Commentary: Grief is unique to each individual

June 24, 2014 

Editor’s note: This is the fourth post of a column on grief and children that runs quarterly. If you have an idea about a future column related to this topic, please be in touch:

When helping children navigating unfamiliar and uncomfortable waters, it is natural to want to know whether how they’re doing is how they’re supposed to be doing.

Young children who demonstrate regression of skills once mastered may be worrisome to parents who do not understand that progress occurs in steps, not a straight line. Parents who understand that forging independence is a crucial part of adolescence are less likely to be concerned by their teenagers eye-rolling or offended by their preference to spend time with friends. In this way, our assessment of our children’s behaviors depends largely on our expectations of how they are supposed act.

For even the most attuned parents, it can be difficult to gauge how a grieving child or adolescent is supposed to be behaving. Similar to the parenting examples above, our sense of what is normal helps determine whether we view a child as grieving in an adaptive manner or an unhealthy one. In these cases, expectations matter, but in the absence of a clear measuring stick it can be difficult to assess.

The most culturally-ingrained understanding of how people grieve stems from the work of Dr. Elizabeth Kubler-Ross and her 1969 landmark book “On Death and Dying.” Many people are somewhat familiar with her stage model theory in which healthy grieving is characterized by successful progression through five separate stages: denial, anger, bargaining, depression and acceptance. This understanding of grief offers a concrete way of grasping a complex topic. In the decades since the book’s publication, the stage model has assumed its place as the dominant formulation of grief and driven cultural expectations of how people should grieve.

Given the popularity of the stage model, it may come as a surprise that “On Death and Dying” was not written about how people grieve the loss of loved ones. Rather, the book stemmed from Dr. Kubler-Ross’ work in helping adults grieve their own expected deaths and focused on grief in this relatively narrow context. It was not until after her book was widely read that the stage model was applied to people grieving the loss of others, for which it is now so well known. Actually, the model was based largely on Dr. Kubler-Ross’ clinical observations rather than research or empirical findings. Nevertheless, the book has shaped our society’s expectations of how people including children should grieve.

The point of this is not to diminish Dr. Kubler-Ross’ significant contributions to a previously under-discussed topic. She introduced new and provocative ways of looking at grief into the nation’s consciousness and is still, to this day, considered a giant in the field. Rather, it is to caution us from holding expectations about how we should grieve and from trying to fit experiences into one of the five stages. A child’s experience is far richer and more complex than can be captured by five stages. A grieving child’s tears do not necessarily mean that he is in the depressed stage anymore than an adolescent’s desire to be seen as normal in front of her friends means she is in denial. More broadly, while models of grief capture the trajectory of how some people cope, we must remember that grief is unique to the individual; personal and ever-changing. Expecting a grieving child to follow a formula or model can lead to guilt, disappointment, increased stress, and complicate the process.

Grief is a dynamic, evolving process unique to each individual and cannot be defined by a handful of phrases predicted to occur around a certain time or in a certain linear order. True for all ages, but especially for children whose emotional development and expression is also part of an individual, dynamic, and evolving process, grief can be more like a hike on a winding path with lots of detours than a straight route to complete healing.

Hadley Kifner is a pediatric chaplain at UNC Hospitals. Justin M. Yopp is an assistant professor in the Department of Psychiatry at UNC.

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