I don’t often read a book that catapults me into as profound a rethink as The Truth About Grief has. It is not a particularly riveting book. It will never make it on to my top 20 greatest reads. But it is making me question how I ever came to accept Elizabeth Kubler-Ross’s stages of grief as if handed down from above on tablets of stone.
One reason, I suspect, is that before I encountered them as a therapy student I had already absorbed them through the pores of my skin. They have become part of our culture. And then later, when EFT became the core tool of my therapy, I made decisions about whether/when tapping was appropriate for grief on the basis that that description of grief was a prescription – that it was normal and inevitable and to be messed with or missed out at our peril. I thought it was fact, not merely belief.
And I also taught that.
So when I was in the gym and stumbled across an old BBC podcast on my iPod in which author Ruth Davis Kongsberg was interviewed about the lack of evidence for Kubler-Ross’s stages of grief and about more recent evidence that actually discredits them, I was online to Amazon to order her book quicker than you could say “workout over.”
Kubler-Ross’s original book was about how the dying face death, not how those left behind deal with it. It grew out of unstructured interviews with terminally ill patients – not necessarily a sound methodology because not everyone is asked the same questions and questions reflect the questioner’s bias rather than the interviewee’s experience. Kubler-Ross was initially more interested to understand better how the medical establishment dealt with death than how the dying, let alone the bereaved, did. That all came later.
It became a book when an editorial assistant at a publishing company, which had recognized a gap on its list for a book on death, read an article she had written and offered her a deal. She had three months to deliver. And, in her autobiography, Kubler-Ross said it took her three weeks of late nights struggling to formulate a concept. Then it hit her she said – everyone who faces a loss including her dying patients went through the same stages.
The trouble, as I am now seeing it, is: a) the stages getting to be seen as gospel b) not just for the dying but also for those left behind c) and then for all losses including jobs and contact lenses d) giving rise to a culture, especially among professionals, that people need to go through these stages or they will be sorry later. And it follows that e) if we professionals intervene, other than to listen and tell them what they are experiencing is normal, we do so at their peril.
In fact, Kubler-Ross never put her theory to any test. She did not do research and have it published in a peer-reviewed journal. She never pointed out that her theory was about how people faced death, not how those left behind coped with it.
In an interview with Playboy magazine in 1981 she said: “Even though I called it the stages of dying, it is really a natural adjustment to loss. Some people go through it if they only lose their contact lens.”
So where am I now? I retain some old certainties. When a death is traumatic, using EFT to process the trauma can be an extremely helpful way to move someone from the shock of the trauma to whatever comes next for them. That has not changed. And if grieving is unusually prolonged and disabling and the grief-stricken person wanted help I have never had reservations about tapping with them.
But the territory in between, the time I believed people needed to go through this “natural” process with support but without interference, is now a big question mark for me. If there is no evidence for the validity or universality of the stages and there is no evidence that there will be detrimental effects of people do not go through them, why not just tap on what people are experiencing and want not to, just as we would with any other client?
My rethink is freeing me up to think it is okay to follow the philosophy I have always had with all clients – with the single exception of this group – that my job as a therapist is to get into the world of the client sitting with me as much as I can and work out together what would be helpful for them.
It doesn’t mean people will not grieve, that they will not continue to miss the person who died for the rest of their lives. It does not mean that sadness will not keep coming back from time to time for a long time, and possibly for as long as they live.
It just means that I no longer feel that bereaved clients should be deprived of the benefits of EFT just because they are bereaved, or therapists constrained by a belief about grief that an author dreamed up to meet a publishing deadline all those years ago.