Good Grief!
by Paul Wilner
JANUARY 10, 2011 TAGS:
It’s fitting that Ruth Davis Konigsberg’s The Truth About Grief: The Myth of Its Five Stages and the New Science of Loss (Simon & Schuster) -- a tart, well-researched take-down of the bereavement industry Elisabeth Kubler-Ross spawned -- takes place when “narcissistic personality disorder’’ has been eliminated from that psychiatric staple, the Diagnostic and Statistical Manual of Mental Disorders.
Given the sorry state of the world – the lousy economy, the violence at home and two wars abroad, and the surprising popularity of Taylor Swift – it seems like it’s time (OK, well past time) to get real.
Which is just what Konigsberg does in her book, a merciless look at the “five stages’’ of grief – denial, anger, depression, bargaining and acceptance - and their scientific basis, which, according to her research, is basically nonexistent.
In the tradition of Jessica Mitford’s expose of the funeral industry, Konigsberg does a fearless job of explaining what Kubler-Ross is saying, and why it doesn’t apply to the situations most of us face when we lose a loved one.
The author dryly notes that her first close encounter with the “five stages’’ outlined in the 1969 bestseller, On Death and Dying, came in a high school psychology class taught by a teacher “moonlighting from his usual role as a wrestling coach.’’ The primal flaw in our culture’s journey into the bereavement and counseling industry, she says, is that Kubler-Ross was initially writing “about the experience of facing one’s own death, not the death of someone else.’’ Her formula was subsequently applied to the grieving process itself, and the good doctor had no objections to the appropriation and marketing of her ideas for this new purpose.
“From the 1970s to the 1990s, thousands entered the field, setting up healing centers and offering individual counseling or hosting support groups at hospitals, churches and even funeral homes,’’ Konigsberg writes. “In this increasingly complex emotional landscape, grief became a ‘process,’ or a ‘journey’ to be completed, as well as an opportunity for growth. Few questioned the necessity of a large corps of private counselors dedicated to grief, despite the fact that no country other than the United States seemed to have one.’’
With good reason. A 1984 Institute of Medicine report found that “a lack of a reliable way to measure grief was a major barrier to being able to help the bereaved.’’ More tellingly, a Yale University study seeking to determine whether the grief process did indeed mirror Kubler-Ross’ theories found instead the opposite. When 233 people were interviewed between one to 24 months after the death of a spouse, “most respondents accepted the death of a loved one from the very beginning,’’ she reports, in stark contrast to Kubler-Ross’ conclusion that “acceptance’’ is only the final stage.
“Grief counselors are by and large, not a sinister bunch out to make a buck off of other people’s misery, but they do, in the interest of self-preservation, have a stake in convincing us that grief is long, hard, and requires their help,’’ Konigsberg writes, with admirable restraint. But she can’t help noting, after attending the 2009 annual conference of the Association for Death Education and Counseling, that “just about anybody who has a completed college can get a Certification in Thanatology,’’ defined on Wikipedia as “the academic, and often scientific, study of death among human beings.’’ Well, maybe not so scientific.
According to the experts Konigsberg contacted, there are “anywhere from 20,000 to 100,000 people who specialize” in to bereavement support, despite slim evidence that it accomplishes anything -- besides, in many cases, prolonging the grieving process.
Konigsberg does not question the desirability of ordinary human traits like sympathy and compassion for helping people deal with death, but she raises serious questions about the way we are going about it.
“Many Americans who lose a loved one are more resilient than we give them credit for,’’ she writes, raising a rhetorical eyebrow at the excesses of such celebrated accounts as Joan Didion’s The Year of Magical Thinking. In it Didion describes being so distraught by the death of her husband, John Gregory Dunne, that she continued to “harbor hope that he was still alive for a full year’’ even though he had lived to 71 and had a history of heart disease.
Most people are familiar with, and have reached “acceptance’’ of, the contours of the circle of life (to quote that famed thanatological work, The Lion King). Konigsberg suggests that those who have relatively happy, stable lives with well-established boundaries, are likely to move on successfully, even as they allot time to mourn the death, and cherish the memory, of someone they loved. In this case the cure may be worse than the disease.
“Instead of rushing about to find the healthiest way to grieve, it would be more helpful to update ourselves on what little science that has been conducted in this area tells us: that most people are resilient enough to get through loss and reach an acceptable stage of adjustment on their own,’’ she writes. “A smaller minority will have a much harder time of it, and clinicians should focus their efforts on tailoring interventions for this group that are based on evidence, not myth.’’
That might be bad news for the grieving industry, but could be a big relief – and a welcome respite from a guilt trip – for the rest of us.
Paul Wilner, a frequent contributor to Obit, is based in Monterey, Cal.
Illustration by COCOMARIPOSA via Flickr
Given the sorry state of the world – the lousy economy, the violence at home and two wars abroad, and the surprising popularity of Taylor Swift – it seems like it’s time (OK, well past time) to get real.Which is just what Konigsberg does in her book, a merciless look at the “five stages’’ of grief – denial, anger, depression, bargaining and acceptance - and their scientific basis, which, according to her research, is basically nonexistent.
In the tradition of Jessica Mitford’s expose of the funeral industry, Konigsberg does a fearless job of explaining what Kubler-Ross is saying, and why it doesn’t apply to the situations most of us face when we lose a loved one.
