Grief is defined as a strong, sometimes overwhelming emotion for people who have experienced a loss.1 One model of understanding and processing grief is the Five Stages of Grief: denial, anger, bargaining, depression, and acceptance. Like other models, this model is not right or wrong but is just a way to help people understand and navigate the grief process.
The Five Stages of Grief
Grief is the response to loss that may have an impact on a person emotionally, psychologically, and physically.2 Elisabeth Kübler-Ross focused on the five stages of denial, anger, bargaining, depression, and acceptance.3 It is also important to know that all stages do not show up at once and may vary in how they present throughout a person’s journey of grieving a loss.
The stages of grief are a journey, and one will not experience these stages in any specific order. One may experience one stage longer or shorter than the other. It is also important to note that everyone who goes through the grieving process may not experience all five stages.
Grief is a normal reaction to life changes that occur when a person experiences a loss. Losses vary and can have a different impact on all people who have experienced these changes in life.
Some of the grief reactions that people may experience include but are not limited to:
- Crying
- Feelings of sadness,
- Hopelessness
- Frustration
- Depression
- Avoidance
- shutting down
- Changes in sleeping patterns.
Some people also have physical symptoms when they are grieving a loss. Even though the five stages of grief are often discussed, this is not the only model of helping people to understand the grief process. Specific information about the five stages of grief as well as other models of grief are outlined below.
1. Denial
Denial is a defense mechanism used by many people when facing challenging situations. Denial is a common coping mechanism when dealing with a loss. Processing a loss can bring about various emotions and can be difficult to accept. In an effort to deal with the array of emotions associated with the grief after a loss, some people’s reaction is to deny the loss. This process can be short term but for others can be a long process.
Kübler-Ross states that if people used denial in their lives previously as a main defense mechanism to cope with difficult situations, it is very likely that they will use this when they are experiencing a loss.2 Therefore, it is useful to assess how one normally copes with challenging situations. However, one must note that denial is used quite often and most likely used as a buffer when people face challenging situations, with denial helping them process the situation on their own terms. Kübler-Ross in her On Death and Dying book stated that denial is just a short solution and often will be replaced with another way to cope.3
2. Anger
As stated earlier, grief elicits an array of emotions. When someone is processing grief, there is always an element of anger.3 However, one must note that anger shows up in many forms. Some ways that anger often manifests are through outbursts, rage, extreme sadness, and isolation. It is also pertinent to process the underlying emotions (eg., sadness, hurt, frustration, fear) under the anger that is being exhibited when someone is experiencing a loss. With others, it can also be beneficial to identifying, questioning, and reflecting on the origin of the anger.
3. Bargaining
Bargaining is defined as negotiating in order to get a desired outcome. Kübler-Ross also believed that at this stage the one was also trying to postpone the inevitable.3 However, at this stage the person is wrestling with accepting the loss. for example, a person might be trying to make a deal that if the pain ends, he/she will be better or do something in exchange for the pain to stop. Bargaining is a way for a person who is grieving a loss to take control over the situation.
4. Depression
Depression is another stage that a person may experience when facing a loss. A heaviness and a deep sadness when one experiences a loss is quite normal. There are two types of depression: reactive and preparatory.3 Preparatory depression is also something of which to be mindful, especially for people experiencing loved ones with a terminal illness. However, it is also important to note the timeframe of the feeling of depression when someone is grieving. If a person experiences depression with an overwhelming sense of hopelessness, it is important to have a safe place to process those emotions and to not isolate in this emotional space. If this begins to happen, a person must be able to ask for help from their support system, which could include but are not limited to friends, family, mental health professionals, support groups or spiritual leaders.
5. Acceptance
Acceptance when discussed in the five stages of grief is not to be taken as a “happy place.”3 This stage is a place where people may not experience emotions but a place of accepting the inevitable and that final resting place.3 At this stage, one is normally at this place of accepting and has come to terms with the loss.
This is not to say that situations related to the loss will not trigger a person to experience the other stages again and have to get to the place of acceptance in different situations related to the loss. It is vital for people at this stage to be patient with the process and also accept that there may be triggers and situations that may cause different feelings related to the loss and those feelings may present in different ways.
Other Models of Processing Grief
Elisabeth Kübler-Ross’ five stages of grief have gotten a lot of attention and have helped people to understand the grief process. However, there are other theorists and researchers who have researched the topic of grief and who have added additional information to the field. Some other models are listed below and discussed briefly.
