January 03, 2019

Source:  Psychology Today, David Feldman, Ph.D

I like to play a game with the college students in some of my psychology courses. I hold up some juicy prize — a gift card to a local coffee shop, bookstore, or restaurant — and promise it to the first person who can name the five stages of grief. Invariably, at least three students prattle them off within a few seconds, making it very hard to know who deserves the reward. What’s particularly amazing is that many of these students have never taken a psychology class before.

Among the general public, one of the most commonly known and accepted psychological concepts is that grief proceeds in stages. If you already are familiar with the stages of grief, you have psychiatrist and visionary death-and-dying expert Elizabeth Kubler-Ross to thank for it. Through her many books and tireless activism, Kubler-Ross managed to change how much of the world thought about death. She helped soften some of the stigma that had previously been present, making it a little more okay to talk about and get support for loss.  

What you may not know, however, is that Kubler-Ross didn’t originally develop these stages to explain what people go through when they lose a loved one. Instead, she developed them to describe the process patients go through as they come to terms with their terminal illnesses. The stages — denial, anger, bargaining, depression, and acceptance — were only later applied to grieving friends and family members, who seemed to undergo a similar process after the loss of their loved ones. 

Unfortunately, grief turns out not to be so simple. 

Studies now show that grievers don’t progress through these stages in a lock-step fashion. Consequently, when any of us loses someone we love, we may find that we fit the stages precisely as Kubler-Ross outlined, or we may skip all but one. We may race through them or drag our feet all the way to acceptance. We may even repeat or add stages that Kubler-Ross never dreamed of. In fact, the actual grief process looks a lot less like a neat set of stages and a lot more like a roller coaster of emotions. Even Kubler-Ross said that grief doesn’t proceed in a linear and predictable fashion, writing toward the end of her career that she regretted her stages had been misunderstood.

The unfortunate side effect of our society’s erroneous but firm belief in the five stages is that many people wind up criticizing themselves for "not doing grief right.” When people buy into the idea that there’s only one healthy way to grieve, then it’s easy for them to attack themselves when they naturally find that they're doing it differently. This kind of self-criticism never helps anyone.

Even if the stages aren’t exactly gospel, there are three important lessons to take from Kubler-Ross’ work, no matter what our unique grief process may be like.

Lesson 1: A Little Denial Is Natural

Asserting that denial is healthy may seem odd given that psychologists have long considered denial inherently harmful. Research now tells us that this is not the case. Ronnie Janoff-Bulman, psychologist and expert in psychological trauma, has observed that denial can be healthy in moderate amounts. It’s the brain’s way of “dosing” itself. Just as medicine is good for us, fully facing the reality that a loved one has died is ultimately good for us. But too much medicine too quickly can cause unpleasant side effects. Similarly, being forced to confront difficult grief-related emotions all at once can be unnecessarily painful.

Janoff-Bulman isn’t advocating ignoring reality. Instead, she believes that denial is the brain’s way of making sure that we don’t get too high a dose of grief before we’re ready. In other words, the brain naturally gives us “denial breaks.” These breaks allow us to relax, regroup, and ready ourselves for the difficult feelings we must inevitably face.

Denial becomes unhealthy only when it’s unshakeable. In such cases, people sometimes fail to face their grief. Taking a temporary breather from grief to watch a movie, have a distracting conversation with a friend, or just daydream for a while, is healthy, but trying to avoid it altogether can have harmful consequences. As a general rule, the only way out of grief is through it. If the emotions are there, it’s important not to run from them. But we shouldn’t feel we have to face them all at once, either. Grieving appropriately means allowing ample time to remember and feel the loss as well as embracing occasional opportunities to distract ourselves and regroup.

Lesson 2: Grief Can Shake Our Faith

Faith doesn’t just refer to religion. We have faith in lots of things — in ourselves, in others, and in the future. When someone passes away, our faith in these things can be shaken. It may seem like the world will never be the same again. We may wonder if we will ever be the same.

People often find themselves asking questions like, “How could this have happened to such a good person?” or “How could the world be so unfair?” According to research by psychologist Melvin Lerner, on some level, most people believe in the old saying, “What comes around goes around.” We have faith that, if we behave well, good things are supposed to happen to us. Many of us are taught this belief as children and don’t entirely surrender it as we age.

Life isn’t always fair, however, and people don’t always get what they deserve. The loss of a loved one challenges these beliefs. As a result, people sometimes find themselves feeling guilty. If the world is fair and our loved one has died, it’s easy to believe that we must have done something wrong. Some people even try to bargain with God (one of the stages of grief). They may promise to be more moral, just, understanding, or caring if only their loved one were returned to them. It’s important to remember, however, that death has medical and physical causes — causes that aren’t our fault or, usually, anyone else’s. It’s natural to question the fairness of losing someone we love. Ultimately, however, death is neither fair nor unfair. It’s simply an unfortunate reality.

In addition to questioning our faith in fairness, we may start to question our faith in ourselves. Some people find themselves wondering, “Who am I without my loved one?” This is especially likely if they and their loved one were close for many years. They may have trouble remembering who they were before that person came into their life. People often define themselves by the roles they play in close relationships. They think of themselves as spouses, siblings, children, friends, mentors, or caregivers. When someone passes away, we may lose one or more of these important roles. In this situation, it’s natural to feel confused, sad, and even angry (some of the experiences Kubler-Ross captured in her stages). Grief takes time because it entails accepting the loss of these roles and redefining ourselves. During this time of change, it’s important to remember what has not changed. Although much has shifted, some constants usually are present — our remaining friends and family are a good start. It’s important to take comfort in what is stable and use this as a “home base” from which to build new faith in who we are.

Lesson 3: Grief Usually Leads to Acceptance

Central to Kubler-Ross’s stages is the notion that grief is a process that eventually leads to acceptance, her last stage. Although most people never stop missing their departed loved ones, the painful emotions they feel shortly after the death almost certainly eventually soften. It can be comforting to keep this in mind. If we tell ourselves, “This will never end,” “I’m weak for feeling this way,” “I’m going crazy,” or some other negative (and probably not fully accurate) statement, we'll wind up feeling needlessly worse. If we instead reassure ourselves that “This is normal and won’t last forever,” it will be easier to honor our loss without added burden.

It’s important not to rush grief, however. Many grieving people have told me that friends have given them all kinds of estimates on how long the grief process should take. One person may say a few weeks, while others might say anywhere from a few months to a number of years. These people aren’t lying; they’re simply conveying their own experiences. But grief is very personal, and each of us is entitled to our own schedule. While people sometimes continue to experience moments of moderate sadness even several years after losing a loved one, most people’s strongest feelings of grief — known as “acute grief” — begin to lessen within a few months. But it’s important not to criticize ourselves if our grief doesn’t act like most people’s.

Grief isn’t a race to the finish line, and it isn’t a contest to see who fits Kubler-Ross’s stages best. It’s a natural, though emotionally difficult, part of life, and one that can’t be easily explained by five simple stages.

David B. Feldman is a Professor of Counseling Psychology at Santa Clara University and co-author of Supersurvivors: The Surprising Link Between Suffering & Success (HarperCollins). Follow him atfacebook.com/davidfeldmanphd or listen to his podcast, “Psychology in 10 Minutes,” on any podcast app, through iTunesSoundCloud, or by subscribing to the show’s RSS feed.