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The Ubiquitous, Confounding, Misunderstood 5 Stages Of Grief


You've probably heard of the five stages of grief. I mean, they're pretty firmly lodged into American pop culture. There's...


STEPHEN COLBERT: Stage one, denial. I've never had that.

CHANG: Anger.


ELLEN POMPEO: (As Dr. Meredith Grey) We become angry with everyone - angry with survivors, angry with ourselves.

CHANG: Bargaining.


DAN CASTELLANETA: (As Homer Simpson) Doc, you've got to get me out of this. I'll make it worth your while.

CHANG: Depression.


UNIDENTIFIED ACTOR #1: (As character) There is no hope. It's over.

CHANG: And acceptance.


SONIA MANZANO: (As Maria) Big Bird, we still have our memories of him.

CAROLL SPINNEY: (As Big Bird) Yeah, memories. Right.

CHANG: Those five words have become a common vocabulary to process the unimaginable, especially this last year, when millions of people lost family or friends to COVID-19. So the podcast "Radiolab" took a closer look at where those five stages of grief came from. Producer Rachael Cusick went in search of the woman who came up with that list, and she joins us now to tell us more about her.


RACHAEL CUSICK: Hi. Thank you.

CHANG: Hi. So you talked about how your interest in this actually started with your own loss. Can you tell us a little more about that? Like, how did the five stages of grief come into your life?

CUSICK: Yeah, so I lost my mom to cancer when I was 6 back in 2001. And because I was so young when she died, there was never really a bunch of words that made sense to, like, go along with the feelings that I had and all the grief that I was experiencing. And eventually, as I got older, the stages of grief came into my life, probably from pop culture. And they were so exciting for a minute because they just finally made sense, all those feelings I had been having.

But I think as I got older, I struggled a lot to fit into those stages. And eventually, instead of becoming my superhero, they became this villain in my life, like, this reminder of all the ways that I couldn't control my grief or make it make sense. And I kind of wanted to know who created these stages that had bullied me my whole life. And eventually I Googled it, and it is Elisabeth Kubler-Ross. And I just became obsessed with her. Like, I met her son, and he kind of opened this door to the many, many people in her world and just the complexity that she was.

CHANG: And what was interesting is that when she was coming up with these five stages of grief, she wasn't studying people who had lost loved ones like yourself, right? Like, she was studying people who were themselves dying.

CUSICK: Yeah. For me, that was what was so fascinating. Like, she had started as a doctor in Switzerland and was this country doctor who watched dying all the time. And then she moved to Chicago, and she was working at the University of Chicago. And she's sitting in her office, and these students came to her.


ELISABETH KUBLER-ROSS: Theology students had a research project on crisis and human life.

CUSICK: So Elisabeth Kubler-Ross died in 2004, but there are a ton of archival interviews that I've been listening to from her.


KUBLER-ROSS: And four of the whole class have chosen dying as the biggest crisis human beings have to face. But you can't do research on this. You can't verify it. You can't make double-blind studies.

CUSICK: And she kind of thought, like, why don't we just go talk to someone who's actually dying?


KUBLER-ROSS: You know, let's get as close to them as they allow us to come. Let's sit with them and listen to them as long as they allow us to sit and listen.

CUSICK: And for her, that started this stone rolling. Like, she wanted to find out everything that the dying wanted to tell us.


KUBLER-ROSS: What kind of fears, fantasies, turmoil they go through, what kind of hopes and expectations perhaps they wish to share.

CUSICK: But in the beginning, it was so hard for her to even find a single dying patient to talk to because dying patients back then, they were tucked away in the back of the hospital corners.

CHANG: Which really struck me because I was thinking, you know, today as a society, we're still really uncomfortable talking about death. But you explain how that discomfort was even more extreme back in the 1960s.

CUSICK: Yeah. Doctors didn't even have to tell patients that they were dying. And so a lot of the times, these conversations just never were had about the end of life.

CHANG: So tell us what happens when Elisabeth Kubler-Ross comes along and she starts urging people not to look away when death is approaching?

CUSICK: People were not fans, especially inside the hospital. The doctors, they really hated what she was doing because it went against everything that they had been taught about protecting patients and preserving life. But the people outside the hospital and the patients, they craved it. Like, they were just asking for more and more. It was like pulling back this curtain to a world that they had never seen before.

CHANG: Yeah.

CUSICK: And so eventually, Elisabeth starts gathering all these interviews she had done and putting them into a book. And she goes on this worldwide tour. And to me, she's kind of like this rock star. Like, people are lined up all around the world. All the seats are filled inside of these halls where she would speak. I talked to one of her assistants, Dennis Klass, and he told me a little bit about what these speeches were like.


DENNIS KLASS: When she started speaking in that little soft voice, she could have an audience in the palm of her hand for the next 45 minutes.

CUSICK: So these speeches, she talked about a lot of things in them, but one thing that came up kind of as like a structure to organize these speeches were these five stages of grief for dying people. But the people in the crowd, they were grieving people they had lost, and it just kind of clicked for them. And they held on to these stages, too.


KLASS: It gave you some handles by which you could say this is not a totally irrational and unpredictable experience. In those days, I would have people, you know, talk to me, and they would say, well, I think I'm OK. I think I hit a bargain the other day. (Laughter) You know, people would measure themselves by that.

CHANG: The thing is, you found as you were digging into this that these five stages of grief weren't imagined as some sort of handy-dandy sequence of steps, right? Like, it was always a lot more complicated than that.

CUSICK: Yeah. If you look at this book, it's really hard to pick out a single stage. She uses them as these chapter headers, but the meat of this book is never, like, this prescriptive grocery list of what you need to go through. It's this really rich and complex portrait of what it's like to die. And when I interviewed her son, Ken Ross, he said that people before, they just didn't talk about death this way.


KEN ROSS: Back in the '60s, there was no common language. There was nothing they could talk about. So she said by creating five stages, it's something simple that any layman or any family member can remember.

CUSICK: And her real mission wasn't just making emotions simple. It was encouraging people to actually express those feelings...


KUBLER-ROSS: If you do not come give them a pat on the back and say, don't cry, it's not so bad - it is bad to leave everything and everybody you love. So if we help them be angry and help them be sad and let them express it and cry...

CUSICK: ...Not to avoid or ignore people who are dying.

CHANG: Where do you personally land after all of this? Like, your original hatred of the five stages of grief was what drove you to do this project. But I'm just curious, how do you feel about these stages now?

CUSICK: It's complicated because these stages, I hate them, and they feel very limiting, especially for something as complicated as grief. But for me, after this last year of reporting on her, they led me to explore my own grief and meet people that kind of changed my life. And so now I feel a little bit grateful for them in this weird way.

CHANG: That is Rachael Cusick. She's a producer with the podcast "Radiolab." Her full episode on the five stages of grief is out today.

Thank you so much for joining us today, Rachael.

CUSICK: Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.
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