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No Stages of Grief

There never have been stages of grief.

Sez who? Sez us - the folks who've been in the trenches with grieving people for more than 30 years.

In the fall of 2008, Skeptic magazine - Vol. 14, Number 2, 2008 - published The Myth of the Stages of Dying, Death, and Grief - a major article we wrote refuting the alleged stages of grief.

Here's an excerpt from that article:

"During the 1970s, the DABDA model of stages of dying morphed into stages of grief, mostly because of their prominence in college-level sociology and psychology courses. The fact that Kübler-Ross' theory of stages was specific to dying became obscured. Students who eventually became therapists, social workers, or doctors carried what they learned about the stages into their careers. The media also played a role in disseminating the idea that specific, inexorable stages of grief exist. When a tragedy makes the news, newscasters and alleged experts recite the DABDA model of grieving. Medical and mental health professionals and the general public accepted the theory without ever investigating its provenance or validity.

"In fact, Kübler-Ross' stage theory was not the product of scientific research. In the second chapter of On Death and Dying she laments:"How do you do research on dying, when the data is so impossible to get? When you cannot verify your data and cannot set up experiments? We [she and her students] met for a while and decided that the best possible way we could study death and dying was by asking terminally ill patients to be our teachers." She then explains her methods: "I was to do the interview while they [her students] stood around the bed watching and observing. We would then retire to my office and discuss our own reactions and the patient's response. We believed that by doing many interviews like this we would get a feeling for the terminally ill and their needs which in turn we were ready to gratify if possible." The phrase, "we would get a feeling" is especially revealing since Kübler-Ross' feelings were processed through the filter of her life-long unresolved grief and retained anger." [There's much more about her anger in the article.]

Here's a link to the entire article:

The article is long, so get yourself a latte or double espresso, and give it a proper reading. Ultimately, we hope what we wrote will help caregivers avoid the pitfalls associated with Stage theories, which we believe are not helpful for grieving people. Worse, we think they can actually harm grievers.

The response from professionals has been overwhelmingly positive and in agreement with our position. But in the spirit of full disclosure, we must tell you that one person took us to task for daring to debunk a scientific study [The Yale Bereavement Study] with what he perceived to be non-scientific methodology. To which we plead, "happily guilty as charged," for reasons we hope you will find obvious as you read the article.

We have recently been in contact with Holly Prigerson, one of the primary authors of The Yale Bereavement Study. Interestingly enough, she did not dispute our right to contest her findings. In fact, we found many areas of common ground. While we don't agree on everything, we are mutually concerned about the well-being of grieving people and may someday put our forces together to find better ways to help those who are dealing with grief.

Here's another excerpt:

"Dabbling in DABDA: A Stage by Any Other Name Prior to publication of her famous book, Kübler-Ross hypothesized the Five Stages of Receiving Catastrophic News, but in the text she renamed them the Five Stages of Dying or Five Stages of Death. That led to the later, improper shift to stages of grief. Had she stuck with the phrase catastrophic news, perhaps the mythology of stages wouldn't have emerged and grievers wouldn't be encouraged to try to fit their emotions into non-existent stages.

"Adding irony to the stages debacle, Kübler-Ross' final book, On Grief and Grieving, is subtitled, Finding The Meaning Of Grief Through The Five Stages Of Loss. Confusingly, inside the book they're called the Five Stages of Grief. Stages of loss conveniently fit the new book on grief and confirmed the chameleon-like capacity of the word stages to arbitrarily mean whatever Kübler- Ross or anyone else wants it to mean."

In an early draft of the article we compared the stages of a butterfly to the alleged stages of grief, to show the problem with any stage theories of grief. To wit: Stages in order to be called stages must go through an orderly progression, each and every time. Starting as an egg, a potential butterfly must go through the four stages Egg, Caterpillar (Larva), Pupa (Chrysalis) Adult (Imago).It cannot elect to skip the larval stage and jump right over to the pupal stage.

Elisabeth Kübler-Ross' herself constantly stated that the stages didn't all happen and not necessarily in order, if at all. We just can't find a way to use the idea of stages which really are absolute—see Butterfly reference—for something as variegated as human grief.

When you read our article, we hope you'll agree with us and comment to that effect, and tell us that you've been waiting your entire professional life to have someone put the whole Stage thing out to pasture. On the other hand, we hope that some of you argue with our position, so we can have a meaningful debate, with the goal of defining what is most helpful for grieving people.

One last note. We need to drop a dime on ourselves for a really dumb oversight. The opening sentence of the article reads, "In 1969 the psychiatrist ELIZABETH KÜBLER-ROSS wrote one of the most influential books in the history of psychology, On Death and Dying." Oops - we took the liberty of attacking a legend and couldn't even spell her name correctly. She was Elisabeth with an "s" not a "z". Our maximum naughty.

One more thing, as many readers who are also writers will know, publications often alter your title. Our original title made no attempt at debunking the stages of dying, as that is a totally different arena than grief. For that we apologize to Elisabeth's memory.

Now go read the article Here's the link again: Then go fill up the comment box.

Let's get ready to rumble.

Russell Friedman
The Grief Recovery Institute

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