The Myth of the Stages of Dying, Death and Grief

By Friedman, Russell; James, John W. | Skeptic (Altadena, CA), Summer 2008 | Go to article overview

The Myth of the Stages of Dying, Death and Grief


Friedman, Russell, James, John W., Skeptic (Altadena, CA)


IN 1969 THE PSYCHIATRIST ELIZABETH KUBLER-ROSS wrote one of the most influential books in the history of psychology, On Death and Dying. It exposed the heartless treatment of terminally-ill patients prevalent at the time. On the positive side, it altered the care and treatment of dying people. On the negative side, it postulated the now-infamous five stages of dying--Denial, Anger, Bargaining, Depression, and Acceptance (DABDA), so annealed in culture that most people can recite them by heart. The stages allegedly represent what a dying person might experience upon learning he or she had a terminal illness. "Might" is the operative word, because Kubler-Ross repeatedly stipulated that a dying person might not go through all five stages, nor would they necessarily go through them in sequence. It would be reasonable to ask: if these conditions are this arbitrary, can they truly be called stages?

Many people have contested the validity of the stages of dying, but here we are more concerned with the supposed stages of grief which derived from the stages of dying. As professional grief recovery specialists, we contend that the theory of the stages of grief has done more harm than good to grieving people. Having co-authored three books on the impact of death, divorce, and other losses, and having worked directly with over 100,000 grieving people during the past 30 years, our reasons for disputing the stages of grief theory are predicated on the horror stories we've heard from thousands of grieving people who've told us how they'd been harmed by them.

[ILLUSTRATION OMITTED]

From Dying to Grief

Elizabeth Kubler-Ross was a fearless pioneer who openly took the medical profession to task for its callous disregard for the feelings of dying people. The subtitle of On Death and Dying explains the book's primary focus: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families. The lessons Kubler-Ross learned from those dying people, coupled with her compassionate regard for them, became a focal point of the emergent Hospice movement. Somehow, over the years, the real virtues inspired by her work have been subordinated to the inaccurately named, largely imaginary stages.

During the 1970s, the DABDA model of stages of dying morphed into stages of grief, mostly because of their prominence in college-level sociology and psychology courses. The fact that Kubler-Ross' theory of stages was specific to dying became obscured. Students who eventually became therapists, social workers, or doctors carried what they learned about the stages into their careers. The media also played a role in disseminating the idea that specific, inexorable stages of grief exist. When a tragedy makes the news, newscasters and alleged experts recite the DABDA model of grieving. Medical and mental health professionals and the general public accepted the theory without ever investigating its provenance or validity.

In fact, Kubler-Ross' stage theory was not the product of scientific research. In the second chapter of On Death and Dying she laments: "How do you do research on dying, when the data is so impossible to get? When you cannot verify your data and cannot set up experiments? We [she and her students] met for a while and decided that the best possible way we could study death and dying was by asking terminally ill patients to be our teachers." She then explains her methods: "I was to do the interview while they [her students] stood around the bed watching and observing. We would then retire to my office and discuss our own reactions and the patient's response. We believed that by doing many interviews like this we would get a feeling for the terminally ill and their needs which in turn we were ready to gratify if possible."

The phrase, "we would get a feeling" is especially revealing since Kubler-Ross' feelings were processed through the filter of her life-long unresolved grief and retained anger. …

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