The 5 Stages of Grief

grief

Losing a parent, spouse, or other loved one is really hard. What most of us don't know, until it happens, is that it hurts for a long time. According to experts, though, there are recognizable stages -- or signposts -- that you'll pass through as you move from bereavement to healing. In her landmark 1969 book On Death and Dying , psychiatrist Elisabeth Kubler-Ross popularized the idea of five stages of grief. Since then some experts have continued to work with Kubler-Ross's model, while others have simplified the theory to include just three or four stages, or expanded the list to as many as ten.

But most experts agree that everyone processes a loss by experiencing a series of different feelings, though we may go through these stages in a different order or skip one altogether. Here's a guide to the stages of grief and how to navigate them to find comfort and healing.

Stage one in the stages of grief: Shock and denial

For the first hours, days, even weeks after someone you're close to dies, you may feel like you simply can't absorb what's happened. It might feel like there's a glass wall between you and your feelings. You know you're sad, but you can't actually grieve. The numbness protects you from dissolving, but it may feel a bit frightening, too -- why can't I cry?

Losing someone you've lived with may also bring intense feelings of loneliness and emptiness as you struggle with the hole left in your daily life. If you've spent the past months or years as a caregiver , it's natural to experience a sense of being cut adrift -- after giving so much of your time and devotion to your loved one, suddenly you are no longer needed.

What you might be feeling:

  • Numb and distracted -- "This can't be happening to me.
  • Alienated from other people , as though everyone else exists in the sunny world of everyday events, while you're in a dark tunnel.
  • Bereft of purpose. Many caregivers say they feel painfully lost, as if the connection that kept them going every day is no longer there.

What you might notice:

  • Memory gaps , such as being unable to recall what you did yesterday, or not knowing how long it's been since you last ate.
  • Being disorganized and "spacey" -- misplacing your keys or cell phone, losing your car in the parking lot, forgetting to return phone calls.
  • Feeling out of touch with your real feelings, reacting in ways that don't feel like "you," such as snapping at a sibling or feeling nothing when a friend tells you some happy or sad news.

What to do:

  • Give yourself permission to feel however you feel. You've just been through an emotional earthquake, and the aftershocks are going to continue for a long time. It's okay if you can't cry, and it's also okay if you cry all the time or at inappropriate moments.
  • Break through the denial. Recognize that numbness has a purpose: It keeps you from falling apart. But if feelings of distance and unreality are bothering you, use family members and close friends as touchstones. Prevent yourself from "stuffing" your feelings by checking in with others: How are you holding up? Create opportunities to talk over the experiences you've been through and reminisce about your loved one.

Stage two in the stages of grief: Pain and guilt

When the protective curtain of denial slowly slips aside, intense feelings start to surface. This may be the hardest time, when things seem darkest. Self-blame is common. You may find yourself replaying conversations and decisions in your mind and asking yourself if you should have done things differently. If you've lost someone who's been suffering or in pain, you may experience a complex mix of relief coupled with guilt. It's common to hear a judging voice in your head, berating you fo r feeling relieved -- but actually relief is a perfectly normal reaction.

What you might be feeling:

  • Extreme mood swings, feeling okay one moment and overwhelmed with sadness the next.
  • Physical and/or emotional exhaustion. You might feel like you can't get out of bed in the morning, or even like you can't go on any longer.
  • Guilt -- if you've lost someone who died relatively young, you may feel guilty that you yourself have your health. If you've been a primary caregiver, you may feel relieved that the intense period of caregiving is over and you can return to your "normal" life, yet you feel terribly guilty for having such thoughts.

What you might notice:

  • Tears that come when you least expect them.
  • Negative thoughts about yourself.
  • Obsessive thought patterns, such as going over in your mind things you did and didn't do or say.
  • Exhaustion and lethargy -- feeling overwhelmed and defeated, asking yourself "what's the point?"

What to do:

  • Find ways to turn off the "tapes" replaying themselves in your mind. If there are moments or images that are particularly traumatic to remember (the decision to turn off life support, for example, or an image of your loved one in pain), talk through the memories with family members and friends who went through them with you.

Saying, "I keep thinking of how much pain she was in and wondering if there was more we could have done" allows you to get the dark feelings and fears out in the open so that you and those who were also present can talk through what happened.

You may be surprised to find that others remember things differently. Getting everyone's feelings out in the open allows you to reassure each other that you all did the best you could in a difficult situation.

