Debating the Stages of Grief, Death and Dying

I’d go into the critical magazine article in more depth, but it doesn’t really deserve the time or attention. For instance, under the “potential harm” noted for continuing to use the “Acceptance” stage of grief, the authors note:

One definition of stages cannot fit all people, or all relationships — in fact we don’t think they fit anybody.

The paragraph then goes into a hypothetical example. None of which describes any potential harm of an acceptance stage. Another example about the “potential harm” of yearning:

Again, calling it a stage suggests a time frame, causing them to wait for that stage to end which adds exponentially to their grief.

So don’t call it a stage! Use a synonym, like “step” or as the YBS researchers did, “indicator.” But suggesting a specific stage of yearning is potentially harmful because it denotes some hypothetical time period in a grieving person’s mind is beyond reaching. It’s just ridiculous.

Even more so when compared with the scientific data from the YBS study. Because the other important finding from the study was that all of these grief indicators tend to peak within 6 months:

The results also offer a point of reference for distinguishing between normal and abnormal reactions to loss. Given that the negative grief indicators all peak within 6 months, those individuals who experience any of the indicators beyond 6 months postloss would appear to deviate from the normal response to loss.

Anything too much beyond a 6 month window might be considered problematic or dysfunctional, especially if such feelings significantly interfere with the person’s everyday life functioning. So although it may be distasteful to suggest that there aren’t “normal” periods of grieving, there are. These aren’t moralistic judgments being made. They are simply data used to help a person understand better if they may be “stuck” in a process of grief or loss and unable to move forward on their own.

And while Friedman and James may honestly disagree with the evidence and data (as five researchers did in three letters to the editor in JAMA published in June 2007), we don’t see the need for the scare tactics used within the Skeptic article.

Grieving is indeed a natural, normal part of the human experience. Grieving is also a highly personal (and personalized) process; Kübler-Ross nor the YBS researchers were suggesting otherwise. They are only attempting to help identify how people grieve to demystify it and help people through it.

References:

Maciejewski, P.K., et. al. (2007). An Empirical Examination of the Stage Theory of Grief. JAMA, 297, 716-723. (Free article)

Read the Skeptic magazine article: The Myth of the Stages
of Dying, Death and Grief (PDF)