You probably won’t be bereaved for long before someone tells you about the five stages of grief. You likely knew of these even before you lost your loved one. This description of the grieving process came from research done in the 1960s when Elisabeth Kubler-Ross interviewed people facing death due to illness.
For reasons that I have never fully grasped, the five-stage model of how people respond to their own imminent deaths became almost universally accepted as an accurate description of what happens when you lose a loved one. Five decades later many people including grief counselors and other mental health professionals as well as members of the general public still accept that this model describes the experience of bereavement.
The problem is that the five-stage model does not describe what bereaved people experience, or at least it doesn’t do that well.
The problem is that the five-stage model does not describe what bereaved people experience, or at least it doesn’t do that well. In my opinion, and that of a lot of other people including some respectable researchers, it stinks.
The most common criticism of the five-stages model is that it seems to prescribe an orderly progression through the five stages — denial, bargaining, depression, anger and acceptance. As most bereaved people know, grief is not orderly. Emotions swoop up and down, back and forth, over and under, around and around.
(Lately I have been thinking of grief as something like a Whac-A-Mole game. A whole bunch of powerful feelings seem to pop up randomly in a chaotic high-speed mess. I barely get guilt pounded down before here comes meaninglessness, after which yearning rears up and so on. It keeps me constantly off balance.)
Kubler-Ross tried to explain away this shortcoming by asserting that stages may be traveled through in any order or skipped or gone through more than once. This explanation does not fix the basic problem of the model, which is that it doesn’t describe what happens.
To me, the most serious shortcoming of this model is that there is no guilt stage.
To me, the most serious shortcoming of this model is that it is missing important stages. There is no guilt stage, to start with. The five stages do describe some of the emotions or feelings that a grieving person may experience. But I don’t recall ever encountering a bereaved person who didn’t experience at least some guilt over a perceived responsibility for their loved one’s death. I’m sure they’re out there, and I may have met and forgotten an example, but no grief model can claim to describe the major elements of grief without including guilt.
Some five-stages fans say guilt is included in the bargaining stage. To me, however, guilt deserves its own stage, if not a stage and a half.
And that’s just the beginning. Where is the meaninglessness stage? The anxiety stage? The yearning stage? None of these very common feelings experienced by bereaved people is included in the five-stages model. It’s got not just one but several fatal flaws.
The need for all these adjustments and excuses is just further illustration of the model’s failings as far as I’m concerned. It confuses more than clarifies. It’s a lousy model.
The Tearful Two-Step: Dual-Process Grief
About 20 years ago another model was developed. This dual-process model has since become the most widely accepted among grief researchers and theorists.
The dual-process model was developed by researchers Margaret Stroebe and Henk Schut (the same two whose 2017 paper criticizing the five-stages model is linked to above) and first described in a 1999 paper. The dual-process model describes two kinds of coping – loss-oriented and restoration-oriented – and suggests that grievers will repeatedly shift back and forth between these two approaches.
The dual-process model describes two kinds of coping – loss-oriented and restoration-oriented – and suggests that grievers will repeatedly shift back and forth between these two approaches.
Here’s how it works:
You engage in loss-oriented coping when you yearn for your lost loved one, feel sad about the way in which he or she died, feel it’s unfair that he or she won’t have more life to share with you, dwell on the guilt you feel, fret over feelings of meaninglessness, etc.
Restoration-oriented coping consists of doing things like trying to build a new life without your lost loved one, looking toward the future, developing goals and objectives, remembering him or her fondly, creating a legacy to honor his or her memory, etc.
Back and Forth, Round and Round
Oscillation is a key part of the Stroebe and Schut model. They say that bereaved people shift their focus from loss-oriented coping to restoration-oriented coping and then back again over and over. This oscillation can happen when people become exhausted by doing one form of coping and move to the other as a way to rest up.
Does this resemble your own experience? It does mine. I’ll spend minutes, hours, days or weeks locked in loss-oriented coping. During this phase I’ll think more or less constantly about Brady’s death, how I yearn to see and talk to and hold him again, my role in failing to prevent his death, the injustice of the fact that he’s not doing what other 17-year-old high school seniors are doing now, my fear that something horrible will happen to my two surviving children and so on.
Then after a while things will shift. I’ll start thinking about writing a new song, training for an upcoming athletic event, signing up for a backpacking trip, finishing his memento shadowbox, or some other future-oriented restoration activity. I’ll find solace and respite in these restoration-oriented activities. For a while. Then the pressure to mourn builds up and I’ll go back into loss-oriented coping for a while.
Lather. Rinse. Repeat.
The two-step is a type of dance we do here in Texas. I think of the dual-process model as the tearful two-step.
A Restoration Focus
The dual-process model as originally presented made no judgment as to whether one kind of coping is somehow better than the other. However, about a decade after introducing their model, Stroebe and Schut and some other Dutch grief researchers investigated whether focusing more on one kind of coping had any effect on the duration and intensity of grief. They found that grievers who spend more time on restoration-oriented coping than on loss-oriented coping seem to suffer less and adjust sooner.
Grievers who spend more time on restoration-oriented coping than loss-oriented coping seem to suffer less and adjust sooner.
What I take away from this is that sometimes I’m going to cry and suffer and other times I’m going to work on developing a new life. And I’m going to try to spend more time on restoration-oriented coping and less on loss-oriented coping. My hope is this will help me adjust better to the loss of my son.
The Usual Caveat
These are models of grief. They are not the real thing. Models may be accurate when applied to a large population of bereaved people, but far off target compared to your individual experience. It is difficult, as always, to reason from the general to the specific. This does not mean these models are worthless.
These are models of grief. They are not the real thing.
Smoking tobacco offers an example of the way a model can fail to describe specific experiences even when it is generally valid. Most people, including me, accept the validity of the research showing that smoking cigarettes will kill you.
If you’ve been living in a cave for decades and are not aware of the ways smoking hurts your health, the U.S. Centers for Disease Control offers evidence about them here. There are a lot. They are bad. Smoking-related deaths are the most common preventable deaths, at least in America, accounting for nearly half a million deaths a year.
Yet these statistics are only probabilities and likelihoods. It is not certain that smoking will kill you or any given individual. For example, my sister’s late mother-in-law smoked for 70 years and died at age 92. If we relied upon this single example, we might tell our kids, “Go ahead! Light up!” We don’t, of course. Instead we urge kids not to smoke.
It is not a bad idea to look at grief models and grief research similarly. If you follow some of the evidence-based bereavement grief coping strategies, odds are that you’ll have an easier time of it. But this is a probability, not a guarantee. In your individual case it may help a lot or not at all.
If you follow some of the evidence-based bereavement grief coping strategies, odds are that you’ll have an easier time of it.
Personally, I’m betting on the odds as supported by the evidence and trying to implement many of these evidence-based coping strategies. Other bereaved people could have a similar or better experience by doing something completely different. Your mileage may vary. I wish I could offer certainty. Certainty is something many blogs promise, but this isn’t one of them.
Thanks for reading, liking, commenting, sharing, reposting and following Grieve Well. I am sorry for the losses that brought you here. Whether you are currently doing more loss-oriented or more restoration-oriented coping, whether you’re trying evidence-based strategies or something completely different, I sincerely hope it brings you some peace today.