I remember learning about Elisabeth Kubler-Ross’ book, “On Death and Dying” in high school.
Like any philosophically-hungry(yet, admittedly “wet-behind-the ears”) teen, I gobbled up the concepts and licked my fingers clean.
For the uninitiated (or unwilling to google), here’s the Reader’s Digest version of her seminal piece:
There’s five stages to grief.
As a young person whose mind was just opening up to grander ideas, the fact that someone had tackled–even talked –about taboo concepts like dying and death was incredibly fascinating.
I began delving into Kubler-Ross’ work more deeply when I was in college. Although I was never assigned her actual book to read(so, of course never read it), her name and stage theories were mentioned in countless textbooks.
I remember having to write essays on grief in my Sociology of Religion class and being tested on these stages while taking an Interpersonal Psychology class in my graduate program in Counseling.
I can’t remember exactly but, nerd that I was, I’m pretty certain that at one point I’d crafted a cheesy acronym on a lined index card to help me memorize the stages; probably something like:
- Abe Lincoln
(Ok. Perhaps acronyms were never my strong suit, but be honest–for a moment your brain tried to imagine what burnt apricots might smell like, right?)
And, thanks to my concocted fruity mnemonic tool, I was able to mind-spill the ordered stages back onto a lined blue-book at some point in my hallowed academic career.
All this learnin’ and junk prepared me for an early-life career as a therapist.
I spent the first ten or so years of my adult life as a counselor, working mainly with kids and teens.
Many of my jobs(yes, jobs—there’s a high burnout rate in social services) found me in communities that experienced higher-than-average levels of criminal activity.
It was not uncommon for the kids and teens I worked with to have lost a family member or friend. Many of these kids were experiencing significant losses in their lives, and not necessarily just to death. Some came from fractured families where a parent’s boyfriends/girlfriends would carousel in and out. Some had more than one family member in jail. Some were in foster care.
These children’s lives were not reflective of the average childhood; loss, instability and uncertainty were familiar themes.
I remember occasionally regurgitating Kubler-Ross’ stages in sessions with the kids and sanctimoniously regaling them with (what I believed to be facts).
I would often say to them, “You know there are 5 stages to grief, right?–It sounds like you might be in the first stage, DENIAL…blah, blah, blah.”
Sometimes the kids would look at me and say, “Oh ok. I never knew that”.
More commonly, they’d simply respond with, “I dunno–I guess.”
And maybe it helped a kid or two somewhere…who knows?
All I knew about grief and loss was Kubler- Ross’ work….typed letters I’d brain-burn memorized from a twenty year-old textbook.
I’d known no real loss.
I’d yet to meet the shape-shifting visage of grief.
It wasn’t until I started working as a therapist at The Emmanuel Cancer Foundation that I put my muck boots on and started drudging myself and my families through the foul mounds of sludge and mud that is grieving.
I would never be so bold as to suggest that there are “degrees” to death; that some deaths are good and some are God-awful.
But, except for maybe the most hard-hearted of us all , we can probably agree that watching a 3 year old die slowly, painfully–well, as one mom who experienced it once described to me,
“It’s like you’re tied up with ropes and someone takes a dull knife and starts slowly peeling off your skin. And he’s laughing while your screaming…”
In my five years with the agency, I witnessed the dying and the deaths of several children. I also witnessed the symbolic dying and deaths of many parents and siblings.
And I also witnessed, thanks to a mournful and(deservedly) agitated recently-bereaved mom, my own absolute ignorance and arrogance in the face of death.
I’d been working with this family for about two years. They’d lost their son about 6 weeks before our emotionally-laden session. This particular follow-up session was the first time I was meeting mom since seeing her at his funeral.
Mom and I had, up until this point, a really solid therapist-client relationship. She’d been in counseling for other reasons in the past, so she knew how it worked.
Her son’s death was not sudden. She and her family had time to prepare; time to plan; time to say their goodbyes.
Here’s some context that’ll lay the foundation for our infamous session:
Mom went back to work a week after her son died. She felt she needed to return to normalcy; her family needed her paycheck and she needed a distraction.
A few days after she went back to work, she started to get some odd physical symptoms.
She shrugged them off for a while but the symptoms soon started getting worse. She went to her doctor and he prescribed a steroid that is almost always effective. The steroid hand’t worked.
She went back to the doctor a few more times to change medications but the symptoms persisted. By the time she’d met with me 6 weeks later, she’d been to two different specialists, been on four different medications and was feeling as poorly as ever.
During our session, she was explaining this all to me–as she was going through her physical symptoms, my “academic’s brain” was quick to come up with the “obvious” diagnosis.
