What Are the Stages of Grief?

The “Stages of Grief” that people refer to often are:

Denial, Anger, Bargaining, Depression and Acceptance.

These stages, however, were never meant to describe the process of grief after a death. Elisabeth Kubler-Ross, the psychiatrist who proposed those stages in her 1969 book “On Death and Dying” was studying the processes of terminally ill patients facing their own mortality. These stages described how patients coped with illness and impending death after receiving a terminal diagnosis. Kubler-Ross also clarified that the “stages” were not linear or progressive in any way, but that patients would generally experience all of them at some point, and often repeatedly throughout their dying days.

In other words, the concept of these stages of grief are useless to grieving people.

Clients come to me often wanting to know more about these stages, hoping they can anticipate what will be next in their grief process. “Oh, I think I’m in Bargaining, I better brace myself for Depression.” Unfortunately, grief doesn’t work that way.

After someone dies, you may experience all of the above, or none of the above. They may or may not occur, and they certainly won’t be in any predictable order. Grief co-exists with myriad emotions including regret, relief, joy, sorrow, amusement, confusion, nearly any emotion you can conceive of. All is fair in love and grief. You may spend the month after your mother’s death feeling at peace with her passing and grateful that she is no longer suffering. And in an instant, you could end up sobbing and screaming, railing against the injustice of her untimely death. Anything goes.

In my years as a grief counselor, the closest thing to “stages” I’ve observed would be the phases I describe as:

Acute Grief and

Integrated Grief

Let me define these concepts.

Acute Grief is when the loss is prominent and commands most of your attention, emotions are intense, and day-to-day activities are impacted by your grief.

Integrated Grief is when the loss is part of your reality but not currently a focus, emotions are fairly stable, and your daily activities continue normally without being significantly impacted by your grief.

Very often people experience Acute Grief shortly after a loss, and over time come to live with Integrated Grief. Time is part of the transition between phases, but it is not as simple as saying that Acute Grief is the immediate experience and Integrated Grief is the experience after a year or more. Sometimes the experience varies day to day, even many years after a loss. In general most people spend more time in Acute Grief shortly after a loss and more time in Integrated Grief once some time has passed by. But both can occur at any time after a loss, and may last a few hours or a few months. You may find you spend less time in Acute Grief as time goes by, but that doesn’t mean it is behind you for good.

While unpredictable and nonlinear, understanding a bit about the two phases can help you adjust your routines and expectations to honor where you are at that moment. If you are living in Integrated Grief and have plans to go out Saturday night, but something stirs up your emotions and now you are experiencing Acute Grief, you might adjust your plans accordingly. You may choose to make things easier for yourself and demand less of yourself while experiencing Acute Grief. Conversely, if you feel calm and stable in Integrated Grief, you might be ready to push yourself into a project that you now have the attention and energy to focus on.

In many ways, I really wish the original “Stages of Grief” were an accurate road map for life after loss. Wouldn’t it be so nice to have some idea what you might experience and when? It seems like we could cope more easily if we weren’t constantly caught off guard by our grieving process. I can’t provide any such roadmap for you, but as a therapist I can be a helpful copilot. Whatever your current experience, take good care of yourself and get support where you can. You don’t have to do this alone.