Beware the 5 Stages

Dr. Kubler-Ross with Mother Theresa.

Dr. Kubler-Ross with Mother Theresa.

Not long after Elisabeth Kubler-Ross’ “On Death and Dying” (1969) was published, her five stages of dying entered the popular consciousness. Those same stages were eventually used to explain the path of grief.

We love lists. Comedian David Letterman did his popular Top Tens right up to his retirement show. If you follow sports, you know the importance of rankings. What team is #1? Is your team in the Top 25? We rate cardiac surgeons and pizza joints. The Internet is filled with lists: 9 steps to financial freedom or 7 ways to grow a new head of hair.

So, my reading friends, what are Kubler-Ross’ five stages? No Googling allowed! No stealing glances at your bookshelf. No asking a spouse, child, colleague, or passing stranger for help. And once you have what you think is the correct five, please put them in order. Don’t look to the next paragraph until you’ve completed the tasks!

These are the five in alphabetical order:

  • Acceptance
  • Anger
  • Bargaining
  • Denial
  • Depression

These are the five in Kubler-Ross’ original order:

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

The first list, the alphabetic order, is accurate. Guaranteed. The second is partially a lie. A deceit. Instead of providing clarity, it promotes confusion. It is not meaningless, but it is far from honestly meaningful. Kubler-Ross wrote . . .

The five stages – denial, anger, bargaining, depression, and acceptance – are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief.

Maybe you knew or suspected the inadequacies of the “five stages.” But the lure of any list is strong. What we know is not necessarily what we feel. When we are most vulnerable, we will restlessly search for logical solutions to our emotional, physical or spiritual quagmires.

In my decades of ministry, I’ve heard some say they weren’t afraid of death . . . but feared the dying process. Dying means pain, dependence, loss of control, and a host of other uncertainties we spend our whole lives avoiding. The old trope “no pain, no gain” of the athlete curdles into a sick joke when dying becomes our last and fiercest competitor. The pain we dread from a cancer as we approach death does not have any “gain” as a goal.

In my decades of ministry, I’ve heard grieving people state: “I would give anything to take the suffering from him” or “I never knew how terrible life could be without her.” We grieve after the death, with acceptable feelings like loneliness and apathy and anxiety. We also grieve with unacceptable feelings. We resent that a loved one died and left us. We blame doctors that failed us. We hate the mean-spirited God that ignored us. Often we despise ourselves because we did too little or not enough, or we arrived too late to help. We’ll even punish ourselves later for helping too much. Humans invariably find ways to feel bad about what was done or not done.

Forget Kubler-Ross’ puny five. There are many more stages and none of them are politely labeled: pissed off, isolated, screwed (I almost used the “F” word, but lacked the courage), cursed, shameful, wounded, frightened, happy (yeah, what do you do when you’re actually glad your loved one died?), and completely, hopelessly adrift.

Who didn't like Letterman's lists?

Who didn’t like Letterman’s lists?

Please, add to the list with whatever feelings you have had when someone you love (or even someone you love and hate) is facing death. Or has died. Or you are now facing death.

I’ll try to stop upsetting or disappointing you. After all, lists can help. We like to know that we’ll graduate from college if we do A, then B, then C, and then we are D for done.

Look again at Kubler-Ross’ five. She was correct. Those feelings, those stages, were and are valid. But don’t look at them alphabetically as a way to make sense. Don’t look at them for a predictable order. You may only experience Anger and Depression. You may only experience Acceptance. You may never bargain with God, or a doctor, or your mother-in-law, but you may experience—for months or years after your beloved’s death—bouts of Denial.

And those other feelings I mentioned—say, pissed off or resentment—may be in the mix of your personal reactions or personal stages.

Your list (if we limit our words to Kubler-Ross’ wondrous insights and work) may be:

  • Anger
  • Depression
  • Anger
  • Anger
  • Anger
  • Acceptance

The person next to you may have a list like this:

  • Acceptance
  • Denial
  • Acceptance.

