Stages of Grief

If you have ever lost a loved one, you know that the pain can feel unbearable. Grief is not a simple thing. Sometimes it can feel like the pain is never-ending.

We can go through a whole range of different emotions, including confusion, anger, and sadness. The beautiful thing about grief, though, is that it connects us.

Everyone will feel grief at some point in their lives. It is something that human beings experience worldwide. This can help us to understand each other as humans.

It can open us up to be able to empathize with others more easily. Understanding the stages of grief can help you to help others better when they are grieving.

What is grief?

Eventually, we will all experience grief at some point in our lives. We tend to think of grief after the death of a loved one. However, a grief reaction can be caused by several different life events. These include losing your job, a breakup, a divorce, a miscarriage or pregnancy loss, or any other change that alters life as you know it.

Grief is a universal concept. However, it is also a personal and individualized experience. It’s not linear and can be messy. Grief doesn’t follow anyone’s schedule or timeline. No reaction is right or wrong. All bereaved individuals grieve differently. You might cry, withdraw, feel emptiness, or even become angry.

Grief is a natural experience in human beings. Although we will be discussing the five stages of grief here, it is important to remember that we all grieve differently. You might not go through all of these stages. Or you may go through them in a different order. These stages are not clearly discrete from each other. You may go from one stage to the next, then back a few stages before going onto the next one. 

There is no specific amount of time you should be in each stage, either. One person might go through these stages in a matter of weeks, while another could take months or even years.

Both of these situations are normal. Your pain is unique to you as an individual. Your relationship to the person or job you lost is unique, too. Everyone processes grief in their own way. Get rid of any expectations of how you should be living your life as you process your grief. Take all the time you need.

Complicated grief

There are times where grief can evolve into what we call complicated grief. This involves persistent and disabling grief symptoms. Complicated grief is related to negative physical and mental disorders. Complicated grief is unusual and persists with a high level of acute symptoms. It is delayed, distorted, and prolonged grief.

Anticipatory grief

Anticipatory grief is grief in anticipation of a loss that has not yet occurred. For example, anticipatory grief is common in caregivers of people with dementia.

What are the stages of grief?

Elisabeth Kubler-Ross is a Swiss-American psychiatrist. In 1969, she outlined the five stages of grief in her book “On Death and Dying.” She based this on years of experience doing grief work with patients with a terminal illness.

She meant for these stages to be for terminally ill patients, older adults, and dying patients, but the stages have since been adapted for other experiences of loss as well. There are other grief models and theories. Some have two stages, while others have seven.

It’s important to point out that not everyone goes through Kubler-Ross’ five stages of grief. Even those who do, don’t necessarily go through them in this order.

Denial

Denying that this horrible loss happened is a defense mechanism. It helps us to minimize the overwhelming pain that loss can cause. After a loss, we are trying to survive through intense emotional pain while also processing what happened.

It can, therefore, be hard to believe that we lost someone important to us. It’s possible you last spoke to this person earlier that week or even earlier that day. It can be unbelievable to us that they are truly gone. This can shift our reality completely.

It takes our minds a while to adjust to this new reality. We are thinking about what we lost and how to move forward now that we have lost it. That’s a lot to process. The reason we go through denial is so that we can slow down this entire thought process. It can prevent us from being overwhelmed by our emotions. An example of a denial stage statement is: “He’s not really gone. He will walk through the door any moment now”.

Anger

Anger is actually a common emotion to experience after a loss. Adjusting to this new reality that we have to face can be uncomfortable. As we said, there is a lot to process during grief, so anger feels like a good emotional outlet sometimes.

The reason why we tend to gravitate towards anger is that it doesn’t require much vulnerability. It might be more accurate to admit that we are scared. However, anger seems to be more socially acceptable than fear.

With anger, there is less fear of rejection or judgment. This is because we are pushing people away with our anger. However, the problem with anger is that it can be isolating. Others may find you unapproachable. This is a shame because connection and validation would probably be beneficial to healing at this time. An example of thought in the anger stage is: “Where is God in this? How could God possibly let this happen?”

Bargaining

When you are coping with a loss, you can begin to feel desperate. You might even feel willing to do anything to reduce the pain you are feeling. You may be considering all the ways you could feel less pain. Enter the bargaining stage. There are many different forms of bargaining. This is when we try to request things of a higher power. We believe that there is something bigger than us out there that may be able to change the outcome.

It can be extremely humanizing to realize that there is nothing we can do to change the outcome of the loss. This helplessness leads to bargaining. Bargaining gives us a sense of control over something that we truly have no control over.

When bargaining, we do tend to focus on our own regrets and what we have done wrong. Sometimes we can even look back on interactions with lost loved ones and think of all the times where we might have caused them pain. We may look back on these moments and wish we had said something different or treated them differently. We can also assume that if we had said something different, we would not be in so much pain after the loss. An example of bargaining is saying, “If I called him that day, he wouldn’t have died.”