  • Ask for help. This is the time to find a support group, therapist, or close friend or family member who's been through something similar, who can help you work through these very difficult feelings.
  • Force yourself to reach out. It's easy to hide away or isolate yourself when you feel that you're "not at your best," but this is just the time to reach out. Put a few close friends or family members on alert by saying, "I'm having a pretty tough time right now. Can I call you when I'm really feeling down?" Setting this up ahead of time gives you permission to pick up the phone.
  • Let yourself off the hook. If you're experiencing guilt for surviving, or relief that their suffering or your caregiving role is over, remind yourself that those feelings are common and natural and nothing to feel bad about. The truth of the situation is that the person you were caring for is out of pain and some of the burdens that have overwhelmed you have been lifted, and it's natural to react with relief.

Stage three in the stages of grief: Anger, frustration, and bitterness

For many people, this stage alternates in spurts with pain and guilt. You may find yourself becoming very reactive. You're going along just fine until something -- a TV episode, a story told by a friend, an ad in a magazine -- sets off an explosion of angry, even hostile feelings. Sometimes anger is a way to shield ourselves from feeling intense pain; other times it's the simple contrast between other peoples' concerns and the sheer magnitude of what we're going through that triggers an attack of bitterness or frustration.

What you might be feeling:

  • Sudden attacks of self-pity and frustration or bursts of outrage and a sense of injustice that may feel childlike: "Why me?" or "This isn't fair!" As one person put it, "I just keep thinking that this isn't what we signed up for."
  • Bitterness or resentment. If you've lost someone who died relatively young, you may feel bitter about having lost her "before her time." Many people describe feelings they're not proud of, such as, "Why couldn't it have been him instead?" One person who lost her father early to cancer reported feeling ashamed of her lack of compassion when other friends described their difficulties with fathers in poor health. She heard a voice in her head saying, "I'll trade you any day."

What you might notice :

  • A desire to avoid certain social situations, particularly those where others are celebra tory or self-congratulatory.
  • Irritation when others complain about things that seem petty and unimportant compared with what you're going through.
  • A tendency to react with mistrust and sarcasm.
  • Anger and bitterness over others' sincere expressions of sympathy. Someone saying "I understand," or "Is there something I can do?" might make you want to scream, for instance.

What to do:

  • Avoid those who bring you down. If you notice that certain people or situations bring on bouts of anger and ill humor, it's perfectly okay to avoid them -- you're protecting both of you. For instance, if a certain friend tends to initiate a "pity party," put that friendship on hold for awhile.
  • Tell people what's happened. It can be hard to bring up a loss, but it's more uncomfortable still if you keep silent and those around you remain oblivious. When there's an appropriate opening, explain that you've recently experienced a loss. People will be more supportive than you think, and some will really "get it," resulting in deeper shared connection. This will also stop most of those who are just having a bad day from telling you about it.
  • Have compassion for yourself. When feelings of anger and bitterness are separating you from others, instead of berating yourself for your lack of compassion, turn that compassion on yourself. You've just lost someone terribly important to you, and it's natural for your mind to compare yourself with others and find their situations less traumatic. Talk to yourself with sympathy and forgiveness and remind yourself that you won't always feel this way.

Learn About Acceptance as a Stage of Grief

No matter how deep your grief, slowly but surely you'll be pulled back into the world -- perhaps even against your will. Life has a way of throwing moments our way that wake us to the possibilities still in front of us.

But at first, i t's almost certainly going to feel like one step forward, two steps back. That's okay. Bit by bit your mind will accept what's happened, and you'll discover new reserves of strength and resilience.

What you might be feeling:

  • A sense of "waking up" to the world around you.
  • Moments of surprising joy and satisfaction , followed by guilt: "How can I feel happy?"
  • New reserves of strength and determination: "I can get through this."
  • If you've lost your second parent, you may feel a sense of moving forward into a new phase of your life. Now you're the "older generation" in your family, which can feel scary and sad. But over time it may also feel freeing. Even if most of the time you're still very low, you'll start to see that there is a way past the grief .

What you might notice :

  • Things can seem funny again. Whereas a few months ago you avoided silly movies and didn't find jokes funny, now every once in a while something makes you laugh or smile.
  • A return to awareness: You notice the smell of roasting coffee or a friend's new scarf.
  • The rediscovery of old satisfactions: You might realize you want to resume knitting, start a new book, or rejoin a volunteer effort that used to be important to you.
  • At least for short periods, you feel like yourself again.

