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The 5 (or 7) stages of grief & loss: Grief cycle & grieving process

In her book “On Death and Dying”, Elisabeth Kübler-Ross described a type of emotional journey among people who are facing death. Since she wrote this book, similar terms have been used to describe people's reactions to other major losses. Elisabeth Kübler-Ross identified and described several stages, which I will describe below.

Before actually describing these stages, I would like to emphasize that we are not talking here about a fixed sequence of events, such as, for instance, the several stages of launching a rocket into space. You would be misunderstanding this page if you saw in it a roadmap in which Point A is always followed by Point B, and so on.

In my mind, the greatest value of this model is to emphasize that grief is not one-dimensional: It manifests in a jumble of intense emotions. Dealing with grief is not a linear progression, but a whole process with chaotic twists and turns. How these "stages" relate to each other has very little to do with logical thinking. Actually, the emotional logic of grief, so to speak, is in the jumble of emotions.

The emotional logic of grief is better understood if you think of it as a series of frantic moves to re-orient to the world after a big loss has left you emotionally off-balance (disoriented). You may want to keep this in mind as you read the following description of the famous "stages".

Typically, the seven stages of grief are described as:
- Shock or Disbelief
- Denial
- Anger
- Bargaining
- Guilt
- Depression
- Acceptance and Hope

Sometimes, people speak of five stages of grieving, putting together:
- Shock/Disbelief and Denial
- Bargaining and Guilt

This is not a mechanistic model -- the stages do not occur the same way for all people; they can last very little time, or a lor of time; and they can be inter-related.

Typically, the first reaction to news of impending doom is shock or disbelief, followed by denial: It’s not true, it can’t possibly happen to me, there must be a mistake–this kind of thing only happens to others, doesn’t it?

Elisabeth Kübler-Ross observed that facing the reality of death leads people to feel very angry, resentful, rageful. This is so unfair!

What do people do when they keep bumping their heads against the seeming invincibility of their opponent? This is the time for unrealistic bargaining – I’ll give you this, and you’ll give me what I want. There’s nothing wrong about bargaining – when it is based on offering the other party something they might really be interested in. It may not be very realistic to try to bargain with natural forces, illness, death…

Guilt is a way of making sense of what is happening, of regaining some form of control over the uncontrollable: It must be my fault.

Once the reality of death sets in, the patients feel overwhelmed, they become depressed. All resistance is futile.

Anger, unrealistic bargaining, depression… this is our struggle against “real” problems in the outside world, but also against our own inner demons.

Some dying people eventually reach a stage where they are fully aware of impending death, and neither angry nor depressed about it. They accept it.

Acceptance of reality need not be synonymous with capitulation, humiliating defeat. There is a difference between accepting what is inescapable – like death, when you’re dying – and cowardly surrendering when you could have fought more. And acceptance need not mean losing your integrity – it can sometimes be quite the opposite. Acceptance is not betrayal.

Acceptance is about using the lessons we learned in life to come to terms with the realities of the world, on our own terms.

It is normal to grieve when we suffer a loss -- in fact, not grieving would be abnormal. On the other hand, it is really difficult to be overwhelmed by grief, engulfed in it, to the point where you can no longer see a way out of it.

At such a time, it doesn't serve to deny the pain. Grief is a natural process, and there is an emotional logic to it. Riding it, as opposed to fighting it, will lead to healing. What helps is to observe it with compassion, to experience it without being swallowed by it. Grief therapy is about creating a gentle and healing environment that allows you to re-orient to the world after a disorienting loss.

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