When people experience the death of a loved one or have a traumatic experience resulting in significant loss, they grieve. Grief is an overwhelming universal series of emotions that touches us all. Psychiatrist Elisabeth Kubler-Ross first introduced the concept of 5 stages of grief which has now moved to seven. Angel Rivera, MD, explains the 7 stage model. “This 7 Stage model has become widely accepted as more inclusive combining two stages that people often experience.”1
What Are the 7 Stages of Grief?
These seven stages are not necessarily in order and may occur more than once. Grief experts caution that “grief is not a linear process with concrete boundaries, but a composite of overlapping, fluid phases that vary from person to person.”2. This model helps gauge your grief process expectations. Other grief experts report frequent looping back and forth between stages.3
Here is the model for the 7 stages of grief:
1. Shock and Denial
Shock is the initial phase when learning about the death of a loved one or other significant loss. “Shock is a self-defense stage of the mind, and the outcome of it, many times, is a denial of the facts that have happened.”4. It occurs when you try to process a loss that seems unimaginable and feels unacceptable.
Denial is a defense mechanism to help cope with a difficult loss. Denial gives you time to understand what has happened and slowly adjust to the new present.
Feelings that may accompany the shock and denial phase of grief include:
- Depression
- Hopelessness
- Confusion
- Loneliness
- Anger
Examples of the shock and denial stage of grief include:
- “If only I could see and talk to him one more time.”
- “She will wake up tomorrow, realize this is the biggest mistake she has ever made, and come running back to me for forgiveness.”
- I dedicated my life to working for that company, and they let me go without warning!”
- “My mom was there for me my whole life. How can I go on without her?”
Denial is one of the most challenging stages, as people may isolate themselves during this phase. Reminders about self-care are needed. One’s identity may have been linked to the person or job loss and must now redefine how they perceive themselves. It’s impossible to attach a time frame to this stage because it varies between people. Suppose your inability to function with daily tasks, make decisions, and break isolation remains persistent. In that case, these may be indicators that you are stuck in this phase.
2. Pain & Guilt
The realization that a loved one is dead or gone or another significant loss can leave an emptiness in your life, causing pain and yearning. You may feel relieved that a loved one is not suffering but guilty for thinking that. Some may believe they could have done more to help. People often regret that the outcome was not what they hoped for, with unrealistic expectations about what they can do to stop a loss or death. They also feel
Feelings that may accompany the pain and guilt stage of grief are:
- Blame
- Sadness
- Guilt
- Regret
Examples of the pain and guilt stage of grief include:
- “If only I had done more to convince my husband to go to the doctor earlier, he might have been able to beat cancer.”
- “I spent 15 years of my life being with him. I should have done more to show him how much I loved him. Then he would have cared about me more.”
- “I should have spent more time focusing on my work and less time staying out late at night partying.”
- “Dad needed me to be there for him. I couldn’t because of work. That is something I will always regret.”
- “How could I have not known she was this depressed and let this happen?”
Debbra Bronstad, LMFT, grief specialist, describes grief’s guilt stage. “Guilt can occur when the bereaved have regrets about things they did or said before the loved one died or left them. There is a wish to turn back the clock and do some things differently.”5
The challenge of this stage is that people can ruminate about perceived mistakes. This negative self-talk can exacerbate feelings of guilt and increase emotional pain. If these thoughts and behaviors persist, this grief stage will last longer. Outside intervention from a mental health professional may help if this self-destructive behaviors continues.
3. Anger & Bargaining
Grief experts studied the length of time for stages of grief in this stage. They concluded that the need for anger management “increases between 1 and 5 months post-loss and decreases between 5 and 24 months post-loss.”7
The Hospice Foundation of America describes the sources of the anger stage as:6
- Anger at being abandoned (creating abandonment issues)
- Anger at the extent of the pain
- Anger that life has changed (similar to adjustment disorder)
- Anger that managing grief feels difficult
- Anger that the world suddenly feels different, empty, unsafe, or lonely
The bargaining stage involves trying to regain a false sense of control after feeling helplessness and displaced anger. Regina Josell, Ph.D., says, “We engage in a type of mental gymnastics to try to undo something that we can’t undo.”8. This stage provides a grieving p erson with time to emotionally come to terms with a loss.
Feelings that may accompany the anger and bargaining stages of grief include:
- Frustration
- Resentment
- Rage
- Hopeful
- Anxiety (specifically anxiety paired with anger)
- Fear
Examples of the anger stage of grief include the following:
- “Why me, god? Why did you give me breast cancer? I don’t deserve this.”
- “My boss was so unfair. He should have given me a chance to do the project again. I should never have lost my job.”
- “If you had not brought that medication into our house, our daughter would not have taken it and would still be alive.”
- “If my husband survives this car accident, I promise to go to church every Sunday.”
- “I will start to do volunteer work if you allow me to stay alive for a little longer.”
- “If the child I hit with my car gets better, I will sell the car and donate the money to charity.”
Anger can be a complex emotion and is a normal reaction to grief with no specific timeline associated with its stage. People can get stuck in an angry phase of grief if they don’t understand how to deal with these feelings. When anger continues or intensifies into repeated rageful episodes or an intermittent explosive disorder towards people not associated with the loss, this signals that you need additional mental health support to cope.
