Debunking the 5 stages of grief

The new grief theories that step in for Kübler-Ross’

“It is evident that coping does not occupy all of a bereaved person's time: Coping is embedded in everyday life experience, which involves taking time off from grieving, as when watching an engrossing TV program, reading, talking with friends about some other topic, or sleeping.” - Schoebe & Schut

“Just be you. If you feel like screaming, you scream. If you feel like crying, you cry. Don't try to follow a textbook or have somebody else tell you what to do. Trust yourself, your own natural emotions.” - Kübler-Ross

For the last few decades, the most commonly parroted response to grief has been Elisabeth Kübler-Ross’ 5 Stages of Grief. So often when someone begins grieving a death loss, they are guided to the five stages of grief to contextualize and understand their grief, and end up feeling deficient because their grief isn’t fitting perfectly into the stages because, even according to Kübler-Ross herself these stages of grief are insufficient. However, while these 5 stages of grief may be insufficient, they were incredibly important in opening the grief conversation in the mainstream and providing a guiding grief theory to help people begin to understand their mourning, to connect them to a greater community of grievers, and give them language to explain their bereavement. And since the inception of the Five Stages, we’ve seen a lot of new grief theories enter the stage, and what you’ll find as a common thread in all of them is that they acknowledge that there is no right way to grieve, but common ways that grief can manifest. All of the theories ask us to acknowledge our person’s gone-ness, and that that absence is permanent. But they also ask us to feel all the emotions that that gone-ness brings up. Like we see in Finding Nemo, it might look scary to go through it, but if you try to go over it, you’re going to get pummeled by all the things you want to avoid. 

These are the Grief Theories I’ll be telling you about in this essay:

The 5 stages of Grief, Kübler-Ross

The Sixth Stage of Grief by David Kessler

Freud’s concept of Mourning

Bowlby & Parkes’ Four Stages of Grief

Worden’s Four Tasks of Mourning

Dual-Process Model of Grieving

The 5 stages of Grief, Kübler-Ross

When Kübler-Ross thought up these stages (denial, anger, bargaining, depression, acceptance), she was writing them with dying terminally-ill patients in mind, which is a considerably different experience than being the surviving griever of a dead loved one, especially when those losses don’t follow terminal illness. But they caught on so fast because, “[her work] was like pulling back this curtain to a world that [people] had never seen before.” “Back in the '60s, there was no common language. There was nothing they could talk about. So she said by creating five stages, it's something simple that any layman or any family member can remember.” But, they were never meant to be prescriptive, the be all end all of grief like unchanging stops on a train. Even Kübler-Ross acknowledged this. “Just be you,” she said later in life, “If you feel like screaming, you scream. If you feel like crying, you cry. Don't try to follow a textbook or have somebody else tell you what to do. Trust yourself, your own natural emotions.” 

Later, David Kessler (with whom she co-wrote On Grief and Grieving) added a sixth stage of grief: finding meaning. In a 2019 publication, Finding Meaning: The Sixth Stage of Grief Kessler asserts that “It’s not about finding meaning in the death [itself]. There is no meaning there. What it’s about is finding meaning in the dead person’s life and knowing how they shaped us…maybe in the way they died can help us to make the world safer for others.” ‘Meaning making’ is a key aspect of a number of the more contemporary grief theories, and we’ll learn more about it as we walk through the theories.

Different bereavement experts have coined grief theories/processes with different phraseology, from “stages” to “phases” to “tasks”, and all of them emphasize different aspects of ‘healing’ grief. I’ll lay out a few of these grief theories for you here (I am partial to the Dual-Process and Four Task models) but first, to make sure we’re all on the same page semantically, J. Williams Worden defines the difference between grief, mourning, and bereavement for us like this: “The term ‘grief’ [indicates] the experience of one who has lost a loved on to death….”Mourning” is a term applied to the process that one goes through in adapting to the death of the person. “Bereavement” defines the loss to which the person is trying to adapt.” (worden, 17)

Bowlby & Parkes’ Four Stages of Grief

Before there were The 5 Stages of Grief, there was John Bowlby’s grief process which was comprised of 3 stages and later, added by his colleague Colin Murray Parkes, a fourth. This grief theory was not originally based on grief at all, but rather on attachment theory–specifically from the ways that children reacted when their bonds with caretakers were broken. The behaviors of the child losing their caregiver attachments lent itself to the hypothesis that the grief reactions would be likely more pronounced the stronger the initial bonds were. This then came to inform Bowlby and Parkes’ ideas about grief. 

