Grief Counseling

The “Five Stages of Grief” were first explicated by Elisabeth Kubler Ross in her work On Grief and Grieving, published in 1961. Since her publication, there has been further research, nuanced explanations, and more detailed descriptions of the grieving process, with some adding up to 12 steps.

For instance, David Kessler, a colleague of Kubler-Ross, says, “The five stages: denial, anger, bargaining, depression, and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling” (Kessler, 2022).

Others have described the process as waves (Roldan, 2022) or a spiral (Lewis, 1961) to signify that grief is not a linear process, but one that meets us throughout life in various orders The stages of grief are meant to be descriptive, rather than prescriptive of how a person processes loss. Below is an overview of Kubler-Ross’ updated seven stages of grief.

Denial and Shock

Initially, the loss may be met with denial—a protective response when the shock of the loss overwhelms and doesn’t make sense. Like Lewis commented on the loss of his wife to cancer, “The death of a beloved is an amputation…No one ever told me that grief felt so like fear.  I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing” (Lewis, 1961).

Like every emotion, grief has visceral components. The shock of a loss triggers your sympathetic nervous system to go into protective stance, namely fight, flight, or freeze. In this state you may find yourself feeling numb, like you want to run or escape, or defend yourself against attack. These are all normal initial stages of beginning to come to grips with a loss.

Pain and Guilt

In this stage of grief, the initial shock of the loss is replaced by beginning to feel the pain of it. Many also experience senses of guilt that their overwhelming pain is not only impacting them, but also affecting the lives of those around them.

Similarly, you may also experience guilt— “you may think there was some way you could have stopped the death from occurring. Knowing that you could have done a million and one things differently – but didn’t –“ (Roldan, 2022). This is a common wave of grief that many get stuck in due to past feelings of guilt surrounding the loss.

Anger and Bargaining

Within this stage of grieving process, you may find yourself overwhelmed with anger. This is a protective response to the loss you have suffered.

Anger can sometimes give a sense of control because it is an active emotion displayed in physical ways such as yelling or throwing things. Contrast this with the underlying pain of grief that often initially correlates with feeling out of control, helpless, or even hopeless.

Bargaining is also a protective part of grief where you may try and regain control by creating if/then or “I’ll never” concrete situations amid feeling out of control of the loss.

As Roldan explains, “Grief is passive in that the loss is thrust upon you. You have no choice – you will be emotionally affected by the death of a loved one. And grief is active in how you choose to respond to this loss” (Roldan, 2022).

Depression

In this wave of grief, you may feel alone and isolated. The protective anger and bargaining responses may be replaced by the weight of the pain of the loss. It is important to seek out support and help if you are feeling as though you cannot handle the weight of your grief. Please see the references below for resources.

The Upward Turn

This stage of the grieving process is one where you regain a sense of control and mastery. You may begin to feel more hope and that your pain of loss is something you can live with and through.

Reconstruction and Working Through

Like the upward turn, this wave of the grieving process is when you continue to adjust and adapt to life as it continues on.

Acceptance and Hope

This is not the end of the grieving process. Rather, it is the stage in which you further adapt to life after your loss. You may experience a shift in focus, such as developing new goals and dreams.

General Symptoms of Grief

Grief is an embodied process. It involves all of you, and thus can impact all aspects of your life, from your emotions to your overall health.

Common symptoms of grief include “anxiety, crying spells, depression, fatigue or lack of energy, guilt, loneliness, pain, sadness, trouble sleeping” (Clinic, 2020). Other physical symptoms may be like those of stress (due to the activation of your sympathetic nervous system) such as loss of appetite or overeating.

You may also experience “grief brain” with symptoms in addition to the ones above such as “panic attacks, sleep disturbances, nightmares, vivid dreams, memory loss, [and] disorientation” (Roldan, 2022).

Coping with Anniversaries and Reminders

Another aspect of the grieving process is that it is often re-heightened around the anniversary of the loss. Your nervous system may revert to the flight/fight/freeze responses as the anniversary nears to protect you from the intensity that was first experienced. This is a natural and adaptive way our bodies remember and process the trauma of loss.

Some ways to prepare for the anniversary include planning visits to grave sites, planning a new tradition or way to honor the person such as donating to a cause they cared about, and planning get-togethers with friends and family who are also going through the grieving process.

It’s also important to remember that grief is a spiral and a wave, and you may go through the stages various times. Furthermore, being mindful of what reminds you of the person or the event can also help you be prepared to cope when you may expect them to occur (e.g., driving by their favorite restaurant or by the place where they died).

Complicated Grief

This is a less-common grieving process, wherein the grief does not lessen in intensity overtime, but persists in an acute state of intensity of feelings of hopelessness, purposelessness, or and an inability to move forward. “Complicated grief also may be indicated if you continue to: have trouble carrying out normal routines, isolate from others and withdraw from social activities…feel life isn’t worth living without your loved one, [or] wish you had died along with your loved one” (Clinic, Complicated Grief, 2019).

If you or someone you know is demonstrating these persistent symptoms, and it has been over a year since the loss, you may be experiencing complicated grief. While grief is individual, you don’t have to go through the grieving process alone. At Texas Christian Counseling, we have many counselors who can walk through the stages of grief with you. Contact us today to schedule an appointment for grief counseling.

Resources

Grief support groups: Find a Group – GriefShare

National Suicide Prevention Lifeline 1-800-273-8255

References

Clinic, M. (2019, June 19). Complicated Grief. Retrieved from The Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

Clinic, M. (2020, November 14). https://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/grief/art-20045340. Retrieved from The Mayo Clinic: https://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/grief/art-20045340

Kessler, D. (2022, 4 11). The Five Stages of Grief. Retrieved from Grief: https://grief.com/the-five-stages-of-grief/

Lewis, C. S. (1961). A Grief Observed. Faber and Faber.

Roldan, K. (2022, February 9). 12 Stages of the Grieving Process (There’s More Than 5??). Retrieved from US Urns Online: https://www.usurnsonline.com/grief-loss/grieving-process/