People on the bargaining side of this stage often don’t find an acceptable resolution they are trying to bargain. Eventually, they recognize that the outcome they hope for will not occur. Trying to bargain with a higher power, an individual, or a system, is a means of diminishing anger and moving closer to acceptance. This phase generally does not last as long as others because it eventually becomes clear that what you hope for won’t happen.
4. Depression
Depression stems from internalized or repressed anger in this stage. It occurs when time has passed for the ramifications of a significant loss become clear. This stage can manifest as reduced concentration, inability to sleep, and sleeping too much. You may have physical symptoms like headaches and body aches or digestive issues as well.
Feelings that may accompany the depression stage of grief are:
- Loneliness
- Sadness
- Depression
- Emptiness
- Anhedonia – inability to feel any joy from anything
- Self-pity
Examples of the depression stage of grief include:
- “How do I go on without my beloved husband?”
- “My job meant everything to me. It was who I am.”
- “Since my divorce, I have lost all my friends. I don’t want to be around people. I feel so alone.”
Psychologists looking at the relationship between grief and depression describe the danger of being stuck there and the difference between normal grief and clinical depression. “People suffering from major depression tend to be isolated and feel disconnected from others and may shun support and assistance. People who don’t get such support, or who avoid it, may be at greater risk for major depressive disorder during the grieving process.”9.
If there is a predisposition to depressive disorder types, there is a greater risk for depression lasting longer in this stage. This stage can be the longest of grief. If you find that you feel depressed almost all the time and your symptoms don’t fluctuate, reach out to a mental health professional.
5. The Upward Turn
In this stage of grief people begin to adjust to life post-loss. People begin to see that they have survived the loss and that they have a future to live. Grief experts report that “life becomes a little calmer and more organized. Your physical symptoms lessen, and your ‘depression’ begins to lift slightly.”10 This shift in perspective is the “part of the grieving process that you’ll start to see the light a bit at the end of the tunnel.”
Feelings that may accompany the upward turn stage of grief include:
- Hopeful
- Moments of happiness
- Feeling a sense of well being
- Calmer
Examples of the upward turn stage of grief are as follows:
- “I can’t believe I smiled and laughed today. I can’t remember the last time that happened.”
- “I do have a pretty good resume. Maybe it’s time to start looking for a new job.”
- “It has been several months since my daughter died. I need to start thinking about ways of honoring her memory.”
Grief expert Darby Faubion, RN, describes that in this phase, “although loss is felt still, it is not as difficult to manage the symptoms. Individuals tend to feel more hopeful about life and begin to find some measure of peace related to the loss.”11 This stage is not as difficult as it offers relief and a sense of hope that a grieving person can build a new life after an enormous loss.
6. Reconstruction & Working Through
In this grief stage, people feel less overwhelmed by emotions created by a major loss. They have more energy and a new desire to begin to move forward by finding meaning and growth after a traumatic event with concrete actions to regain control. Here people start to manage their lives and may feel like reconnecting with loved ones once again.
Feelings that may accompany the work through and reconstruction stage of grief include:
- Energized
- Optimistic
- More at peace
- Hopeful
- More confidence
Examples of the reconstruction stage of grief include:
- “I don’t know how much time I have left, but I am determined to make the most of it as best I can.”
- “I know my partner wanted me to date again after he died. Maybe it’s time to start thinking about it.”
- “I’m tired of fighting with my wife about the terms of our divorce. I want it to be over so I can move on with my life.”
Moving forward in this stage involves asking “what actions do I need to take to build a new life for myself?” It can create a sense of anticipation or anticipation anxiety. It’s a time to redefine what everyday life will look like for you. People often resume self-care activities like exercise for mental health, which can bring more energy, optimism regarding the future, and a desire to find some measure of success.
7. Acceptance & Hope
Acceptance and hope is the last stage in the grieving process. It comes with a sense of optimism from a realistic life assessment with a deep understanding of your loss’s impact. You permit yourself to plan for a future, knowing you will not forget what has happened. You have learned ways to care for yourself and cope and how to set new self-expectations as you begin to move ahead. There is still pain and sadness attached to your loss. However, you recognize that you are entitled to create a different life offering yourself a measure of contentment.
Feelings that may accompany the acceptance and hope stage of grief are:
- Relief
- Optimism
- Reflection
- Acceptance
- Hope
Examples of the acceptance and hope stage of grief include:
- “It feels scary to go on the dating scene again. I miss my wife, but I know I’m ready for a new relationship.”
- “I have revised my resume and will aim to apply for three jobs in the next month.”
- “I miss my son every day. I think he would love that I have started this program in his name to help other kids struggling with thoughts of suicide.”
People in this phase have not fully healed from their loss but understand they have renewed strength and determination to move on. They allow themselves to reflect on past cherished memories associated with the loss. There may be feelings of sadness that arise at holidays or birthdays. However, they don’t cause the level of despair previously experienced.
Are There 5 or 7 Stages of Grief?
