The 5 Stages of Grief & Bereavement
How does experiencing grief actually feel? We've described grief as a complex set of physical, emotional and intellectual reactions to any kind of loss. Naturally, since each of us is unique, our reactions to loss (whether it's divorce, unemployment, ill health, foreclosure, or a death) are also very different from those of other people. In addition to an overview of the experience of grief, this article also features an outline of the grief process.
As we've said, the experience of grief is different for everyone. It's multi-faceted, and affects each of us in six possible areas of being: physical, behavioral, psychological, spiritual, social, and philosophical. Grief is such a profound experience; in fact, some experts, like George Engle, argue it's very much like the experience of illness. In his 1961 journal article, "Is Grief a Disease? A Challenge for Medical Research", Engle argued that the loss of a loved one is as psychologically traumatic to the same degree as being severely wounded or burned is physiologically traumatic. In fact, he argues that (much like disease) grief is a departure from the (normal) state of health and well-being; one which requires a period of time (much like recuperation from illness) to return the mourner to their natural balanced, healthy state-of-being.
If we were to ask five people with a head cold how they were feeling; everyone there would tell us of the symptoms they were experiencing. To varying degrees, some would have a sore throat, others a cough; a few may have a runny nose, and some may have a headache. Everyone is ill, but each feels it in their own unique way. The same is true of experiencing grief: each of us feels it in a very personal way.
The 5 stages of Grief / The Grieving Process
You've no doubt read about the grief process at some point in your life. And you may have also come in contact with various ideas about the stages of grief; one theory, developed by Elizabeth Kubler-Ross in 1969, breaks down the grieving process into five (5) stages: denial, anger, bargaining, depression, and acceptance. However, it's essential to realize that Ms. Kubler-Ross was writing about the grief experienced by the terminally ill; these five stages really only identify key emotional reactions to the experience of the dying. Despite her narrow focus, this five stage model has been mistakenly applied to grieving in all areas of our lives; and despite this misuse, it's effectively guided thousands of people through their experience of grieving. Giving them a basic framework from which to view their grieving experience, the five stage model for grieving has been amended by some grief counselors, resulting in a grief process which includes:
Pain & Guilt: In those moments when denial passes, it can be replaced by psychological and physical pain or even guilt.
Anger & Bargaining: Anger is a common reaction to loss. It can cause us to behave badly with those around us, and the desire to "bargain" with whatever higher power we acknowledge can be intense.
Depression & Loneliness: This can be a time when the reality of your loss weighs heavily on your heart, resulting in depression. It could also be a time when you isolate yourself from others, adding to your sense of loneliness.
Upswing: Fortunately, there are also moments where you recognize a shift in your experience of grief. It's the experience of adjustment, where your physical and psychological symptoms of grief lessen a bit (giving you room to breathe).
Reconstruction: Becoming more focused on the "here and now", this is a time when you begin to work on the practical issues involved in reconstructing your life without your family member.
Acceptance/Hope: Accepting your situation doesn't mean you'll find immediate happiness; this stage of the grief process is a time when you actively move forward with your life.
Certainly, the experience of grief is anything but a straight line. We don't slip easily from one state to another in a forward motion; instead grief loops, twists, and turns back on itself. To illustrate this cycling, circular nature of grief, in the Preface to her book, The 5 Stages of Grief: Finding Your Personal Path to Healing after the Loss of a Loved One, Susan Berger, quotes a poem from American Poet Laureate Linda Pastan:
"...Denial was first.
...Anger seemed more familiar.
...Bargaining. What can I exchange for you?
...Depression came puffing up.
...Acceptance. I finally reach it.
But something is wrong.
Grief is a circular staircase.
I have lost you.
Ultimately, "the five stages of grief," notes Ms. Berger, "do not ultimately offer bereaved individuals comfort or assistance. Survivors must go on. But they follow a different trajectory toward healing, one that involves not just shock and denial but also confusion, disorganization, and despair before they can reorganize their lives. The process is not linear...our knowledge of grieving and healing informs us that recuperative from significant loss is like any other healing process: it occurs over time and requires considerable energy."
What Does Experiencing Grief & Bereavement Involve?
The WebMD online article, "Grief and Grieving–Symptoms", notes the expression of grief often includes "crying and sighing, headaches, loss of appetite, difficulty sleeping, weakness, fatigue, feelings of heaviness, aches, pains, and other stress-related ailments." They also share the emotional expressions of grief can include "feelings of sadness and yearning. But feelings of worry, anxiety, frustration, anger, or guilt are also normal."
What about the social expression of grief? They tell readers it may include "feeling detached from others, isolating yourself from social contact, and behaving in ways that are not normal for you"; and spiritual expressions "may include questioning the reason for your loss, the purpose of pain and suffering, the purpose of life, and the meaning of death." They remind readers that grief "can cause prolonged and serious symptoms, including depression, anxiety, suicidal thoughts and actions, physical illness, and post-traumatic stress disorder."
Grieving Styles: Which Describes You?
Returning to Ms. Berger's book, The Five Ways We Grieve: Finding Your Personal Path to Healing after the Loss of a Loved One, we can close this article with a brief look at those five ways, or styles, in which we grieve our losses. Using her categories, take a few minutes to think about how you're currently experiencing grief; then consider the manner in which you'd like to grieve. Ms. Berger argues you’re your grieving style commonly falls into one of the following types:
Nomads: These people have not resolved their grief, and they continue to experience a range of emotions including denial, anger and confusion about what to do with their lives.
Normalizers: Placing primary emphasis on their family, friends, and community, these individuals are committed to creating or re-creating them because of their sense of having lost family, friends, and community.
Memorialists: These individuals are committed to preserving the memory of their loved ones by creating concrete memorials and rituals to honor them.
Activists: Creating meaning from their loss by contributing to the quality of life of others through activities and careers which give them purpose in life; the main focus of these individuals is on education and on helping others who are dealing with the issues that caused their loved one's death.
Seekers: These people look outward to the universe and ask philosophical questions about their relationship to others and to the world. They adopt religious, philosophical, or spiritual beliefs to create meaning in their lives and provide, or restore a sense of belonging.
Let Us Help
As Ms. Berger noted, grieving occurs over time, and takes considerable energy. If you're struggling with the experience of grief, please know that we are here to assist you. We'll listen closely to your story, share our insights, and do our best to point you to online, as well as local, resources to support you in your grief experience. Simply call us at (313) 982-1000.
Engle, George, "Is Grief a Disease? A Challenge for Medical Research", 1961, Psychosomatic Medicine, 23, pages 18-22.
Berger, Susan, The Five Ways We Grieve: Finding Your Personal Path to Healing after the Loss of a Loved One, Trumpeter, 2009.
Web MD, "Grief and Grieving - Symptoms", updated 2011 and accessed 2014.