- The "5 Stages of Grief" is a model developed by Elizabeth Kubler-Ross in the 1960s based on interviews with over 200 dying people.
- This model is intended to describe how the dying come to terms with their impending death, vacillating among these stages.
- Others interpreted the model as an orderly progression and then applied it to people who grieve the death of a loved one.
- Applied to the bereaved, this model is a myth that does harm, bringing unnecessary suffering when grievers worry that they aren't conforming.
You know the drill. When we experience a significant loss, we supposedly go through five stages of grief:
- First, denial — This can't be happening.
- Then bargaining — There must be something I can do to fix it.
- Followed by anger — This is so unfair. Why me?
- Then descending into depression — Life sucks.
- Finally, coming into acceptance — It happened, and I'm OK with it.
Wouldn't it be great if grieving were such a simple process that it could be described in stages? It would be so handy to know what to expect as time passes. It would be reassuring to track our progress and a relief to know that, even though we're super depressed about it right now, at least once we got to that stage, we wouldn't have to confront feelings of disbelief, anger, or regret ever again. Wouldn't it be fantastic if we could eventually be "OK with it"?
Alas, grieving is a far more complicated and bewildering process. And decades of research on grief and mourning have debunked this five-stage model, which does more harm than good. What's the harm? Many of us expect to go through neat stages of grief. We tend to turn to it as if it were a recipe or a prescription. We hope to measure our progress through it. And when grief doesn't conform to these stages, we worry that we are doing it "wrong" or that we are failing to adjust.
Even more troubling, when we find ourselves in a grieving process that is far more chaotic and complicated, many of us wonder if we are going crazy. We worry that there is something "defective" about us or our mental health. Many people feel impatient because they think they should be feeling better "by now." After all, isn't it time for "acceptance" to kick in? Adding to the misery, folks attempting to support the bereaved may offer unhelpful stage-based advice. Buying into this myth adds unnecessary pain and suffering for those who mourn. And yet, this myth persists.
To eradicate it, let's start by asking where "the five stages of grief" came from. And how did it become "conventional wisdom?"
The origins of "the five stages of grief"
It all started in the 1960s, when psychiatrist Elisabeth Kubler-Ross, M.D., researched how the dying process affects people. Her classic 1969 book On Death and Dying brought this long-neglected topic out into the light. Until then, it was accepted medical practice for doctors to avoid talking to patients about death and dying, often not even revealing a fatal diagnosis or grim prognosis to patients or their families. As a result, dying patients were typically hospitalized but neglected and alone when they died.
Dr. Kubler-Ross envisioned that dying patients could benefit enormously from support rather than neglect. So she started talking to them about what it was like and what kind of support they wanted. Most notably, she observed that dying people were grieving due to the fact that their lives were coming to an end. And based on her interviews, she created "the five stages of grief" to describe how the dying come to terms with their own approaching death:
- Denial — The doctors are wrong. The tests are in error. I'm going to be fine!
- Anger — This is pissing me off. This is so unfair. God/fate/the doctors let me down!
- Bargaining — Dear powers that be, if you spare my life or let me attempt a new treatment, I will devote myself to x, y, z.
- Depression — I'm so sad thinking of all I'll be missing and those who will miss me.
- Acceptance — It is what it is. This is my fate, my destiny; I'm ready to go whenever the time comes.
She also described vacillation among these emotional states. Unfortunately, others interpreted this model literally as an orderly progression and then applied it to the bereaved — the people who grieve for the loved one who died. Because of its simplicity and a certain degree of common sense, it became accepted as fact. But research shows that grieving is a far more complex, bewildering, and unpredictable experience.
Also, when someone dies, the bereaved don't insist the deceased is alive, nor do they try to strike bargains to reverse death. Furthermore, healing is not a destination, with acceptance being the goal. Instead, grieving and healing are inseparable; even as you grieve, you are also healing. And you needn't "accept" what happened. Instead, you learn to live with it as you reinvest in your life.
Still, the five stages of grief persist, having become a myth that is deeply embedded in society. Even medical and psychotherapy professionals are still taught this model, and then they promote it. In the past few years, I've watched conference speakers and TED talkers refer to the stages of grief. I've found articles outlining the stages of grief, posted on education, health, and wellness websites, perpetuating the myth.
The bereaved are far better served by accurate information on the grieving process so that they can have realistic expectations, compassion, and patience for themselves. Similarly informed, others can support the bereaved far more effectively by listening and accepting whatever a person's mourning experience is, rather than trying to shove their journey of grief and mourning into mythical stages.
Please, pass it on.
Patrick Tyrrell; Seneca Harberger; Caroline Schoo; Waquar Siddiqui. Kubler-Ross Stages of Dying and Subsequent Models of Grief. Continuing Education Activity for NIH National Library of Medicine. Last Update: November 19, 2022.
Mary-Frances O’Connor. The Grieving Brain : The Surprising Science of How We Learn from Love and Loss. New York: Harper Collins, 2022.
Elisabeth Kubler-Ross. On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Families. New York: Scribner Reissue Edition, 2014.