What are the Five Stages of Grief After a Significant Loss?

“The pain of grief is just as much part of life as the joy of love: it is perhaps the price we pay for love, the cost of commitment. To ignore this fact, or to pretend that it is not so, is to put on emotional blinkers which leave us unprepared for the losses that will inevitably occur in our own lives and unprepared to help others cope with losses in theirs.”

Dr Colin Murray Parkes, ‘Bereavement: Studies of Grief in Adult Life’

Grief is often one of the most difficult experiences humans go through. It can be completely overwhelming, affecting all aspects of our lives. We feel grief emotionally and physically, and its impact on our mental health can be huge.

While there is no ‘normal’ or ‘right’ way to grieve, after a significant loss it is understandable for people to want to know if their grief is typical. In this article, we explore what grief is, what it can feel like, grief’s effect on the body as well as outlining three models of grief, including the five stages of grief.

What does grief feel like?

Losing someone close to us can be extremely painful and is likely the most annihilating experience any of us will ever experience. It is often frightening, upsetting, and devastating.

Emotions or feelings of grief can include sadness, denial, despair, shock, guilt, numbness, relief, helplessness, and/or anger. Many grief sufferers also experience anxiety or depression, which can vary in its longevity. Some people talk of feeling like they’ve lost a limb or a part of themselves, describing the loss of a loved one as if they have been cut in half.

Guilt can play a part in grief, particularly if your relationship with the person who has passed away was not an easy one. Some people find they feel to blame for the death of their loved one in some way, or that they could’ve done something differently to prevent this from having happened. (It’s highly unlikely anything you did or didn’t do would’ve made a difference so try to treat yourself kindly, particularly in the early days following a death.)

Psychotherapist Julia Samuel talks about the paradox of grief. She describes this as being the need to let grief rage through us with its full force if we are to process it effectively. Letting grief rage through can feel intensely painful so trying to stop grief or control it in some way in order to avoid its powerful impact is understandable. Anyone who has been through grief of some kind will know the futility of trying to prevent it, however.

What happens in your body when you are grieving?

Many people are surprised by the physical feelings they experience after someone dies. The pain of grief can feel like illness, affecting every part of your health and causing very real physical pain.

When you’re grieving, different hormones and neurochemicals flood your brain. This can result in symptoms like disturbed sleep, loss of appetite, fatigue and anxiety, all of which can have a big impact on your brain function.

Cortisol (sometimes called the “stress hormone”) is often released more frequently and in higher quantities during grief, in particular over the six months after the loss of a loved one. These elevated cortisol levels can impact your overall health, potentially resulting in high blood pressure or increased risk of heart disease. Likewise, the loss of a spouse increases your risk of dying within the first 90 days by 66%, according to a 2013 study^[1]. Such is the power of grief.

The bereaved often report seeing or hearing the person who has died, which can happen when our brains are working hard to process their death. It’s a normal way for humans to begin to accept the finality of death.

What are the five stages of grief?

The five stages of grief is a model of grief developed by Elisabeth Kübler-Ross, a Swiss-American psychiatrist. She was the author of a book called On Death and Dying, published in 1969, where the Kübler-Ross model (the five stages of grief model) was first outlined.

The five stages of grief model was developed as a way to support terminally ill people to face their imminent death, but other types of mental health practitioners found it so useful that the model was adapted in order for use when thinking about grief in general.

The five stages of grief as outlined by Kübler-Ross are:

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Do the five stages of grief happen in order?

Kübler-Ross’s model allowed for people to experience the stages as happening in any order and at different times, which is contrary to the popular understanding of the five stages. Some people do not experience all five stages. Experiences vary from person to person but also within each of us – while we may experience all five in a recognizable order with one death or loss, this may change under different circumstances.

Bear this in mind when you read about the five stages in more detail below.

The five stages of grief, in detail

1. Denial

After someone dies, it can be a strange, transitional time. While we know intellectually a death has happened, often the shock of bereavement causes feelings of numbness and denial. People may carry on as if nothing has changed. The time it takes to process the loss of a loved one means there is a lag between learning the information about their passing and your brain beginning to process what this really means – that they are not coming back. This can be exacerbated by believing you hear their voice, see them or feel their presence.

This type of shock can also make you feel very disconnected from the rest of the world. It can be incredibly confusing to see life carrying on around you while you feel as though your world has stopped turning.