Their four stages of grief were 

1. Shock and Numbness

2. Yearning and Searching

3. Disorganization and Despair

4. Reorganization and Repair.

Meaning that when first experiencing a loss, one is often in shock and feeling emotionally disconnected from their loss, not yet fully believing its truth (similar to K-R’s ‘denial’ stage). 

The yearning and searching is acknowledging the loss, but still hoping to see the dead person around; yearning for their return. 

Note: When one gets stuck in this yearning stage, that’s when Prolonged Grief Disorder (aka Complicated Grief) (which I discuss in this essay and briefly here) enters the stage–this is the continued activation of the nucleus accumbens an important reward center in the brain about which Mary-Frances O’Connor says: “when we deeply connect with someone else in a long-term relationship, this is part of the brain that enables us to do that.” She explains that when we think of reward we think of pleasure, but the brain interprets reward as a signal that something should be repeated. When we see someone we love, this part of our brain saying, ‘let’s keep doing this.’ Let’s keep having dinner together, let’s keep watching TV together, let’s keep spending time together. So “when people are adapting to the absence of this person, they realize that is never going to happen again. But for people who have complicated grief, it is perhaps as though that reward is still something they could potentially experience. They still yearn for that person to walk in the door so that they can sit with them on the couch.”

The disorganization and despair that follows is the understanding that one must accept that their life will never be the same and they will need to adapt their behaviors and habits to this new world. This can lead to despair, depression, apathy. But, in time, they will make it to 

Reorganization and repair, which is coming to terms with the loss, once again finding meaning in the world and adapting to the new roles one had to take on in the wake of their loss. This, according to Bowlby and Parkes, is when the grief is ‘resolved,’ which reflects Freud’s grief theory. Similarly to Kübler-Ross’ work, while this theory may not be completely encompass grief, the work he did with attachment theory was imperative to the understanding of the formation and impact of strong emotional bonds.

Freud believed that “when the work of mourning is completed the ego becomes free and uninhibited again.” (Freud, 1917:245) To Freud, grief was a mood to be solved, an experience that had a beginning, middle, and end and once the ties with the dead were broken, the griever would be able to move on–readjust and find another love (which he went on to say “has unfortunately not yet been confirmed by observation.” 250 )

Dual-Process Model of Grieving, Stroebe and Schut

The Dual-Process Model of Grieving identifies two grief processes that one flip-flops between– Loss-Oriented Stressors, and Restoration-Oriented Stressors “and a dynamic, regulatory coping process of oscillation, whereby the grieving individual at times confronts, at other times avoids, the different tasks of grieving. This model proposes that adaptive coping is composed of confrontation avoidance of loss and restoration stressors. It also argues the need for dosage of grieving, that is, the need to take respite from dealing with either of these stressors, as an integral part of adaptive coping.” This model wants you to give yourself breaks from grieving. “this model is not a phasal model, we do not propose a sequence of stages, but rather a waxing and waning, an ongoing flexibility, over time.”

Loss-Orientation

Refers to the processing of the loss itself and includes rumination - about the dead, about your life together, about how they died - and yearning - looking at old photos, imagining how they might react to something happening in your life, what they might do to solve a problem, etc. The emotions experienced here range from nostalgia and happy remembering to painful longing. 

Restoration-Orientation

This aspect focuses on the secondary losses that come from a death - the losses that occured because of the main loss (death or even a breakup/divorce) that took place.You will see this described in Task III of Worden’s Four Tasks of Mourning below, but can include taking on the skills and tasks that your person once took care of - you may have to learn how to cook, or balance a checkbook, or file your taxes if they were the person that used to take care of those things. You will have to readjust your sense of self - from wife to widow, partner to widower, child to orphan, and so on. 

“Again, a myriad of emotional reactions can be involved in coping with these tasks of restoration, from relief and pride that one has mastered a new skill or taken the courage to go out alone, to anxiety and fear that one will not succeed or despair at the loneliness of being with others and yet on one's own.”

