Theories or models of grief have contributed to our understanding of adjustment. All those in existence are based on the original model, conceived by famed psychiatrist Elisabeth Kübler-Ross. Let’s consider the model, and also some misconceptions about her work.
Kübler-Ross’s Five Stages of Loss
In her groundbreaking book, On Death and Dying, Elisabeth3 presented the first model of grief. Her findings suggested that individuals experience five natural grief reactions, which she termed “stages.” They are denial, anger, bargaining, depression, and acceptance. Her Five Stages Theory became an international model for understanding loss. Unfortunately, some therapists began using it as a tool without reading or comprehending her book. As a result, the theory came under fire from some healthcare professionals for three reasons.4
The main objection resulted from some professionals’ assumption that bereaved individuals literally progress through five sequential stages. As a result, they classified which “stage” the client was currently in and then attempted to guide him or her through those remaining, in linear order. They directed, for example, “You’re in the denial stage, so anger is next” or “You’ve been in the bargaining stage long enough. It’s time to move to depression, and when you complete that, acceptance will follow.” In effect, each client was placed in a grief box, with an identifying label attached.
Elisabeth developed her theory from her background as a psychiatrist. When the theory is examined carefully, it becomes evident that she presented the stages as coping mechanisms (the manner in which people deal with trauma or crisis). Unfortunately, the semantics caused confusion—a difficulty that can be eliminated by replacing the term stages with the more flexible states.
Human beings experience various states of grief. Any of these states may coexist with other states, be completely skipped, occur intermittently, or repeat themselves.
Second, critics complained that the Five Stages Model dismissed the uniqueness of grief. They regarded it as a grief template. In Elisabeth’s defense, she recognized that mourning is highly variable. In fact, not only is it impossible to apply one standard to all mourners, but one standard model for a single mourner is unrealistic.
The third objection to the Five Stages Theory came from bereavement specialists who alleged that its model of grief was too passive. According to them, when a loved one dies, those left behind sense a loss of control. The stage concept heightens that sense. It says, “Death happened to me, and now grief.” Elisabeth explained that grief is a continuously evolving process that offers potential for growth. She did not, however, include specific suggestions for achieving that growth.
The bereavement movement is trying to move away from the misunderstood and misused model. Nevertheless, Elisabeth Kübler-Ross deserves tremendous regard. Her work continues to benefit many people. Moreover, she opened the door to the field of thanatology (the study of death and dying).
After On Death and Dying was published, colleges and universities began offering classes in death studies. By 1978, 938 universities in the United States alone offered death-education courses.5 Classrooms filled to capacity, and students demanded waiting lists in order to sign up for subsequent semesters. Americans jumped forward to look behind death’s door, and then recoiled, slamming it shut again. They wanted no foretaste of their inevitable demise. Now, however, four decades later, another generation of students is rushing to sign up for an evolved form of those early courses. Studies in life after death (which investigate beyond death’s door) flourish. Once again, students will be introduced to the pioneer work of Elisabeth Kübler-Ross.