Stages of Grief: Complete guide on what stages to expect when grieving
Everybody grieves at some point in their life… but what is grief? What are the different stages of grief? How does grief affect the body? How can I deal with my grief? In this article, you will find all the answers to these questions and more.
What is grief?
Grief is a universal happening. Everyone in the world experiences grief because it’s a response to the loss of something or someone we value and love. We are born to grieve. That said, it can be quite challenging. Because grief is a process (the stages of grief) that each individual will experience in their own, unique way, it’s essential that we give ourselves and others who are grieving permission to grieve and that we develop the ability to be patient when the grieving process takes longer than expected. Grief is expressed in a variety of ways and there is no one exact timeline for getting over grief. However, the pain will lessen over time.
“Grief – in its most basic form – represents an alarm reaction set off by a deficit signal in the behavioral system underlying attachment.” -British psychology professor John Archer.
It is believed by evolutionary biologists that grief happens not because it provides a healing benefit to us, but rather that grief is a side effect of having relationships. Our biological want to stay with someone we are close to is remarkable. For example, as a kid, you probably experienced separation anxiety from your parents or siblings, maybe when you lost them in the grocery store. The best way to relieve us from the stress hormones produced from this separation anxiety is to come together again and be reunited.
Charles Darwin, the founder of Darwinism, once wrote, “Strong affections have always appeared to me the noblest part of a man’s character and the absence of them an irreparable failure; you ought to console yourself with thinking that your grief is the necessary price for having been born with (for I am convinced they are not to be acquired) such feelings.” Essentially, the price we pay for having friendship and companionship is grief.
Sigmund Freud, one of the most influential thinkers of the 20th century, coined the phrase, “the work of grief” in a work of his published in 1917. This phrase, grief work, lead us to believe that the process of mourning is the homework to do before we move on beyond the grief.
One of the first studies on grief in the United States was done by the Harvard psychiatrist Erich Lundemann in 1942. It studied a group of grieving and upset people who had recently lost a friend or two in a recent (at the time) nightclub fire. Lundemann observed these people who were mourning and recorded his observations with the hypothesis that traumatic loss is a medical problem.
Since Freud’s and Lundemann’s time, there have been many psychologists that now claim grief is a pathology, a “disease”, that should be included in the psychological domain.
What are the stages of grief?
In the 1960’s, Elisabeth Kubler-Ross, a Swiss psychiatrist identified what she called the Five Stages of Grief. After interviewing patients at a Chicago hospital about the experience of dying, she came up with a theory of five periods/stages of grief, with each stage being an essential part to the overall mourning process. Included within the Kubler-Ross Model of the five-stages of grief (in order) are denial, anger, bargaining, depression, and acceptance.
The first step in the stages of grief, is the refusal, whether conscious or unconscious, to accept facts, information, or reality. It’s a perfectly natural defense mechanism that works by letting us know there is only so much we can handle at one time. The reason we go through denial is that it helps us deal with the initial loss by easing the pace of our grief feelings. Some people can become stuck in denial when dealing with grief. And sometimes the opposite happens when denial is skipped and the mourner goes straight to the second step.
- Example: “Mike died? There’s no way! He was so young…”
It can manifest in many ways. Some people, when in this stage of grief, will become angry with themselves and/or others. The target of anger is most commonly those closest to the person grieving. People who are grieving can also become upset with the person who they lost or the situation that put them in their grief state. Anger happens as a way to stay detached from the situation. The key to this stage of grief is to be willing to really feel your anger. The more you feel angry, the more the anger will begin to disappear and the more you will heal.
- Example: “Why did she ride that motorcycle without a helmet? Didn’t she know how dangerous that was?”
This is known as the third level in the stages of grief rarely provides a sustainable or happy solution. A lot of questions beginning with “what if…” are asked and lots of sentences start with “if only…”The “if only” sentences allow us to find fault within ourselves and what we believe we could have done differently. It’s possible that people will even try to bargain with the pain, perhaps promising that if cancer goes away, they will attend church regularly.
- Example: when facing a break-up, a way of bargaining would be to ask, “Can we still be friends?”
This stage of grief, also known as preparatory grieving, is a way of acceptance, yet still with an emotional attachment. While it’s natural to feel depressed and have some negative thoughts due to grief, this stage of grief means that the person has begun to accept reality. It’s important to note that, contrary to popular belief, depression may take awhile to truly set it. The depression felt when grieving is different than clinical depression, which may be genetic. Depression due to grief is episodic, meaning it only exists for a certain period of time, although that period of time may last a while.
