Let's shake up the world of grief theory! Ever wondered why the traditional five stages of grief don't seem to fit your own experience? Or questioned why this widely recognized model is still so prevalent? Join us as we challenge this flawed concept with Dr. Terri Daniel, a bereavement counselor who brings a fresh perspective on grieving. We'll delve into the origins of the five stages theory and why it may not be the most viable approach for everyone.
Moving beyond the five stages, we're thrilled to be joined by Robert Niemeyer, the man who coined the term "meaning making," and also David Kessler. Get ready to discover a new understanding of grief as we reveal the four tasks of grief, the six Rs of grieving, and the two styles of grieving. We'll also explore different grief experiences using the Loss and Restoration Model. As we wrap up, we'll shed light on the various credentials and certifications in grief counseling. This episode is a must-listen for anyone seeking a deeper understanding of the complexities of grief or for professionals aiming to make a difference in the field of grief counseling.
Let's shake up the world of grief theory! Ever wondered why the traditional five stages of grief don't seem to fit your own experience? Or questioned why this widely recognized model is still so prevalent? Join us as we challenge this flawed concept with Dr. Terri Daniel, a bereavement counselor who brings a fresh perspective on grieving. We'll delve into the origins of the five stages theory and why it may not be the most viable approach for everyone.
Moving beyond the five stages, we're thrilled to be joined by Robert Niemeyer, the man who coined the term "meaning making," and also David Kessler. Get ready to discover a new understanding of grief as we reveal the four tasks of grief, the six Rs of grieving, and the two styles of grieving. We'll also explore different grief experiences using the Loss and Restoration Model. As we wrap up, we'll shed light on the various credentials and certifications in grief counseling. This episode is a must-listen for anyone seeking a deeper understanding of the complexities of grief or for professionals aiming to make a difference in the field of grief counseling.
The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity they represent.
Speaker 1:
Welcome to, as I Live in Grief, a podcast that tells the truth about how hard this is. We're glad you joined us today. We know how hard it is to lose someone you love and how well-intentioned friends and family try so hard to comfort us. We created this podcast to provide you with comfort, knowledge and support. We are grief advocates, not professionals, not licensed therapists. We are you.
Speaker 2:
Hi everyone, welcome back to another episode of as I Live in Grief, so delighted today to have as guest Dr Terri. Daniel, dr Terri has been on before. At it to say Dr Terri has been on before and I'm always delighted to have her back again. Today. We're going to discuss a special topic, but before we start, dr Terri, would you just kind of reintroduce yourself to our listeners and let them know a little bit of your background.
Speaker 3:
Sure, I'll start at the present and work backwards. I guess that's fine. Presently I work for two hospices, as a bereavement counselor and PRN chaplain. I am a chaplain, trained as a chaplain, but I'm completely non-religious and religiously neutral, and I work with the dying patients, but mostly with their family members who are grieving. Most of the work I'm doing now with hospice is related to grief. I also teach in the death studies program at Marion University and University of Maryland. It's actually called Thanatology, but what that means is the study of death and I teach in the chaplaincy program at the Graduate Theological Union.
Speaker 3:
So, going back, I got interested in this topic when my 16-year-old son died after a long illness. He was severely disabled for the last half of his life. I was well prepared for his death and being with him as he died was one of the most spiritually transcendent things I ever experienced, and I knew that I wanted to do more of that and to help other people do that. So I became a hospice volunteer. I quickly realized that as a volunteer I wasn't going to be able to do as much as I wanted to, and when I realized I wanted to be a chaplain. So at age 56, I went to college for the first time, took all the required classes and got all the required degrees, did the internships and all the stuff that you do to be a hospice chaplain.
Speaker 3:
Long story short 10 years later it's 66. I got my doctorate in pastoral counseling and that's how I got here. I also ran something called the Afterlife Conference for about 13 years that probably some of your listeners are familiar with, and I have now modified that. It's now called the Conference on Death, grief and Belief, because my focus changed a little bit. In the beginning I was very, very enamored with after-death communication and mediumship and mystical experience, which I still am.
