Mourning and the Five Stages of Grief

[David Baxter PhD]

The 5 Stages of Grief After Facing a Loss​

PsychCentral.com
Feb 24, 2021

Mourning is an intimate and unique experience for each of us. There’s no manual on how to cope with loss and certainly no right or wrong way to go through the stages of grief that might come from it.

If you or someone you love are going through a loss, the new emotions may feel overwhelming and confusing.

Feeling this way is natural and even necessary. These emotions are forward steps in the healing journey, even when it doesn’t feel like it at the moment.

Healing from a loss is possible, but it does take time and patience. Even if you’re having a particularly hard time with it, resources like counseling and support groups can help you cope.

The Kübler-Ross model on grieving​

In an effort to better understand the grieving process, many mental health experts and researchers have dedicated years to studying loss and the emotions that come with it.

One of these experts was Elisabeth Kübler-Ross, a Swiss American psychiatrist. She created the Kübler-Ross model, the theory of the five stages of grief and loss.

In her 1969 book, On Death and Dying, Kübler-Ross examined the five most common emotional reactions to loss:

• denial
• anger
• bargaining
• depression
• acceptance

Originally, Kübler-Ross referred to them as the “five stages of death.” This was because she was working with terminally ill patients at the time, and these were the common emotions they had regarding their own mortality.

Years after her first book, Kübler-Ross adapted and extended her model to include other kinds of loss. The five stages of death became the five stages of grief.

This grief can come in many forms and from different reasons. Everyone, from all walks of life and across cultures, experiences loss and grief at some point.

Mourning doesn’t come only from dealing with your own death or the death of a loved one. Mourning can also come as a result of an illness, the end of a close relationship, or even the end of a project or dream.

Grief can similarly come from a perceived or real change in your life. For example, moving to a new city, school, or job, transitioning into a new age group, or staying in isolation because of a pandemic.

In other words, there’s no written-in-stone list of “valid” reasons to grieve.

What matters is how you feel. And there are no right or wrong feelings regarding a loss.

Going through the 5 stages of grief​

Exploring the five stages of grief and loss could help you understand and put into context where you are in your own grieving process and what you feel.

Similarly, if you’re concerned or want to understand someone else’s grieving process, remember that there’s no one way of going through it. Everyone mourns differently.

You could go through many intense emotions, or you could seemingly not react at all. Both responses are valid and not uncommon.

How much time you spend navigating the stages of grief also varies from person to person. It might take you hours, months, or longer to process a loss and heal from it.

You might not experience all these stages of grief or in the order listed above. You could go back and forth from one stage to another.

You may even skip all these emotions and process your loss differently altogether. The five stages of grief are supposed to serve you as a reference, not as a rule.

Denial​

For some people, this may be the first response to loss.

Denial is a common defense mechanism. It may help you buffer the immediate shock of the hurtful situation.

As an immediate reaction, you might doubt the reality of the loss at first.

A few examples of this type of denial are:

• If you’re facing the death of a loved one, you might find yourself fantasizing someone will call to say there’s been a mistake and nothing really happened.
• If you’re dealing with a breakup, you might convince yourself your partner will soon regret leaving and come back to you.
• If you lost your job, you might feel your former boss will offer you the position back after they realize they’ve made a mistake.

After this first reaction of shock and denial, you may go numb for a while.

At some point, you could feel like nothing matters to you anymore. Life as you once knew it has changed. It might be difficult to feel you can move on.

This is a natural reaction that helps you process the loss in your own time. By going numb, you’re giving yourself time to explore at your own pace the changes you’re going through.

Denial is a temporary response that carries you through the first wave of pain. Eventually, when you’re ready, the feelings and emotions you have denied will resurface, and your healing journey will continue.

Anger​

Sometimes pain takes other forms. According to Kübler-Ross, pain from a loss is often redirected and expressed as anger.

Feeling intensely angry might surprise you or your loved ones, but it’s not uncommon. This anger serves a purpose.

It might be particularly overwhelming for some people to feel anger because, in many cultures, anger is a feared or rejected emotion. You might be more used to avoiding it than confronting it.

During the anger stage of grief, you might start asking questions like “Why me?” or “What did I do to deserve this?”

You could also feel suddenly angry at inanimate objects, strangers, friends, or family members. You might feel angry at life itself.

It’s not rare to also feel anger toward the situation or person you lost. Rationally, you might understand the person isn’t to blame. Emotionally, however, you may resent them for causing you pain or for leaving you.

At some point, you might also feel guilty for being angry. This could make you angrier.

Try reminding yourself that underneath your anger is pain. And even if it might not feel like it, this anger is necessary for healing.

Anger might also be a way to reconnect to the world after isolating yourself from it during the denial stage. When you’re numb, you disconnect from everyone. When you’re angry, you connect, even if through this emotion.

But anger isn’t the only emotion you might experience during this stage. Irritability, bitterness, anxiety, rage, and impatience are just some other ways you might cope with your loss. It’s all part of the same process.

Bargaining​

Bargaining is a way to hold on to hope in a situation of intense pain.

