Grief is one of the most overwhelming and difficult types of pain to experience. It is defined as a “deep sorrow, especially that caused by someone’s death” and can be brought on by many events, such as a death, miscarriage, serious illness, job loss, etc. Grief is often marked by finality or irreversibility which adds to its complexity.
In 1969, Elizabeth Kübler-Ross in “On Death and Dying” wrote that grief could be divided into five stages: denial, anger, bargaining, depression, and acceptance. It’s a popular model that most people have at least heard of. At the same time, it is also criticized for lack of empirical research and evidence. I am adding a disclaimer that Its helpfulness in the grieving process is debated.
In this post, I will break down the five stages and a new one added in 2019, explain what they are and what some of them may sound like, and how they can be used to practice mindfulness in grief to process your pain and hopefully reduce and/or prevent unnecessary suffering.
Denial
Denial occurs as a defense mechanism against the first wave of pain, similar to how shock after an accident or injury can protect you from feeling physical pain.
It can sound like:
Actually, I may have misunderstood the news.
Maybe they got the wrong person.
This isn't real.
Am I dreaming?
Anger
Anger is a way to connect with the pain in a way that feels less vulnerable. People feel anger towards themselves, their loved ones, doctors, even the person who has passed and/or those close to them.
These are some examples.
Why didn’t s/he tell me? `
S/he was selfish to not think of how this impacts others.
Why didn’t I do anything (or do more)?
This isn’t fair.
They should have known! They were so close to the situation. Why didn't they do anything to help, or let others know so they could help?
Bargaining
Bargaining is a way to hold onto hope and/or push away feelings of powerlessness. This can come in the form of “what if” questions that try to change the course of events, even though often, the event that caused the pain has already occurred.
Such thoughts can include:
I promise to be better if this isn’t really happening.
What if I just reached out sooner? It could have made a difference.
Depression
Depression occurs as you face the pain and feel its effects. It can feel like deep sadness, crying, feeling incomplete, empty, or simply not whole (as though you've lost a part of yourself). It can feel overwhelming and intense, or like a dull but all-encompassing numbness. It can affect your appetite, energy, and/or interests.
Acceptance
Acceptance occurs as you acknowledge the loss experienced, what it means for your life, and how you will "move on." Understand that this doesn’t mean you are over the loss or event, but that you have accepted it as a part of your life and experience.
Finding or Making Meaning
David Kessler in “Finding Meaning: The Sixth Stage of Grief,” writes that “meaning comes through finding a way to sustain your love for the person after their death while you’re moving forward with your life. Loss is simply what happens to you in life. Meaning is what you make happen.”
To find or make meaning is not “everything happens for a reason.” Instead, it is a way to honor the person (or event) in a way that helps you process your grief. It is helpful to those who can’t move on without doing more, or don’t feel right continuing on as if nothing has happened.
This can come in many forms, such as:
Reconnecting with someone you’ve lost touch with.
Hugging your loved ones a little tighter.
Slowing down to enjoy small moments in your day.
Pursuing a passion in your own life.
Contributing to a cause that s/he cared about in his/her honor.
Additional notes on the 5+1 stages of grief
People will process grief differently. Some people may experience all of the stages, and others some or none.
The process is not linear. Some may be short-lived, while others drag on. You may bounce back and forth between them. And you could feel as though you are experiencing more than one stage at a time.
This is only a model. This may be your experience or may not be at all. It may be very helpful, completely unhelpful, or somewhere in the middle. There are others to look into, or you can always develop your own model or process.
Mindfulness in grief
By knowing the stages of grief, you can use mindfulness exercises to acknowledge and understand your thoughts. The thoughts that correlate with these stages are a means of protecting yourself from pain. Giving these thoughts undue meaning can lead to unnecessary suffering. Mindfulness can be a way to process grief in a way that acknowledges and honors your loss without adding to your suffering. Here are ways you can be mindful in your grief.
Notice when you are having grief thoughts. You can give them labels--ones associated with grief stages or ones that you make up yourself. This allows you to better notice and acknowledge your thoughts, without spiraling into judging yourself for having them, trying to figure out whether they are true, or trying to convince yourself they are true or false. This can be as simple as “I notice that I am having a what-if thought. It is part of bargaining.”
Give your thought space. Breathe with it. Know that It can exist without hurting you, or otherwise impacting you. The thought bubbles or lazy river exercises can help you with this. You can breathe normally; 3-3-3 breathe (3 second inhale, 3 second hold, and 3 second exhale); or you can use a breathing app like https://mindfulbreathing.app/.
Ask yourself: Does this thought need my attention or action at this time? Can I set it aside to engage with later, if needed? Do I just want to sit with it now? Answer yourself rationally and without judgement.
If you feel anxiety or another emotion building, try these exercises for grounding.
S.T.O.P.: Stop; Take a few slow breaths; Observe what is going on in your body (sensations), emotions (feelings), mind (thoughts); and Proceed with what you were doing but with awareness and intention.
5-4-3-2-1: Use your senses to list things you notice around you. List 5 things you see, 4 things you hear, 3 things you smell, 2 things you taste, and 1 thing you can touch.
If you feel like crying at a time you don’t want to cry, begin subtracting 7s starting from 100. This exercise is from Moody Bitches by Julie Holland M.D. and helps shift from emotional to logical thinking by activating different parts of the brain for the moment. This can also help if you have trouble sleeping because you get caught up in emotional thoughts.
Give yourself time and space to grieve. Don’t suppress your feelings, thoughts, or emotions, and don’t judge them. There is no need. If you feel like crying, cry. If you feel like laughing, laugh. You do not need to portray a grieving person as others may imagine one. Allow yourself to grieve in the way that you feel honors your experience best.
Closing thoughts
If you are here because you’ve experienced loss, please know that I am truly sorry. I understand that it is a deep pain and almost nothing anyone can say or do can truly help. I hope the information in this post helps you to lessen the hurt, even if only temporarily, and guides you away from suffering because you cannot change what has happened. I hope that the severity of your pain is dulled with time, even if it may feel now like that could never happen. I hope that you can find your own form of acceptance and meaning in the time and space that you need.
This, unsurprisingly, has described my last few days nearly to a T. I particularly like what you mentioned here:
There have been many times where I felt guilty that I should be acting a certain way throughout my grieving. Crying too much ("she's an adult, can't she hold herself together?"), feeling like I'm taking too much time ("yes it's sad what happened to her but does she really need to take the time off work? Someone else just lost a loved one and they're already back to work."), or that I'm recovering too fast ("she's laughing, she must not have cared about them that much."). I…