All of us process through grief in a unique, personal way. Many professionals recognize that there are patterns or stages that most people share as they handle a loss. The concept of the stages of grief was popularized by Elisabeth Kubler-Ross (1926 – 2004) a Swiss American psychiatrist. She was a pioneer in the study of death and was the author of the best-selling book, On Death and Dying, in which she first promoted her theory of five stages of grief. Though she saw them as fluid, Kubler-Ross identified denial, anger, bargaining, depression and acceptance as the key threads in the process of grief.

Although these stages have been widely accepted by the general public, other clinical psychiatrists and research studies have offered several variations or alternatives to the five stages of grief.

The Extended Grief Cycle

The Extended Grief Cycle, as seen in the graphic below, indicates the roller-coaster emotional ride that an individual goes through trying to wrestle with the changes occurring in life. The initial stage is stability – and it may start at any spot on the line, depending upon one’s personality and circumstance. Once the person receives the bad news, the response is usually shock, which results with immobilization. The person is almost paralyzed from making decisions or having reactions.

From paralysis, the person moves through denial, trying to avoid the terrible news and reality. Frustrated, the person then begins to release the pent-up emotions and outbursts of anger is the result. Bargaining – trying hard to find a way out of the circumstance – is the next spot on the cycle. When no way out is seen, the person slips into depression, finally coming to grips with the inevitable reality.

The testing stage begins when the person starts to venture out, trying and testing ways to make life return to a more stable time. Acceptance is the result of finding a way to move forward. The way will be different – but will be one where progress can be found.

No Real Grief

George Bonanno, in his book, The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss, insists that the stages of grief do not exist. His research indicates that most people who experience a loss do not grieve. His findings conclude that people experience a natural resilience to the main trauma of loss. His work demonstrates that the absence of grief symptoms is a healthy outcome, rather than something that may indicate serious psychological problems.

A Positive Environment and Support Group

A study of bereaved individuals conducted by Yale University during the years 2000 through 2003 showed some findings that were consistent with Kubler-Ross’ five stages of grief, but others that were inconsistent with it. Primarily this study presented that Kubler-Ross did not take into consideration the environment of the bereaved. If patients were surrounded by positive experiences, by people who were supportive and loving, and by opportunities to focus on the needs of others, they experienced things differently than if they were isolated or surrounded by negative experiences.

Seven Stages of Grief

Several authors agree with the concept of the stages of grief, but either add additional stages or redefine the stages. Currently, the most popular alternative to Kubler-Ross’ five stages of grief is a theory of seven stages of grief. Shock and Denial represents the first stage and is parallel to the Denial stage from Kubler-Ross. This theory adds a second stage of “Pain and Guilt,” emphasizing a period of intense suffering on the part of the bereaved. This almost always is accompanied by incredible feelings of guilt.

In the seven stage theory, the stages of Anger and Bargaining from Kubler-Ross are combined into one step, followed by Depression. The fifth stage is “The Upward Turn” and represents an event or small series of events which becomes the catalyst from moving from depression toward acceptance and hope. The sixth stage is labeled “Reconstruction” in which the bereaved begins to conceptualize a life without the deceased. Finally, “Acceptance and Hope” become reality in the seventh and final stage.

Although certain characteristics seem to be present when moving through grief, each of us possess a unique combination of past experiences, personality, style, ways of coping with stress, and our acceptance of circumstances. We each blend our beliefs concerning the spiritual and supernatural, our understanding of the possibility of life after death, and the relationship that we have with the departed into the grieving process. Each approach to grief is as unique as the fingerprints that we possess.