The Five Stages of Grief - Why It’s Time to Debunk The Myth

Over the years, one of the most commonly accepted theories for understanding grief has been ‘the five stages of grief’ - first outlined by Swiss-America psychiatrist, Dr Elizabeth Kubler-Ross in her 1969 book, ‘On Death and Dying’. The theory suggests that grief can be understood as a series of sequential emotional stages that we progress through as we confront loss. It’s a theory that has become ingrained in our cultural consciousness and is widely regarded as the go-to instruction manual for processing our feelings of grief. However, this blog will outline why the ‘five stages of grief’ has actually been misinterpreted, how it could in fact be detrimental to our grief journey and how other models may better explain our experience of loss. 

What are the five stages of the Kubler-Ross model? 

1. Denial: a stage characterised by shock, numbness. We might find ourselves pushing back on the reality of our loss, refusing to believe that we’ve lost someone we love.
2. Anger: as our grief presents as raw emotion, we may start to experience anger towards our loved one, ourselves or those around us. This can manifest in verbal or physical outbursts, seeking revenge or blaming others.
3. Bargaining: this is the stage at which we may start to negotiate with a ‘higher being’ or try to find ways to reverse our loss and are prepared to do anything to bring our loved one back.
4. Depression: the point at which our loss starts to sink in, where we feel - often intensely - the excruciating pain of our loved one’s passing. Symptoms may include crying, self-isolation, loss of appetite, lack of motivation and feelings of hopelessness.
5. Acceptance: the stage at which we start to accept the reality of our loss and begin to reimagine our life without our loved one.

The problem with using the five-stage model

• It’s misleading. What many people aren’t aware of is that Dr Kubler-Ross’ theory has, for decades, been misappropriated. The model was not originally designed to understand the experiences of bereaved people, but to better understand the experiences of terminally ill patients confronting their own death. During her work as a psychiatrist, Kubler-Ross started to notice how the psychological needs of patients with terminal illness were often sidelined by medical staff in hospitals. As a result, she decided to interview around two hundred terminally ill patients to better understand their experience of confronting death. Over the years, similarities between the experience of terminally ill patients and bereaved family members were noted and the five-stage model rapidly became accepted as the overarching roadmap for understanding all types of grief and loss. That this theory has been consistently misinterpreted and misapplied is unsurprising. Why? Because the model provides us with a convenient way to tuck messy, barely-understood emotions into neat boxes and bring some structure and order to our chaotic grief journey.

• It’s based on anecdotal not empirical evidence. Kubler-Ross’ model  is based on a collection of case-studies created from the conversations she held with dying patients. Whilst such anecdotal evidence can be useful in building empathy and helping us to understand what others may be feeling or experiencing, it can be biased, subject to interpretation and moulded to fit a pre-determined conclusion. Empirical evidence in contrast is based on systematic observation and investigation and involves data collection and measurement. Attempts to verify Kubler-Ross’ model and test it empirically found that it fell short as a way of explaining or understanding the experience of widowhood and that most widows did not follow the stages mapped out in the model.

• It can lead to pressure and distress.  By interpreting this model prescriptively, by using it as a formula to work through grief, we leave ourselves open to confusion, pressure and additional distress. Grief is not linear, it’s not a methodical step-by-step process that has a definitive beginning or end. It is a chaotic, fluid and uniquely personal experience that defies universal definition. Whilst some of us may follow the trajectory laid out in the model, many of us won’t. Whilst some of us may experience all of the stages at some point in our grief journey, many of us may only experience a couple. And all of these ways of experiencing grief are valid. There is no wrong way to grieve. Only your way. Therefore attempting to follow a theory in the hope that it will make the grieving process easier, can be harmful as it can leave us feeling inadequate. If we skip, revisit or miss out stages altogether - we might begin to question whether we’re grieving the right way, whether we ever really loved our person, or whether there is something fundamentally wrong with us. And as we chastise ourselves and  leap (wrongly) to the conclusion that we’re somehow failing at grief, we layer on more suffering, our self-esteem erodes and we’re often left feeling less able to cope. 

• It can disrupt relationships with others. As the Kubler-Ross’ model is such a widely-accepted approach to understanding grief, it has seeped into the public’s consciousness. It’s something many people mention or refer to when discussing loss, grief or even change. Its appeal lies in its simplicity and its structure - in the way it quenches our thirst for order and direction when we find ourselves drowning in our sorrow. However, it can lead to expectations - expectations we place on ourselves and that others place on us. As our loved ones urge us on in our recovery, they may refer to this model to help frame their understanding of our grief experience and sadly, this can lead to misunderstandings and judgement about where we should be in our grief. It can lead them to feeling we’re not grieving ‘properly’ or ‘well enough’. We live in a grief-illiterate society, and as such, readily available and easily digestible models such as the five stages of grief, often fill the knowledge vacuum - but this can lead to unintended and unwelcome consequences.

