Grief can be overwhelming and traumatic, and sometimes people search for any form of explanation as to why they must go through such an experience. The 5 stages of grief were defined to be used to help people deal with grief, but are these stages real? I did some research to find out where these stages came from and what science really knows about the process.
The 5 stages of grief are factual in as much as they lay out the general framework of the patterns seen in those who are grieving. They can be considered something like guidelines, used for a general understanding of how the mind tends to cope without taking into consideration the many variables that can alter this pattern from one person and situation to the next. With that said, not everyone experieces all of the stages and it very common that you experience the stages in a different order. No one grieves and mourns in the same way.
Understanding the stages as guidelines suddenly makes the subject much broader. From the many variables that can affect how a person grieves to new discoveries and variations of the process, to the different forms of coping and treatment, dealing with grief doesn’t come with any clear-cut answers. There are, however, patterns and tried-and-true tools that have been proven to help, and just a bit of insight can lend direction towards a new place of acceptance and happiness.
The Kübler-Ross Model
The 5 stages of grief stem from the model first presented in 1969 by the Swiss psychologist Elizabeth Kübler-Ross in her book On Death and Dying. In this book, she outlines the various stages she saw people go through in the process of dying after spending years working with terminally ill patients, but these stages have since been applied to a variety of situations that can bring grief including the loss of another, the loss of a limb(s), and even the loss of a job. In fact, Kübler-Ross’s model has become the most widely used way of understanding the grieving process.
The stages of the grieving process begin with denial. This stage is born out of the initial shock of whatever happened to lead to grief. It is a time when the mind is still attempting to understand this new reality, but if it gets overwhelmed with the many “hows” and “whys” that are bound to be present in any traumatic experience, it may begin denying the occurrence all together as a way of protecting the mind from great stress, anger, and sadness.
Denial is a defense mechanism implemented to keep the feeling of being overwhelmed and overcome with emotions at bay. It helps us think rationally, if only at times, and it eases the reality in at a pace that our minds can handle.
Anger is the second stage of the grieving process, replacing denial as we begin to accept the reality of the situation. Anger stems from feeling the many emotions that come with grief. This means that there are many more emotions lurking beneath the surface, but anger is generally what is first recognized and fueled as another defense mechanism.
Anger allows us to create structure in a time when the world as we knew it seems flipped upside-down, and our thoughts and emotions feel like a distorting whirlwind. However, for anger to create structure, it must be directed at someone or something. This creates a direct connection, and although it is not positive nor beneficial in that relationship, it is something to hold on to in the middle of the storm.
When the mind uses anger as a coping mechanism, it is often misdirected. Misdirected anger certainly has the potential to cause other issues if those who the anger is being directed to take offense, but it is nothing to fear. David Kessler, an author and expert on grief and loss, explains that “The anger is just another indication of the intensity of your love.”
The third stage of grief is bargaining, in which the mind goes through all of the hypothetical “if only,” “what ifs,” and “maybes.” It is feeling the sadness of our loss and wishing that it could somehow not be true. It is having come to the realization that what happened is true, but intensely wishing it weren’t so and trying desperately to somehow offer ourselves or our services up if it could undo the situation. It is holding on to the last hope of there maybe being some other power present that would take pity on us if only we bargained correctly.
Jumping from one hypothetical to the next will often bring about feelings of guilt, making us think that we could have somehow prevented this traumatic incident from happening. This guilt makes it easy for us to offer ourselves up, but can also cause greater stress and anxiety as we convince ourselves it is true. It also keeps us stuck in the past as we continue to play through scenarios that never were and can never be, hindering our progress in moving past the trauma and forward in life.
After bargaining for some time to no avail, a grieving person moves back into the present. They begin to feel the sad and empty weight of the new reality. This is the stage when grief truly sets in.
It is important to remember in this stage that this depression is nothing more than a natural response rather than a mental health condition. Although this stage can seem to suck people in as it may last quite some time, it is an important step in the process of grieving and overcoming grief. Although it may be a step, most of us would love to be able to skip over, being able to truly feel all of our emotions helps us solidify reality, which in turn will help us to move forward as emotions begin to subside with time.
Acceptance is the 5th and final stage of grief, as laid out by Kessler. It is accepting what has happened and accepting the new reality. Although we may never welcome or like any of the things that can cause grief, we can accept that they happened, and that sometimes horrible and tragic things happen in life. Accepting may not immediately make us happy again, but it re-establishes stability and allows us to put our focus on other things again and move forward.
Acceptance is, in itself, moving forward. By accepting reality, we realize that we can never fully go back to the normal we knew before grief struck. We realize that there is no choice but to accept and live in the new reality. Often times, if this realization is looked at as an opportunity, this becomes a time of even greater change, a complete lifestyle change, perhaps, as a way to shake the past and boldly step forth into the future.
Variations of the Kübler-Ross Model
Also known as the DABDA model, these five stages are an easy way to begin to understand how the mind copes with grief, and it has become as widely popular as it is because it allows providers, particularly those not accustomed to dealing with great levels of grief, to understand where their patients are and who are then more able to provide for them.
