Why are the 5 stages of grief important?

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.

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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).

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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.”

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