Understanding the Five Stages of Grief

Whenever a person loses a loved one or faces a massive change in life either by a job change or relationship breakup, grief comes up as the natural response to that event. The way we all were going through this during recent times has made us look at the importance of truly understanding grief in ways that we are better able to cope with it ourselves, and also help our near and dear ones, who may be in those difficult situations.
When we are talking about this, it is important to understand that everything that happens to a person who is grieving that major loss, may make them feel like it is all very abnormal. But we want to reiterate here that it is all a part of the process, and everything you feel is what genuinely one might be feeling when facing such times.
For that very purpose, the five stages presented here give some distinction to the various emotions that we can be going through. These stages are characterized by different kinds of beliefs and behaviors that may even vary in individuals according to their specific circumstances. Overall, the Kübler-Ross model works in identifying the patterns that are most common in people handling grief. The following are the five stages:

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

All of these stages help us better understand how we can cope with the complicated feelings we are experiencing when grieving. They should not be seen as stops on the path to healing that happen linearly. Instead, they are better understood as tools that can help us identify the flurry of emotions in such situations. Many people won’t feel all of them in this order and may not even stay in one stage as long as the other.
Dr. Kübler-Ross herself emphasizes that these aspects of grief could happen at different times with different people and may very well be non-linear. People may also feel some other emotions along their way to healing. Like the concept of fingerprints, each individual has their unique way of handling it. But, these stages help us traverse through the terrain of grief in a knowledgeable manner, which is why they are most widely accepted as the five stages of grief.
Grief Counseling Expert Dr. Ashwini also makes it clear that while the stages guide us into a pattern of sorts, each person processes it in an individualistic way. It may even have differences within the family; one person may be in the denial stage at one time, and another could have accepted the loss.

The Kubler-Ross Model

The five stages became famous after Elizabeth Kübler-Ross, a Swiss-American psychiatrist, published her book, “On Death and Dying,” in 1969. Her theory, known as the Kübler-Ross model, was formulated after her observations of years of working with terminally ill individuals. Although initially the theory was devised for people facing death, over the years, the model got adapted for other experiences of loss and grief.

This is from where the five stages were initially derived. Subsequent research and findings later by other mental health professionals expanded on these to understand how people coped with it.

1. Denial

It initially helps us in surviving the loss. You may be in a state of shock and start to feel that life has no meaning, is too overwhelming, and in effect, you tend to go numb. The shock of the loss might make you wonder how you can go about in life, if at all you can or should we even go on. In reality, life changes in an instant, but in denial, you tend to live in a preferable reality instead of the actual reality. When someone gets the news of the loss of their loved one, they may cling to a false hope that they have identified the wrong person. Or, when someone gets diagnosed with a life-threatening disease, they may believe that some mix-up must have happened at the lab.

There is also grace in denial, as it can be seen as nature’s way of saying to us that there is only so much you can handle. In this manner, denial can help you in pacing the feelings of grief. Once this shock starts to fade and you start coming out of denial, the real healing process begins. At this point, the feelings you had been suppressing all along start to come to the surface.

2. Anger

A necessary stage in the healing process is anger. During this stage, it is quite common to put the blame on other people for your sorrow. It could be directed towards those particular family members who are acting weirdly after the loss, that friend who could not show support during this time, or even the loved one who left us in bereavement. People who are strong in faith can even feel angry at God, thinking, “how could God let this happen to me?”
We are moving from the preferable reality of the denial stage towards the actual reality, and anger here becomes that anchor of an emotion which ties us to real life. This emotion gives structure to our feelings, acting as a bridge to connect our life and the people in it. When people may feel completely lost due to the loss they are experiencing; anger gives them something to hold on to, as a basis of reality.
A point of distinction to note here is that in our everyday life, we are mostly advised to suppress the emotions of anger. But when we talk about the upsurge of anger coming out at such times, it is basically believed to be a part of the healing process by mental health professionals. According to the experts, the more we are able to fully feel our anger at this stage, the more it tends to dissipate, and the more we can eventually come out of grief.

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3. Bargaining

We try to bargain with the pain of grief by creating false hopes through negotiations that we keep conjuring up in our minds. We try to make a deal with God or any supreme powers to the tune of “if my wife gets to live more, I will never be angry at her,” or “if I could be cured of cancer, I will help the needy more.” Guilt is often combined with bargaining, and we are left in a loop of thinking to ourselves, “what if we could have known it earlier” and “if only I would have stopped her from going out that day.” Such statements related to the event, specific to that anguish, may keep coming up in a person’s head.

During this stage, we become desperate to get that life back, which we were living before the event, and for that, we are seen making deals in our minds in order change the effect on the outcome.

4. Depression

The stages of anger and bargaining may feel like active ones as our emotions are on the rise and the mind is running in many directions. But, when we reach the stage of depression, we start to truly feel the loss and enter into a much quieter stage. We feel pain on a deeper level in the present moment. In our depressive state, we mostly see ourselves cutting ties with the people around us to the level that we prefer loneliness. In fact, we may feel so numb that we withdraw from life, live in a mental fog of despair, and may even have suicidal thoughts as we start to question, “why move ahead in life?”
The emptiness of the loss feels all too real and overwhelming at this stage. It may even feel like this feeling will last forever, and if you or someone around you feels this way after a loss for a long time, it may be advisable to take professional help in dealing with depression associated with grief. Here, it is important to note that after a loss, feeling depressive is a natural and acceptable response and not a sign of mental illness. If you do approach a certified professional, that is because you want to heal in a healthful manner and not otherwise.
In fact, Dr. Ashwini also says that it is during this stage only that people come for counseling, which can be voluntary but could also be happening through referrals given by the family or friends of the grieving person. She says that around 15-20% of people do come after some nudging by their loved ones, but many voluntarily seek a counselor’s help through the healing process.
Another thing that she noticed in recent times is that in India, after the second wave of the pandemic, many people came forward to seek that help, as till that time the intensity of the pandemic had been fully felt, and people lost their loved ones more than the first wave, and overall, the discussion on mental health awareness out there in the open also made them look for help rather than silently suffering.

