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Health > Under the Rainbow3/14/07 IS Online

How Do We Grieve?

Testing the traditional theory.

By Angela Ellenwood

A study published in the Feb. 21, 2007, issue of the Journal of the American Medical Association presents the first empirical examination of the stage theory of grief. The theory gained popularity after publication of the 1969 book, On Death and Dying, by Elisabeth Kübler-Ross. In it, Kübler-Ross examined her studies of people facing their own death and adapted the previously accepted stages of grief to present denial, anger, bargaining, depression and acceptance as the “Five Stages of Receiving Catastrophic News.”

The stage theory of grief has since evolved and been applied to losses other than death. It’s commonly believed that the grieving process starts with disbelief, followed by yearning, anger, depression and finally acceptance. Doctors and mental health professionals often use the stage theory of grief as a guide when evaluating patients.

Medical researchers from Harvard and Yale universities studied 233 people who had a loved one die from natural causes. Participant responses to three grief assessments in the two years following their loss produced some surprising results.

Contrary to the stage theory of grief, the study indicates that disbelief is not the first, dominant grief response, and most people reach the acceptance stage much earlier than previously believed. The researchers concluded the most common initial responses to the natural death of a loved one are an acceptance of the loss and a yearning for the deceased, not disbelief or depression.

Another finding shows most people will experience all stages of grief by six months after the loss. But the grieving process takes longer than originally believed. Current clinical guidelines say depression more than two months after the death of a loved one can indicate a major depressive disorder. However, most people don’t move through depression until the six-month mark. When treating grieving people, the researchers recommend focusing on symptoms of yearning, rather than sadness or depression.

Acknowledging that not everyone moves through the precise stages and sequence of grief, the researchers hope their results will help health professionals and laypersons understand what to expect following the death of a loved one. Since the study showed negative emotions tend to peak and subside within six months of the loss, further evaluation and treatment may benefit people whose negative grief responses last beyond that period.

 
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