Although the base model, as Kübler-Ross originally presented, it is still in use, it has grown and been expanded upon through years of further research. David Kessler explains on his website grief.com that these are merely, “part of the framework that makes up our learning to live with the one we lost,” rather than any hard and true, chronological process.
David Kessler has worked closely with Elizabeth Kübler-Ross and co-authored two books with her, and through years of study, they have explained and refined these initial five steps. On his website, Kessler explains more about these stages.
“They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss as there is no typical loss.”
The Sixth Stage of Grieving
In working to better clarify these stages and to better understand the process and it’s many variables, Kessler has added another stage to Kübler-Ross’s initial model, as presented in his book Finding Meaning: The Sixth Stage of Grief.
Through many years of counseling healthcare workers, frontline workers, and other professionals on loss and grief, as well as through his own heartbreaking experiences, Kessler found that finding meaning and ways to honor those lost helped him overcome the great grief he has personally had to deal with. Finding meaning as opposed to closure is significant because it brings into the situation hope, something to rejoice about, and something to look forward to. It shines a shimmer of light into a dark situation, and sometimes that small ray is all that’s needed for someone to keep going.
7 Stages of Grief
Another popular variation is a seven-stage model. This framework adds shock and disbelief as the first step before denial. This stage explains the numbness that many experience when they first find out about the loss they must now deal with. It is a time before the news registers enough for the brain to deny.
Although generally short-lived, this is a notable stage because it can be an odd and unexpected experience to not immediately feel upset, an experience that can carry guilt with it down the line if not understood as a natural reaction.
This seven-stage model also includes guilt as its own step, the fifth step between bargaining and depression. The guilt described in this step is that of regret, born from the things the griever wishes he or she could have said or done differently before the loss occurred.
Social Work Tech also provides their own spin on these seven steps, with their framework including:
- Shock and Denial
- Pain and Guilt
- Anger and Bargaining
- Depression, Reflection, and Loneliness
- The Upward Turn
- Acceptance and Hope
- Reconstruction and Working Through
Social Work Tech has provided a well-put-together and printable PDF of these 7 stages of grief with further explanations of how someone is likely to think and act in each of them, a useful resource for those dealing with their own grief or helping others to do so.
Other Symptoms of the Grieving Process
Elizabeth Kübler-Ross outlined the most commonly seen psychological and emotional steps of someone going through the grieving process, but there are many other side effects and symptoms that can occur throughout the entire process as well. As listed on psycom.net, some of the most common symptoms of grief can include the following:
- Difficulty Sleeping
- Questioning the Purpose of Life
- Questioning Your Spiritual Beliefs (e.g., your belief in God)
- Feelings of Detachment
- Isolation from Friends and Family
- Abnormal Behavior
- Loss of Appetite
- Aches and Pains
These physical symptoms are the body’s responses to the thoughts in our heads. While the mind may tune-out, distort, re-route, or completely shut-off certain thoughts and emotions as a defense mechanism to the stress and pain of grief, so do our bodies react defensively when triggered by difficult experiences.
Although these symptoms are normal, they nevertheless contribute even more stress and negativity to the situation, often drawing-out the process to recovery and sometimes pulling the griever down even further before they are able to come back out on the other side.
With the many variables and factors that play into each individual case, grief is best treated on a case by case basis. Each person may be affected to different degrees, may show different physical symptoms, and may come across help at different stages of the process, all of which must be assessed before any proper treatment can be recommended or prescribed.
The two most common ways of treating grief are through prescription medications and counseling. While medications can help stabilize the mind and body at a time when they are feeling in turmoil, counseling can help us work through reasoning out and understanding how to live with our new realities.
Most medications prescribed to help in treating grief do so by relieving or calming certain reactions. These types of medications include anti-depressants, anti-anxiety medications, sleep aids, and sedatives. Although the intention of these medications is to alleviate prominent and difficult symptoms so that the person can feel more normal and continue to move forward and function in life, they are sometimes also criticized for exactly these same reasons.
As the 5 stages of grief describe, the grieving process is naturally a rollercoaster of thoughts and emotions as the mind attempts to understand loss. Although it is not an easy nor enjoyable experience, grief is something that everyone will inevitably experience, and it is the way in which we learn to overcome and cope with negative experiences.
It can be argued that by taking medications to lessen and alleviate these natural steps, we are preventing our bodies and minds from going through and completing the process. By essentially skipping these steps, we never have the opportunity to fully process the events. By skipping these steps, we jump forward into the future without naturally coming around to a place of acceptance, which risks aspects of grief lingering and sporadically resurfacing as time goes on.
Proponents of medication may, however, argue that it simply allows them to move through the process. Some of the symptoms and side effects of deep grief can be debilitating. If someone were to fall into a deep depression and have a complete loss of appetite, for example, they would not very well be able to focus on much other than the pain they are feeling and would grow weak, keeping them from functioning properly on a day-to-day basis and from moving towards a new form of normalcy beyond the grief.