• It ignores cultural and societal differences in grieving. Different cultures and societies have different ways of dealing with grief - different norms, beliefs and practices, including expectations around the length of mourning and how, where and when mourning is expressed. These play an important role in shaping how people react and respond to loss. In some cultures, grief is subdued and sometimes not discussed, in others overt expression of pain and loss such as weeping and wailing, is encouraged indeed, expected and in some societies funerals are jovial events characterised by laughter and reminiscing. The five stages of grief model does not account for these cultural and societal differences. It also ignores other factors such as our personal relationship with the deceased, our mental health history and our own personality and individual ways of coping with trauma and change.
• It ignores other emotions we experience during grief. Whilst we may experience varying degrees of denial, anger, bargaining, depression and acceptance during our grief journey, rarely do we experience them in succession or in a prescribed order, nor are they the only emotions we feel. There are a raft of other commonly felt emotions that often materialise during grief, that the five-stage model doesn’t mention and yet which are equally powerful and valid. These include feelings of guilt, fear, yearning, helplessness and anxiety. Every and any emotion that arises during our grieving process should be given the time and attention it deserves. Only in doing so will we ensure that we fully honour our grief and embrace our healing journey.

• It focuses primarily on emotional responses to loss. As well as the emotional turmoil we’re thrown into when we lose someone we love, grief also exerts an enormous physical toll on our bodies - which can be just as damaging and set us back in our healing. From increased inflammation to a compromised immune system, to problems with our gut to general aches, pains and unrelenting fatigue -  our bodies are pushed to the extreme when we deal with loss. Kubler-Ross’ model does not account for the physiological effects on grief and in doing so ignores how much they can derail our grief process. 

Reaching a better understanding of grief

As I have navigated my way through grief, I have researched an abundance of literature around grief and discovered other models which I believe offer a more accurate explanation of the experience of the bereaved. They take into account the nuanced and complex nature of grief, its ebb and flow and its non-linear nature.

Grief counsellor, Lois Tonkin model, ‘growing around grief’, suggests that our grief doesn’t ever diminish or disappear - rather, that it is an ever-present companion that we need to learn to live with. What does change with this model of grief however, is that whilst our grief remains the same, our life grows around it. Slowly but noticeably, we will begin to reimagine our future and rebuild a life around our loss - a loss that we still feel deeply, that we will forever grieve, but one around which we can continue to live our lives. This model, unlike the five stages of grief, helps us realise that we can integrate our loss into our present, that we can continue to love our deceased partner or spouse, but still build a new life for ourselves. 

Another helpful theory of grief is Stroebe and Schut’s, ‘Duel Process Model of Grief’, developed in 1995. It identifies two different types of stressors in grief - one is loss-oriented that focuses on how we deal with the loss of our loved one and the relationship we had with them. The other is the restoration-oriented stressor that focuses on the secondary sources of stress we experience, such as having to complete tasks that our loved one used to do, as well as the rebuilding of our lives that we need to tackle following our loss. This model of grief is particularly helpful in depicting grief as fluid and accepting that whilst some days we will struggle to even get out of bed, on other days we’ll be able to think about and even plan for our future. This dynamic approach to understanding grief and loss, is something I have resonated with and something that has helped me to process my loss. It’s helped me to understand that grief, as I experience it,  is not pre-determined or a linear route we can follow. It is instead a continual oscillation between confronting our loss and seeking respite from it.

Conclusion

Kubler-Ross’ made a phenomenal contribution to raising the public consciousness around grief, breaking the stigma surrounding it and paving the way for more open and transparent conversations on what has traditionally been a taboo subject.  And her model can help us to understand how grief evolves, how our emotions change and transform over time and how what we are feeling during grief is not permanent. It can provide comfort and affirm that our feelings of anger, depression, denial, bargaining and acceptance are all valid and may crop up during the course of our healing process. 

However, we must accept the theory’s limitations. The elements of the process don’t apply to everyone, nor should we buy into the idea that grief is a prescriptive process with a series of different stages to work through.  Grief is personal to each of us. It takes numerous forms and can be felt and experienced in multiple ways throughout the world. Only by respecting and honouring our grief however and whenever it shows up for us, only by embracing and validating the range of emotions we feel will we be able to start reimagining our lives and moving towards a more balanced and hopeful future.