The Five Stages of Grief: Why do I find it so confusing?

‘What stage am I at?’…‘ Have I missed a stage?’... ‘How long does this stage last for?’… ‘Am I grieving the wrong way?’ I have heard these concerns or similar concerns from many clients over my years as a bereavement counsellor.

The concept of bereavement based upon the Five Stages of Loss and Grief has entered popular culture and has become the touchstone for people’s understanding of their loss. In the process it has become simplified, reduced to five unbreakable rules, losing all sensitivity and nuance. It is the misunderstanding of this simplified set of rules, I believe, that can add another level of pain to those already deep in an insoluble grief.

The Five Stages of Loss and Grief is a model based on the observations made by Elisabeth Kübler-Ross on the emotional states of terminally ill patients, people who were dealing with the eventual loss of their own lives. She later developed this into a more general model of loss that occurred during bereavement and later still to any major personal loss such as redundancy or relationship breakdown.

Kübler-Ross’s Five Stages of Loss and Grief are:

Stage One: Denial and Isolation - The initial reaction to learning about the death of a loved one is to deny the reality of the situation. This is a normal response in the face of overwhelming emotions and acts as a defence mechanism that shields you from the immediate shock. We do not hear, do not want to hear what has just happened. This is a transitory reaction of closing down and isolating ourselves that lets us endure the initial onslaught of pain.

Stage Two: Anger - Anger emerges as the protective effects of denial and isolation begin to recede and the painful reality resurfaces. The intense emotion is overwhelming and an outlet is needed; this is redirected in the form of anger. This anger can be aimed at anyone or anything, from close friends or family to inanimate objects. It can be rational – for instance, blaming the medical profession for perceived incompetence – or irrational: anger at people who are older, for example, and have outlived your loved one. Anger may also be directed at the deceased; rationally, we know the person is not to be blamed, but emotionally we may resent them for leaving us and causing us pain. This irrational anger makes us feel guilty, which in turn gives rise to even more anger.

Stage Three: Bargaining - This is a normal response to feelings of helplessness to such a devastating situation. We often need to regain control and ask ourselves ‘if only’ questions in a bid to change the inevitable.

• If only we had listened more when they needed us…
• If only we had gone to the doctor sooner…
• If only we’d got a specialist to give a second opinion …
• If only we had not left the bedside when they were in pain …

We bargain with God or some other higher power in an attempt to alter the past, but we know we cannot. Again this acts as a defence to shield us from a painful, unchangeable reality.

Stage Four: Depression - There are two types of depression associated with grief. The first one is a reactive depression to practical implications of the loss. Sadness and regret are the major emotions within this type of depression. We worry about how our lives have changed due to the loss. How can we cope with the change in our financial or social status that the loss has engendered? We worry that, in our grief, we are not spending time with our children, or are ignoring other members of the family who are also dealing with their own grief. The second type of depression is more private. It is the deep sense of the absence of our loved one and is the preparation for final acceptance that they are no longer here.

Stage Five: Acceptance - Eventually, for most, some form of acceptance is reached. We know and accept that our loved one has gone and cannot return. The loss is internalized, we can see beyond the events of the death and perceive the deceased’s life as a whole. This final stage is marked by withdrawal and calm as the grief recedes. It can be seen as a return to a more normal life.

These are all valid points in our journey through grief, but to many they seem like rules, a step-by-step guide that you have to progress through before you reach your goal of a grief-free life. Popular culture and Google searches have entrenched the misunderstanding of what they mean. I believe this misunderstanding comes from the very word used to describe them: stages.

The popular understanding of stages is one phase followed by another until a conclusion is reached, whereas Elisabeth Kübler-Ross saw them more as aspects of bereavement. These stages are in no set order: Anger and Bargaining can reappear after you believe you have found Acceptance, or Acceptance can be reached without the Anger or Bargaining stages. Furthermore, these stages do not preclude each other and can happen simultaneously, or you can swing randomly between any or them. You can feel Acceptance, only to be crushed by Anger and Denial a second later. These aspects of grief can feel horrifically random as you attempt to heal the wound the bereavement has caused.

The belief that these are inflexible stages can cause more suffering to the bereaved, who may feel that they are not grieving properly, that they are doing something wrong. They are concerned that they have not reached their Anger stage yet, have by-passed the Denial stage or are stuck in the Depression stage for too long. They cannot understand that if these are stages, why are they all happening at what seems to be the same time. Many people believe that there is something wrong with them.

There is nothing wrong; they are simply experiencing the unpredictable power of the mind coming to terms with an unbearable loss. Emotions lurch without warning from one to another, pain comes in waves, but it eventually subsides within its own time. The Five Stages (or the Five Aspects, as we should call them) is a useful guide to some of the experiences of bereavement, but these are not rules that enclose your experience of loss. There is a lot to worry about during a period of grief, but ‘what stage am I in’ is not one of them.