By taking medications to relieve these intense symptoms, a person is able to remain more level-headed, to function better daily, and thus to deal with the other symptoms they are still experiencing. Instead of becoming crippled by grief, medication allows them to remain strong and present enough to be able to deal with the grief they undoubtedly still must tackle.
Counseling is the other common way of treating grief. Speaking with someone, especially a licensed professional who has had experience dealing with situations and/or symptoms similar to what the griever is going through, can greatly help in reasoning-out and understanding the reality of loss.
While sometimes all we need is a sounding board, someone who will sit and listen to us rant as we let every thought and emotion pour out from the depths of our minds, flowing out to take the heavyweight of our chests, professional counselors can offer even more than that. Someone trained in the field will not only be better able to understand the needs of each individual, but will also be able to provide personalized strategies, tools, and techniques in coping with the various stages.
Counseling can be found in the traditional one-on-one as well as group settings, both of which can be highly beneficial depending on what each individual is more comfortable in and what type of grief they are dealing with. While one-on-one sessions may suit those who are not ready to be more open about what they are dealing with or who require specialized attention to work through the emotions and thoughts they are experiencing, group settings provide a support system among people who are dealing or have previously dealt with similar issues.
A support system can be a crucial tool in getting through grief because it creates a bigger pool of people to reach out to in times when thoughts become overwhelming, and emotions run wild. It provides people with insight into the various stages and can offer strength in weakness. Seeing someone in a similar situation as our own makes us feel less alone, and seeing someone who is functioning well despite their grief or who is further in the process of acceptance can motivate and reassure us in times of doubt.
Tips and Techniques on Coping with Grief
While professional help is often necessary, we can also often learn some of the strategies they provide on our own. According to healthline.com, there are three different categories of coping:
Distracting yourself from grief creates distance and space. It is easy to get sucked into a vortex of thoughts and emotions, so this little bit of space and time away from the grief can allow us to better process the situation by bringing us into the present reality. Some healthy forms of distraction include, but aren’t limited to:
- Getting into nature
When looking for a distraction, be weary of unhealthy ways of numbing such as:
Although these mechanisms may distract you and temporarily make the pain seem to go away, they also numb the emotions to a point at which we can’t properly process them, and they can also create problems of their own.
Soothing can be internal or external, but the premise is to neutralize our emotional state. Soothing activities are things that provide joy and comfort. External practices can include activities such as;
- Listening to music
- Getting a massage
Soothing internal activities can include:
- Various mental exercises designed to reduce stress and anger
The balancing strategy aims to bring logic and understanding into the situation. Some balancing exercises can include:
- Making lists or graphs
- Being honest about your thoughts and emotions, whether it is out loud to a person or written down in a journal or letter
- Remind yourself of positive times and be grateful that you have those memories
- Reach out if you feel the need to, whether it is for professional help or just someone to talk to
Finding Help in Dealing with Grief
Although time is the greatest healer and the pain and sadness of loss will usually lessen on their own, this is not always the case. This occurrence is known as “complicated grief” and can be recognized through symptoms such as:
- An inability to go about daily tasks and routines
- Loss of appetite
- Thoughts of self-harm or suicide
There are many resources for dealing with loss and grief, but this wide selection can be overwhelming at a time when the mind is already filled to the rim with all that comes with grief. Below are some direct contacts to organizations that can help, as well as some useful and informative links.
- Helpguide.org is a great resource for understanding several types of therapy and counseling that are available
- The Center for Grief Recovery and Therapeutic Services has put together a wonderfully diverse list of resources on dealing with grief, from organizations dealing with specific types of loss to meditation and support groups
- The Center for Complicated Grief is an excellent resource for both informative articles as well as for finding specialized therapists around the world
- The Substance Abuse and Mental Health Services Administration has a direct phone number to their helpline, through which they will refer you to therapists, counselors, support groups, or other applicable organizations in your area. This service is free, confidential, and available 24/7
- The Suicide Prevention Lifeline is another confidential hotline available 24/7 for anyone who feels in distress. Even if there is nobody in your life to talk to and you have not gone to a support group, there is always someone to talk to on the other line
- Talkspace and BetterHelp are two virtual counseling services that can be conducted over a computer or smartphone. With just a brief assessment of your needs, they match you with a counselor and will set up your first session without ever having to visit an office
It is normal to feel lost and alone during the grieving process, but it is important to remember that you never truly are. There are vast resources and people who are ready to help, and we are often stronger than we realize in trying times. Through tools and information such as those brought around by the Kübler-Ross Method, we can take control of our thoughts and emotions to successfully get through grief and come out stronger on the other side.
When dealing with grief, it is important to remember to take care of yourself. Although guilt may try to make you feel as though you don’t deserve it or that you have to put all of your focus and energy into grieving, taking small measures to keep routine and bring joy into your life will help immensely in moving towards a place of acceptance. Remember that taking care of yourself does not take away from who or what was lost, but allows the living to keep on going.