Speaker 3:
I still love that stuff. But after 11 years of doing the conference on those topics and running through all the lists of the big superstars in that arena, I had enough. I had sort of saturated, I had all I needed of that and I wanted to go into a different angle, which turned out to be a more academic, research angle on this stuff.
Speaker 2:
That's amazing. It's an incredible background and to me that just encompasses so much of the areas where I have questions. So I'm an avid learner and will follow you for a long, long time, Okay. So, thank you so much for all the work you do. I didn't even know the word Thanatology until I started this podcast.
Speaker 3:
Yeah, most people don't. That's why I just say death studies, exactly exactly.
Speaker 2:
At any rate, today you have chosen a topic that you are really working on now, and that is the stubbornness of the stubborn persistence of grief theory. Would you kind of clarify for me exactly what that means?
Speaker 3:
Yeah, but let me clarify what it's actually called. It's the stubborn persistence of grief stage theory, grief, stage theory. That's important, grief theory is fine Grief stage theory is the thing that we're talking about, and by that I mean the five stages, originally from Elizabeth Kubler-Ross Right, popularized and capitalized upon by David Kessler Right.
Speaker 2:
Okay.
Speaker 3:
Yeah, so okay, so everybody knows the five stages of grief. Elizabeth Kubler-Ross, back in the 70s, was a psychiatrist. She researched 200 people in a hospital who had terminal diagnosis and they were dying. And it was not an academic research project, it was just kind of a casual interviewing process when she interviewed all these people who were dying and she narrowed down all their responses to the five most common responses that they all had to facing their own death, which was, as we all know, denial, anger, bargaining, depression, acceptance. And she published this book and she basically said here's the most common responses people have, according to my research, when they're facing their own death. So that became hugely famous, as everybody knows.
Speaker 3:
And fast forward several years she meets a guy named David Kessler at a conference and he suggests to her and this is the story as I understand it, it may not be 100% accurate he suggested to her let's take those five stages you came up with and apply them to grief. And she says, wow, that's a great idea, let's do that. And they wrote a book. Her original book was called On Death and Dying. The book they wrote together was called On Grief and Grieving and they took those five responses and I'm going to keep calling them responses, because that's what they are, they're not stages and they said here's the five stages of grief.
Speaker 3:
So that became a tremendous bestseller because everybody would love for grief to be that easy. And it became so huge that real, authentic, credentialed grief researchers started to look into it and very quickly found that it wasn't a viable approach at all, and I can tell you all the reasons for that. And so started publishing papers and you know, talking about here's why this doesn't work. And eventually the professional grief community counselors, therapists, people who work with grief, social workers, whoever nobody uses it anymore. Nobody with any education or credentials uses it. Really, in the last 20 years it's a junk theory in professional circles. However, david Kessler and the Elizabeth Kubler-Ross Foundation were making money hand over fist, so their response to this criticism was to say, yes, it's true that these stages are not necessarily a sequential, that you go through them in order, but we still sort of we stand behind this. And they stood behind it so much that Kessler came out with a new book a few years ago called Meaning Making the Sixth Stage of Grief.
Speaker 3:
So, rather than modifying it with you know, based on good evidential research. He just added another stage with the permission of the Elizabeth Kubler-Ross Foundation, and had another bestselling book. So those of us in the grief counseling world are very unhappy with this. And while we're on the subject of David Kessler and we'll get into the meat of this in a minute he now has workshops where he trains people and certifies them as certified grief educators. He himself has no academic credentials in grief at all. He's not a mental health professional and he most certainly does not have any qualifications that allow him to certify other people. So it's you know, in the grief world, this is a bad thing, all right, so we got that out of the way.
Speaker 2:
Okay.
Speaker 3:
Now do you want me to talk about all the reasons why the stage theory isn't good?
Speaker 2:
The floor is yours. I want to hear anything you can, any wisdom you can impart to me this is fascinating.
