There Are No ‘Five Stages’ of Grief
Losing my son left me in a state of infinite sadness. The internet of grief didn’t help.
www.theatlantic.com
The five-stage model wasn’t generated from data. It’s a theory, developed by the psychiatrist Elisabeth Kübler-Ross and published in 1969, that explains how people come to terms with their own impending death. I remember watching Kübler-Ross on television when I was a young teenager, absolutely enthralled, and later buying some of her books. By the time her second one was published, in 1974, Kübler-Ross had expanded her claims, such that the five stages would apply to the grieving process too. Families go through them once while their loved one faces death, she argued—and then they may again when that person has died.
he five stages, so the theory goes, aren’t simply bidirectional either; they can also come on out of sequence, or with stages skipped over. “Keep in mind that these stages are meant to be descriptive and don’t necessarily apply to everyone or happen in the order presented,” Cleveland Clinic says. But other sources seem to argue just the opposite, suggesting that certain stages might be central to the grieving process: Depression may be overwhelming, psychcentral.com told me, but “this stage is a necessary part of your healing journey.” And the time we spend in any stage, I learned from grief.com, “can last for minutes or hours as we flip in and out of one and then another.” If the five-stage model does not describe predictable steps along a typical path, then why even call them “stages” at all?
Some writers retrofit the substance of each stage to make them match up better to the reality of grieving. None of Kübler-Ross’s original stages, for example, seem to capture one of grief’s most common features: yearning for the person lost. But cramming new emotions and ideas willy-nilly into the model’s elements is nothing more than tinkering. The last straw for me came at the website for Cake, an end-of-life start-up that boasts of being “founded by MIT and Harvard alumni” and has raised $7 million in venture funding. At Cake, the “bargaining” stage has been rebranded as “bargaining and guilt,” in which you could be “feeling desperation, helplessness, and lose [sic] of hope.” The “depression” stage? Well, that could leave you “feeling overwhelming sadness, despair, and loneliness.” Meanwhile, the University of Washington suggests that bargaining means “ruminating on the future or past, over-thinking and worrying, comparing self to others”—none of which has anything to do with bargaining, either as Kübler-Ross originally described it or as the word is generally defined.
Read: Grief, everywhere
I learned that my doubts were well founded. Plenty of researchers, practicing psychologists, and expert panels have given up on Kübler-Ross’s theory; some have called for it to be “relegated to the realms of history.” Already by the early 1980s, a U.S. Institute of Medicine committee cautioned “against the use of the word ‘stages’ to describe the bereavement process,” as it might “result in inappropriate behavior toward the bereaved, including hasty assessments of where individuals are or ought to be in the grieving process.” And a few years after that report, the research psychologists Camille Wortman and Roxane Silver thoroughly debunked the five-stage model, noting, for example, that most people don’t experience depression after bereavement. What’s more, when a grieving person does become clinically depressed, they might be at risk of long-lasting suffering rather than in the middle stage of a steady advance toward “acceptance.”
Yet despite decades of attempts by scholars and professionals to let the five stages die, the model remains dominant. Research surveys of its spread confirmed my own experience: The stages appeared in roughly 60 percent of English- and Dutch-language websites about grieving that were evaluated in 2020. Another recent study asked roughly 60 mental-health professionals and 150 people from the general public whether they believed that the grieving process “can be expected to progress through a predictable series of stages, starting with denial and ending with acceptance.” Nearly half of the clinicians and more than two-thirds of the other adults rated that statement as being “definitely” or “probably” true.