The 6 Stages of Grief
The Six Stages of Grief
The 6 Stages of Grief: Denial, Anger, Bargaining, Depression, Acceptance, and Meaning reflect where we are in our journey of grief at any given moment. These 5 stages are about change we do not want. They are unconscious and natural responses to loss.
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Unfortunately, over the years, the 6 Stages of Grief have been misinterpreted by many, including mental health professionals. Sometimes, grievers can think that they have completed their grief journey once they have experienced all five of the Stages, only to find they revisit them again and again. Sometimes the griever can move through several of the stages within a few minutes. Elisabeth Kübler-Ross explicitly stated that the stages “are not stops on some linear timeline in grief." David Kessler, who worked closely with Elizabeth, reminds us that English was not her first language. Had it been, she probably would have chosen a different word than stages. Grief is most often messy, especially when it involves a traumatic, unexpected loss such as the ending of a pregnancy or the death of a child.
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I want to share a message from David Kessler regarding the 6 stages. He said, "I was privileged to co-author two books with the legendary Elisabeth Kübler-Ross, as well as adapt her well-respected stages of dying for those in grief. As expected, the stages would present themselves differently in grief. In our book, On Grief and Grieving, we present the adapted stages in the much-needed area of grief. The stages have evolved since their introduction and have been very misunderstood over the past four decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss as there is no typical loss."
He continues, "The Five Stages: denial, anger, bargaining, depression, and acceptance, [and meaning] are a part of the framework that makes up our learning to live without the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief's terrain, making us better equipped to cope with life and loss. At times, people in grief will often report more stages. Just remember your grief is as unique as you are.”
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People often think of the stages as lasting weeks or months, and that we finish one, then move on to the next. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another, and back again to the first one.
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Denial
Denial is moving from distraction to reality. You touch the pain and then take a break from the pain. True complete denial is rare.
Denial is the first of the six stages of grief. It helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. We can touch the grief, and then pull back from the intense pain. As one accepts the reality of the loss and starts to ask themself questions, they are unknowingly beginning the healing process. They are becoming stronger, and the denial is beginning to fade. But as they proceed, all the feelings they were denying begin to surface.
Anger
Anger is our strongest emotion. It covers up the pain underneath. People are uncomfortable with someone else's anger.
Yet, anger is pain's bodyguard. Someone may say regarding their grieving loved one, "He's angry at everyone." Bereaved people are angry at everyone because they can't be angry at the deceased or God. Anger is acute pain. It is the balance between where the pressure meets our skill set.
Anger is a necessary stage of the healing process. We need to be willing to feel our anger, even though it may seem endless. The more we truly feel it, the more it will begin to dissipate and the more we will heal. There are many other emotions under the anger, and someone will get to them in time, but anger is the emotion we are most used to managing. The truth is that anger has no limits. It can extend not only to their friends, the doctors, their family, themself, and their loved one who died but also to God. They may ask, “Where is God in this? Underneath anger is pain, their pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first, grief feels like being lost at sea: no connection to anything. Then we get angry at someone, maybe the doctor or the social worker, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe the friend that said that unthinkable thing trying to comfort them, or maybe a person who is different now that their loved one has died. Suddenly they have a structure–– their anger toward them. The anger becomes a bridge over the open sea, a connection from them to someone else. It is something to hold onto; and a connection made from the strength of anger feels better than nothing. We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of the love.
Bargaining
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The what-ifs, if-onlys, the coulda, woulda, shouldas, the self-blame, the stories the mind creates to fill in gaps in our understanding of what happened are a normal part of the grieving process. Yet, this mind chatter can begin to cause suffering. The pain from loss is inevitable, yet the suffering can become optional as we do the work of tending to our grief. David Kessler says, “We don’t actually run from grief. We run from the pain of loss. Grief is the gift that has been given to us to heal the pain.”
​Before a loss, it seems like we will do anything if only our baby or loved one would be spared. “Please God,” we bargain, “I will go to church every week and be the best mom ever if you’ll just let my baby live and stop this miscarriage.” After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others? Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what it was; we want our loved one restored.
We want to go back in time:
"If only I had paid closer attention to my baby's movements."
"If only I hadn't waited an hour to go to the ER like the ambulance driver said, my dad wouldn't have died alone."
"What if I had not taken that supplement? I might still be pregnant."
"If only I could have stopped the accident from happening."
…if only, if only, if only.
Guilt is often bargaining’s companion. We can blame ourselves for the death, and mothers often blame themselves for the loss. That something they did or didn’t do caused the miscarriage or death of their baby. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt.
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Depression
Sadness has now become considered depression culturally. With clinical depression, the person doesn't care about anything. It is pervasive depression. Sadness is a healthy and normal response to a loss.
After bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all? Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask is whether or not the situation they are in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual. When a loss fully settles in their soul, the realization that a loved one didn’t get better this time and is not coming back, or that the pregnancy has ended is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way.
Acceptance
Acknowledging the reality.
Acceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. We must try to live now in a world where our loved one is missing. In resisting this new norm, at first, many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed, and we must readjust. We must learn to reorganize roles, re-assign them to others or take them on ourselves. Finding acceptance may be just having more good days than bad ones. As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one. We can never replace what has been lost, but we can make new connections, new meaningful relationships, new inter-dependencies. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve. We may start to reach out to others and become involved in their lives. We invest in our friendships and in our relationship with ourselves. We begin to live again, but we cannot do so until we have given grief its time.
Meaning
With the blessing of the Elisabeth Kubler-Ross foundation, David Kessler has added 6th stage, Meaning. Meaning doesn't indicate understanding. No one can help someone find meaning. The griever has to discover it on their own.
Meaning comes through finding a way to sustain love for the person after their death while moving forward in life. That doesn’t mean we will stop missing the one we loved, but it does mean we will experience a heightened awareness of how precious life is. There are challenges to finding meaning. Every moment we are making choices - whether to move toward healing or stay stuck in pain. Like all the other stages, the sixth stage of grief requires movement. We can’t move into the future without leaving the past. We have to say goodbye to the life we had, or were planning with our baby, and say yes to the future.
There is pain in the loss, but there is also good. Meaning is finding ways to savor the love, not just stay with the pain, to find that meaning in their memories and take that good into the future. If we see only the pain in a situation, it will grow. The suggestion is not to minimize or negate the pain, but if that’s all we pay attention to, that’s all we will have.
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Guide to Finding Meaning
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Meaning is relative and personal.
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Meaning takes time. We may not find it until months or even years after the loss.
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Meaning does not equal understanding. When we find meaning in loss, it doesn’t mean we understand why our loved one died.
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Even though we may find meaning, it still isn’t worth the cost of the loss.
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Meaning does not negate loss. The loss is not a test, a lesson, something to handle, a gift, or a blessing. Loss simply happens in life.
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Only the griever can find their own meaning. Meaningful connections will replace painful memories.
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We want to create meaning that remembers the loss and honors the life.