Speaker 3:
Okay, so I'll start with some academic stuff. There was a really good analysis of it done by a really well-known grief researcher, and Kastin Baum is his name, and here's a couple points that he made. The existence of these stages has not ever been documented or demonstrated in research. There's no evidence that people move from stage one to stage five. The line is blurred between the description of this and the prescription as like.
Speaker 3:
How does it really work for real people? It neglects the totality of the person's life and all the other factors that contribute to your grief experience, and just gives you these five things, regardless of past trauma, religious belief, circumstances of the death, age of the person, cultural influence. It just ignores all of that, and that's pretty much it. So we'll stick with those. One of the big things? All right, here's a real simple one. In that stage theory, the very last thing you experience, supposedly, is acceptance. That's number five. In real life and in the bona fide research on grief, acceptance is supposed to be the first thing. Right, right, so the and. So if you look at all the, you know the good material. The very first thing you have to do is recognize and accept that the loss has happened.
Speaker 2:
Exactly.
Speaker 3:
So acceptance comes first. Yeah, Having it at the end of a list like that and, by the way, everything on that list is a stressful, painful, negative experience, depression, denial, anger, bargaining and the end of that whole process of sadness and suffering is acceptance, like passive resignation, like all right, I guess I finally accept this totally backwards. So acceptance comes first, and then what comes after acceptance? A whole world of possible responses. Now that I see that my person has died you know, I am at the funeral, I see the body, I know he's dead. Now what am I going to do? That's where the processes start, and what we should be looking at are responses. So throw out the word stage and we're going to replace it with response.
Speaker 2:
Okay.
Speaker 3:
And what are some possible responses you can have? Let's say you're caring for your 95 year old father who is in a nursing home with advanced dementia and COPD suffering. He's bedbound, he's not aware of his surroundings and he dies and he dies a peaceful, beautiful death in hospice. What kind of responses might you have to that? You might be relieved, you might be happy, you might have gratitude for the good care that he got or the good life that he lived. You might feel optimistic about what the future is going to look like now that you're no longer caregiving for this person and maybe you've inherited some money and you can start a new life.
Speaker 3:
And even if it's not a happy, perfect death like that, even if it's a tragic death like, let's say, the death of a child or a violent death, there are still going to be those kinds of responses. There is going to be guilt. There could be regression. Let's say you were you're recovering addict and your child gets killed. You might go back to drinking or drugs right, you might distance yourself from the situation. So there's distancing, there's stoicism, there's regression, there's guilt, regret, shame, blame, resentment. There could be obsession fear.
Speaker 2:
Those are near. And those five stages, are they? No?
Speaker 3:
they're not, and then, on the upside, an experience like that transform you in a positive way. You can have curiosity about you know. Why did this happen? What does this mean for my life? What's my life going to look like now? What creative options are now open to me that I didn't have before? You might find new strengths. It might, you know. You might change your spiritual perspective completely and you could become more spiritually expanded or you can become more spiritually shut down, depending on your perspective. So if you feel like there's a God in the sky that answers your prayers and you prayed and prayed and prayed and the thing you wanted didn't happen, you could be really angry at that God and be very conflicted. Or you can say you know what? Maybe that's not what God is, maybe it doesn't work that way and you can change your thinking. So you know, when I teach this in groups, I ask people to shout out responses and there's just this endless possibility. So that's like the main reason why the stage theory is so limited.
Speaker 2:
That's so many questions have come up in my head when you were talking about that. I'll kind of start back where you began with the five stages by Kulu Ross. I had in my research and everything. Of course, I had run across the fact that originally they were created, or labeled if you will, for people who were terminal, people who were dying. I didn't know the other parts about that, so that opens up a whole nother area now that I want to do some digging and learn a little bit more. But almost sounds like there has to be a standard for people to use instead of just these theorization, if you will. So is anyone working on that type of a standard?
Speaker 3:
Oh, god, yes, Absolutely.
Speaker 2:
And is there anything that you feel is going to actually come out to give those guidelines to practitioners? It's already come out.
