What Are the Six Stages of Grief? Where They Came From and What They Miss

The six stages of grief are denial, anger, bargaining, depression, acceptance and finding meaning. The first five come from Elisabeth Kübler-Ross's 1969 book On Death and Dying, which described people facing their own deaths, and David Kessler, her later co-author, added meaning as a sixth stage in 2019.

If you have been waiting to reach acceptance, or worrying that you skipped a stage, nothing has gone wrong. The Elisabeth Kübler-Ross Foundation says she never meant the stages as a rigid sequence, and grief researchers have questioned the evidence for them.

Where Did the Five Stages of Grief Come From?

They started with dying patients, not with mourners. According to the Elisabeth Kübler-Ross Foundation, On Death and Dying, first published in 1969, came out of interdisciplinary seminars at the University of Chicago, where she invited seriously ill patients to speak directly with medical students, clergy and clinicians. The Foundation names the five stages as denial, anger, bargaining, depression and acceptance. Kessler's site, grief.com, says they later adapted those stages from dying to grieving in On Grief and Grieving.

The Foundation says her model evolved between 1968 and 1974, and that she also described shock, anxiety, hope, guilt, numbness and relief. People could move back and forth, skip stages or feel several at once, and the Foundation says the stages were "intended as a clinical vocabulary, not a checklist or timetable". Kessler's site likewise says not everyone goes through all of them, or in a prescribed order.

What Is the Sixth Stage of Grief?

The sixth stage is meaning. Kessler introduced it in Finding Meaning: The Sixth Stage of Grief, published by Scribner in November 2019. His publisher credits both decades of work with grieving people and his own loss after the sudden death of his twenty-one-year-old son. Kessler also writes that meaning does not go around the pain of losing someone but comes through it.

It is an idea from a book, not a stage research has tested. Davis, Wortman, Lehman and Silver (Death Studies, 2000) studied one hundred and twenty-four parents whose infant had died and ninety-three adults whose spouse or child died in a crash. Fewer than half in each group reported finding any meaning more than a year after the loss, and some who did not search for meaning still seemed well adjusted. Neither is a sign that a loss is being handled badly. See also our guide to Man's Search for Meaning.

Do the Six Stages of Grief Happen in Order?

Not as a fixed sequence. HealthLink BC says grieving does not happen step by step, that there is no normal or expected length of time for it, and that despair and relief about the same death can sit together.

What Did the Yale Bereavement Study Find?

A 2007 JAMA study by Maciejewski, Zhang, Block and Prigerson (abstract on PubMed) tested the stages directly, measuring disbelief, yearning, anger, depression and acceptance in two hundred and thirty-three people in Connecticut whose close person had died, one to twenty-four months afterwards.

In the raw scores, disbelief was not the main early response: acceptance was endorsed more than any other indicator from the first month onward, and yearning was the dominant negative response. The authors reported peaks in the predicted order only after rescaling each indicator onto one scale, and concluded on that basis that they had identified normal stages of grief after a death from natural causes.

Their models used one randomly chosen observation per person rather than following each person over time. The study excluded fifty-eight people with complicated grief — grief that stays intense and keeps disrupting daily life — and nineteen whose loved one died a traumatic death, so every death was from natural causes.

In a letter to JAMA, George Bonanno and Kathrin Boerner wrote that little research evidence supports grief moving through set stages, and that even with this study there is no solid empirical support for stage theory. None of this predicts how your own grief will go.

Why Can Expecting Stages Make Grief Harder?

Stroebe, Schut and Boerner argue that stage theory lacks sound evidence and conceptual clarity and does not identify who is at risk (Omega, 2017). They warn that expecting grieving people to move through stages can harm those who do not, and argue it should be discarded in favour of models that better represent grieving.

A model like this can turn into a scorecard. If you have not cried yet, you may wonder whether you loved enough. If anger comes back after a calmer stretch, you may think you have gone backwards. Neither is evidence of grieving wrongly.

If Not Stages, How Do Researchers Describe Grief?

The Dual Process Model

The dual process model, from Stroebe and Schut (Death Studies, 1999), describes grieving as movement between loss-oriented and restoration-oriented stress: in plain terms, the death itself and the life changes that follow. The model calls that back-and-forth oscillation — a grieving person faces these demands and then sets them aside — and treats taking breaks from both as coping. It is a framework, not settled fact: in a 2010 review its authors set out how it still needs rigorous testing.

Continuing Bonds

For much of the twentieth century, letting go of the person who died was treated as grieving's goal. Continuing Bonds: New Understandings of Grief (1996), edited by Klass, Silverman and Nickman, set that expectation against evidence that an ongoing inner connection can belong to grieving too. That is not a rule either: a 2005 review by Stroebe and Schut concluded that neither keeping nor relinquishing bonds can be called helpful across the board.

