How to understand the five stages of grief

Grief is one of the most complex human experiences. Your grief journey may include unexpected emotions, or you may find your feelings are more or less intense than you thought they would be. Grief is difficult to predict, and there’s a wide range of experiences that are considered normal. Still, many people want to know what to expect when they’re grieving. The five stages of grief can be useful to shed some light on what the grieving process may look like — understanding that grief looks different for everyone. «The stages of grief are not meant to be prescriptive but rather descriptive. They are meant to give more detail and context about grief to help normalize the experience for the individual griever,” says Jaymie Byron, LMFT and grief therapist. The guidance below was reviewed by Jaymie Byron, LMFT, and Community & Education Director at Kara Grief.

What are the five stages of grief and loss?

The five stages of grief are denial, anger, bargaining, depression, and acceptance. They were first published in a 1969 book by Elisabeth Kübler-Ross, and are also known as the Kübler-Ross model of grief. As the model gained popularity, the experts behind the book clarified that the stages of grief are not prescriptive — everyone experiences them differently. “A key misnomer in the understanding of grief is that it is sequential,” says Jaymie. “The five stages of grief aren’t intended to imply linearity or sequencing, but a collection of experiences that can take place within one’s grief journey.” Several other experts have published other models of the stages of grief after a death that expand on the Kübler-Ross model. Many experts add a stage of guilt as well as a stage called reconstruction in which the bereaved begins to rebuild. Author David Kessler added a sixth stage to the traditional five-stage model called finding meaning: turning your loss into more love than pain.

How long do the five stages of grief last?

The five stages of grief and loss can vary widely, including how long they last. Some stages can last longer than others, and there’s no set length of time for grief in general. The stages don’t necessarily occur in the same order or at the same time for everyone. You can experience the stages in any order, repeat stages, and even experience multiple stages at the same time. «Grief is a reflection of the depth of one’s relationship. It’s not bound by the construct of time; instead, it exists beyond time, as the griever has the option of continuing the bond even after death,” says Jaymie.

What is the hardest stage of grief?

There’s no way to tell which stage of grief will be the most difficult. Each grief journey is unique and a myriad of factors can play into how you process your loss. If you feel that you’re stuck in a painful stage, such as depression or denial, seek the support of a clinician who can help you process your feelings and teach you coping mechanisms. Support from loved ones and trained professionals is incredibly important during this time.

Is it possible to skip the stages of grief?

Not everyone grieves in the same way, and you may find that you naturally don’t experience some stages of grief and loss. For example, you might skip the bargaining phase, in which you think that if only you could do something differently or make a deal with a higher power, you could overcome your grief. Or you may skip anger, depending on the circumstances of your loss. When you’re dealing with something as personal as grief, there is a wide range of experiences and feelings that are normal. All you need to do is allow yourself to feel. There are also many grief therapy techniques you can try to help you come to terms with your loss.

How do I know if my grief is normal?

Grief is deeply personal, so it’s difficult to predict how long the stages of grief and loss will take. However, it’s possible to tell if your grief is healthy. While grief always involves a number of intense emotions, you should begin to feel like you’re working through them and making progress. And while you’ll never “get over” a painful loss, you should believe that it’s possible to overcome your grief and regain a semblance of normalcy. While everyone experiences grief differently, if you ever feel like you’re stuck and are unable to move forward, it may be time to seek help. No matter what you are feeling, it is important to always have hope. The pain of this loss will someday subside and hopefully encourage you to live a life that would make them proud. June 8, 2020 Posted by Caitlin Stanaway, Psy.D., Licensed Psychologist, UWCC The pandemic has impacted our routines, social lives, school, work, and more. It has caused the loss of lives around the globe, as well as the loss of normalcy. The recent death of George Floyd has put police brutality, murders of Black and Brown people, racial and social injustice into the spotlight. There are many losses to grieve amidst the intensity of civil unrest, on top of more typical stressors like taking finals and looking for a job. Elisabeth Kubler-Ross developed the five stages of grief in her 1969 book, On Death and Dying. Grief is typically conceptualized as a reaction to death, though it can occur anytime reality is not what we wanted, hoped for, or expected. Persistent, traumatic grief can cause us to cycle (sometimes quickly) through the stages of grief: denial, anger, bargaining, depression, acceptance. These stages are our attempts to process change and protect ourselves while we adapt to a new reality. While there are consistent elements within each stage, the process of grieving looks different for everyone. When you combine experiences of stress and trauma to grief, it is overwhelming. It takes a toll on our mental and physical health. Our minds and bodies are consistently being impacted by the stress response, a nervous system reaction to feeling threatened. It triggers the release of adrenaline and cortisol, impacting sleep, appetite, making it difficult to function at your best. Symptoms of anxiety and depression may develop, as well as trauma symptoms like intrusive thoughts, nightmares, feeling disconnected from self. Trauma related to racial injustice is chronic. Resources for Black healing, including crisis support, self-care, and reducing cortisol levels in response to racial stressors can be found here. Being aware of the grief stages and how you uniquely experience them can increase self-understanding and compassion. It can help you better understand your needs and prioritize getting them met.

