5 Important Reminders for People Who Are Grieving

Denial, anger, bargaining, depression, acceptance — those are the five stages of grief famously outlined by psychiatrist Dr. Elisabeth Kübler-Ross in the late 1960s.  

While many grieving people do experience those emotions, grief is too large, messy and individualized to be contained in generalizations. Grief can look like someone crying quietly but can also look like someone having no energy or wailing on the floor. Or none of these things. 

The history of the five-stage model 

The Kübler-Ross model of grieving was originally applied to people who were terminally ill; Kübler-Ross interviewed many such people in her book “On Death and Dying,” published in 1969. The same stages were later used to describe the grieving experiences of family members and loved ones, too. 

The stages she outlined may be helpful for some people and restrictive for others. Yet, the reason psychiatrists and psychologists know more about the grieving process nowadays is because of the early work of scientists like Kübler-Ross. 

“Back then there were very few women in STEM, so she did foundational work and amazing observational and interview work with people who lost loved ones, trying to describe the commonalities in their experiences,” says Dr. Julia Brechbiel, a clinical psychologist at Fred Hutchinson Cancer Center. 

Since then, research and understanding of grieving has expanded. Brechbiel tells her patients and their families that being guided by the five stages model is great if it resonates with them; but if it doesn’t, it’s OK to leave it behind.  

No right way to grieve 

The way you grieve is influenced by many things and there’s no “right” way to do it. (Although there are times when the way you grieve may indicate you need extra support, such as if your grief makes you feel suicidal; more on that later.)  

Instead of the five stages of grief, here are five ways grief can manifest in your life that you may not realize. 

Grief isn’t linear or finite 

While the five stages of grief may not apply to everyone, they do in fact show up for a lot of grieving people, though not necessarily in the order Kübler-Ross described. Maybe someone will accept a loved one’s death at first but then feel angry about it. Or maybe someone will experience denial, move on from it, and then experience it again. 

“Grief is ever-evolving and not something we can fix right away; it is a lifelong piece of you that you carry along with you and that changes with you,” says Lauren Schmidt, a palliative care social worker at University of Washington Medical Center – Montlake.  

There are often societal expectations around grief, though, that get in the way; people around you may tire of hearing you talk about your loss or may grow increasingly uncomfortable (and not know how to respond) the more you share about it over time. People also may lose patience with you.  

However you decide to handle your grief publicly, it’s important to remind yourself that you have the right to grieve how you want to and shouldn’t feel pressured to stop just because other people think you should be “over it” by now. 

Grief isn't always about death 

For Brechbiel, who works with patients who have chronic illness, grief doesn’t always mean grieving something finite like death: It can show up as anticipatory grief for how the illness may complicate or shorten someone’s life expectancy. 

People may also grieve things that aren’t related to death, like the loss of their health or independence, or may grieve how physical changes make them feel or look different or prevent them from doing activities they used to enjoy. There’s a reason why Alzheimer’s dementia is often called the long goodbye: You’re grieving the loss of who someone was as a person before their body dies. 

After someone dies, you may grieve them as an individual but also feel the loss of the role they played in your family or friend group. If they were the person who kept everyone else connected, they leave behind a hole that may or may not be filled by someone else stepping up. 

Grief is cultural 

Your cultural context — including your religious beliefs, family and friends, media and community organizations like churches — can also influence how you grieve. 

After a death, some people may stay with the body or stand vigil; some people might show outward expressions of grief while others won’t; some people will fast while others may be surrounded by family who bring food.  

The key is not to judge yourself (or others) for how you experience and show grief.  

“Sometimes as a social worker I’ll get paged that a mom has thrown herself on the ground and is wailing, and colleagues want me to do something about it, but I'm just like, ‘Yeah, that’s an appropriate way to grieve,’” says Kira Schreiber, a palliative care social worker at Harborview Medical Center.  

Grief is physical 

In addition to the emotions that typically accompany grief, grief can also cause physical symptoms that you might not realize are due to your grief. 

You might have brain fog or be unable to focus or make decisions. Your stomach might become upset or you might start getting regular headaches. You might develop insomnia or, conversely, sleep more than usual. You might have panic attacks or feel like you’re going to have a heart attack or that you can’t breathe. Or maybe you’re tired and having a hard time finding motivation to do anything. 

“There’s also evidence that grief impacts the immune system,” says Brechbiel. “When you’re caring for someone, your body knows you’re doing something important and it keeps you healthy, but it’s not uncommon for you to get sick and for your immune system to weaken after a loved one passes.”  

Grief is stressful, after all, so anything that stress can do to your body, grief can do, too. 

Grief is personal 

Along with culture, family and media influencing how you might approach grief, there are also aspects of grieving that are uniquely yours, based on your own thoughts on death, your relationship with the person who died, and all the other facets of your life, like your mental health and financial stability and social connections.  

You might feel guilty (not necessarily justifiably so) that you didn’t spend more time with the person or do something you think could have helped them. You might feel abandoned by them. You might keep your feelings to yourself and not want to discuss them with others. Or you might even feel relief that your loved one is no longer suffering or find that you’re able to process the loss more easily than you expected. 

“Grief is hard, but it can also be empowering, knowing that as humans we can love someone so much,” Brechbiel says. 

The point is: all of these things are OK. There isn’t any particular way you “should” feel. However, if grief has left you feeling suicidal or unable to function, you need to confide in someone you trust and get help from a professional, such as a doctor or therapist.   

In most cases, though, people learn how to live alongside their grief.  

“People are far more resilient than we often give them credit for,” says Schreiber. “Grief is universal, yet most of us are still able to function and move forward in some ways. Grief can be debilitating, but people generally find a way to figure out the new normal.”