- Example: “What’s the point of living now that the love of my life is no longer by my side?”
This is the fifth stage of grief according to five-stages of grief theory. Although the beginning and the end of this stage varies person-to-person, this stage of grief indicates that the person who was mourning and grieving has emotionally detached and let go of the situation – albeit only a little. This does not mean that the grieving person is over the situation or is complete.
- Example: Sometimes people who know they are going to die, for example, a terminal cancer patient, may achieve a state of peace and acceptance before their loved ones who will all need to pass through their own stages of grief.
7 Stages of Grief
There is another version of the stages of grief called The Seven Stages of Grief which include:
- Shock & denial
- Pain & Guilt
- Anger & bargaining
- The upward turn
- Reconstruction & working through
- Acceptance & hope
All of these stages of grief have the same main idea as the Kubler-Ross Model (five-stages of grief). The biggest difference is that each of the stages of grief in the 7-stage version allows for a lot more interpretation than the stages of grief done by Kubler-Ross. There is more detail offered in the later stages, including the ideas of upward turn, which are the feelings you begin to have once the depression has begun to life, reconstruction and working through.
How do the stages of grief affect the body?
- The parasympathetic nervous system: located in the brain stem and lower spinal cord, this section of our nervous system handles rest, digestion, and breathing. The parasympathetic nervous system is affected when our breathing is cut short or becomes shallow, for example after the news of the death of a loved one. This system is also why our appetite decreases, increases, or completely disappears, and why sleep (or the lack thereof) become an issue when grieving.
- The prefrontal cortex/frontal lobe: manipulating our ability to plan, have self-control/self-expression, and find meaning, our prefrontal cortex/frontal lobe is impacted a great deal when grieving. Scientific brain scans have shown that loss, grief, and trauma can change our emotional and psychical processes – all controlled by our prefrontal cortex.
- The limbic system: because this part of the brain, the hippocampus, is in charge of our recollection, emotion, attention, and our ability to take interest in things, it creates a protective response to grief. Because the brain is perceiving grief and loss as a threat, the amygdala instructs our body to resist the grief.
According to a study done at the University of Birmingham, grief not only has immense effects on our brain but our bodies, too. Grief can:
- Worsen overall health: in a study done on those who had lost a loved one and how the grief affected their health, it was found that while those suffering a loss did not go to a hospital or see a doctor more often than those who did not, they did report a higher number of cases of illness and depression.
- Increase blood pressure and blood clots
- Increase appetite loss: a study done on widowers found that many who suffer a great loss find less pleasure in food overall as well as a general decrease in appetite, thus in weight loss, too.
- Lower immunity: in a study done by the University of Birmingham, the flu shot is less effective in older people who had grieved immensely within the past year compared to those who had not.
- Raise the likelihood of heart attacks: in a 2012 study published in Circulation, it was found that a person is 21 times more likely to suffer a heart attack in the day after the death of a loved one and 6 times more likely within the following week. Another study found that the risk of having a heart attack can stay elevated for a month after losing a partner.
- Create Broken-heart Syndrome: also known as takotsubo cardiomyopathy, broken heart syndrome is a real thing and simply means that the left ventricle in the heart is weakened by severe stress and emotion.
How to deal with stages of grief
When dealing with the stages of grief, it is absolutely essential to keep in mind that grief is a process. No one will grieve the same way nor for the same amount of time. We don’t enter and leave the stages of grief in a linear, orderly fashion. It may be that we feel one stage, then another, then we go back to one of the previous stages of grief before moving on again.
Grief and healing can be especially influenced by:
- How close the relationship is with the thing or person being grieved
- The circumstances surrounding the loss
- How emotional distress has been handled before (i.e. heavy drinking or exercising to clear away emotions)
- Available support networks
Some common symptoms of grief include:
- Behavioral: social withdrawal, intolerance of others, irritability, loss of interest, restlessness,
- Cognitive: forgetfulness, confusion, poor concentration, sense of unreality, difficulty in making decisions
- Emotional: shock, sadness, disbelief, blame, numbness, shame, helplessness, suicidal thoughts, fear, anxiety, regret
- Physical: change in appetite, tiredness, change in sleeping, colds, headaches
- Spiritual: loss of meaning in life, questioning faith, questioning beliefs, yearning, loss of direction, searching for understanding
If you feel like grief is not leaving or that you may be skipping from one stage back to another and so on, it might be best for you to visit a therapist that can help you cope with these overwhelming feelings.
If you have ever gone through the stages of grief and/or have any advice, let us know in the comments below!