The Stages of Grief Theory

The 5 Stages of Grief were first defined by Elsabeth Kubler-Ross In her book "On Death and Dying” in 1969, and have been widely used by health providers and counselors ever since. They are Denial, Anger, Bargaining, Depression, and Acceptance. It’s usually taught that the grieving person must pass through these stages, one after the other, finally reaching acceptance. The concept has been criticized quite widely and effectively, and now Boston scientists have reported a study that re-evaluates the model.

Over 230 bereaved persons living in Connecticut were interviewed at regular intervals from one to 24 months after their loss. The five ‘stages’ or items, with Yearning replacing Bargaining, were assessed by raters after an average period of 6½ months, and again at between 6 to 12 months, and 12 to 24 months.

Yearning, not depression, was the most common emotion felt. On average, the negative emotions – disbelief, yearning, anger, and depression – had peaked by 6 months after the loss and were declining. Disbelief was highest initially, yearning peaked at about 4 months, anger peaked at 5 months, and depression at 6 months. Acceptance was quite high and grew over the 2-year period. People who have great distress beyond 6 months may be at risk for “prolonged grief disorder”, and should be treated by a mental health practitioner.

This study will be useful in helping all those concerned with grief – family, friends, physicians, hospital and hospice staff, and bereavement counselors – understand what’s the norm, and when help is required from an expert.