Rethinking Kübler-Ross
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The grieving process, says the Columbia psychiatrist, doesn’t happen in defined stages; it’s about breaking an “attachment system.”
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Dr. Katherine Shear:

Dr. Katherine Shear is the Marion E. Kenworthy Professor of Psychiatry in Social Work at Columbia University. A graduate of the University of Chicago and Tufts University Medical School, her primary areas of investigation include anxiety disorders, depression, and (most recently) bereavement and grief. Her research has produced a number of widely used clinical assessment tools, including the Panic Disorder Severity Scale and the Generalized Anxiety Disorder Severity Scale. Dr. Shear's groundbreaking grief research was recently featured in the New York Times.
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TRANSCRIPT:

Question: Do people grieve in stages, as Kübler-Ross suggested?

Dr. Katherine Shear: Yeah. I mean, I think Kübler-Ross did an enormous service to medicine and to the world at large by drawing attention to the importance of basically reactions to dying and then to death itself. However, her insights or whatever – her ideas, I think, about what exactly happens have not turned out to be very helpful because they don't turn out to be very accurate. And so what I think about the trajectory of grief really is informed very much so by many colleagues who have now done work looking closely at that process in different kinds of situations. And I think that I put it together in a slightly different way than maybe some other people do, but I think that what actually happens when someone dies –again, that you're very close to – that's really what we're talking about here, because you don't go through such a dramatic process when it's someone that you know. So this is someone very, very close. So what happens – how I understand what happens is that we have to start with what is that love relationship to start with. And love is something that we all feel and that we're biologically probably programmed to feel.

In psychology or psychiatry, we talk about a love relationship as an attachment relationship. And so the attachment system is a biological system that actually occurs in other animals, not only in humans. And it begins even before we're born. So a baby can recognize its mother on the very first day of its life. And then, of course, you've got that very strong attachment relationship between an infant and its caregiver – usually its mother and other people in its environment. And as the child grows older, there may be a couple of other people to which it's very, very attached. And actually what starts to happen also as a child gets older is that he child starts to learn how to be a caregiver. Because, of course, the mother is the caregiver early on, so as we get older and by the time we're adults, we are caregivers for the people that take care of us. So what happens when someone dies is that we lose not only the person who's taking care of us, but also a person who we put a lot of energy and a lot of ourselves into, taking care of them. And actually, it turns out that for adults, if you make them decide is it more important –you know, if you make them choose – is it more important to take care of someone else or to be taking care of yourself, do you have any idea what they'd say? So basically they will always say – most of the time say – that it's much more important to feel good about taking care of someone else.

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