Thursday, March 4, 2010

The trouble is that it turns out largely to be a fiction

Megan O'Rourke has an interesting article in the February 1, 2010 edition of the New Yorker, Good Grief: Is there a better way to be bereaved. Interesting because it highlights how tentative and theoretical scientific information becomes incorporated uncritically and sometimes dogmatically into popular discourse from which it then becomes difficult to correct.
The "stage theory," as it came to be known, quickly created a paradigm for how Americans die. It eventually created a paradigm, too, for how Americans grieve: Kubler-Ross suggested that families went through the same stages as the patients. Decades later, she produced a follow-up to "On Death and Dying" called "On Grief and Grieving" (2005), explaining in detail how the stages apply to mourning. Today, Kubler-Ross's theory is taken as the definitive account of how we grieve. It pervades pop culture - the opening episodes of this season's "Grey's Anatomy" were structured around the five stages - and it shapes our interactions with the bereaved. After my mother died, on Christmas of 2008, near-strangers urged me to learn about "the stages" I would be moving through.

Perhaps the stage theory of grief caught on so quickly because it made loss sound controllable. The trouble is that it turns out largely to be a fiction, based more on anecdotal observation than empirical evidence. Though Kubler-Ross captured the range of emotions that mourners experience, new research suggests that grief and mourning don't follow a checklist; they're complicated and untidy processes, less like a progression of stages and more like an ongoing process - sometimes one that never fully ends. Perhaps the most enduring psychiatric idea about grief, for instance, is the idea that people need to "let go" in order to move on; yet studies have shown that some mourners hold on to a relationship with the deceased with no notable ill effects. (In China, mourners regularly speak to dead ancestors, and one study has shown that the bereaved there suffer less long-term distress than bereaved Americans do.) At the end of her life, Kubler-Ross herself recognized how far astray our understanding of grief had gone. In "On Grief and Grieving," she insisted that the stages were "never meant to help tuck messy emotions into neat packages." If her injunction went unheeded, perhaps it is because the messiness of grief is what makes us uncomfortable.

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