Despite older adults having more experience with grief, the
classic grief study that has determined grief counseling was developed for
children.
Most everyone knows of the Swiss physician Elizabeth Kubler-Ross
stages of grief. Based on earlier work by the psychologists Bowlby and Parkes, Kubler-Ross
crystalized the stages in her 1969 book On Death and Dying. What was
unique is focusing on communication during grieving. She singlehandedly overturned
how physicians were treating dying patients—as medical failures to be ignored
until they expired.
The theory states that we go through a series of stages
before we come to accept the loss. Kubler-Ross defines five stages starting
with an initial short period of Denial (D) that it could not happening, moving
into Anger (A) when the loss is taken personally, followed by a series of Bargaining
(B) strategies to try and reverse the outcome, and then once the realization of
the loss is seen as permanent, Depression (D) and eventually, at the end of the
grief there is Acceptance (A) that we cannot change these events. DABDA model of stages
of dying morphed into stages of grief.
It is the only grief theory discussed in psychology training.
The stage theory of grief is also part of the medical curricula and part of the
grief education at the National Cancer Institute. It has been accepted widely across the globe.
It is the script provided to grieving relatives and has even entered into product
market research to understand the reaction to the “death” of iPhone 4 in favor
of iPhone 5. It is a pervasive theory.
Despite its popularity, how accurate is it for older adults?
George Bonanno with Columbia University, New York, has been
the main counterpoint for these stages.
Bonanno takes a diametrically apposing approach. He argues that there are no stages. In fact having
no stages is healthy. In 2002 Bonanno studied elderly bereaving spouses and
nearly half showed no signs of shock, despair, anxiety or intrusive thoughts
six months after their loss. This he termed as Resilience. Suggesting that grief
stages are not prescriptive, dispelling "grief work hypothesis."
This idea of expressing grief in order to cope was also
dispelled by the Dutch husband-and-wife Dutch research team Wolfgang and
Margaret Stroebe of Utrecht University. They found that widows who avoided
confronting their loss were not any more depressed than widows who "worked
through" their grief—talking or writing about the experience. More
recently, in 2008, Mark Seery from State University of New York and his
colleagues studying reactions to the attacks of September 11, 2001, reported similar
findings. There are no stages. It is not prescriptive to healthy coping.
But what these stages have done is that it allowed grieving
to be accepted as healthy. It is the first time since Victorian times that
grief is validated. Because there were assumed stages, people felt more
comfortable to allow others express their grief—thinking, this is only a stage,
it will pass. Although there are many valid criticisms, focused on the meaning
of constructs and the therapeutic value of expressing loss, one outcome has
been that we are discussing grief. And that is healthy, because grief is real
and painful.
© USA Copyrighted 2014 Mario D. Garrett
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