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By Zawn Villines
In her seminal book, On Death and Dying, psychiatrist Elisabeth Kübler-Ross identified five distinct stages of grief. Kübler-Ross worked with dying people and designed her model to describe the distinct grief of dying. In On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, a book co-authored with David Kessler, Kübler-Ross expanded her model to include many other types of grief. A modified version of Kübler-Ross’s model adds two new stages, shock and testing. This seven-stage model of grief is familiar to many people who have grieved a loss, yet little research supports the model. This page contains at least one affiliate link for the Amazon Services LLC Associates Program, which means GoodTherapy.org receives financial compensation if you make a purchase using an Amazon link. THE SEVEN STAGES OF GRIEFAccording to Kübler-Ross, and later to her co-author David Kessler, there are five stages of grief: denial, anger, depression, bargaining, and acceptance. Some grief experts suggest this model might leave out two additional stages. This is sometimes called the Extended Kübler-Ross Model. According to that seven-stage model, the stages of grief are as follows:
While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order. They may also repeat or revisit stages, especially during times of intense emotional distress. For example, a person grieving the loss of their father might become angry over his loss when he is not present at their wedding, even if they already experienced the anger stage years before. While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order. SHOCK: THE FIRST STAGE OF GRIEFGrief often begins with bad news—a stunning diagnosis, a phone call announcing a loved one’s death, or an ultrasound that reveals a baby is not developing normally. This can feel like a massive blow, sending a person into a state of emotional shock. During this earliest stage of grief, a person may feel unable to process the meaning of the news. Shock can last just a few moments or for many days. For some people, shock reappears as the grieving process unfolds. A person grieving the death of a relative may feel another wave of shock settle in at the funeral or burial, for instance. Some hallmarks of shock include:
Testing differs from bargaining in that testing is about finding sustainable strategies for living with bad news. Bargaining is about escaping the bad news and regaining control. A person in the testing stage may:
Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves. Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves. Some studies have found a person’s grief may depend on the loss. A 2016 study, for example, argues that people caring for a loved one with dementia face a unique grieving process. This is because they “lose” the person before they die but then experience another loss at death. The study proposes a dementia-specific model of grieving and argues that ambiguity is a core component of each stage of dementia grief. The extent to which a stage-based model of grief helps people is unclear. People who experience one of the traditional stages may feel less alone when they learn their feelings are common. People who do not go through the stages of grief, however, may feel alone or stigmatized. They may even feel pressured to manifest outward signs of internal grief stages they do not actually feel. There is no right or wrong way to grieve. Grief is the natural reaction to a loss. Cultural norms, personal factors, social support, health, religious and social values, and myriad other factors may affect how a person experiences grief. Therapy can help people manage their grief and find a way forward. The right therapist may even help a person find meaning in a loss, or a sense of purpose in persisting despite the loss. “These models can…help people understand and explain their experience. However, grief is not predictable, linear, stable, or neat. It is an experience marked by its ferocious aliveness and proclivity for shape shifting. Models run the risk of being too prescriptive…and can render people feeling like they have a map of mere country borders and seashores, not the detail or scope to actually navigate one’s way around with any seriousness. Use the seven stages as a basic introduction to the language of grief, but when one becomes fluent in their own personal grief experience, they will realize it’s a language entirely unto its own. Therapy and other therapeutic work help hold and develop the latter,” says Jade Wood, MA, LMFT, MHSA, a Washington, D.C. therapist who specializes in managing grief. To begin your search for a compassionate grief therapist, click here. References:
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Michelle Stewart-Sandusky
I write articles based on my experience as a therapist or a training or conference attendee. Many of these articles are written by others who are experts in their field and I share their information as resources for others. Categories
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