Denial

can look like:	can feel like:
avoidance	shock
procrastination	numbness
forgetting	confusion
easily distracted	shutting down
mindless behaviors
keeping busy all the time
thinking/saying, “I’m fine” or “it’s fine”

Anger

can look like:	can feel like:
pessimism	frustration
cynicism	impatience
sarcasm	resentment
irritability	embarrassment
being aggressive or passive-aggressive	rage
getting into arguments or physical fights	feeling out of control
increased alcohol or drug use

Bargaining

can look like:	can feel like:
ruminating on the future or past	guilt
over-thinking and worrying	shame
comparing self to others	blame
predicting the future and assuming the worst	fear, anxiety
perfectionism	insecurity
thinking/saying, “I should have…” or ”If only…”
judgment toward self and/or others

Depression

can look like:	can feel like:
sleep and appetite changes	sadness
reduced energy	despair
reduced social interest	helplessness
reduced motivation	hopelessness
crying	disappointment
increased alcohol or drug use	overwhelmed

Acceptance

can look like:	can feel like:
mindful behaviors	“good enough”
engaging with reality as it is	courageous
“this is how it is right now”	validation
being present in the moment	self-compassion
able to be vulnerable & tolerate emotions	pride
assertive, non-defensive, honest communication	wisdom
adapting, coping, responding skillfully

Generally, if we are not in the stage of acceptance then we are in some way fighting against or avoiding reality. We might start sleeping more. Our mood or anxious thoughts might become the focus of attention, distracting from external stressors. We might use alcohol or drugs to avoid or disconnect from reality. We might keep our focus on tasks, responsibilities, or the needs of others – staying busy as much as possible to avoid feeling distress. Acceptance doesn’t mean not experiencing distress, emotions or trauma. It does not mean you condone what is happening. It means noticing what you are fighting against, validating your desire to fight against it, and re-orienting yourself to the reality of the moment you are in. It means not getting stuck, or getting un-stuck, from other stages. Mindfulness and a non-judgmental, curious attitude can be a big help. Acceptance might look like saying to yourself: “If I sleep too long today I’ll keep sleeping through the mornings. I’m going to prioritize getting my schedule regulated.” It might look like noticing: “I’m directing my anger and sadness about what’s going on toward myself and ruminating on self-criticisms. I’ll acknowledge my anger and what it’s really about.” Or reflecting, “how could I not be angry about ___? Who wouldn’t be anxious about ___? Of course it’s extremely hard to accept ___”; It might look like checking in on yourself: “If I keep neglecting my own needs and focusing on work/others, I’ll end up feeling burned out and exhausted. I’ll take time to assess how I’m doing and what I need.” It is rare to move through the stages in a linear way. It is normal to experience ups and downs in mood, thoughts, attitudes, and behaviors. It can be difficult maintaining acceptance while things feel so unacceptable. If you are feeling overwhelmed by grief, loss, trauma you do not have to go through it alone. The Counseling Center can offer culturally-sensitive support and guidance through the grieving process. If you’ve ever lost a loved one or gone through another dark time, you may be closely acquainted with grief. Loss can hit our emotions hard, and in unforeseen ways—you may expect to feel sadness, but other emotions like anger may come to the forefront as well. Grief also comes in response to role transitions, major life events and changes in our social world, such as loss of friendships or breakups with romantic partners. While everyone experiences grief differently, a popular psychological theory puts it into five distinct stages. That includes denial, anger, bargaining, depression and acceptance, according to Swiss-American psychiatrist Elisabeth Kübler-Ross, M.D. Dr. Kübler-Ross introduced this model in her 1969 book On Death and Dying, and it still has wide mental health applications today. Experts explain the five stages of grief below, and the role they play in our well-being. You Deserve To Be Happy Asking for help takes strength. BetterHelp can match you with a professional, licensed and vetted therapist from any device.

What Are the 5 Stages of Grief?

