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Grief not limited to five stages

December 4, 2011
	<p>Dorr</p>

Dorr

When a beloved student or friend dies, when a well-respected coach or university — such as Penn State University — loses its way, when terrorists reveal how vulnerable we Americans are, we grieve. The losses might be phases of development, self-images, relationships, separations, beliefs, emotional states, or cultural myths.

The natural response to loss is grief. The most helpful book on loss and grief published in 2011 was “The Truth About Grief: The Myth of Its Five Stages And The New Science of Loss.” The title and subtitle of Ruth Davis Konigsberg’s book reveal its subject, thesis, emphasis, strengths and weaknesses.

The five stages of grief came from Elisabeth Kübler-Ross’s taboo-breaking book, “On Death And Dying,” published in 1969. Dying patients, Kübler-Ross claims, went through five stages when they faced their own death: denial, anger, bargaining, depression and acceptance. Others soon applied the stages to grieving, and Kübler-Ross did nothing to stop the confusion between someone facing one’s own death and someone grieving another’s death.

For 40 years, people have applied such “stageism” to losses of all kinds. Why? The five stages are easy to remember, manageable and predictable. According to Konigsberg, they “may reflect a desire to make sense of how the mind comes to accept events and circumstances that it finds wholly unacceptable.”

The truth about grief, however, is that the five stages don’t match many people’s experience. Most people don’t go through grief in the order Kübler-Ross prescribed. Many, if not most, accept the death of another person long before the fifth stage. “Pining” might occur more than anger and depression.

Joy and sorrow, gratitude and anger, hope and despair — such emotions rise and fall like waves, sometimes in the same day or hour.

The most common response to the most common death — that of an elderly spouse — is resilience; the ability “to maintain relatively stable, healthy levels of psychological and physical functioning” after such a loss.

In Columbia University professor George Bonanno’s study of widows and widowers, 45 percent showed no signs of shock, despair, anxiety or intrusive thoughts six months after their loss. Fifteen percent, however, still were having problems at 18 months. Ten percent displayed moderately high symptoms of grief at six months, but not at 18 months. A number of people, depressed before the death of a spouse, remained depressed. And still a fifth group found their depression lifted because of the death of their spouse. “Many Americans who lose a loved one are more resilient than we give them credit for,” Konigsberg concludes.

Resilient survivors, psychologist Toni Bisconti adds, “remained connected to other people, rather than isolated; they felt that their grief was manageable and under control; and they embraced and learned from new experiences, rather than avoiding or feeling threatened by them. They were psychologically hardy, optimistic and able to rise to the challenge that widowhood presented.”

Recent research in the social sciences provides Konigsberg with much of her evidence. Bonanno’s book, “The Other Side Of Sadness,” sounds like the best of such insight. But Konigsberg, a journalist, essayist and editor, includes two other pertinent sources: Anecdotes by widows and widowers, as well as the experience of people affected by the terrorist attacks in New York and Washington, D. C., in 2001.

Kübler-Ross’s model should not dominate because “no one particular approach is more effective, or healthier, than another,” Konigsberg concludes. Her chapter on the “American Way of Grief,” and her persistent criticism of Kübler-Ross’s model belie her nonjudgmental view.

Much of “The Truth About Grief” is valuable. I often wondered why people put grieving into such a lockstep theory and why “sadness” was not one of the stages. Konigsberg’s emphasis on resilience is a welcome correction. There is a lot of common sense in what the author says.

By the end of the book, however, her tone and some of her assumptions bothered me. Anyone who has attended worship services and funerals regularly would not find the most recent research “startling” or “groundbreaking.” Pastors put grief in religious perspective, which Konigsberg doesn’t do. In 1989, Camille B. Wortman and Roxane Cohen Silver’s essay, “The Myths of Coping With Loss,” also covered much of the territory that Konigsberg does.

Finally, contemporary social science is not the only, or even the main, way in which Americans learn about death, dying and grief. For instance, in “McGuffey’s Readers” from 1836 to 1896, renewal was the central theme concerning death and grief.

These primers were neither morbid nor melancholic. Language, nature, heroic deeds, acts of love, biblical stories and even funerals conveyed a strong sense of the mystery of — yet confidence in — life amidst death. In facing death, in grieving, McGuffey’s pupils were learning how to be resilient.

Ron Dorr is a State News guest columnist and professor of rhetoric and humanities, James Madison College. Reach him at dorr@msu.edu.

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