec 15th 2006

Kubler-Ross's Stages

Probably the most famous formulation of the stages of grief was developed by Dr. Elizabeth Kubler-Ross in her book "On Death and Dying."

Dr. Kubler-Ross actually wrote about the stages that dying people tend to go through as they come to terms with the realization that they will soon be dead. However, her stages have since been borrowed by the larger grief community as a means of describing the grief process more generally.

Coming to terms with dying is certainly a loss experience and an occasion for grief, so there is merit to this borrowing and reason to become familiar with Dr. Kubler-Ross' stages.

Again, not everyone will experience all of these stages, or, if all are experienced, they won't necessarily occur in this particular order.

• Kubler-Ross' first stage is Denial. In this stage, grieving people are unable or unwilling to accept that the loss has taken (or will shortly take) place. It can feel as though they are experiencing a bad dream, that the loss is unreal, and they are waiting to "wake up" as though from a dream, expecting that things will be normal.

• After people have passed through denial and accepted that the loss has occurred (or will shortly occur), they may begin to feel Anger at the loss and the unfairness of it. They may become angry at the person who has been lost (or is dying). Feelings of abandonment may also occur.

• Next comes Bargaining. In this stage, people beg their "higher power" to undo the loss, saying things along the lines of, "I'll change if you bring her (or him) back to me". This phase usually involves promises of better behavior or significant life change which will be made in exchange for the reversal of the loss.

• Once it becomes clear that Anger and Bargaining are not going to reverse the loss, people may then sink into a Depression stage where they confront the inevitability and reality of the loss and their own helplessness to change it. During this period, grieving people may may cry, experience sleep or eating habit changes, or withdraw from other relationships and activities while they process the loss they have sustained. People may also blame themselves for having caused or in some way contributed to their loss, whether or not this is justified.

• Finally (if all goes according to Dr. Kubler-Ross's plan), people enter a stage of Acceptance where they have processed their initial grief emotions, are able to accept that the loss has occurred and cannot be undone, and are once again able to plan for their futures and re-engage in daily life.

******

From November 2008 Scientific American Magazine

Article Two:

Five Fallacies of Grief: Debunking Psychological Stages

From the stages of grief to the stages of moral development, stage theories have little evidentiary support

by Michael Shermer

Denial, anger, bargaining, depression, acceptance.

So annealed into pop culture are the five stages of grief—introduced in the 1960s by Swiss-born psychiatrist Elisabeth Kübler-Ross based on her studies of the emotional state of dying patients—that they are regularly referenced without explication.

There appears to be no evidence, however, that most people most of the time go through most of the stages in this or any other order.

According to Russell P. Friedman, executive director of the Grief Recovery Institute in Sherman Oaks, Calif. (www.grief-recovery.com), and co-author, with John W. James, of The Grief Recovery Handbook (HarperCollins, 1998),

“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.... No matter how much people want to create simple, bullet-point guidelines for the human emotions of grief, there are no stages of grief that fit any two people or relationships.”

Friedman’s assessment comes from daily encounters with people experiencing grief in his practice. University of Memphis psychologist Robert A. Neimeyer confirms this analysis. He concluded in his scholarly book Meaning Reconstruction and the Experience of Loss (American Psychological Association, 2001):

“At the most obvious level, scientific studies have failed to support any discernible sequence of emotional phases of adaptation to loss or to identify any clear end point to grieving that would designate a state of ‘recovery.’”

Nevertheless, the urge to compress the complexities of life into neat and tidy stages is irresistible. Psychoanalyst Sigmund Freud insisted that we moved through five stages of psychosexual development: oral, anal, phallic, latency and genital. Developmental psychologist Erik H. Erikson countered with eight stages: trust vs. mistrust (infant); autonomy vs. doubt (toddler); initiative vs. guilt (preschooler); industry vs. inferiority (school-age period); identity vs. role confusion (adolescent); intimacy vs. isolation (young adult); generativity vs. stagnation (middle age); and integrity vs. despair (older adult). Harvard University psychologist Lawrence Kohlberg postulated that our moral development progresses through six stages: parental punishment, selfish hedonism, peer pressure, law and order, social contract and principled conscience.

Why stages? We are pattern-seeking, storytelling primates trying to make sense of an often chaotic and unpredictable world. A stage theory works in a manner similar to a species-classification heuristic or an evolutionary-sequence schema. Stages also fit well into a chronological sequence where stories have set narrative patterns.

Stage theories “impose order on chaos, offer predictability over uncertainty, and optimism over despair,”

explained social psychologist Carol Tavris, author of The Mismeasure of Woman (Touchstone, 1993) and co-author, with Elliot Aronson, of Mistakes Were Made (But Not by Me) (Harcourt, 2007), in an interview with me. “One appeal of stage theories is that they tell a story—they give us a narrative to live by (‘you feel this now, but soon ...’). In cognitive psychology and also in ‘narrative psychotherapy,’ there has been a lot of work on the importance of storytelling. Some therapists now make this idea explicit, helping clients change a negative, self-defeating narrative (‘look at all I suffered’) into a positive one (‘I not only survived but triumphed’).”

What’s wrong with stages?

First, Tavris noted, “in developmental psychology, the notion of predictable life stages is toast."

"Those stage theories reflected a time when most people marched through life predictably: marrying at an early age; then having children when young; then work, work, work; then maybe a midlife crisis; then retirement; then death. Those ‘passages’ theories evaporated with changing social and economic conditions that blew the predictability of our lives to hell.”

Second, Tavris continued, “is the guilt and pressure the theories impose on people who are not feeling what they think they should. This is why consumers of any kind of psychotherapy or posttraumatic intervention that promulgates the notion of ‘inevitable’ stages should be skeptical and cautious.”

Stages are stories that may be true for the storyteller, but that does not make them valid for the narrative known as science.

Note: This story was originally printed with the title, "Stage Fright".

Five Stages article: http://bit.ly/7ki9ZZ

Debunking Stages article: http://www.scientificamerican.com/article.cfm?id=five-fallacies-of-grief