Working Through The Phases Of Grief

It can be hard to fully describe grief. Grief typically refers to an emotional response to loss, whether it’s the loss of a loved one or a significant life change, like losing a job, moving to a new country, or adjusting to an injury or illness. If you are coping with grief, it can be helpful to understand more about the process and the stages through which people go as they experience grief. A licensed mental health professional can help you move forward if you’re having trouble coping with loss.

The five stages of grief

One of the most common frameworks for the grieving process is the five stages of grief model developed by Dr. Elisabeth Kübler-Ross in her 1969 book, On Death and Dying. Note that while the stages in the Kübler-Ross model were initially developed to explain the stages of coming to terms with a terminal illness diagnosis, they were broadened to apply to multiple forms of grief.

Denial

Denial is a defense mechanism that can be used to protect against difficult emotions. Kübler-Ross noted that, after receiving a terminal diagnosis, people would often directly deny the reality of the situation, instead avoiding the topic altogether or blaming the results on unqualified doctors or faulty testing.

Ongoing denial can be damaging, but a short period of denial in the context of grief can be common. In general, denial is different from not understanding something. It can serve as a method of protecting oneself from the shock of upsetting news and can be helpful to the grieving process, as it may allow individuals to process the situation in their own time.

Anger

The anger stage usually occurs as people begin to accept the reality of what is happening. This anger can manifest in many ways, including blaming doctors or being upset with a higher power for allowing the situation to occur. People may also experience generalized anger that is not specifically directed at anyone or anything, and this may be displayed through impatience, irritability, or a bad temper.

Bargaining

Bargaining typically occurs when someone is trying to exert control over the situation. It can be rational or irrational. When people bargain, they may make pacts with themselves for things they would do or could have done to get a different outcome. For example, if a loved one is given a terminal diagnosis, a person might tell themself, “If they get better, I promise I will make sure they follow their treatment plan,” or, “If I would have gotten them to the doctor sooner, this wouldn’t have happened.”

The bargaining stage can also be aimed at a higher power. People in this stage of grief may say things like, “God, if you make her better, I promise that I will never argue with her ever again,” or, “If you let this person live, I promise I will go to church every week.”

Depression

This stage is usually what comes to mind when people think about grief. Deep sadness, yearning, and other challenging emotions can be a significant part of mourning. People in this phase may also experience symptoms like fatigue, sadness, changes in sleep or appetite, and an inability to concentrate. 

Acceptance

The final stage in this theory is acceptance, which generally refers to the point when a person stops struggling against the situation. They may still feel upset, but they usually reach a point of accepting the reality of what has happened. In the case of terminal illness, studied by Kübler-Ross, someone may start to focus on making the most of the time they have left or preparing for death by getting their affairs in order.

The seven stages of grief

Another model of grief focuses on seven stages instead of five. Many of these stages overlap with the Kübler-Ross model, but there are some differences. 

Shock and denial 

These are usually the early stages of grief, when an individual may still be trying to process the situation. People can experience several symptoms during this phase, including changes in appetite or sleep, nausea, or vomiting. For some people, this stage may seem surreal, as if they are watching it happen to someone else.

Pain and guilt

In the next stage, people may begin to recognize the pain of the situation, with some starting to feel guilty about things they believe they should have done. People may seek rational explanations and wonder if there was anything they could have done to prevent the loss. 

Anger and bargaining

Someone who is experiencing grief may also experience frustration and anger. Grief can be challenging to process, and people may direct their anger outward to doctors or a higher power or blame the person they’ve lost for getting sick or dying. 

As in the five-phase model, individuals may also make pacts with themselves or with a higher power to try to fix the situation. 

Depression, reflection, and loneliness

In this stage, an individual may reflect on what has happened and how it has affected their life. They may realize that their efforts at bargaining were unrealistic and begin to recognize the reality of the loss. It is not uncommon for people to withdraw from others during this phase. They may experience confusion or fear about the future, and while they may need some time to themselves, having a support system can also be important.

The upward turn

Eventually, the intense emotions of earlier phases may begin to fade. Individuals may notice that they begin to experience positive emotions more frequently.

Reconstruction and recovery

In the final stage, the person usually begins to work through the aftermath of their loss and may begin to experience a sense of control over life again.

Acceptance and hope

Acceptance and hope typically allow people to reflect on how their experiences have shaped their lives. This phase does not necessarily mean that someone has moved on and put the loss behind them entirely. Instead, it’s usually the part of the process during which they can acknowledge their loss, begin to find peace, and move forward healthily. Individuals may realize that they look back at the good times with their loved one without dwelling on the negative emotions surrounding the loss.

Working through grief

Research suggests that throughout the grieving process, many people experience highly intense periods of distress that last approximately 30 minutes. These periods, often called grief pangs or waves of grief, may arise in response to reminders of someone who has passed, the anniversary of a loved one’s death, or the experience of coming across sentimental items. At times, though, these pangs can occur without an external trigger.

In time, symptoms may occur less frequently, become less intense, and last for shorter periods. Many people experience a lessening of symptoms after about six months and return to normal function within a year.

Seeking help

Grief can seem very isolating and lonely. Nearly everyone experiences this mental state at some point in life, and many individuals move through it on their own. However, grief that impacts a person’s ability to function day-to-day for over a year is usually labeled as prolonged grief disorder (PGD) and may require professional treatment. In addition, grief can co-occur with other mental health challenges, like depression or substance use disorder.

If you are experiencing grief in any capacity, talking to a mental health professional can help. A therapist can provide a safe space where you can work through all the complicated emotions of grief without fear of judgment. 

Online therapy can be a convenient, flexible option for professional support. When you sign up with a platform like BetterHelp, you can meet with a licensed mental health professional from the comfort of your home at a time that works for you. Most people are matched with a provider within 48 hours of signing up, and you can change therapists at any time until you find the right one for you. 

In addition to being convenient and flexible, research has found that online therapy can be an effective treatment for symptoms of grief.