The 7 Stages of Grief
Over the years many have talked about Elisabeth Kübler-Ross’ five stages of grief and more recently people have talked about the seven stages of grief. The seven stages of grief that are often discussed are listed below. Again, it is important to note that these various stages can happen in a different order, some stages may be skipped, and for others they may not experience all the stages.
The seven stages of grief are:
- Shock: When one hears the news of loss, quite often the first response is shock or disbelief of the news.
- Denial: Denial, as stated earlier, can be a defense mechanism for one when experiencing a loss. This process of denial can be short lived or longer depending on how the person experiences the loss.
- Anger: During the stage of anger, it is important to get to the root cause of the anger and understand the thoughts that are associated with the loss.
- Bargaining: The bargaining stage is a way that people negotiate what it is that they would like to see as the outcome from the situation.
- Guilt: Some people when they experience a loss also experience guilt. This guilt can come from various sources, and again, a person must assess to see the root cause of the guilt that he/she is experiencing.
- Depression: Depression is a grief reaction that many people may experience when suffering from a loss. Symptoms of depression may vary from person to person and must not be taken lightly when one experiences behaviors that are out of the norm after a loss.
- Acceptance and Hope: Acceptance and hope allows for a person who has experienced a loss to accept that the loss has occurred and began to accept that life will be different due to the loss. During this stage, a person does not get over losing what he/she has lost but is able to begin moving forward.
6 Rs of Grief
Dr. Therese Rando created the Six R Processes of Mourning. The Six Rs consist of:4,5
- Recognizing the loss: At the recognizing the loss stage, one acknowledges the death of the loved one and understands that the death has taken place
- Reacting to the separation: During reacting to the separation, one experiences the pain and actually feels, identifies, and accepts the separation due to the loss. During this stage, one also identifies and mourns secondary losses that they have experienced due to the loss.
- Recollecting and reexperiencing the loved one who has died: During this stage of mourning one may review and remember the loved one who has died. One may also reexperience emotions that they experienced previously.
- Relinquishing old attachments to the loved one who had died: During this phase one has to confront old attachments and be able to move forward with the new norm.
- Readjusting to move into the new without forgetting the old: During this stage, one may create a new relationship with the loved one who is dead and adopt new ways of moving forward in the world without the loved one.
- Reinvesting: At this stage, one may begin to compensate and reinvest in self to establish life without the loved one being present.
The Dual Process by Margaret Stroebe & Henk Schut
The Dual Process Model (DPM) of Coping with Bereavement was created by Margaret Stroebe and Henk Schut in 1999. The DPM was created to provide a model that described coping with a loss in a way that could provide some predictability to people who were grieving.6 The model was also created to predict good versus poor adaptation to the stressful life event of losing a loved one.6
The key goal of the model is not a “one size fits all” model but a model that provides an explanation of the range of coping that is affiliated with the bereavement process.6 When Stroebe & Schut discuss coping in their model, they are referring to the processes, strategies, or ways of managing situations in which bereavement places on the individual that is suffering the loss.6
Getting Help for Grief
Living with grief and loss is a unique journey that takes time and support to navigate the process. Throughout the grief process one may experience an overwhelming amount of sadness and an array of other emotions. Therefore, it is imperative to seek out help when grieving a loss. Some therapeutic supports that are available include but are not limited to individual counseling, support groups, and bereavement groups.
Individual counseling sessions can help one process their loss, emotions related to the loss, and provide a safe place to discuss thoughts, triggers, and other information related to one’s journey of processing a loss. It can feel daunting to find a therapist, but an simple place to start is an online directory, where you can search for a mental health professional who specializes in helping people through grief.
Support groups can also provide a layer of help when one is grieving a loss. Many support groups are put in place to normalize that grief reactions are normal and to help people connect with others who may be experiencing a loss. Some support groups may provide a psychoeducation component. Through psychoeducation, participants can learn information about the grief process and healthy ways to cope based on research and literature that has addressed this topic. Support groups and bereavement groups may vary, as bereavement groups often focus on the specific person that group members have loss (eg., partner, parent, sibling).
Therapeutic methods are one way to learn healthy coping methods when grieving a loss. However, it is important to identify healthy ways to cope with the loss to help with the process of grieving. If you or someone you know is experiencing a loss and symptoms related to the loss, it is never too early to seek out support. This support can vary and is often needed when people are experiencing transitions due to a loss. Getting help early can help one process the various emotions and help people transition while experiencing losses.
