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Grief counseling

The five stages of grief were identified by psychiatrist Elisabeth Kubler-Ross in 1969 in her groundbreaking book On Death and Dying. Her theory explained the process of grief over five distinct, linear stages: denial, anger, bargaining, depression, acceptance. Kubler-Ross’s work was revolutionary. It acknowledged that grief is a normal emotional process, which helped reduce the stigma associated with grieving. However, Kubler-Ross’s research was done with patients who were dying of a terminal illness which gave the impression that grief was a linear process — where one step had to follow another. This became problematic as the grief experienced by the survivors of loss is unique. People move in and out of the stages of grief in varying ways and time frames. The idea that someone was not grieving “correctly” was confusing and painful.

Dr. Kubler-Ross later regretted the misunderstanding of her original work and revised her 5-stage model to a 7-stage grieving process. The stages of shock and testing were added so that the complete process consisted of shock, denial, anger, bargaining, depression, testing, and acceptance. Shock describes an initial response of emotional paralysis, or numbness, and the testing stage involves trying new ways of coping with the loss and rebuilding life after loss.

There is no “getting over” loss but there is a gradual process of acceptance that is complex and individual. Many find it helpful to think of grief stages in broader ways like shock, suffering, and recovery, which normalizes the human experience with room for a wide range of individual experiences.

Talking with a mental health professional about loss and grieving can be helpful in many ways. Some mental health professionals specialize in the grieving and bereavement process which can be useful when coping with a traumatic or complicated loss. Since grieving is a normal part of the human condition, most therapists are equipped and skilled to help their clients navigate their individual grieving process.

Some people may experience “complicated grief” during which they feel stuck in persistent, unrelenting despair and functional impairment that warrants seeking help from a mental health professional. If someone has the following symptoms in a prolonged manner they may be experiencing what’s known as Persistent Complex Bereavement Disorder:

• Intense sadness and emotional pain
• Feelings of emptiness and hopelessness
• Yearning to be reunited with the deceased
• Preoccupation with the deceased or with the circumstances of the death
• Difficulty engaging in happy memories of the lost person
• Avoidance of reminders of the deceased
• A reduced sense of identity
• Detachment and isolation from surviving friends and family
• Lack of desire to pursue personal interests or plans

The symptoms listed above are consistent with and mimic a Major Depressive Disorder which may require clinical intervention in order for the healthy grieving process to resume.