Until the middle of the twentieth century, death was a taboo topic in Western culture. Then psychiatrist Elisabeth Kubler-Ross threw the conversation wide open with her groundbreaking 1969 book "On Death and Dying." She proposed five stages that people experience when dying or when mourning a loss. Although presented in a set order, they are not necessarily experienced in that order. In addition, most people cycle through each stage multiple times.
Denial
Shock is often the initial reaction to a loss. A mourner may be unable to accept that the death has occurred and may try to continue to live like everything is the same as before. Numbness may set in, causing you to question about how you will get through each day. Although denial may sound negative, it serves a purpose, according to David Kessler, co-author of "On Grief and Grieving" along with Kubler-Ross. "Denial helps us to pace our feelings of grief," he says.
Anger
The anger that accompanies grief is intense, overwhelming, and directed at everything and everyone. Mourners might blame God, other people, and/or the deceased for the death. The rage might be experienced against nothing in particular, simply causes feelings of being pent up and spitting mad all of the time. Although the anger may feel unwelcome, Kessler warns against suppressing it. "Anger is a necessary stage of the healing process," he says.
Bargaining
In the bargaining stage of loss, mourners work to find ways to get rid of the immense pain they're feeling. In exchange for promising to do good, they ask God or some other higher power to relieve them of the agony of loss. For example, after losing a relative to cancer a person might think, "I will devote my life to cancer awareness if you will just free me of this pain." Along with these bargains come feelings of guilt. "Guilt is often expressed as 'I could have, I should have, and I wish I would have" statements," says the National Mental Health Information Center (NMHIC).
Depression
Depression is an inevitable and healthy stage of grieving. Overwhelming fatigue, apathy, sadness, and withdrawal are all hallmarks of this stage. "It's important to understand that this depression is not a sign of mental illness," Kessler says. If the depression interferes with your ability to function and does not lift, therapy may be needed. The Elisabeth Kubler-Ross Foundation reports that grief therapy works especially well when combined with a support group.
Acceptance
The final stage of loss is acceptance. This does not refer to being "OK with what has happened," Kessler says. Instead it refers to the knowledge that the loss has occurred and cannot be reversed. The NMHIC says that the grieving process ends once a person has completed four steps: accepted the loss, worked through the stages of loss, adjusted to a world without the deceased, and made a new life that does not include the lost loved one.