What to do:

  • Seek out experiences that feel meaningful. If seeing your grandchildren is the only thing that gets you out of bed in the morning, make as many dates as possible to spend time with them. If watching birds at the bird feeder lifts your spirits in midwinter, keep the feeder filled and perhaps invest in a bird guide and try to identify your winter visitors.
  • Fight "survivor's guilt." Don't feel bad about being happy. Life goes on, and we're meant to go on with it. If the moments are few and far between, notice them and seek out similar moments. Ask yourself what your loved one would have wished for you -- to see you in perpetual mourning or happy to see you rediscovering joy in life?
  • Give back to others. Many people, when grieving a loss, find solace in helping others. It can take you out of yourself and put things in perspective to help others in need. Volunteer in your community or at your place of worship, or offer to help a friend or neighbor who is going through a hard time.

Remember all the people who helped you through your loved one's last illness? There are others out there for whom you can perform the same valuable service, with a new depth of compassion and understanding.

Books to Read About Grieving

Calvin Trillin, About Alice (Random House, 2006). Trillin mourns the death of his wife, Alice.

Joan Didion, The Year of Magical Thinking (Knopf, 2005). Didion writes about the year that followed the loss of her husband, John Gregory Dunne.

Patricia Hampl, The Florist's Daughter (Harcourt, 2007). Hampl reflects on her life as a "dutiful daughter," taking care of her parents until their deaths.

David Rieff, Swimming in a Sea of Death (Simon & Schuster, 2008). Author Susan Sontag's son writes about her death from cancer .

Lee Montgomery, The Things Between Us (Free Press, 2007). Memoirist Lee Montgomery tackles her father's death from cancer and her mother's alcoholism, highlighting the complexity and importance of family relationships.

Ianthe Brautigan, You Can't Catch Death: A Daughter's Memoir (St. Martin's/Griffin, 2001). Author Richard Brautigan's daughter writes of his death by suicide with insight and compassion.


6 days ago, said...

To the one who lost your dad around Christmas: I lost both parents only a few months apart. There was very little conversation during Dad's final days, we also told each other "I love you". There was so much more to be said, not enough time. I know by the look in his eyes that all was forgiven for past differences between us. I still have the same feelings of regret and guilt that you may be feeling. I stop and ask God for strength to remember the good times and trust that Dad died peacefully because I was there. I will pray for you that you will find peace in your heart and mind. It takes time...a lot of time. My parents have been gone 7 years now and it seems like a dream, it's still not real to me.


6 days ago, said...

My Dad passed around Christmas at the end of last year and my life will never be the same. I'm experiencing the worst pain in my life because I feel like I didn't get closure with him. We were very close until about 17 years ago when he cheated on my Mother, divorced her and married somebody else. I never stopped loving him but because of his manipulative wife, our relationship was never the same again. He had been sick for about 15 years and towards the end of his life I started helping to take care of him until he passed away. We always said we loved one another but we never reached closure on things. I 'm going through all kinds of emotional feelings and most of the time it's depression. How do I deal with this? It's tearing me apart.


16 days ago, said...

It's Sunday and my mum passed in hospital on Friday aged 91 she had dementia and Alzheimer's and been in hospital for four weeks. Please help as I can't cry and don't feel any emotions I'm just really irritated by my husband who never shows me any love or empathy also doesn't touch me only asking occasionally if I'd like a hug and then it's not a proper hug. I feel as though I want to cry but just feel nothing-am I an awful person I'm nearly 70


24 days ago, said...

Sorry Lolo 2000, not LoL2000


24 days ago, said...

LOL 2000 What stands out the most is you must forgive yourself. You were trying to help your mother and that is known by her and God. So love yourself. Your Mom loves you and knows you love her. Would your Mom want you to be in pain forever over this? I also lost my caring husband about a month ago. I was his caretaker primarily and he had diabetes and things your Mom did. I LOST him after a weekend shopping spree I spent away from the hospital. I also blame myself yet there were many factors at play. My heart is always in pain. May God bless...Acts 2:38, Acts 22:16 Rev. 1:5


28 days ago, said...

Hi, I just lost my uncle and all I can feel is pain in my heart, I'm scared of the crying because I'm the type of person who holds it in until I burst. I know that it is recent but the whole day it rained and looked cloudy and if I do cry it will be when I'm in a class most likely. I miss him already. I used to tell myself when he was alive but sick that I he deserves to live and I don't and I still am telling myself this. I just want to know how to tell the deference between a dream and what real because this feels like a dream. I don't want to cry because of my family, they need me and I can't be weak, i need to be the strong one.


about 1 month ago, said...