“Duh!”, I thought to myself as she was sharing her frustration over these odd symptoms, “She’s in Stage 1–Denial!!!!! She’s failing to feel her emotional pain–failing to address the reality of her son’s loss–and that EMOTIONAL pain is manifesting itself in a PHYSICAL form!!! UREKA!!!!! I’m an awesome therapist–I can’t wait to tell her so she can have a huge breakthrough and start going moving on to Stage 2 Anger“.
So I waited for her to finish her synopsis of the previous six weeks and, in my most empathic and well-intentioned clinician’s voice, responded with,
“You know there are 5 stages to grief, right?–It sounds like you might be in the first stage, DENIAL…blah, blah, blah.
She politely waited for me to step down from my sanctimonious soap box and followed-up with a question,
“How many people have died in your arms?”
My face flushed. I started shaking. I was shocked.
“Uhhhh…..none?…” was all my 18 years of formal education had to offer.
“Come back to me when someone has and we can start talking about your bullshit stages then.”(note….those may not have been her exact words, but the feelings underneath bleed through)
I took off my book-smart therapist’s hat at that moment and turned into a human being.
I apologized, told her she was right and said I would be there if she needed to talk in the future.
To her credit, she did reach out a few more times and invited me to a celebration of a memorial garden in her son’s honor. Still, I never feel our relationship was the same.
Sure, any good therapist would’ve capitalized on this opportunity for her to show anger. Any good therapist would’ve turned this into a “teachable moment” a “clinical breakthrough”; would’ve seen this as evidence, perhaps of transference.
But any good therapist would also have been able to see what was going on on a deeper level–countertransference. She (quite appropriately) called me out. I was so quick to intellectualize–to “put a stage” to her experience–to label it, that I failed to just listen.
I defaulted to book knowledge because I had no real-world knowledge.
And she called me on it.
And I felt like an idiot.
Fast forward a few years, and I am that mother. I am that feeling, grieving person.
But I’m also still that therapist. So the human being in me “feels” a certain way, but then the therapist in me goes, “hmmm…but what does that feeling really represent..”
And the answer is, neither the feeling human being nor the thinking therapist has any fricking clue what the truth is.
Regretfully, what I’ve often done over the past two years has been to go to the only Grieving Treatise I know, and that’s those verdamate Five Stages of Grief.
A few weeks ago, my cousin started a blog called Good Grievings. You should check it out.
In it, he chronicles the series of sudden, dramatic losses he’s experienced in his relatively short life and the impact it’s had on him as a man. While reading through his posts, I noticed that he mentioned stages of grieving. Not only did he mention said stages, he also suggested that, for him, understanding the stages of grief was really helpful in allowing him to heal.
This totally confused the heck out of me!! I started questioning what I was doing wrong. He refers to the stages and is offered clarity! I refer to the stages and am more muddled than ever! How is this possible? What the heck is wrong with me?
So I decided to go back and revisit what I’d learned in school over twenty years ago.
The teacher in me decided to do some more research on Elisabeth Kubler- Ross’ work.
I’m not going to lecture, don’t worry.
If you’re interested, you can find a wealth of information at this website: Elisabeth Kubler Ross Foundation.
What I will share with you is a brief description of a Foreward taken from the 40th anniversary of the edition of “On Death and Dying”:
“… the so-called “stage theory” that you will read in this book is openly described and discussed as a heuristic device. In other words, these stages are merely a set of categories artificially isolated and separately described so that the author can discuss each of these experiences more clearly and simply. The careful reader will note Kübler-Ross’s own repeated warnings that many of these “stages” overlap, occur together, or even that some reactions are missed altogether. To emphasize this conditional way of taking about stages, the word “stages” was even put in inverted commas to emphasize their tentative nature in the only diagrammatic representation of these ideas in the book.”
So basically, Kubler-Ross deserves some major cred for giving a crap about dying people at a time when death was way more taboo a topic than it was today(and it’s still something most of us would like to pretend does not exist).
She cared enough to not only talk to people facing their imminent mortality, but to take note of and categorize some common themes in their emotional responses.
And those categorizations of themes got turned into a book…and somewhere over the years, those words of dying people–those stories shared of their own individual fears and desires and hopes became distilled, homogenized and “Listicled”.
If Kubler-Ross were alive today, I could see these stages displayed in a Buzzfeed listicle:
“Dead Man Talking: Shocking List of The Last 5 Things You’ll Think When You’re Dying”
“Final Five While You’re Alive: What are They?”
“Five Stages for the Ages: What are YOUR Last Words Likely to Be?”
We like lists. We’re all about answers. We savor sinking our teeth into the stability of the stages because they offer us something that is “known”.
But here’s the thing: just like our lives and living is an ever-unraveling mystery, so, too are our deaths and dying.
So I’ leave you with this;
In the end, I think I find solace in the aforementioned acronym for the Five Stages of Grief. When I’m feeling particularly stuck or low, I ask myself the following question:
Did Abraham Lincoln burn dried apricots?
And I’m content with the answer I hear.