Speaker 3:
People have been working on this for 20, 30 years, and when I say people, I'm talking about actual academic research, and this material exists everywhere. So we have Robert Niemeyer, who came up with the term meaning making, which David Kessler hijacked, and meaning making is, and he teaches this and he trains therapists in this and like how to make meaning out of it. So your five-year-old kid died in a car crash with a drunk driver. What does that mean for your life? How can you make use out of that? How can you metabolize and compile and compost that experience into something else?
Speaker 2:
Right, and some people create legacies based on that Exactly Right.
Speaker 3:
Yeah, or they go back to school and become a grief counselor or something.
Speaker 3:
Right, there's Warden, william Warden, who came up with something called the Four Tasks of Grief, and I can't remember exactly what the four are, but the very first one is to recognize and accept the loss. Terese Randho is a researcher who came up with the six Rs of grieving, which kind of overlap with the task, and they are things like recognize the loss, reassess your attachments and the places where things fit in your world, reconstruct a new vision of the world, rebuild that relationship with that person who died, so no longer do you have this little five-year-old child in your house.
Speaker 3:
You now have this essence of this child who's no longer here in the physical. How can you rebuild that relationship from an interdimensional perspective? There's all kinds of theories, and so that's Randho's six Rs, warden's four tasks, neemeyer's meaning making. Ken Doca is another really important researcher who has broken down types of grief experiences into things like anticipatory, if we're taking care of somebody who's dying, or disenfranchised grief, if your loved one got killed while committing a crime robbing a store in the police shot him, or the guy in the store shot him. So that's disenfranchised, because society is not going to be very supportive of you because your loved one did something bad.
Speaker 2:
I've heard people even associate death of a pet with disenfranchised, because for some people their pet is like a child and they don't get the support that can also be disenfranchised.
Speaker 3:
Absolutely.
Speaker 3:
And another kind of disenfranchised grief. When gay people were dying of AIDS in massive numbers, if you were grieving that person, it was so socially taboo. So that's, and there's also now also I believe Doca came up with this two styles of grieving that people tend to fall into. So notice the words I'm using. I'm using styles, tasks, processes. Nowhere are you going to hear every day of your stages. And so he said that some people are instrumental grievers and some are intuitive grievers. And an intuitive griever is the person who's going to do a lot of emotional feeling, a lot of crying, maybe writing in a journal and sitting and looking at the old pictures and calling friends and reaching out and just doing a lot of emoting. And the instrumental griever is the one who is going to immediately go and take the person's clothes out of the closet, remodel the house, start a foundation, go back to school yeah, and neither one is right or wrong.
Speaker 3:
But one of the things that we're learning in terms of new approaches is therapists in general tend to lean on the side of the intuitive griever, because they will ask you how do you feel, how does it feel today, how did it feel when your husband died? And feel, feel, feel. I am not an intuitive griever. When someone asked me how something feels, I just like I can't describe how it feels. Instead of asking how it feels, ask how did you respond? Oh, completely different. Yes, yeah, like how did it feel when your person died? Well, it felt terrible. Yes, I mean, that's a dumb question, it's not even answerable. But how did you react? Could be, could open the door for better therapy conversation. So well, let's see.
Speaker 3:
The first thing I did is I screamed and yelled and I threw things and exactly. And then I was drunk for three weeks. I wouldn't let any of my friends help me, I was very angry. Or the first thing I did is I went to my church and I looked for support from my religion. That's the question that you ask, right?
Speaker 3:
So this is some of the new stuff that's coming out. One of the best ones now is called the loss and restoration model, or the dual process model. That shows how we oscillate back and forth between two different kinds of focus. So one is called loss orientation and the other is called restoration orientation. So when you're that person, you're drunk for three weeks and you're throwing things and you're screaming, you're in loss orientation. You're totally focused on your loss. The next day or the next week when you come out of that and maybe you go find a therapist and you start talking to friends and you start eating better and exercising and taking care of yourself now you're in restoration orientation and you can go back and forth between those two things 50 times a day.