5. Acceptance

The last of the five stages is acceptance, as recognized by Dr. Kübler- Ross. Acceptance here doesn’t mean that we are “OK” with what happened, rather it is on the lines that we accept the reality as a permanent one. We might never like this new reality where our loved one is gone forever, but we will have to learn to live with it. At this stage, we are ready to adjust and readjust to the new life that we now face. In some ways, we may even try to live as we used to before the event, but gradually we understand that it won’t be possible. Acceptance at this stage also means that we rethink life in a new manner and re-assign new roles to ourselves and other people around us, to function properly.
What has been lost can never be replaced, but after acceptance, we make new friendships and more meaningful relationships with the people around us. Instead of running away from our needs and emotions, we face them, grow from them and evolve into a new stronger person. But, all of this becomes possible only if we give due time to the process.
None of the stages can be rushed into intentionally. It is all about them coming to us in time; it may take a few hours or weeks, months, or even years to fully process the sorrow. You may not even feel all of the stages in a clear-cut manner, and can feel the first and second stages, then coming back to one rather than going on to the third stage. We should let grief take its own time and course, even if it seems like a roller-coaster ride, rather than forcing ourselves to snap out of it.

Ways to Cope

When grieving a major loss, understanding how to take care of yourself and seek support from the people who care about you is of prime importance, as these aid in the healing process. Read on to know how you can cope:

• Face your feelings and share them when you’re ready- If we try to run away from the complicated feelings that arise in the grieving process, we only delay the eventual acceptance and healing. In your own way, face the emotions that come up and share them with friends, family, or any other trusted person.
• Take care of your health- The mind and the body go hand-in-hand in making us live a healthy life. The mental trauma of the loss takes a toll on our health, and during these times, it becomes all the more important that we take better care of our physical health. Being able to get good sleep, the right nutrition, and exercising can help in your healing process.
• Try to be creative with your outlet of pain- At times, we are not able to share the heavy feelings normally, and at such times finding a new way through art or any other hobby to express that pain can aid in the creative outlet of the pain. You may want to write your feelings in a journal or paint your heart out; try new things and see what makes you feel lighter and better.
• Find refuge in the routine- When moving on with life after a loss, it may be difficult to find our way back to the old life, but that also remains one of the ways that can help us ease the pain. Getting back to activities and habits that we had before the event, which we knew made us happy back then, would help us out eventually.
• Seek and accept support from your loved ones- Now might actually be a good time to ask for support from the people who do care about you. Often, people don’t know how to offer that help, so you could ask a trusted person for a shoulder to cry on, a listening ear, or even just their presence. When someone approaches you, try and accept the care they are offering, because they are doing it out of love.
• Share your feelings with support groups- When you feel that the people around you are unable to understand your pain, looking out for support and bereavement groups can be of great help. Here, you will find people who have or are suffering the same pains as you are, so they are better able to understand and provide support in a much more empathetic manner.
• Taking help from a certified therapist- The magnitude of some losses can be so overbearing for people that none of the coping mechanisms work to give respite. People also face obstacles in the healing process, never becoming fully ready to move on with life. If that seems to be the case with you and you feel that moving ahead won’t be possible, you should consider taking professional help from therapists who are specialized grief counselors.

Seek Grief Counseling from a Trusted Therapist With DocVita

From the team of therapists we have at DocVita, Dr. Ashwini shares details about grief counseling to facilitate a better understanding for anyone considering counseling as a way out of their grief. We believe our readers should know that their feelings can be respected by trusted therapists.
Dr. Ashwini says, “When a person is grieving, they may feel as if they are drowning in a sea of complicated emotions, and counseling in such times helps them see through that water. It gives them a vision, a perspective that grieving is okay, it gives them a supportive holding hand that may not at once pull them out, but will help swim to the shore, from where they could then move on with their life.”
According to her, in order to understand how grieving therapy might work for someone, we also need to fully understand that there will be different dynamics at play that eventually help in the healing process.
Although there is no set time frame to heal, as different incidents have a different impact on people, Dr. Ashwini suggests that in about 5-6 sessions, a person might start to accept, express, and process the grief. When either they openly share that they have started to focus on their work and life in a better way, or it is noticed by other parameters, that is when we can finally say that the person has started to heal. Beyond that point, the loss of a loved one may still make us break down, even after years, but we get the courage to move on in life.
Reaching this point, if you or anyone around you is facing a similar issue and would like help in processing it all, you can contact us for further details. We have dedicated grief counselors at DocVita, who are always there to help you out. Nobody in the world can ever replace the loss you are facing, but we can together help in your healing.
Our team of trusted therapists can give you a safe place to discuss your particular situation and help in healing from the grief so that you are able to move ahead in life in a healthy manner.