You might think to yourself that you’re willing to do anything and sacrifice everything if your life is restored to how it was before the loss.

During this internal negotiation, you could find yourself thinking in terms of “what if” or “if only”: what if I did XYZ, then everything will go back to normal; if only I had done something differently to prevent the loss.

Guilt might be an accompanying emotion during this stage as you inadvertently might be trying to regain some control, even if at your own expense.

All these emotions and thoughts aren’t uncommon. As hard as it might feel, this helps you heal as you confront the reality of your loss.

Depression​

Just as in all the other stages of grief, depression is experienced in different ways. There’s no right or wrong way to go about it, nor is there a deadline to overcome it.

In this instance, depression isn’t a sign of a mental health condition. Instead, it’s a natural and appropriate response to grief.

During the depression stage, you start facing your present reality and the inevitability of the loss you’ve experienced. Understandably, this realization may lead you to feel intense sadness and despair.

This intense sadness could cause you to feel different in other aspects too. You could feel:

• fatigued
• vulnerable
• confused and distracted
• not wanting to move on
• not hungry or wanting to eat
• not able or willing to get ready in the morning
• not able to enjoy what you once did

This is all typically temporary and a direct response to your grieving process.

As overwhelming as it may feel at this point, this stage is a necessary part of your healing journey.

Acceptance​

Reaching acceptance isn’t necessarily about being OK with what happened. Depending on your experience, it might be understandable if you don’t ever feel this way.

Acceptance is more about how you acknowledge the losses you’ve experienced, how you learn to live with them, and how you readjust your life accordingly.

You might feel more comfortable reaching out to friends and family during this stage, but it’s also natural to feel you prefer to withdraw at times.

You may also feel like you accept the loss at times and then move to another stage of grief again. This back-and-forth between stages is natural and a part of the healing process.

In time, you may eventually find yourself stationed at this stage for long periods of time.

That doesn’t mean you’ll never feel sadness or anger again toward your loss, but your long-term perspective about it and how you live with this reality will be different.

Other possible stages of grief​

The five stages of grief proposed by Kübler-Ross have served as a framework for many mental health professionals working with the grief process.

Some of these professionals, such as British psychiatrist John Bowlby, have developed their own work around the emotional responses to loss. Others, including Kübler-Ross herself, have adapted and extended the original five-stage model.

This adaptation is usually known as the Kübler-Ross Change Curve. It extends the five core stages of grief to seven overlapping stages:

1. Shock. Intense and sometimes paralyzing surprise at the loss.
2. Denial. Disbelief and the need to look for evidence to confirm the loss.
3. Anger and frustration. A mix between acknowledgment that some things have changed and anger toward this change.
4. Depression. Lack of energy and intense sadness.
5. Testing. Experimenting with the new situation to discover what it actually means in your life.
6. Decision. A rising optimism about learning how to manage the new situation.
7. Integration. Acceptance of the new reality, reflection on what you learned, and stepping out in the world as a renewed person.

Common misconceptions about grieving​

Because everyone mourns differently and for different reasons, sometimes you might feel your own grieving process isn’t going “according to the norm.”

But remember, there’s no such thing as a right or wrong way of coping with a loss.

These might be some of the thoughts that could cross your mind when looking at your own or someone else’s way of grieving.

1. 'I am doing it wrong'​

One of the most common misconceptions about grieving is that everyone goes through it in the same way.

When it comes to healing from a loss, there’s no correct way of doing it. You might find it useful to remind yourself there’s no “I should be feeling this way.”

Grieving isn’t about going over or following a set list of steps. It’s a unique and multidimensional healing journey.

2. 'I should be feeling…'​

Not everyone experiences all the above-mentioned stages or even goes through these emotions the same way.

For example, maybe the depression stage feels more like irritability than sadness for you. And denial could be more of a sense of shock and disbelief than an actual expectation that something out of the blue will fix the loss.

The emotions used to contextualize the stages of grief aren’t the only ones you’ll experience. You might not even experience them at all, and that’s natural too.

This is no indication that your healing journey is faulty in some way. Your healing experience is unique to you and valid nonetheless.

3. 'This goes first'​

Remember, there’s no specific or linear order for the stages of grief.

You could move along the stages one by one, or you could go back and forth. Some days you might feel very sad, and the very next day you could wake up feeling hopeful. Then you could go back to feeling sad. Some days you might even feel both!

In the same way, denial isn’t necessarily the first emotion you’ll experience. Maybe your first emotional reaction is anger or depression.

This is natural and part of the healing process.

4. 'It's taking too long'​

Coping with a loss is ultimately a deeply personal and singular experience. Many factors affect how long it takes.

Some people navigate through grief in a few days. Others take months or longer to process their loss.

You might find it useful to not set any deadlines to your process.

In grief, you’ll experience some of these emotions in waves of intensity. In time, you’ll notice this intensity decrease.

If you feel your emotions stay or increase in intensity and frequency, this might be a good time to seek professional support.