Speaker 2:
So it's like the two steps forward, three steps back. No, it depends, it's different for everybody.
Speaker 3:
There's no right or wrong way. I tell people to take a piece of paper and draw a vertical line down the middle loss on one side, restoration on the other and use it like a journal and just right in the loss column here's what I did today. That was focused on my loss and then right in the restoration column. But then I went outside and I walked by the river and it was so pretty and I decided that I was going to plant a garden and I went and bought some seeds and you put that in.
Speaker 2:
That's a great idea. That's a great idea.
Speaker 3:
It's a really good tool, wow.
Speaker 2:
OK, one of my other questions that came up is you had made a comment about not being certified in and I know with social workers, with well, thenatologists can have a degree, but in this community of practitioners, is there a license or a certification in grief?
Speaker 3:
That's a really, really good question. That's like asking is there a license or certification in being a death doula?
Speaker 2:
Exactly it's very similar.
Speaker 3:
So there is not a license. Well, you can certainly get a license as the therapist or a counselor.
Speaker 3:
So, you could get that license. Hopefully, if you're going to work in grief, you've spent some time getting specific training in grief and, yes, there are bona fide certifications for that. So any Thanatology program, you can get a certificate in Thanatology. At one of the places where I teach, at either Mary and University. They all have them, you can find them. But that's not a license. That. It does not make you a professional. That gives you some good education. There is no real professional credential, except the one thing. Actually there's two.
Speaker 3:
So there is an association called ADEC ADEC, the Association for Death, education and Counseling and you can get their credential certified in Thanatology and the language they use for that is you are certified in death, dying and bereavement. It's very prestigious. It goes a long way. Are you legally allowed to call yourself a counselor and have counseling sessions and charge money? Well, it's different in every state. So I have that certification. I do counseling. I'm not a licensed counselor. Counseling isn't my main thing and I kind of mix it up with education. It's not like come every week to my office and do counseling. I don't even believe in that. But that certification is good.
Speaker 3:
However, you have to have letters of recommendation. You have to have a certain amount of hours, of some kind of clinical experience or other certifications. You can't just walk in with nothing and get that. And they give a test once a year. There's all these study materials. It's a big deal. The other great credential is Robert Niemeyer's. It's called the Portland Institute and they have a program where he gives you a certificate in I can't remember exactly what it's called. Well, there's four different kinds. I did that program and I have the certificate in family-focused grief therapy. But again, I believe they require you to have at least a bachelor's degree in a related field. So there are those. And then, if you want a license, specifically, you go get a master's degree in social work or counseling or psychology and you go through the internship and you do the licensing program.
Speaker 2:
Right. Is it fair to say that licensing is more connected with a governmental agency or organization? Absolutely and certification is connected more with an educational facility or institution.
Speaker 3:
More academic.
Speaker 2:
Yeah, Although I'm pretty much. Anybody can hold a workshop and give you a certification that you have passed their workshop.
Speaker 3:
Right, which is ridiculous, you know, we it's just. I mean, I saw a website once where there was a woman offering certifications and all this different stuff, right, and she showed her own credentials and her credentials was that she had an hour and a half of training in trauma and two hours.
Speaker 1:
This was her training.
Speaker 3:
I mean, be careful. People go, you know, don't throw your money away on this stuff. It isn't going to get you anywhere. Exactly, you might be able to, you know, promote some sort of counseling business, you know, and people will come to you and pay you money because people will do that. But you have to be really careful about ethics and what I recommend if you want to work with death related grief because not all grief is death related go volunteer for hospice. Go spend six months or a year as a hospice volunteer and be around grief not just your grief and your family and your friends. But the whole trick to it is to know how to do it for strangers.
Speaker 2:
Absolutely, Absolutely. You know, I've been connected with several hospice homes in our area for about eight years now and it is an education in itself. It's they are. They actually are sadly in need of volunteers. A lot of the volunteers are aging out.
Speaker 3:
Yeah.