How Do Faith Traditions Mark Mourning?

The US National Cancer Institute's clinician summary separates grief, the emotional reaction to a death, from mourning, its public display (NCI PDQ). What follows describes texts and institutions, not rulings, and it is two examples rather than a survey. Other faiths, cultures and families, including families with no religion, mark a death in their own ways, practice varies between schools and churches, and what your faith asks of you belongs with your own imam, scholar, priest or pastor.

In Islam. Sahih al-Bukhari 1303 records the Prophet Muhammad (peace be upon him) weeping as his son Ibrahim was dying, and calling his tears mercy. The mourning periods in the texts describe iḥdād, outward observance such as setting aside perfume and adornment, rather than a deadline on sorrow. Sahih al-Bukhari 5334 narrates no more than three days for a woman mourning anyone other than her husband, and four months and ten days when a husband dies. Qur'an 2:234 names that same span as a widow's ʿiddah, her waiting period, which is not the same thing as iḥdād. The Islamic Institute of Toronto writes that iḥdād is not a suspension of ordinary life.

In Christianity. The United States Conference of Catholic Bishops describes Catholic funeral rites in three parts — the vigil or wake, the funeral liturgy and the committal — and says the Church believes death does not break the bonds formed in life. The Greek Orthodox Archdiocese of America describes memorial prayers on the fortieth day and through the first year. See also our guide to A Grief Observed, C. S. Lewis's record of grief and doubt.

When Does Grief Need More Support?

No score or date decides it. If grief is getting in the way of daily life, a grief counsellor or your doctor can help you look at what's happening. The Canadian Mental Health Association notes that grief can be more complicated when a loss was sudden, frightening, or the result of an accident, disaster or crime. If you lost someone to suicide or an overdose, you can say that plainly to a counsellor or doctor; it does not need to be softened first.

No calendar decides it either: the mourning periods a faith marks are outward observances, and reaching the end of one does not mean grief should have stopped. Prolonged grief disorder was added to the American Psychiatric Association's diagnostic manual, the DSM-5-TR, in March 2022. It is assessed by a health professional who knows your situation, not worked out from a date; our grief counselling page explains it further. TEO's clinicians do not diagnose, screen or assess; that conversation belongs with a family doctor, nurse practitioner or psychologist.

If grief has brought thoughts of ending your life, call or text 9-8-8 (Canada, 24/7).

How Can You Help Someone Who Is Grieving?

Let them set the pace, and keep showing up. These draw on HealthLink BC, Canadian Virtual Hospice and the Canadian Mental Health Association, as guidance rather than rules.

• →Let grief take its own course. It does not move in steps, so avoid hinting they should be further along.
• →Offer to listen when you don't know what to say. Listen without judging, and respect beliefs that differ from yours.
• →Talk about the person and the death. Canadian Virtual Hospice suggests using the word death rather than softer substitutes, and sharing a specific memory. Ask what they need.
• →Watch how familiar comfort lines land. Phrases such as "at least they're not suffering anymore" or "I know how you feel", and sentences starting with "you should", can come across as shrinking the loss. Words from a faith you share can comfort or can close the subject; the question is whether they are said instead of listening.
• →Offer something concrete, only if you will follow through. Babysitting, a walk together, or frozen meals with reheating instructions.
• →Keep the door open. Some people appreciate regular contact through the first year and beyond, especially around the anniversary, holidays and birthdays. Let them know the invitation stands without needing an answer, take a no at face value, and know it is never too late to send a card.

If they talk about wanting to die, ask them directly whether they are thinking about ending their life, and stay with them. Offer to call or text 9-8-8 (Canada, 24/7) together. If they are in immediate danger, call 911.

How Does Grief Counselling Work at TEO?

TEO Counselling works online, by video, with clients in British Columbia, Ontario, Alberta, Saskatchewan, Manitoba, and Newfoundland and Labrador. Rola Shbib, Registered Social Worker, RSW (Ontario) #866715, leads grief work and sees clients in English in all six provinces; she took an honours degree in thanatology — the study of death, dying and bereavement. For grief counselling in Arabic, Mohamad Shabib, MACP, CCC, a Registered Psychotherapist (Qualifying) with the CRPO (Ontario), works with clients in all six provinces.

Grief counselling at TEO does not sort grief into stages or promise when it will ease. Sessions can make room for questions of meaning or faith, at a pace you set, but they do not give religious rulings; what your tradition requires stays with a leader or scholar in it. TEO does not run grief support groups, diagnose or prescribe.

Individual sessions are $150 and couples sessions $175, each 60 minutes, and no referral is needed. The first step is a free 15-minute consultation by video or a scheduled phone call, booked online. TEO's free Grief Toolkit is a printable you can use in the meantime.

Book a free consultation, or text (519) 760-5211 with a question first, including if you would like to start with Rola. This text line is not a crisis service.