The Great “Stages of Grief” Debate: Gaining a Functional Perspective

Article By: Timothy O’Brien

Are there Stages of Grief? “Yes,” said Elisabeth Kubler-Ross. “Current scientific literature has found no evidence of the 5-stage model,” says Dr. George Bonanno. “They’re a myth,” says Ruth Davis Konigsberg.

Time out — Step back and go to your neutral corners! Let’s sort this one out. While informative and interesting, all of these approaches explain the “what and why” of grief, but they miss the critical point that the death of a loved one produces the most severe stress responses humans can experience. And, grief should be approached, dealt with, and treated from a stress management point of view.

In her defense, Kubler-Ross was writing in her book, On Death and Dying, for terminally ill patients to explain the stages of emotions that they might experience. Reviewers, critics, and writers took her 5-stage model and adapted it to the bereavement process in hopes of giving grievers guidelines or guideposts of what to expect while they grieved and mourned.

It became the predominant, uncontested explanation for grief. Problem was, no one really ever questioned or tested this model to see if it actually was how we as humans experienced grief. That has changed.

In his book, The Other Side of Sadness, Dr. Bonanno accurately observes that scientific researchers have never been able to find evidence of Kubler-Ross’ 5 stage model. Citing the researchers Stroebe and Schut, Bonanno discusses the new thinking about grief as having more wave- like patterns of emotional experiences than actual stages. Bonanno also accurately states that bereavement is “essentially a stress reaction.”

In her book, The Truth About Grief: The Myth of Its Five Stages and the New Science of Loss, Konigsberg argues that the stages, if they do exist, do not all happen to every person, and they might or might not occur in the order or linear fashion described by Kubler-Ross.

A second major point that Konigsberg makes is that not everyone is automatically and immediately a candidate for grief counseling or medical intervention, just because someone close and important to them has died. Sidney Zisook, MD, Professor of Psychiatry at the University of California, San Diego, agrees, noting, “Grief is a normal natural phenomenon. It shouldn’t be treated. It is not a medical condition.”

The hardiness research of Martin Seligman and his colleagues would tend to agree with this assessment. A resilient person, when faced with a major setback like the death of a loved one, tends to be better equipped mentally, emotionally, and physically to withstand the impact of the situation.

Dr. Zisook, and all major discussions on what path or format grief follows, agree on one point: if the person who is grieving feels overwhelmed, was depressed at the time the death occurred, or is unable to handle the loss of their loved one on their own, they should seek professional help in the form of group or private counseling.

The course and resolution of the bereavement process for an individual depends on the frequency, duration, and intensity of the grief episodes they experience. And, these episodes or events will vary from person to person, and for an individual also, based on the relationship they had with the person who has died and the triggers that set a grief episode in motion.

Grief is a major stress event. Look to stress management and relaxation training, both mental and physical, for clues about how to best deal with it. If you approach Grief this way, you can leave the “stages or no stages” debate to others.

Timothy J. O’Brien, M.S. http://www.thegriefsupportnetwork.org is the Director of The Institute for Stress Management & Performance Improvement, in Tallahassee, Florida. He is also a Fellow of the American Institute of Stress and a Life Member of the International Society for Performance Improvement. He is the author of two Grief Support Programs for both Human-loss and Pet-loss, that deal with Grief as a Stress Response.