With a nod to Kubler-Ross, I put acceptance at the end of every list of those confronted by dying. But please criticize my hypocrisy . . . since I’ve vehemently claimed there’s no order. But the reality of mortality is everyone dies. Someone dying may never “accept” death because they believe a miracle will happen, or that lasting until the next week or month means participation in an experimental drug trial that will cure them. But we know nothing cures death. I think most understand and, in a sense, finally “accept” that.

And this is my truth about grief. It is love’s inevitable companion, on any list of love’s stages. Here’s a hastily created list about the stages of love in life:

  1. I hate boys or girls or both. I’m just a kid!
  2. I like boys or girls or both. Ah, fickle adolescence!
  3. Puppy love. Going steady. A crush. (Or whatever phrase is popular now for teens.)
  4. How ‘bout some lust? You’re getting older!
  5. Love . . . ah, finding the “one.” You complete me, Dorothy Boyd rightly said to Jerry Maguire in the 1996 film.
  6. Significant others. Soul mates.
  7. Oops, there may be divorce. (And sometimes, as adults, the list begins again near the top.)
  8. For many, whether young or old, a lifetime relationship deepens as the years pass.
  9. Death of the beloved.
  10. Grief

8f5a5798In true love, #10 anchors every list. When love matters like breath itself, grief can’t be avoided.

Despise grief. Scheme to ignore grief. Stay busy and avoid grief until you drop from exhaustion. But grief still shadows every move and moment. Guaranteed.

But there’s one thing that barely, hopefully, possibly helps us survive the “stages” of dying, death, and grief. Be with others that care about you, that understand you, and that treat you like the precious, wounded, beautiful, fragile person you are.

In the 2014 film “The Good Lie,” an African proverb was quoted: “If you want to go fast, go alone. If you want to go far, go together.”

Alone, we’ll never outrun grief. It is always a step quicker than you.

In grief, fast fails. Lists have limits. Instead, I urge you to seek time and healing and support and tenderness and understanding from others, and go far.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. I believe that someone knows when they are going to die.
    Take my sister she rang on the Monday to say our cousin had invited both of us to a family reunion, but she turned round and said it is a long way for her to travel and would be a long journey for me. She had to pick me up in bridgnorth, and had to travel from Wolverhampton, whilst she had to travel 7 miles to Bridgnorth, my journey was 15 miles on the bus. I said that I would thin k about it as it meant that I had to find accommodation in Bridgnorth to stay over the weekend. Unfortunately due to the hot weather there was no where to stay.
    I contacted my sister to say I could not make the reunion, which taken place Sunday 29th July 2018. Joan went on her own. She was found dead Wednesday 1st August 2018.
    I believe she did not want me to attend the reunion as she new her days were numbered, and worried in case there had been an accident. Instead she went to bed and died in her sleep.

  2. Having just lost my Dad to pancreatic cancer, I am grateful for this post. I am writing rather stream-of-consciousness here, so forgive the meandering.

    We so wanted to come to Acceptance. We did only in the sense that we accepted that death would end his pain; we never “accepted” his horrifying disease and found its progression and his dying process traumatic.

    I felt bitter at prayers to a “merciful and loving God”; after all, this God had either created pancreatic cancer or allowed Dad to develop it. It felt like spiritual abuse to hear and be expected to embrace prayers of gratitude for God’s love and trust in God’s wisdom.

    One of the stages we were all stuck in during his death — and me since — is Anxiety. When might we go from good health and hope and vitality to being struck with a hideous illness that debilitates, enfeebles, pains, and kills us in a matter of weeks?

    There was also a fair amount of Regret — for things done and undone in the course of his life that could never be rectified.

    Yes, there were lovely moments of Gratitude we felt for each other, and for the wonderful caretakers, but those moments were vastly and profoundly overshadowed by Anger and Anxiety.

    • Sher:

      So sorry to learn about your father. Pancreatic cancer can arrive with speed and ferocity. I very much appreciate your “stream of consciousness” thoughts. I suspect that anger and anxiety (and the other emotions and reactions) will continue, but even more I hope there will be ongoing support from family and friends as you grieve and heal.

      Thank you for sharing . . .

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