5. 'I'm depressed'​

Going through the stages of grief, particularly the depression stage, isn’t equivalent to clinical depression. There’s a distinction between having clinical depression and grieving.

This means that even though some symptoms might be similar, there are still key differences between both.

For example, in grief, the intense sadness will lessen in intensity and frequency as time goes by. You might even experience this sadness at the same time you find temporary relief in happy memories from times before the loss.

In clinical depression, on the other hand, without the proper treatment, your mood would stay negative or worsen with time. It would likely affect your self-esteem. You may rarely experience feelings of pleasure or happiness.

This doesn’t mean there isn’t a possibility you could develop clinical depression during the grieving process. If your emotions progressively increase in intensity and frequency, reach out for support.

When to reach out for help​

If you’re experiencing intense grief and feel unsure about how to cope with it, reaching out for help can provide comfort and support.

Any reason that’s valid to you is a good reason for reaching out for help.

Other instances in which you might want to seek help processing your loss include the following:

• You need to go back to school or work and have a hard time going about your daily tasks. For example, you’re having trouble concentrating.
• You’re the sole or main guardian or support source for someone else. For example, you’re a single parent or someone else’s caretaker.
• You’re experiencing physical discomfort or pain.
• You’re skipping meals or medications because you don’t feel like getting up or doing anything.
• Your emotions are increasing in intensity and frequency instead of coming in waves or lessening over time.
• You’ve thought about hurting others or yourself.

If you or someone you know is considering self-harm, you’re not alone. Help is available right now:

• Call a crisis hotline, such as the National Suicide Prevention Lifeline at 800-273-8255.
• Text HOME to the Crisis Text Line at 741741.

There are a few other ways to reach out for help, depending on what is available to you.

Friends and family​

Talking with friends or relatives might give you a sense of relief.

Verbally expressing how you feel can sometimes release some of the inner turmoil you might be experiencing.

Sometimes you might not feel like talking but instead prefer to have silent company.

Expressing your needs to others can allow them to help you in the way you feel is best for your situation.

Support groups​

Engaging in support groups can be helpful too. There are local support groups as well as online support groups.

You can connect to others in the group who have gone through or are going through similar losses. They can direct you to further resources as well.

Support groups can also become a safe space where you can express yourself without feeling judged or pressured if you feel that might be the case when talking to somebody else.

Mental health professionals​

Grief counseling and therapy are two ways to work with a mental health professional who might support your own process.

If you have insurance, call your insurer to determine whether this grief counseling is covered under your policy and, if so, under which conditions.

If your insurance doesn’t cover counseling sessions, your primary care doctor might be able to offer some support or guidance.

If you don’t have health insurance or aren’t covered for this service, you could try searching for a local organization that provides grief counseling at a low or no charge.

Many national mental health organizations, like the National Alliance on Mental Illness (NAMI), have local or regional chapters. Calling them directly might give you access to some of this information and their specific grief support services.

How to help someone who is grieving​

You’ve taken the first step by just wondering how you can help your loved one.

Here are some ways you can support them now and in the future.

1. Listen​

Perhaps one of the main legacies from Elisabeth Kübler-Ross and her work is the importance of listening to the grieving person.

You might have the best intentions and want to provide comforting words. But in some instances, the best support comes from just being there and making it clear that you’re available to listen to whatever — and whenever — they want to share.

It’s also important to accept it if your loved one doesn’t want to talk with you. Give them time and space.

2. Reach out​

Not everyone knows how to comfort others. It might be intimidating or overwhelming seeing someone you care about have a rough time.

But don’t let these fears stop you from offering help or from being there. Lead with empathy, and the rest will follow.

3. Be practical​

Look for ways to ease the weight off your loved one’s shoulders. Explore the areas they might need help managing while they process their loss.

This could mean helping with food preparation or grocery shopping, organizing their room or house, or picking up their children from school.

4. Don't assume​

You might want to verbally offer your support and be attentive to whatever they tell you might help them feel better. But avoid assuming or guessing "which step" of the process they’re going through at the moment.

A smiley face or no tears don’t necessarily mean they’re not grieving. A change in their physical appearance doesn’t mean they’re depressed.

Wait for them to express how they feel, if they’re ready, and go from there.

5. Search for resources​

You might have the clarity of mind and the energy to browse local support groups and organizations, call an insurance company, and find a mental health professional.

The decision of reaching out for this kind of help is, of course, entirely up to the grieving person. But having the information at hand might save time whenever they’re prepared or willing to take it.

Some resources you might find helpful are:

• GriefShare support groups
• The Compassionate Friends: Supporting Family After a Child Dies
• American Psychological Association: Search for a Psychologist
• Helping Kids Grieve: Toolkit

Sources

• Hamilton IJ. (2016). Understanding grief and bereavement.
  bjgp.org/content/66/651/523
• Kübler-Ross E, et al. (2005). On grief and grieving: Finding the meaning of grief through the five stages of loss. Scribner, New York.
  
• National Cancer Institute. (2020). Grief, bereavement, and coping with loss. PDQ cancer information summaries.
  ncbi.nlm.nih.gov/books/NBK66052/