Monday, May 28, 2012

The truth about grief: The myth of its five stages and the new science of loss

By Ruth Davis Konigsberg

Book review by Richard L. Weaver II, Ph.D.

Konigsberg discusses the way the five stages of grief provided by Elisabeth Kübler-Ross in the book, On Death and Dying, have become a cultural touchstone and, thus, embedded in our everyday lexicon and a mainstay of pop psychology.  I first learned about the stages quite early and incorporated them into one of the editions of my book, Understanding Interpersonal Communication (Harper/Collins), and I talked about the stages, too, when lecturing in my interpersonal communication classes.  They weren’t weighty, philosophical discussions but just an introduction to a way of thinking about (interpreting?) grief.

Konigsberg writes well, and she supports her ideas effectively.  There are 200 pages of text and 41 pages of “Notes.”

I loved the way Konigsberg notches her successes.  That is, she eats away at various theories and books (like The Year of Magical Thinking by Joan Didion), morsel by morsel like a mouse eating a hunk of cheese.  By compelling her adversaries to the dust bin, she clears the way for acceptance of her ideas and point of view.

“Like Kübler-Ross’s original five [stages of grief], these additional stages [proposed by other writers about the process] were all based on anecdotes and personal experience, not methodologically sound surveys” (p. 70).

For my purposes (as a motivational speaker and writer), I found Konigsberg’s emphasis on optimism and self-preparation to deal with grief supportive of my own position:

    “Resilient grievers,” she writes on page 54, “appear better equipped to accept death as a fact of life and tend to have a more positive worldview.  Chronic grievers seem less confident about their coping abilities and more dependent on the relationship to the deceased.  (A lack of social support and financial resources also plays a role.”  These differences become apparent within the first month and are good predictors of how someone will handle the loss over time, with early success seeming to set the course toward greater well-being, while early difficulties — intense negative emotions such as the desire to die or frequent crying — are associated with poor coping after two years” (p. 54).

I found Konigsberg’s Chapter 4, “The Making of a Bestseller,” particularly interesting (being a writer myself).  How Kübler-Ross’s book, On Death and Dying, came to be published was fascinating stuff.  Konigsberg writes, “The way Kübler-Ross described it, the stages came to her suddenly, almost as if through divine inspiration” (p. 96).  The chapter is, basically, a biography of Kübler-Ross’s life.

People like stages because they are clear, specific, easy-to-follow, and easy-to-remember.  But, as Chris Feudtner of the Penn Center for Bioethics, a pediatrician who has treated hundreds of dying children at the Children’s Hospital of the University of Pennsylvania, and who, in addition to his medical degree, has a Ph.D. in the history and sociology of science, has said, according to Konigsberg:

    “The way he looks at it, any form of generalized treatment for grief is likely to miss its target.  “When you’re trying to treat someone, you’re trying to mechanistically make them better,’ he explains.  ‘If it’s something simple, like pneumococcus infects your lungs, we can kill that germ, but with something like grief, we don’t know the mechanism.  The other thing is that people have resources like resilience and strength and will just get better on their own, and it’s very hard to show a treatment effect if most people just get better anyway.  Most people spontaneously recover from six months to a year” (p. 124).

Quoting psychologist and grief researcher Toni Bisconti, now at the University of Akron, in Ohio, as reported by Konigsberg:

    “Grief is anything but linear [as in Kübler-Ross’s stages], and my data showing consistent ups and downs are obviously in conflict with stage theory,’ Bisconti told me.  ‘Stage theories are also conducive to self-fulfilling prophecies and confirmation biases.  In other words, if I lose my partner/spouse and I am angry on a given day, I’ll think I’m in the anger stage and discount the fact that also on that day I might be sad, distraught, even happy at a given moment” (p. 72).

I found this book intriguing, enlightening, and thoroughly engaging.  For those involved in, or who know others who are going through, the grieving process, it is a must read.

The truth about grief: The myth of its five stages and the new science of loss can be purchased at Amazon

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