Hello , like a lot of you reading this article I recently lost a parent , I lost my mom on may 6 2016 , I was 19 , it still hurts today and I still cry, I miss her and it seems like this grief won't stop . My mom was proud of me , especially the fact that I was a marine . I was discharged a month before she passed away, she was still proud of me for that little amount of time, she told me it happened for a reason, however the thought that she would die anytime soon was bizarre , and that day came , i wanted to call bullshit on life, I still dont understand yet why God took her , somedays I cry , somedays I'll take it out on myself, others I'll just lose all sense of time and not even notice that I'm alive . I recently got news that I want to tell her so bad , I wish she was here to hear it . I miss her and I've been crying all night thinking about it I just want out of the grief , I don't want to get lost in a bottle , I just want to show my wife that she makes me happy , and I just want to k ow how to make my mom proud of me still


about 1 month ago, said...

Lost my mom when I was 13 and never knew my father I'm 24 and the oldest of 3 so I had to be strong for my brothers. I still miss my mom I think about her every day , I feel like I'm stuck and can't move on.


about 1 month ago, said...

I lost my Mom almost a year ago. I was her caretaker even though she was really self sufficient. We looked after one another and were best friends my entire life. She had diabetes, high blood pressure, cholesterol, congestive heart failure and we had to watch her kidney function. She also had vascular dementia but not severe. I was so use to knowing what to do and what she needed or didn't... She always felt I could fix her. Well she started eating less and less until I literally saw her withering away before my eyes. I started to fight with her to eat which I didn't mean and regret but I wanted her to eat. To make it worse I panicked and took her to the ER and said she wasn't eating and had to be dehydrated. They gave her fluids I ran my son to get something to eat.... Came back to her in congestive heart failure. Then they gave her diuretics. This all took it's toal a damaged her heart more. I mean what was I tninking I know water equals congesti e heart failure. Then leaving to get my son food. I feel like I am responsible for her death. I cannot stop greiving or blaming myself. I miss her so much there are no words for my pain. I take depression and anxiety meds for grief but they do nothing as I do mot have a chemical imbalance. I don't know what to do or where to turn. I only have my 16 year old son and he is all that keeps me going at all. I go to work, function and take care of him and hide my pain as much as possible. Does anyone have any advice? I feel as though my grief is getting worse over time.


about 1 month ago, said...

KDeb39.....I am just coming up on the year anniversary of my father passing away, February 15th, 2016. Your words are stages I went through in the beginning. The only advice I can give is that it will get easier but it will always hurt. I am sorry your heart is heavy and broken. I agree with you that concentrating on the good times is extremely hard especially since they are not here to talk about it with. Talk to your mom in your heart. She sees you I promise you that. She was in pain as my father was and God needed them more than we did for the time being. She is proud of how strong you are trying to be. Proud of what a great daughter you were to her and a wonderful caring mother. Time...that is all I can tell you. Go through the stages of grief and don't fight it but instead try and accept it. I know it is hard. My heart breaks for you and your family but in time we will see them again.


about 1 month ago, said...

Hello to everyone. I just lost my mother to cancer 11 days ago and I'm struggling to get out of bed and perform my daily tasks and duties of being a mother and business owner. I feel guilty I'm not able to attend to my children as I always have and I feel absolutely defeated in pretty much every aspect of my life. My father passed away when I was 4 years old and my mom played the role of both parents over the years. Not a day went by that I didn't call my mom on the phone...she was my best friend. Everyone around me keeps telling me to focus on the good times and the many wonderful memories, but that pains me even more. The fact that she's no longer suffering brings me comfort, but it still leaves me shattered. I just wish someone could tell me how to hurt less and move on. I fear the future because that's more time I won't be able to talk to her, hug her, kiss her and be with her.


2 months ago, said...

Took care of my father for 3 years and my mother for 16 years. Both deaths were devastating. I think when you are the only caregiver and a son it is much worse. Took a year to get over my fathers death. Finally had to force myself to stop going over it in my mind. The What if, etc. were driving me insane. My mother died less then a year ago. Still can't shut off the What if? I believe men have a harder time with this. We are wired to protect, defend and problem solve. When we fail with a death to do this we find it hard to process - even knowing your parents are in a better place.