By Sue Morris, PsyD
Traditionally, the stages of grief have been identified as denial, anger, bargaining, depression, and acceptance. But do these stages really exist? What happens if you skip one? And how long does each last? These are all normal questions, especially if someone you loved has recently died from cancer and you are trying to make sense of the many feelings you are experiencing.
In reality, although stages such as these can help simplify the world and our experiences, there are no set stages of grief that every bereaved person must go through. Even though many grieving people experience similar feelings, grief does not follow a set order; each person’s experience is unique. How someone grieves depends on many factors, including their personality, how they tend to cope with other difficulties in life, and how prepared they were for their loved one’s death. Rather than thinking of grief in stages, which would give us a better sense of what to expect and provide some certainty at a time of great turmoil, it is more helpful to imagine it following a wave-like pattern, where the waves are characterized by deep sadness and a yearning to be with the deceased again. With time, the frequency and intensity of the waves lessens as you adjust to the absence of your loved one.
The story behind the stage theory of grief dates back to the 1960s, when Dr. Elisabeth Kübler-Ross, a Swiss-American psychiatrist, began interviewing terminally ill patients about the end of their lives. From these interviews, Kübler-Ross proposed “The Stage Theory of Grief,” which identified five stages that dying patients might experience: denial, anger, bargaining, depression, and acceptance. Over the years, Kübler-Ross’ stages of grief about a person’s pending death somehow morphed into “The Stages of Grief” for recently bereaved individuals. The theory gained prominence in lay and medical literature to the extent that bereaved people often question whether they are grieving in the “right” way if they don’t go through these stages or experience other emotions such as loneliness and guilt. More recently, Kubler-Ross did write about the stages as they related to bereavement.
Several years ago, researchers studied the experience of bereaved individuals whose loved ones had died from natural causes, and found some support for the stage theory of grief. They described five “grief indicators” that peaked in the following order: disbelief (at about one month), yearning (four months), anger (five months), depression (six months), and acceptance, which steadily increased over time. While these indicators can help us understand the trajectory of a bereaved person’s experience, these stages should not be seen as linear or the only emotions people experience when they are grieving.
There is no right or wrong way to grieve, and no set time frame. If someone you loved has recently died, think of grief as coming in waves that will lessen over time. If, however, you feel as though you are stuck or getting worse, it can help to talk to your doctor or a grief counselor, or to join a support group.
Sue Morris is director of Dana-Farber’s Bereavement Program, where she provides one-on-one counseling and support groups for bereaved individuals whose loved ones were treated at Dana-Farber. If your loved one was not a Dana-Farber patient, bereavement support is available through local hospices and other community-based organizations.