2. Anger

Feelings of anger can surface after a death in several different ways. You may feel angry towards the person who has died, or anger at yourself if you feel you should have done or not done certain things before they died. You could feel both of those feelings simultaneously. You might notice feelings of anger towards others, too, such as older people who have outlived your loved one.

Anger can also surface in ways that don’t seem to relate to people. Feeling angry at the world is common, and can be a way to respond to strong feelings that life is cruel or unfair. Anger in all its forms is a natural emotion, particularly after someone has died, but it can feel shocking to experience especially when it feels very strong or overwhelming.

3. Bargaining

This stage of grief relates to the ways in which we resist what has happened. By making deals with yourself, the world, or with God, the reality of death can be held at bay for a little longer. It’s also a way to try to get some control over what has happened, hoping that by holding up our end of the bargain is a way to feel less pain.

Bargaining also relates to the ways in which we ruminate on past events, wondering if we’d done things differently our loved one might still be here. It’s a way to imagine alternative outcomes, a form of ‘magical thinking’ that is a way for our brains to process the reality of the situation in a relatively safe way.

4. Depression

This stage is perhaps the most familiar to those who’ve experienced grief and to those who have witnessed it. Living without your loved one can feel impossible, and the sadness and longing can be very intensely painful. The depression stage often comes in waves over months or years, leaving the bereaved feeling as though nothing matters, and even that life is not worth living.

If you feel suicidal and are concerned you may act on this, please seek help.

The 988 Suicide & Crisis Lifeline exists to help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress. Dial 988 if you need this type of support.

5. Acceptance

While grief can leave people feeling like they will never be able to accept the loss of their loved one, many people do find the pain eases, albeit gradually and perhaps in a non-linear way.

While grief changes us in many ways, and we rarely get over the loss of someone dear to us, acceptance is a way of learning to live again.

Are the five stages of grief still accurate?

Since the five stages model was first developed over fifty years ago, the ways in which we think about and understand grief have grown. More research has taken place into the best ways to help and support those who’ve experienced loss.

As Kübler-Ross explained when she developed her model, each person’s experience of grief is unique which means the five stages of grief may be accurate for some people and not for others.

Other models of grief

With this in mind, here are two other models of grief that provide insight and comfort to those experiencing loss and bereavement:

1. The ball in the box analogy

The ‘ball in the box’ analogy first came to mainstream prominence in 2017, popularized by a Twitter user called @LaurenHerschel who was given this advice by her doctor:

There’s a box with a ball in it, and a pain button. In the beginning, the ball is huge. You can’t move the box without the ball hitting the pain button. It rattles around on its own in there and hits the button over and over. You can’t control it – it just keeps hurting. Sometimes it seems unrelenting.

Over time, the ball gets smaller. It hits the button less and less but when it does, it hurts just as much. It’s better because you can function day to day more easily. But the downside is that the ball randomly hits that button when you least expect it.

For most people, the ball never really goes away. It might hit less and less and you have more time to recover between hits, unlike when the ball was still giant.

Lauren Herschel

2. Growing around grief

The idea of ‘growing around your grief’ acknowledges that there are no set stages or phases to bereavement, allowing for the uniqueness of everyone’s own experience of grief.

Growing around grief refers to the idea that, once bereaved, your grief will always be there. It remains the same as it was when it first happened. Initially, the grief takes up a huge amount of space in your life, which refers to how difficult it can feel to put one foot in front of the other in the early hours, days, weeks, or months of grief.

What changes, however, is what happens in that time. Naturally, you grow as a person, meaning that the grief gradually starts to take up less space in your life. You grow around it, so while it doesn’t get smaller, you get better at accommodating it.

Grief is tidal. In time, it can recede and leave us with feelings of peace and advancement, only for it to wash back in with all its crushing hopelessness and sorrow. Back and forth it goes, but with each retreating drift of despair, we are left a little stronger, more resilient, more essential and better at our new life.

Nick Cave, singer/songwriter

If you feel that you need help with the emotions you’re experiencing as a result the loss of a loved one, The Center • A Place for HOPE can help. An award-winning mental health treatment facility offering Whole Person Care to treat the entire you – your mind, body, and spirit – we can support you through your grief.

Reach out to us today to find out more about the programs we offer. Contact our admissions team now.

[1] J. Robin Moon, M. Maria Glymour, Anusha M. Vable, Sze Y. Liu, S. V. Subramanian, Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses, Journal of Public Health, Volume 36, Issue 3, September 2014, Pages 382–389, https://doi.org/10.1093/pubmed/fdt101