Where the Five Stages of Grief Actually Came From

Almost everyone knows the five stages. Very few people know they were not written about grief.

Denial, anger, bargaining, depression, acceptance. The model came out of work with people who were dying, describing how they came to terms with their own deaths. It was a description of one situation, based on observation, offered as a pattern rather than a schedule.

Somewhere between there and here it became a ladder for the bereaved, with an implied pass mark at the top.

Why the tidy version won

I do not think the stages spread because they were the best account available. I think they spread because they are easy to hold.

Grief is formless and open ended, which is unbearable to sit near. Five named steps in a fixed order turns something shapeless into something with a beginning and an end. It gives the people around you a way to ask how you are doing and receive an answer that has a shape to it.

That is a real service. It is just being provided to the wrong person. The tidy version mostly helps everybody else.

What the model costs the person actually grieving

Two things, and I see both regularly.

The first is a scoring system. If there are stages, there is a correct position on them, so there is a way to be behind. People arrive apologizing for still being angry, or for the fact that some part of them has quietly not accepted anything at all.

The second is subtler. A staged model implies grief is a process you pass through and then leave. So when it turns up again eighteen months later, in a supermarket, over something small, it does not register as normal. It registers as relapse.

Neither of those is coming from the loss. They are coming from the model.

Order is the part that does not hold

The specific claim I would let go of is sequence.

The states described are all real. People do feel disbelief, and anger, and bargaining of a kind, and flatness. What does not hold up is that they arrive in turn, once each, and hand over cleanly to the next. In practice they overlap, recur, and show up in different intensities on different days, and none of that indicates anything is going wrong.

Once someone stops expecting an order, a lot of self-monitoring falls away. That alone tends to free up energy that was being spent on grading the grief.

What I use instead

I am less interested in where someone is on a ladder than in what is still live.

So the questions I actually ask are closer to: what part of this still feels unfinished, what are you carrying that has nowhere to go, and what does your day currently cost you that it did not cost before. Those have answers. They also point somewhere, which “you are probably in bargaining” does not.

None of this means the stages are useless as vocabulary. If saying “I think I am still angry” helps you name something, use it. I would just hold it loosely, and I would not let it tell you whether you are doing this correctly.

There is no correct pace

That is the practical upshot. There is no schedule you are behind on, and no stage you were supposed to have cleared by now.

If you want to talk it through with someone who is not going to grade it, that is a reasonable reason to get in touch.

Ariel VanDoren, LPC

True North Psychotherapy

1555 Connecticut Avenue NW, Suite 401A, Washington DC 20036

202.599.0522