Denial. Anger. Bargaining. Depression. Acceptance.
The well-known five stages of grief, introduced by Swiss-American psychiatrist Elisabeth Kübler-Ross in 1969, have become the way many people around the world think about loss.
But what are the stages of grief? Kübler-Ross actually developed the model to describe the emotions and thought processes of people with terminal illness facing their own death. This framework has also been adapted to include seven stages of grief (“shock” was added as the first stage and “testing” was suggested as the last stage before acceptance).
Whether coming to terms with the death of someone close to you or watching others deal with similar challenges, it’s tempting to place a set of feelings, thoughts, and behaviors in one of the five stages of grief (or even seven stages of grief). But many researchers and mental health professionals through the years have cautioned against holding up the Kübler-Ross model as the definitive blueprint for grieving, noting, for example, that people don’t necessarily move through all the stages and certainly don’t always do so in order.
There are other, potentially more helpful, frameworks you can use to cope with loss and think about the future, says clinical psychologist Cindy Moore, PhD, from Massachusetts General Hospital. She explains that the stages of grief model has sometimes been criticized because it “blurs the line between description and prescription.”
“There’s no evidence to support the idea that going through these stages in this order is universal, or the ‘best’ or most successful way to grieve,” Dr. Moore says. “Sometimes people become concerned that they aren’t grieving correctly if they don’t go through these stages.”
Instead of the stages of grief, other models may serve as more helpful frameworks for thinking about the grieving process, Dr. Moore adds.
The Task Model: An Alternative to Stages of Grief
These models describe grieving in terms of tasks rather than phases or stages, Dr. Moore says.
As one example, she points to the framework developed by Harvard psychologist and researcher William Worden, whose book Grief Counseling & Grief Therapy: A Handbook for the Mental Health Practitioner has become a standard reference on the topic. Dr. Worden identified four main “tasks of mourning.” Grievers adapt to a loss by addressing these challenges:
- Accept the reality of loss.
- Process the pain of grief.
- Adjust to the world without the deceased.
- Maintain an ongoing connection to the deceased while re-engaging in life and new relationships.
The Dual Process Model
This approach, developed by Dutch psychologists Margaret Stroebe and Henk Schut, suggests that people cope with loss by oscillating between two processes: loss orientation and restoration orientation.
Loss-oriented coping includes things like incorporating grief work, managing the “intrusion” of grief, and finding continuing bonds with the deceased to keep their memory close, Dr. Moore explains. Restoration-oriented coping focuses on reorienting yourself to a changed world without a loved one and learning to do new things, take on new roles, and invest in other relationships.
“Grief tends to move forward best with an alternating focus or ‘oscillation’ between emotional processing of the loss and re-engagement in a satisfying, meaningful life,” Dr. Moore says. “This model incorporates the idea that breaks from the intensity of grief can be restorative.”
Meaning-Making models
First proposed by grief expert Robert Neimeyer, PhD, meaning-making models suggest that grieving is about finding a way to integrate the past and memories of a deceased loved one with the present and future. This involves creating new narratives that help make sense of the loss within your life story.
Another key feature is to view grief as transformative, a meaning-making process that can lead to personal growth, insight, and resilience. And unlike the stages of grief, the meaning-making model acknowledges that grief doesn’t unfold in predictable patterns over time, Dr. Moore says.
Other Thoughts on Grief
Grief and grieving are complicated subjects and experiences. Sometimes losses have characteristics that influence the experience of grief and can make it more difficult for grievers to feel well supported.
Dr. Moore suggests it’s worth understanding other concepts, such as:
- anticipatory grief and mourning, which include reactions to, and efforts to cope with, losses that have not yet happened
- disenfranchised grief, when a loss can’t be publicly acknowledged or mourned, or be socially supported. This may apply to certain relationships, or if a griever is not recognized or acknowledged by others who are grieving (an ex-spouse or estranged relative, for example), or if the death is stigmatized (such as a drug overdose).
- ambiguous loss, which involves uncertainty, making it more difficult to accept the finality of the loss. For example, it could be a loss where a person has disappeared and is unlikely to have survived but no remains have been found, or losses related to a loved one’s dementia.
Takeaway
One of the most important things to keep in mind is that there is no universal prescription for grieving, no “right way” to grieve, Dr. Moore says. So many factors can affect how you think and feel about a loved one who has passed or other types of loss you might experience.
Divorce, job loss or retirement, family estrangement, and other experiences can be followed by a grieving process. “The idea that we might oscillate between coping with a number of intense emotions, including sadness, anger, fear, and in some cases relief, and finding ways to develop new roles or identities, or cope with stressors that accompany that loss, rings true for a range of losses,” Dr. Moore says.
Sharing your feelings with others you trust can be very helpful. “Social support is incredibly important for people who are grieving,” Dr. Moore says. And a grief counselor or other mental health therapist may provide you tools to help you move through the grieving process. Therapy may be particularly helpful if you feel yourself “stuck” or are having difficulty with any aspect of the grieving process.
