What are the Five Stages of grief, and why do we NOT recommend them?
You may have heard of Elisabeth Kübler-Ross' Five Stages of grief. For many of us, it's the only theory of grief we know about. The Five Stages model has been disputed by many mental health professionals and bereaved people, but it continues to be a much-used approach to grief worldwide.
We’ll get to why that is, but first, a bit of background. Kübler-Ross worked in palliative medicine, and she originally conceived these stages to explain what a terminally ill person goes through as they approach death. These five stages – denial, anger, bargaining, depression and acceptance – were then applied to grieving in her 1969 book On Death and Dying.
Kübler-Ross’ model wasn’t the only one from around this time based on stages or ‘tasks’ a grieving person has to work through. It was a common approach to grief.
Kübler-Ross didn’t intend for her Five Stages to tell people how to grieve. But as her model grew in popularity, it was taken literally by many. And it’s easy to see why: it’s a neat, ‘easy to remember’ package. It’s convenient and reassuring – a simple structure that seems to tame the turmoil and unpredictability of grief, and boil it all down to a step-by-step process.
In reality though, the Five Stages have had the opposite effect. The model has been harmful for grieving people who have felt pressured to experience the stages in a certain way, confused about where they’re up to or worried that their grief is not following the progression it ‘should’.
The truth is: there is no ‘should’ in grief. Some of us never go through any of these stages, or we move constantly between them (and plenty of other feelings). The way we grieve is influenced by a whole range of things: the circumstances of the death; our cultural background; our family situation; our previous experiences with death or trauma... to name just a few.
Another problem with the Five Stages and similar models is that they tell us we’ll reach acceptance one day – that we’ll all ‘move on’ or ‘finish’ grieving. But we know from bereaved peoples’ experiences that we never stop grieving for a person we loved who has died. Grief isn’t a process, a set of stages or a list of tasks that has a beginning and an end.
Elisabeth Kübler-Ross did extremely important work in advocating for the needs of dying people and by opening up discussions about death in our society. But for most of us, her Five Stages model is not a helpful way to think about grief.
Modern Grief Theories
Life grows around grief
While working as a grief and fertility counsellor, NZ researcher Dr Lois Tonkin challenged the long-held perception that grief shrinks over time. Overused phrases like ‘time heals’ suggested that eventually your grief will lessen: this had been the accepted way of thinking for decades.
But while working with bereaved clients, Dr Tonkin found that our grief doesn’t get smaller; instead, she proposed that our life grows bigger around it. Her beautiful model allows us to honour the life-changing importance of our grief, the way it remains an integral part of who we are – and at the same time to recognise our resilience as we build a life around it.
What exactly is it that grows around our grief? That’s different for everyone. The life you live around your grief can be occupied with new responsibilities, experiences, relationships and emotions. Crucially, your life with grief can also expand to take in new meaning: things that may be newly important to you since your loved one’s death (this can also be called a ‘survivor’s mission’).
It’s important to recognise that Tonkin's model is not linear. Some days our grief seems to take up all of ourselves – the whole circle. On other days, there’s some space around our grief to feel hope or joy, to be in the present, and plan for the future.
Dual Process or ‘Oscillation Theory’
The Dual Process model of grief, sometimes called Oscillation Theory, suggests that there are two modes that we naturally move, or oscillate, between when we’re grieving.
On one side there are loss-focussed feelings and actions; this is when we approach or are thrown into our grief. Yearning for the person who has died, touching their belongings, crying or screaming, going deep into the what-ifs... Sometimes we choose to go there ourselves, and at other times we’re triggered or ‘ambushed’ by our grief and it’s out of our control. Either way, we’re engaging fully with the pain of the loss.
On the other side are the restoration-focussed feelings and actions, which are all the times we engage in what’s required of us in the day-to-day. This includes new responsibilities and life changes, new opportunities and relationships, and importantly: distraction.
This is one of the most revolutionary parts of the Dual Process model. For its creators, Dutch researchers Stroebe and Schut, giving yourself a mental break from your grief is not only healthy, it’s essential. Grief is intense and exhausting, and as awful as this reality is, life doesn’t stop when someone we love dies. To survive it all, we need to go gently with ourselves. If that means zoning out in front of Netflix, go for it!
This model gives us permission to live in both worlds. We can approach our grief, dive into it, be with the feelings – then we can take a break and allow ourselves to go fully into our lives, whether that’s to take some time out or to engage with what’s needed of us in the here and now.
Other Ideas
There are too many interesting and insightful approaches to grief to cover here, but we’ve included two more ideas that fit well with the modern grief theories we’ve discussed above.
Active grieving
An increasing number of grief researchers are talking about grief as an active, and even a creative process.
We know this is a hard topic. You may well feel like the last thing you want to be is an active participant in your own grief. When someone we love dies, it’s all happening to us. Our agency has been taken away, and we’re just trying to keep on breathing. This is all true: we don’t choose to be bereaved.
But as you live your life with your grief, there will be moments when you can take the wheel and make some decisions – big or small – about how your life and your grief are going to play out.
Researcher Dr Thomas Attig outlines the difference between a ‘grief reaction’ and a ‘grief response’.
A grief reaction: is the suffering and the sorrow; the symptoms that immediately affect your body and mind after the loss; and the way your world seems to fall apart. This reaction is out of your control. It’s horrific and terrifying, and all you can do is to try to survive it.
A grief response: is what you do with what’s happened to you. It’s the way you live on after the death, and the choices you make.
This concept can quickly feel overwhelming: a burden added to an already impossible load. Take it slow.
A small amount of agency – your ‘grief response’ – can be powerful. If you’ve made a decision about what to eat, what to do (or not do), who to talk to, whether to turn on the TV for some downtime, or to read this article... you’re actively grieving. You’re responding to what’s happened with a choice, and that’s huge. It means you have some control over how you’ll go on from here: the ways in which you take care of yourself and those around you; the way you remember your loved one; the meaning you may want to bring into the space around your grief.
Continuing bonds
We know already that grief doesn’t ever end. There’s no resolution, and it’s not a journey – because journeys have destinations. Grief is a part of you and always will be.
Building on this idea, researchers Klass, Silverman and Nickman proposed the theory of Continuing Bonds. For them, not only does grief remain a part of you, so does your relationship with your dead loved one. You remain connected to them, and your relationship can grow and change as you do. You’ll think of your person – their influence on you and the world – differently as time goes on. Their impact on your life doesn’t lessen with time, it matures with you.
Talking to your loved one, wondering how they’d respond to something you’ve seen or done, keeping up with rituals or habits that bring them into your day-to-day life: these and any other things you do to feel connected are meaningful and healthy ways of carrying them with you.
In conclusion
Grief is individual, and these are all just ideas. Take on board only the things that resonate with you.
We all experience grief, and most of us more than once. We’re still learning as a society to live alongside grief – not to fight it or try to force it into tidy boxes. Instead to let it exist in our lives in all its complexity; to live with it and grow with it.
We hope these ways of thinking about grief can be a stepping stone to help you do just that.