Most important to this model is that you will oscillate between the two processes - you will ruminate and then you will learn to adjust to a new world and then you will grieve the loss and then you will build your resilience to it. But you will not only do this. You will also alk about things with no relationship to your person or their loss. You will watch TV and you will go to work and you will paint and run and read, and the ‘avoidance’ that happens in these times is perfectly healthy. You have to dose your emotional experiences or you will be entirely burnt out on coping.

This Dual-Process Model is similar to the next grief theory, the Four Tasks of Mourning: 

Worden’s Four Tasks of Mourning:

J. William Worden in his 2009 book, Grief Counseling and Grief Therapy introduced his take on the process of grieving with his Four Tasks of Mourning. He uses the language of ‘task’ to give a sense of action that the griever can take, rather than ‘phase’ whose passive implication may let the mourner believe that “the phases [are] something to be pass[ed] through.” Worden’s Task Theory incorporates ideas from previous theories like processing emotions, addressing secondary losses, and identifying meaning and continuing bonds, but it sets the griever up to take action. 

“Although the tasks do not need to be addressed in a specific order, there is some ordering suggested by their definitions. For example, you cannot handle the emotional impact of loss until you first come to terms with the fact that the loss has happened and is irreversible at least in this lifetime.” 39 (And this is true of all grief theories.)

His four tasks are:

1. To Accept the Reality of the Loss

2. To Process the Pain of Grief

3. To Adjust to a World Without the Deceased

4. To find an Enduring Connection with the Deceased in the Midst of Embarking on a New Life

1. To Accept the Reality of the Loss

“The opposite of accepting the reality of the loss is not believing through some type of denial.” This task is a spot in the mourning process where many people get stuck. This can take forms from your brain playing tricks on you by thinking you see your person in a crowd, to ‘mummifying’ their bedroom or personal spaces as if ready to be used again at any moment. It can be denying the meaning of the loss by rewriting history to say that your person was not as big a part of your life as they actually were to try to soften the blow of their being gone, or making yourself forget their face or their laugh through ‘selective forgetting’. Intellectualizing the loss without emotionally experiencing it is a sneaky way that you can be stuck in this process– knowing they are dead intellectually, but not emotionally accepting it. Mourning rituals (like funerals) are a huge part of “completing” this task. 

2. To Process the Pain of Grief 

“The negation of this second task of processing the pain results in not feeling. People can short-circuit task II in any number of ways, the most obvious being to cut off their feelings and deny the pain that is present. Sometimes people hinder the process by avoiding painful thoughts. They use thought-stopping procedures to keep themselves from feeling the dysphoria associated with the loss. Some people handle it by stimulating only pleasant thoughts of the deceased, which protect them from the discomfort of unpleasant thoughts. Idealizing the dead, avoiding reminders of the dead, using alcohol or drugs are still other ways people keep themselves from dealing with task II issues.” He goes on to emphasize here that the pain of grief is not only sadness and, as he says, ‘dysphoria’ (which I think is a fascinating way to approach this feeling), but that anger, anxiety, guilt, loneliness, and depression are all feelings that need to be addressed, acknowledged, and worked through in this (and every) step.

3. To adjust to a World Without the Deceased

There are three types of adjustments that fall into this task:

1. External Adjustments

2. Internal Adjustments

3. Spiritual Adjustments

I. External Adjustments

When someone close to us dies, especially someone with whom we shared responsibilities, we have to learn to pick up the slack that results from their loss, since when someone dies we lose not only their physical presence and body, but a companion is lost, a sexual partner, a cook, a cleaner, a breadwinner, an attentive listener, someone to hand you a wrench and a philips head in the garage - the secondary losses.

“Many survivors resent having to develop new skills and take on roles that were formerly performed by their partners.” Left brained people may have to find ways to take on the right brained skills their partner fulfilled and visa versa. 

II. Internal Adjustments

One of the challenges of losing someone is also losing the relationship you had to them, especially if it was a life-defining relationship. Being a twin implies a sibling, being a spouse implies a partner – these are self relationships that hinge on the existence of another. So when that person is lost, so too can your sense of self be lost. You may wonder if you are still a sibling, still a twin or triplet if the person that bestowed that title upon you is no longer living. Becoming a widow or widower, or having a nesting partner die, if you are polyamorous, calls for a great deal of internal shifting and adjusting. 

