Grief: The Myth of the Five Stages of Grief, and the Truth about Recognition and Resolution

Throughout Western societies, we buy into the prevalent sociocultural belief of the stage theory of grief. As if to bring comfort and understanding of our loss, we are told we should progress through a series of five stages: denial, anger, bargaining, depression, and acceptance.

Even while I was in graduate school for social work, I can vividly recall some professors ascribing to this model, never once questioning if their claims were accurate since it seems to be a universal statement as true as 2+2=4.

In short, this belief pushes the idea that bereaved individuals must undergo a specific sequence of reactions over time as the result of the death of someone who was significant to them. Not only is this inaccurate since individuals may not experience all the stages in their set order, but it also is stigmatizing to those who never experience the stages at all as they may think there is something “wrong” with them. Thus, I argue that the stage theory should be abandoned, for there are newer, different models that are more accurate for illustrating the grief journey.

On the History of the Five Stages of Grief

In 1969, psychiatrist Elisabeth Kübler-Ross introduced the model in her groundbreaking book On Death and Dying. At the time, there was a severe deficit in medical schools on the topics of death and dying, which motivated Elisabeth Kübler-Ross to do the research herself by observing the reactions of her patients with terminal diseases. She was also influenced by some researchers with stage models from decades earlier.

Quickly, the Kübler-Ross Five Stages of Grief model was branded as universal knowledge among the medical community, scholars, and the public at large.

Later, Kübler-Ross clarified she never intended for the stages to be viewed as a linear progression, and that she wrote them in a way that was misunderstood. She added she meant for the stages to reveal how people with terminal illness cope with learning they are close to death, not as a reflection of how people grieve once that person has died.

In a later book Kübler-Ross coauthored, she lengthened her model to consist of all forms of loss, such as bereavement (the specific term designated for the death of someone who was significant), the end of a relationship, unemployment or loss of income, substance abuse, incarceration, infertility, and the diagnosis of disease. Thus, at best, the model is helpful for understanding grief across multiple contexts.

Major Problems with the Model

Unfortunately, there are significant problems with the Kübler-Ross model. They include the following:

  • Oversimplicity. The model does not consider the variance in grief reactions between individuals, families, and cultures across time.
  • Passive model. It describes what an individual will experience, but there is an absence of the active force to come to accept the grief.
  • No sociocultural lens of grieving. The model assumes all people will grieve in the same way, regardless of relevant factors such as religion, culture, family traditions, socioeconomic classes, or historical elements.
  • Absence of secondary stressors. There is no mention of the stressors that can arise because of the grief, such as new roles.
  • Prescriptive statements. For instance, the model implores that someone must feel angry to pass onto the bargaining stage. While this is a common emotion to experience, it does not happen for everyone.
  • Assumption of a smooth, simple progression. The model portrays an easy, observable, predictable progression from one stage to the next. This does not account for the emotions and beliefs that can seesaw or be otherwise conflicted during grief.
  • Variances in how to cope with loss. The model assumes all people will cope the same way, ignoring the important fact that some people will reject the reality of death in a means to cope.
  • Vague terminology. The model uses vague wording to describe the complex thoughts and emotions that can accompany the grief. For instance, the word “depression” can range from sadness to major depressive disorder.

Please note: For a detailed report on the problems resulting from the Kübler-Ross model from an academic perspective, please visit the citations at the bottom.

On Grief Recognition and Resolution: The TEAR Model

In an effort to replace the Kübler-Ross model with a more practical, forgiving model to help people navigate through their bereavement, therapists and other professionals have adopted the TEAR model. This is also known as the Four Tasks of Mourning and is explored in-depth by researcher J. William Worden.

T: To accept the reality of the loss.
E: To experience the pain of the loss.
A: To adjust to the new environment without the lost object.
R: To reinvest in the new reality.

Notice the paramount difference between the two models. In the 5 Stages of Grief, acceptance is at the end of the sequence which assumes the work has been completed. Conversely, in the TEAR model, acceptance is at the start of the journey. In other words, grief work can only begin once the mourning period has ended. It must come after the sympathy cards, texts and phone calls have stopped. It approaches when the bereaved individual is expected back at work or school, operating as if things are “normal” like nothing happened.

This comes after the mourning period, after when the sympathy cards, texts and phone calls stop coming. This is when the bereaved individual is expected back at work, operating as “normal” like nothing happened.

It is time we discard the widespread belief that grief is a set of prescriptive stages. We should embrace grief as an ongoing set of work, ready to be approached only once the public mourning has ceased. Acceptance is the prerequisite to face true, raw grief, and from it come recognition and resolution.

Further Reading:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/

https://web.archive.org/web/20100322212850/http://home.windstream.net/overbeck/grfbrf13.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/

About the Author, Valerie Smith, LMSW:
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Suffolk Family Therapy under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master’s degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.