Wednesday, March 1, 2017

The 5 Stages of Grief, and Why They May Not Be Accurate

In Western culture, we often talk about grief coming in phases. When we first hear about death of a loved one, we may not believe it. Then, once we come to terms with it, we may need to mourn for a very long time before we are able to move on. Many cultures around the world have ceremonies and traditions that deal with mourning, but in the US, people most often talk about the 5 Stages of Grief. This model, also known as the Kubler-Ross Model, goes as follows:

  1. Denial (this can't be happening)
  2. Anger (why me)
  3. Bargaining (maybe if...)
  4. Depression 
  5. Acceptance
This model, though it does focus on grief, was developed specifically in relation to those who are dying. Rather than being developed about someone grieving a dead friend or family member, it was meant to teach loved ones of a dying person what they go through emotionally upon finding out that they are dying. So, for example, the bargaining phase is not meant to show that a person may think there is a way to get their dead friend back. Instead, it shows that, at a certain point, a dying person may be convinced that there is a way to cure them of whatever is killing them, or hope that their illness may mysteriously disappear.

So what does the process of grief actually look like?

In the 80s, John Schneider developed what he calls the Transformational Stages of Grief. This model looks not only at emotional responses, but cognitive, behavioral, spiritual, and physical responses as well, and thus is designed to nurture growth. Rather than just covering loss of a loved one, it also covers other losses like break ups and divorce, as well as more internal losses like a change in beliefs or a loss of faith. Schneider's model is:
  1. Initial awareness of loss (shock, confusion, disbelief)
  2. Attempts at limiting awareness by holding on (bargaining, guilt, ruminating, and trying to use coping behaviors that have worked in the past, all in attempt to put off instability. often associated with insomnia, muscle tension, and yearning.)
  3. Attempts at limiting awareness by letting go (depression, anxiety, shame, pessimism, forgetting, and hedonism, sometimes involves giving up on formerly held ideals and beliefs)
  4. Awareness of the extent of the loss (mourning, deprivation, grief, defenselessness, flooded thoughts, noticing what you are now missing)
  5. Gaining perspective on the loss (healing, peace, acceptance, noticing growth and change, awareness of the extent of your and others' responsibility, realizing any positives)
  6. Resolving the loss (self-forgiveness, finishing unfinished business, accepting responsibility, saying goodbye)
  7. Reformulating the loss in a context of growth (discovering potential, problems as challenges, regaining curiosity, think of a divorced person who has decided to start dating again)
  8. Transforming loss into new levels of attachment (awareness of interrelationships, wholeness, empathy, end of searching, reflection)
As a counterpoint to traditional models, there is also what's called The Dutro Model, which doesn't focus on stages at all. This model claims that traditional "stages of grief" models are not supported, and placing time limits on grief is inappropriate. It also holds that pathologizing the suppression of sadness as a response to grief is also incorrect. Instead, the model sees grief as being complex, multidimensional, and individualized, based on a number of variables that are different for each person's individual experience. 

Often times, a grieving person can expect a flood of support when people first hear about the loss, though the support may wind down when the news is no longer as new. It is important to keep in mind that grief can go on for a long time. Sometimes, particularly when grief involves trauma, people can experience post-traumatic stress along with their grief. Think of the couple going through a particularly contentious divorce, or someone who witnessed a friend being killed. This can result in a complicated grief reaction, which can take much longer to process than grief on its own. 

Ultimately, each person's experience of grief is going to be different, depending on the type of grief they are going through and the circumstances around the loss. Stage models are useful for those in the middle of the grieving process, as well as friends and loved ones of the grieving person. The grieving person may find comfort in knowing what may happen next and understanding that this too shall pass, while their friends and family may feel that knowing what's going on and what to expect can better help them be supportive. Complicated emotions around grief can be sudden and painful, or they can sneak up on you when you don't expect it. Understanding what you are going through and knowing that you are not alone in your experiences can often be one of the most helpful things in getting through that dark tunnel and out the other side.

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