Speaker 2:
Well, sadly, our time is winding down. I have found today's discussion fascinating for many reasons. Now I get to go do some research and learn even more, so thank you so much for that. Yeah, if you're oh, go ahead. I'm sorry, no, no, you go right ahead.
Speaker 3:
I'm just going to say, if people want to read my paper that I published on the stubborn persistence of grief stage theories. I don't think you can find it online, but they can email me and I'd be happy to send it to you. That's perfect, or I can give you a link and you can put it up on your page or whatever.
Speaker 2:
Okay, all right, we can figure out the best way to do that. What I was going to say is, before I sign off, though, I actually want to turn the microphone over to you, dr Terry, so you can speak directly to our listeners. I know you've got some interesting events coming up, and I want them to at the very least be aware that you routinely offer different sessions and workshops. So take it away, it's all yours.
Speaker 3:
Okay, the big thing that I do every year is the conference on death, grief and belief used to be the afterlife conference. We used to do it in person 13 years every summer. I've now changed that and I it's now a yearly symposium every January, online. It's coming up January 20. And it's called the symposium on death and bereavement studies, and this one, our theme, is emerging spiritualities at the bedside when people are dying, and we've got experts talking about, you know, using psychedelics at end of life. We're talking about how end of life practices and grief changed in the black community since COVID.
Speaker 3:
We've got somebody talking about experiencing death through dreaming and the die before you die process. That's popular in Buddhism and Islam die before you die. His name is Andrew Holichag Great people, so you can find that at death, grief and beliefcom. That's where you can find pretty much everything for people who are in. I'm in Portland, oregon, and something wonderful and new has just come up here is the hospice that I work for is now letting me do workshops under their umbrella that are free to the public.
Speaker 2:
Wow.
Speaker 3:
And this is my workshop that I've been teaching for years, and I'm now able to do it with the support of this hospice and offer it to the community for free, and it's a full day workshop. Normally, if I was just doing this on my own, you'd have to pay about 200 bucks for it, and now it's free. So it's in Portland where I live. So the way people can find out about all of this is to subscribe to my email list, and if you just go to either death, grief and belief, calm, or spirituality and grief, calm, and hit the subscribe link on either one of those and you'll get on my email list.
Speaker 2:
That sounds great and I have to say I've been on your email list for Well, probably almost three years now, but since the podcast started and in our paths first cross and it's an Interesting newsletter even because there are all these offerings and I think, oh, I'd like to do that, I'd like to do that. Now, do I get to do them all? No, of course not. Time doesn't always allow. But I know that those options are there and I look again.
Speaker 2:
For me, I'm going to be a lifelong learner, so anytime I hear or see a phrase that I've not heard, or words put together in a way I'm not used to seeing them, I have to do a little more research. So the time has come, sadly, that I have to sign off, wrap up and everything. Again, dr Terry, I want to say thank you so much I have enjoyed today. I look forward, hopefully, to another time when we have another Focus that you're working on. You always give such interesting perspectives. This has been great and there's so much information in it that I know the listeners are going to love, and I encourage everybody to reach out to dr Terry. At the very least, get on her newsletter list. Your life will be enriched.
Speaker 3:
Oh, because of it. Thank you so much.
Speaker 2:
Oh, you are very, very welcome. It's truly my pleasure. Other than that, I'm just going to remind everyone to take care of yourselves. Grief is lifelong. I'm going to grieve until the day I die. My grief has changed shape. It is kind of intertwined with my life, but my life today is vastly different than it was 25 years ago and I'm probably happier today than I've ever been in my life, and actually that grief is part of my happiness Because of the memories and the love that I still hold for the four major losses in my life and everything else. So take care of yourselves everyone, and come on back next week for another episode of as I live in grief.
Speaker 1:
Thank you so much for listening with us today. Do you have a topic that you'd like us to cover or do you have a question from one of our episodes? Please email us at info, at. As I live in grief, calm, and let us know. We hope you will find a moment to leave a review, send an email and share with others. Join us next time as we continue to live in grief together.