The original five stages model of grief was created in 1969 by Elisabeth -Kubler-Ross, MD, in her book on Death and Dying, based on her work with terminally ill patients. The stages in her model were: Denial, Anger, Bargaining, Depression, and Acceptance.
The seven stages of grief include the five stages Dr. Kubler-Ross outlined but also include guilt, an upward turn, and reconstruction. The reason for this was that most grief experts agreed that these were also stages experienced by those who grieved.
There is a 4 step model that includes:
- Shock & Numbness
- Yearning & Searching
- Disorganization & Despair
- Reorganization & Recovery
In addition, there is a 10-step model described by Brooke Dean, Ph.D. that includes:12
- Shock
- Facing emotions
- Depression
- Physical symptoms
- Panic
- Guilt
- Anger
- Resistance
- Hope
- Acceptance
How Long Do the 7 Stages of Grief Last?
Grief is a personal and unique experience. There is no designated time frame for these stages or processes. Grief experts say, “Healing happens gradually; it can’t be forced or hurried-and there is no ‘normal’ timetable for grieving. Some people start to feel better in weeks or months. For others, the grieving process is measured in years.13
What Is the Hardest Stage of Grief to Go Through?
There are different professional opinions about the most challenging stage of grief to go through. Some believe Acceptance is the hardest because you finally have accepted that a loved one is dead. Others say the Depression stage is the hardest because symptoms of depression are so debilitating that it can take more time to move beyond this stage. Many people begin to understand their loss in this stage better. Each step has its challenges and can be difficult depending on the individual’s grief.
Do I Need to Go Through the 7 Stages of Grief?
People do not need to go through all seven stages of grief. They do not necessarily occur in order. Some people may go through a given stage more than once or sometimes multiple stages simultaneously. Dr. Kubler-Ross said that “The stages have evolved since their introduction, and they have been very misunderstood over the past 3 decades. They were never meant to 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. Our grief is as individual as our lives.”14
When to Get Professional Help for Grief
Indications that working with a mental health professional may be an option to pursue if these conditions exist:
- You cannot adjust to living in a world without the person or event you lost.
- You are unable to get to a place of acceptance regarding your loss.
- The symptoms in the stages of grief remain and get more frequent with greater intensity.
- You cannot imagine moving on with your life.
Finding an online licensed mental health professional with expertise in loss, grief, death, dying, and traumatic grief. They can help you cope with and process your grief and the associated feelings of loss.
What Type of Professional Help Can I Get for Grief?
There are several options for people who need counseling or therapy to cope with grief. Counseling focuses on a specific issue, like grief, and uses problem-solving or coping techniques to address it. Counseling options are short-term, while psychotherapyis generally more long-term and can address numerous issues hindering relationships or a person’s ability to function healthily. Licensed, certified practitioners can do both and can be found on an online therapist directory.
There are different treatment options for people experiencing grief, such as:
- Faith-Based Counseling: Spirituality, faith, and god are the centerpieces of this treatment to help cope with grief from a significant loss. It uses behavioral science and scripture with counseling. Examples of people that do this counseling are Pastors or Priests.
- Cognitive Behavioral Therapy (CBT): This short-term therapy looks at thought processes and how they influence behavior to elevate mood.
- Grief Support Groups: Grief support groups can be led by mental health professionals or peers. Many people find it helpful to talk to others who have experienced similar losses. It helps normalize feelings and can be a source of comfort and support.
- Grief Counseling: This counseling is designed to help people to come to terms with emotions and behaviors that occur after a significant loss. It helps to understand these feelings and offers ways to cope with them.
- Grief Therapy: Grief therapy helps to process a significant loss and learn ways to cope with it. Similar to trauma-informed therapy, it allows people struggling with issues outside of the normal ones associated with grief and identify healthy ways to grieve.
- Hospice Care: Hospice bereavement and palliative care counseling are available to patients and family members whose loved one has a life-threatening illness or died. The hospice-licensed staff offers counseling and support to help cope.
Final Thoughts
If your experience with grieving does not fit this model, don’t be worried. There is no “right or wrong way” to grieve. When deaths occur, the way a person died influences the course of grief. Grief experts reveal that “bereavement adjustment following deaths from traumatic causes may be more difficult to process and demonstrate higher degrees of disbelief and anger and lower levels of acceptance…those bereaved by traumatic vs. natural deaths had greater difficulty in making sense of loss.” 15
The same person may grieve differently depending on the nature of the loss. Don’t place arbitrary time frames on your grief process. If you’re aware you’re stuck in a stage that negatively impacts your ability to function and your relationships with others, consider reaching out to a mental health grief specialist for help.
For Further Reading
- 21 Best Books on Grief
- 15 Best Grief Podcasts
- Best Grief Books for Children
- Compassionate Friends For Families Whose Child Has Died
- The Dougy Center for Grieving Children and Families
- AfterTalk Online Support for Grieving
- Grieving.com Online Chat Rooms & Support Groups
- Actively Moving Forward Review: What’s Offered & Who It’s Right For
- Grieving the Loss of a Pet
- Grieving the Loss of a Child: Coping & Moving Forward
- Coping With the Death of a Parent
7 Stages of Grief: Examples & What to Expect Infographics
