The Science of Grief: Why the Five Stages Were Never Real Rules

TEST_YOURSELF · How well do you know this science?

1. 01 Where did the famous 'five stages of grief' actually come from?

   A large longitudinal study of widows and widowersInterviews with terminally ill patients facing their own deathA meta-analysis of grief therapy outcomesFreud's clinical case studies of mourning

   Kübler-Ross developed the stages in On Death and Dying (1969) from interviews with dying patients about facing their own death. The model was later applied to bereavement without being validated for it. source ↗

2. 02 In the first large prospective study of bereavement (Bonanno et al., 2002), which trajectory was most common?

   Chronic grief — distress that stays high for yearsCommon grief — high distress followed by gradual recoveryResilience — low, stable distress throughoutDelayed grief — feeling fine at first, then breaking down later

   Resilience was the most common trajectory at 45.9% of the sample — measured from about three years before the loss through 18 months after. The 'expected' pattern of high distress then recovery fit only about 11%. source ↗

3. 03 According to the Dual Process Model (Stroebe & Schut, 1999), what does healthy coping with loss look like?

   Confronting the grief continuously until it is fully processedOscillating between facing the loss and attending to everyday lifeDistracting yourself until enough time has passedCompleting each of the five stages in order

   The model identifies loss-oriented and restoration-oriented stressors and describes a regulatory process of oscillation: the griever at times confronts, at other times avoids, the different tasks of grieving. Both movements are part of coping. source ↗

4. 04 What did the continuing bonds research (Klass, Silverman & Nickman, 1996) conclude about staying connected to someone who died?

   It is a sign of unresolved grief that requires treatmentIt only occurs in the first year after the lossIt is common across cultures and typically part of healthy adaptationIt prevents people from forming new relationships

   Continuing Bonds (1996) documented that bereaved people across cultures maintain inner relationships with the deceased, and that these bonds are typically a normal, often helpful part of adaptation — not pathology. source ↗

5. 05 When stage theory was finally tested in a large empirical study (JAMA, 2007), which response did bereaved people endorse most frequently from the start?

   DenialAngerBargainingAcceptance

   Maciejewski and colleagues found acceptance was the most frequently endorsed item throughout the study period — including right after the loss — while denial never dominated. Most people did not move through the stages in the theorized sequence. source ↗