While the original model introduced by Dr. Kübler-Ross proposes that the five stages of grief occur in a particular order, experts today emphasize that there’s no specific arrangement in which these emotions occur, and not everyone experiences them all, says Holly Schiff, Psy.D., a licensed clinical psychologist and grief counselor in Greenwich, Connecticut. Rather, “grief comes in stages and changes over time. It doesn’t have a clear beginning and end.” Indeed, the five stages of grief are a “normal reaction to loss and have a wide range of feelings,” adds Robin Hornstein, Ph.D., a psychologist and life coach in Narberth, Pennsylvania. And, it’s important to recognize these categories depend on the individual, adds Dr. Schiff: “You can go back and forth between the stages, and sometimes even feel like you are in multiple stages at once as you cycle through a variety of emotions.” Here’s a closer look at each one:

Stage 1: Denial

Denial is a form of shock that slows down our reaction to a loss, according to Dr. Hornstein. It’s almost like living in virtual reality, trying to make some sense of something too large to accept, she says. In this stage, a person might imagine the information they’ve received is wrong, or they or their loved one will beat the odds. Denying a situation can act as a defense mechanism while the individual processes upsetting news. They may avoid the topic altogether for a period of time or pretend that something upsetting didn’t happen, but “once that initial denial and shock start to fade, you can start to heal and the feelings you were suppressing start to come to the surface,” says Dr. Schiff.

Stage 2: Anger

Anger infuses us with fiery energy, adds Dr. Hornstein. Despite knowing that life includes death and other losses, anger moves us into a space of power, even if it’s short-lived, she explains. During this stage, people may question doctors, the person who is ill or God, and wonder why this happened, says Dr. Hornstein. In most cases, however, anger can be useful in processing grief. It often masks other emotions since it’s easier sometimes to be mad than to sit with profound sadness that may come with a loss. But we may take our frustration out on those who don’t deserve it, blaming a person who diagnosed with lung cancer for smoking, for example, or ourselves for not intervening. Not everyone feels anger in every situation, though, says Dr. Hornstein. Some may instead experience feelings of defeat or acceptance. If we don’t process anger when it arises, it can be hard to let go of. That’s why truly feeling that emotion is necessary, adds Dr. Schiff. The more you allow yourself to feel it, the more quickly it will dissipate, so she suggests you don’t suppress it. You May Also Be Interested In Online Therapy Services From Our Featured Partners Talkspace Therapy Type General, professional therapy Starting Cost $65 per week Key Feature Therapists have 9 years of experience on average Subscription Includes Live chat, live phone sessions, live video sessions Cerebral Therapy Type General, professional therapy Starting Cost $259 a month Key Feature Therapists available morning, night, weekdays and weekends Subscription Includes Live phone sessions, live video sessions BetterHelp Online Therapy Therapy Type General, professional Therapy Starting Cost $65 per week, 20% off first month Key Features Match with a license therapist in 48 hours Subscription Includes Live chat, live phone sessions, live video sessions (Note: Product details and price are accurate as of publication and are subject to change.)

Stage 3: Bargaining

In the bargaining stage, individuals may be so desperate to get their lives back, that they grasp at straws and try to avoid grief through negotiation. “Bargaining typically manifests as patients seek some measure of control,” notes research in the book Stages of Dying^[1]Tyrrell P, Harberger S, Siddiqui W. Stages of Dying. [Updated 2021 Apr 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. . “The negotiation could be verbalized or internal and could be medical, social or religious.” And, according to the researchers, “proffered bargains could be rational, such as a commitment to adhere to treatment recommendations or accept help from their caregivers, or could represent more magical thinking.” This may mean bargaining with a higher power of some kind, says Tasha Holland-Kornegay, Ph.D., a licensed professional counselor in the Raleigh-Durham, North Carolina area, and founder of telehealth counseling service Our Treatment Center. “The essential goal of the bargaining stage is to prevent the expected outcome or loss.”

Stage 4: Depression

People in the depression stage start to process their loss in a more realistic way. This stage can be particularly challenging, says Holland-Kornegay. At this point, you’ve come to terms with what to expect for your future after loss and realize your life will be different. Giving in to feelings of sadness and despair can make it harder to function in everyday activities, adds Dr. Hornstein. Sadness can overwhelm our systems with symptoms of lethargy, diminished joy, a feeling of emptiness and even suicidal thoughts, she says. However, there are ways to manage these feelings and improve one’s outlook, such as through connecting with community, practicing mindfulness, and receiving evidence-based psychotherapies like cognitive behavioral therapy (CBT). Connect With A Counselor If you’re in crisis or having suicidal thoughts, call the National Suicide Prevention hotline at 988 or message its live online chat service for immediate support from a trained counselor. If you’re in immediate danger, call 911. Although it’s noted as the fourth stage, Dr. Hornstein emphasizes that just as with the other stages, we can’t predict when or if depression will show up as a part of our experience.

Stage 5: Acceptance

While you still might experience feelings of grief over your loss, during acceptance, you are able to acknowledge it, says Dr. Schiff. That means learning to live with the loss and readjusting your life accordingly. During this stage, your emotions will begin to stabilize, she says. When and if you reach acceptance, you’ll have worked through your thoughts, feelings and concerns for the future, adds Holland-Kornegay. What’s more, you’ll have established a plan for a routine promoting inner peace and self-trust. “You have learned to live with your loss while holding on to the values that you have gained from both the object of loss and what you have learned for yourself through the grieving process,” she says.