The author dryly notes that her first close encounter with the “five stages’’ outlined in the 1969 bestseller, On Death and Dying, came in a high school psychology class taught by a teacher “moonlighting from his usual role as a wrestling coach.’’ The primal flaw in our culture’s journey into the bereavement and counseling industry, she says, is that Kubler-Ross was initially writing “about the experience of facing one’s own death, not the death of someone else.’’ Her formula was subsequently applied to the grieving process itself, and the good doctor had no objections to the appropriation and marketing of her ideas for this new purpose.
“From the 1970s to the 1990s, thousands entered the field, setting up healing centers and offering individual counseling or hosting support groups at hospitals, churches and even funeral homes,’’ Konigsberg writes. “In this increasingly complex emotional landscape, grief became a ‘process,’ or a ‘journey’ to be completed, as well as an opportunity for growth. Few questioned the necessity of a large corps of private counselors dedicated to grief, despite the fact that no country other than the United States seemed to have one.’’
With good reason. A 1984 Institute of Medicine report found that “a lack of a reliable way to measure grief was a major barrier to being able to help the bereaved.’’ More tellingly, a Yale University study seeking to determine whether the grief process did indeed mirror Kubler-Ross’ theories found instead the opposite. When 233 people were interviewed between one to 24 months after the death of a spouse, “most respondents accepted the death of a loved one from the very beginning,’’ she reports, in stark contrast to Kubler-Ross’ conclusion that “acceptance’’ is only the final stage.
“Grief counselors are by and large, not a sinister bunch out to make a buck off of other people’s misery, but they do, in the interest of self-preservation, have a stake in convincing us that grief is long, hard, and requires their help,’’ Konigsberg writes, with admirable restraint. But she can’t help noting, after attending the 2009 annual conference of the Association for Death Education and Counseling, that “just about anybody who has a completed college can get a Certification in Thanatology,’’ defined on Wikipedia as “the academic, and often scientific, study of death among human beings.’’ Well, maybe not so scientific.
According to the experts Konigsberg contacted, there are “anywhere from 20,000 to 100,000 people who specialize” in to bereavement support, despite slim evidence that it accomplishes anything -- besides, in many cases, prolonging the grieving process.Konigsberg does not question the desirability of ordinary human traits like sympathy and compassion for helping people deal with death, but she raises serious questions about the way we are going about it.
“Many Americans who lose a loved one are more resilient than we give them credit for,’’ she writes, raising a rhetorical eyebrow at the excesses of such celebrated accounts as Joan Didion’s The Year of Magical Thinking. In it Didion describes being so distraught by the death of her husband, John Gregory Dunne, that she continued to “harbor hope that he was still alive for a full year’’ even though he had lived to 71 and had a history of heart disease.
Most people are familiar with, and have reached “acceptance’’ of, the contours of the circle of life (to quote that famed thanatological work, The Lion King). Konigsberg suggests that those who have relatively happy, stable lives with well-established boundaries, are likely to move on successfully, even as they allot time to mourn the death, and cherish the memory, of someone they loved. In this case the cure may be worse than the disease.
“Instead of rushing about to find the healthiest way to grieve, it would be more helpful to update ourselves on what little science that has been conducted in this area tells us: that most people are resilient enough to get through loss and reach an acceptable stage of adjustment on their own,’’ she writes. “A smaller minority will have a much harder time of it, and clinicians should focus their efforts on tailoring interventions for this group that are based on evidence, not myth.’’
That might be bad news for the grieving industry, but could be a big relief – and a welcome respite from a guilt trip – for the rest of us.
Paul Wilner, a frequent contributor to Obit, is based in Monterey, Cal.
Illustration by COCOMARIPOSA via Flickr
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COMMENTS (2)
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Joanne Cacciatore wrote on January 24, 2011 4:46pm
Certainly, adding to the body of scientific knowledge on either side of the "devastation vs resilience" following death fence is important. I applaud Ms. Davis Konigsberg for an provocative exploration that will keep us talking about death. However, traumatic deaths should not only be differentiated, but journalists, mental health providers, and researchers alike carry the onus of responsibility to note this when discussing death and grief. Simply, traumatic deaths are vastly different from deaths which occur within the expected range of human experience and the nature of relationship and the quality of attachment also matter. The deaths of babies and children, suicides, and homicides, for example, will incite an entirely disparate range of emotional experiences and expressions from the person whose 100 year old grandmother dies. Failure to illuminate these nuances in death experiences, particularly in public places like this, feels a grave oversight and may add to the already salient intolerance for the traumatically bereaved. The fact is that most parents whose children die are not so willing to "accept" as is posited here. --Joanne Cacciatore, PhD, LMSW [Report Comment]
Joanne Cacciatore wrote on January 24, 2011 4:38pm
Certainly, adding to the body of scientific knowledge on either side of the "devastation vs resilience" following death fence is important. I applaud Ms. David Konigsberg for an provocative exploration that will keep us talking about death. However, traumatic deaths should not only be differentiated, but journalists, mental health providers, and researchers alike carry the onus of responsibility to note this in discussing death and grief. Simply, traumatic deaths are vastly different from deaths which occur within the expected range of human experience. The deaths of babies and children, suicides, and homicides, for example, will incite entirely disparate range of emotional experiences and expressions than the person whose 100 year old grandmother who dies. Failure to illuminate these nuances in death experiences in public places like this feels a grave oversight and may add to the already salient intolerance for the traumatically bereaved. The fact is that most parents whose children die are not so willing to "accept" as is posited here. --Joanne Cacciatore, PhD, LMSW [Report Comment]