Depression

The previous three stages of grief have involved a lot of imagination. Eventually, our imaginations take a back seat, and reality begins to sink in. At this point, bargaining doesn’t feel helpful anymore.

We are faced with the present situation. This is where the feeling of loss becomes strong. Panic reduces, and there are less emotions bouncing around in our minds. This is when the loss appears to be unavoidable.

This is when people tend to retreat inwards. We may reach out to others less and be less sociable during this stage. An example of thoughts during the depression stage include: “Who am I without him?” or “I don’t know how to go on from here.”

Acceptance

It’s important to point out that just because a griever has reached the stage of acceptance does not mean that they aren’t in pain anymore. However, it does mean that they aren’t resisting their pain anymore. They are no longer denying the reality of the situation or trying to create a different outcome.

There may still be intense sadness and even some guilt or regrets in this stage. However, there is less likely to be emotional survival mode going on here. An example of thoughts in the acceptance phase include: “I feel so lucky to have known her, I will never forget her.” And “I will be able to go on and find a way forward through this.”

Other models of grief

Grief expert Kubler-Ross wasn’t the only one who came up with a stage theory for grief. There are some other theories out there. For example, there are seven stages of grief, which are as follows:

• Shock and denial
  
  
• Pain and guilt
  
  
• Anger and bargaining
  
  
• Depression
  
  
• The upward turn
  
  
• Reconstruction and working through
  
  
• Acceptance and hope

All these theories of grief try to explain patterns of the grief process. The hope is that people will use these models to understand those who are in pain over loss. There is also the Attachment Theory of Grief. John Bowlby developed this grief theory while researching the emotional attachment between parents and their children.

He believed that attachment with caregivers early on in life helps to form secure connections and a sense of safety. British psychiatrist Colin Murray Parkes used this theory to develop a model of grief with four phases. The four phases of mourning after the loss of a loved one are as follows:

• Shock and numbness
  
  
• Yearning and searching
  
  
• Despair and disorganization
  
  
• Reorganization and recovery

Symptoms

Symptoms of grief include the following:

• Recurring feelings of sadness over time
  
  
• Being preoccupied with thoughts of loss and sadness
  
  
• Functional impairment
  
  
• Higher risk of depression and suicide

Managing grief

When it comes to managing grief, there are several different approaches. Doctors often prescribe medication for the bereaved person, but research to support the effectiveness of this is lacking.

When it comes to complicated grief, cognitive behavioral therapy techniques appear to be the most effective. These can be either face to face sessions or internet-based. Cognitive-behavioral therapy that includes an exposure component is even more effective.

Grief counseling, dynamic psychotherapy, grief support groups, and family work are all effective ways to manage grief.

One research study looked at the state of evidence concerning the effectiveness of treatments for grief. One treatment involved cognitive-behavioral approaches, four treatments involved bereavement groups, and one used writing therapy.

Five of the seven treatments were effective in reducing grief intensity on at least one outcome measure. Bereavement groups are effective at lowering the intensity of uncomplicated grief. Cognitive-behavioral therapy was found to be helpful for people with suicidal ideation in particular.

Grief counseling with an empathetic approach and active listening is best. The most effective psychologists and grief counselors give their patients permission to grieve. They acknowledge your loss and validate your grief.

Grief can be tricky because it can be misdiagnosed as stress, anxiety, depression, mood swings, or other behavioral concerns.

Cultural norms can play into how people deal with grief. Cultural traditions around death, bereavement, mourning, and coping all play a role.

What if someone you know is grieving? How do you help them? It can be challenging to know what to say or what to do. You may do your best, but sometimes even your best efforts can feel like they aren’t enough.

Try not to rescue or fix the grieving person. Keep in mind that there is no fixing to be done here. Encouraging comments or humor have good intentions behind them but are not helpful. This can leave a person feeling unheard, unseen, and like their pain is not valid.

Don’t push the person. Although you may want them to feel better sooner, encouraging someone to process their emotions before they are ready to do so can be detrimental to their healing. Make yourself available to talk to the person without pressuring them to do so. Let them know that you’re there to talk to whenever they are ready. Be understanding and validate their feelings if they express that they are not prepared to talk about it yet.

Conclusion

Grief is a complicated thing. Unfortunately, we will all face it at some point or another. Now that you have a better knowledge of the grief cycle, it may help you to understand your grief when you experience it.

Keep in mind that you may not necessarily go through all of Kubler-Ross’ stages of grief. Or you may go through them in a different order. In fact, you could go through them and then backward and then back through a different stage all over again. But know this: that’s okay. There is no one “normal” way to grieve. Grief is a personal and individualized journey. There is no right or wrong when it comes to grieving.

If you or someone you know is going through the grieving process, it may be a good idea to reach out to a psychologist or counselor. Even though friends and family members may mean well, a mental health professional can provide tools, resources, and knowledge that your loved ones may not have access to. There is no shame in seeking professional help. Speak to your healthcare provider about referring you so you can receive help through the grieving process.