New Five-Stage Theory for Grieving
A friend of mine in Thomaston, GA did some research on grief. She passed her findings along to me and I wanted to share them with all of you that have lost someone. I don't think any of us faces a harder challenge than losing a loved one or comforting a friend or relative after the death of someone close. Most of us have heard about the "Kubler-Ross" five-stage theory of grief for people who are dying, which many people believe also holds true for grieving over the loss of a loved one. The theory describes five distinct emotional stages to grief that terminally ill patients go through - denial . . . anger . . bargaining . . . depression . . . and acceptance.
Surprisingly, little research has been done to affirm the validity of this theory, which was popularized by Swiss psychiatrist Elisabeth Kubler-Ross, MD, when applied to bereavement. My friend called to ask about the new study, published in the Journal of the American Medical Association, Holly G. Prigerson, PhD, senior author of the article, said "It struck us as odd that a theory with such wide acceptance had never been actually tested." Hence, Dr. Prigerson and her team set out to take a closer look at how people process grief and loss and to determine whether the five-stage model is accurate.
A FRESH LOOK
The researchers followed 233 people who had lost a loved one -- a spouse, parent, sibling or child, with the majority (84%) bereaved spouses. All deaths were from natural causes, mostly following a long illness. During the two-year study period, participants kept track of how often they experienced each of the five grief indicators --denial/disbelief ... yearning ... anger ... depression ... and acceptance. Theorizing that separation anxiety plays a major role in mourning the loss of others, the researchers removed "bargaining" (they believed that "bargaining", was more relevant when processing your own forthcoming death) and used "yearning" as the core indicator of separation anxiety. The results found some important differences from the five-stage theory.
Grieving, they learned, isn't exactly a linear process of working one's way toward acceptance. Instead the various emotions overlap considerably during mourning, with some predominating at different times. Interestingly, disbelief did not top the list as the initial dominant response although it scored at its highest level during the first month post-loss. Rather, acceptance (the last phase in the five-stage theory) was what people reported most often feeling during each period of the study.
It turns our that the new stage -- "yearning" -- was actually the most frequently reported negative emotion, peaking at four months post-loss. Anger peaked at five months and depression at six months after the death.
IT'S ALL NORMAL
While interesting to have this new perspective on the science of bereavemewnt, what's most important is how the study results might be helpful in coping with loss, or being supportive to friends and family who've suffered one. What's most meaningful is how this research can help normalize how people experience grief, by rendering acceptable the wide range of emotions that surface in the ensuing months.
Anger is likely the most difficult emotion to cope with. Most people have a hard time accepting or expressing their anger at the departed loved one. They feel tremendous guilt about being angry -- but as this research shows, anger does come up. It's reassuring to know this so that unnecessary and damaging guilt can be avoided. Bereavement shouldn't be considered something to "get over" but instead a fact to be eventually integrated into the survivor's life. Everyone is different after the experience of profound grief.
IS HELP NECESSARY
The fact that the intense emotions (yearning, anger and depression) all peaked within six months of loss in this study led researchers in their conclusion to suggest that those for whom those feelings continue after six months may need to seek help or might benefit fromn evaluation. Dr. Dennis McCann, PhD, director of pastoral care at Middlesex Hospital in Middletown, Connecticue disagreed saying there's nothing significant about the six-month mark. A better determination of whether a person needs help at any time during the bereavement process is how well they are getting on with the activities of daily life. If the pain is so great that one cannot function, then help is certainly needed no matter the time frame after the loss. This might take the form of individual counseling or joining a bereavement support group -- or for some people, medication for depression or anxiety to allow them to handle their responsibilities and navigate their daily lives after a profound loss.
Is there any way to prepare in advance for such a loss? Dr. McCann said that meditation and mindfulness can be helpful as practices to lead toward realization and acceptance of an uncomfortable reality -- which is that all things and people in this world are impermanent. While not all losses allow time for preparation, coming to terms in advance with both the inevitability and capriciousness of the cycle of life may go far in helping you and your friends/family cope with a painful loss when it strikes.
I hope that some of the findings above will help those on this site. I found that the few weeks following Sam's one-year anniversary have been unbelievably hard so there is just no majic time frame. Martin Luther, one of the most fascinating figures in Christian history, said "There is no sweeter union than that in a good marriage. Nor is there any death more bitter than that which separates a married couple. Only the deaths of children come close to this; how much this hurts I have myself experienced."
Whether you lose a spouse, a child, a parent, a sibling, the hurt and pain can only be felt by those that experience this loss. I have quoted C.S. Lewis on this site before but I love what he said "their absence is like the sky . . . spread over everything."
Love to all of you