A Sixth Stage of Grief?

Finding meaning is a sixth stage of grief attributed to loss expert David Kessler, who co-authored On Death and Dying with Dr. Kübler-Ross. It incorporates the act of remembering and honoring our loved ones in meaningful and unique ways. Maybe we’ve already gone through earlier stages of grief, but need to find a course of action or achieve peace, says Dr. Hornstein. This stage is particularly important for people who experience incomprehensible losses, such as a child passing or an unexpected death. “Finding meaning helps bring us to a place where we can honor our loss knowing that the pain may dull but the love will continue,” she says.

When to Seek Professional Help

The grieving process may never be easy, but there are ways to cope, says Dr. Schiff. She recommends allowing yourself the time and space to mourn whenever and however it surfaces. Plus, “practicing self-care [can] help make the process easier. Taking care of ourselves physically, mentally, emotionally and spiritually is vital to our psychological well-being and our ability to manage feelings of grief.” As well, it’s important to get support from others during a period of loss, especially if it’s hard to move on. That can come from empathetic friends, family members, a bereavement support group, or the professional help of a psychologist or psychiatrist. It’s important to know that you are not going through it alone, says Dr. Schiff. “Grief hurts. However, it is not meant to end your life or your joy,” adds Dr. Hornstein. “To go on, to accept, means we can bring the loved one’s memory into our life.” Talkspace Online Therapy Talkspace connects you to licensed therapists based on their expertise from across the country. Chat with a therapist online about sleep disorder, anxiety, panic attacks & stress.

A Message from David Kessler

I was privileged to co-author two books with the legendary, Elisabeth Kübler-Ross, as well as adapt her well-respected stages of dying for those in grief. As expected, the stages would present themselves differently in grief. In our book, On Grief and Grieving we present the adapted stages in the much needed area of grief. The stages have evolved since their introduction and have been very misunderstood over the past four decades. 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 five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief ‘s terrain, making us better equipped to cope with life and loss. At times, people in grief will often report more stages. Just remember your grief is an unique as you are.

NEW BOOK

Finding Meaning: The Sixth Stage of Grief

In this groundbreaking new work, David Kessler—an expert on grief and the coauthor with Elisabeth Kübler-Ross of the iconic On Grief and Grieving—journeys beyond the classic five stages to discover a sixth stage: meaning. In this book, Kessler gives readers a roadmap to remembering those who have died with more love than pain; he shows us how to move forward in a way that honors our loved ones. Kessler’s insight is both professional and intensely personal. His journey with grief began when, as a child, he witnessed a mass shooting at the same time his mother was dying. For most of his life, Kessler taught physicians, nurses, counselors, police, and first responders about end of life, trauma, and grief, as well as leading talks and retreats for those experiencing grief. Despite his knowledge, his life was upended by the sudden death of his twenty-one-year-old son. How does the grief expert handle such a tragic loss? He knew he had to find a way through this unexpected, devastating loss, a way that would honor his son. That, ultimately, was the sixth state of grief—meaning. In Finding Meaning, Kessler shares the insights, collective wisdom, and powerful tools that will help those experiencing loss.
Read More 5stages2 DENIAL Denial is the first of the five stages of grief™️. It helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. As you accept the reality of the loss and start to ask yourself questions, you are unknowingly beginning the healing process. You are becoming stronger, and the denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface. 5 stages3 ANGERAnger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal. There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing. The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea: no connection to anything. Then you get angry at someone, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe a person who is different now that your loved one has died. Suddenly you have a structure – – your anger toward them. The anger becomes a bridge over the open sea, a connection from you to them. It is something to hold onto; and a connection made from the strength of anger feels better than nothing.We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of your love. 5stages4 BARGAININGBefore a loss, it seems like you will do anything if only your loved one would be spared. “Please God, ” you bargain, “I will never be angry at my wife again if you’ll just let her live.” After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others. Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only. Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt. People often think of the stages as lasting weeks or months. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one. 5stages5 DEPRESSIONAfter bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all? Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask yourself is whether or not the situation you’re in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual. When a loss fully settles in your soul, the realization that your loved one didn’t get better this time and is not coming back is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way. 5stages6 ACCEPTANCEAcceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. We must try to live now in a world where our loved one is missing. In resisting this new norm, at first many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed and we must readjust. We must learn to reorganize roles, re-assign them to others or take them on ourselves. Finding acceptance may be just having more good days than bad ones. As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one. We can never replace what has been lost, but we can make new connections, new meaningful relationships, new inter-dependencies. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve. We may start to reach out to others and become involved in their lives. We invest in our friendships and in our relationship with ourselves. We begin to live again, but we cannot do so until we have given grief its time.