You may feel that no one can ever love you the way your person did, you may feel that you have lost all agency over your life. Your self-definition, self-esteem, and self-efficacy are impacted. This task asks us to consider “Who am I now?” “How am I different from loving & being loved by my person?” This task implores us to move from “What would Jack do?” to “What do I want to do?”

III. Spiritual Adjustments

Finally, there are adjustments that may be made to our life values and philosophical beliefs following a loss, as with a loss, our assumptive world changes – that is, the world as you know it has been irrevocably altered, and that alteration may impact your belief in a God or in the world around you at a fundamental level. A world that once made sense and was fair and kind may suddenly be understood as a cruel world with no order. This level of change doesn’t always happen, but when it does it can be very disorienting. “Over time, new beliefs may be adopted or old ones reasserted or modified to reflect the fragility of life and the limits of control.” 

4. To find an Enduring Connection with the Deceased in the Midst of Embarking on a New Life

In the first edition of his book, Worden had named this task “withdrawing emotional energy from the deceased and reinvesting it in another relationship”--an adaptation of Freud’s idea of the mourning process. Luckily, Worden continued to develop his understanding of grief and mourning and, with the help the 1996 book, Continuing Bonds: New Understandings of Grief by Klass, Silverman, & Nickman, came to understand that relationships do not dissolve when someone is no longer physically in our lives. 

As I’ve written elsewhere, “When we make a clay pot, the fingerprints do not disappear just because we are no longer touching it. The marks we make stay long after we are gone. Our hands and our art and our compassion and our love and our gift giving and our tenacity and our support and our words live with people. When we see a pinch pot we don’t ignore the fingers that pressed the clay into shape, just like we cannot ignore the hands that pressed us into shape. It’s not fair to try to, and it’s not fair to expect anybody else to.” This task acknowledges that and encourages us to find ways to keep our person in our lives in such a way that we are able to go on living and forming new relationships without feeling like we’ve left them behind. 

Worden says of this task that the closest description to not completing it would be not living. “[When] One’s life has stopped with the death and has not resumed. [This] task is hindered when one holds on to the past attachment that precludes one from forming new ones.”

So what are the common threads in all of these? To acknowledge the ways in which the world is different now that your person is no longer in it, and to acknowledge that they are no longer in it because they have died and cannot return. To feel all the hurt that comes with that acknowledgement. To find the meaning that still exists in life, to find ways to keep connected to your dead loved one, and let yourself continue to live and make new bonds.  And that all of this doesn’t happen at once, and it doesn’t happen in a specific order or at a specific time. That there are a million different ways to experience bereavement, grief, and mourning. 

I hope this helped you understand that not fitting into the 5 stages of grief has no reflection on your (in)ability to grieve, and showed you that grief is vast and long term and includes everything you are experiencing. 

Love, Alekz

Sources:

Abumrad, J. et al. “The Queen of Dying .” Radiolab.org, NPR, 2021, radiolab.org/podcast/queen-dying/transcript. Accessed 8 Aug. 2024.

Chang, A., Donevan, C., & Jarenwattananon, P. (2021, July 23). The ubiquitous, confounding, misunderstood 5 stages of grief. NPR. https://www.npr.org/2021/07/23/1019892729/the-ubiquitous-confounding-misunderstood-5-stages-of-grief 

Freud, S. (1917) Mourning and Melancholia. The Standard Edition of the Complete Psychological Works of Sigmund Freud 14:237-258

Kwong, Emily , and Mary-Frances O’Connor. “What Happens in the Brain When We Grieve : Short Wave.” NPR, Short Wave, 8 Nov. 2021, www.npr.org/transcripts/1052498852.

Stroebe, Margaret, and Henk Schut. "The Dual Process Model of Coping with Bereavement: Rationale and Description." Death studies 23.3 (1999): 197-224. ProQuest. 8 Aug. 2024 . 

Worden, J. William. Grief Counseling and Grief Therapy, Fourth Edition : A Handbook for the Mental Health Practitioner, Springer Publishing Company, Incorporated, 2008. ProQuest Ebook Central.