How Grief Works—And Why It Rarely Follows a Neat Path

The Origins of the Stage Model — and Where It Falls Short

Most people have encountered the five stages of grief: denial, anger, bargaining, depression, and acceptance. Introduced by psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying, the framework emerged from her work with terminally ill patients describing their own anticipated deaths — not from observations of bereaved survivors.

Over decades, the model was broadly applied to grief in general, often in ways Kübler-Ross herself later cautioned against. The stages were never intended as a strict sequence that every person passes through in order. Yet that misreading became culturally dominant, leaving many grieving people feeling they were doing it wrong when their experience didn't match the script.

Contemporary grief researchers, including psychologist George Bonanno, have found that people show remarkable variability in how they respond to loss. Bonanno's longitudinal studies found that a substantial portion of bereaved individuals demonstrate resilience — they experience grief without being incapacitated by it — while others follow trajectories of chronic grief, recovery, or delayed grief. No single path is universal.

“Grief is not a disorder, a disease, or a sign of weakness. It is the price of commitment. For as surely as commitment is the highest expression of human possibility, grief is the ultimate price we pay for that commitment.”

— George A. Bonanno, Professor of Clinical Psychology, Columbia University; researcher on human resilience and grief

What Grief Actually Looks Like

Grief is not a single emotion. It is better understood as a cluster of responses that can shift rapidly and unpredictably. On any given day, a person might feel deep sadness, then laugh at a memory, then feel guilt for laughing, then feel nothing at all. This oscillation is normal and expected.

Researchers William Worden and Margaret Stroebe have each contributed models that describe grief as involving ongoing tasks or processes rather than fixed stages — things like adjusting to a changed world, maintaining a continuing bond with the person lost, and rebuilding a sense of meaning. These frameworks treat grief as active and adaptive rather than passive and sequential.

Grief also has a physical dimension that is often underappreciated. Studies have documented that bereavement is associated with disrupted sleep, appetite changes, fatigue, reduced immune function, and even elevated cardiovascular risk in older adults in the period following loss. Recognizing these physical effects helps explain why grief can feel so exhausting.

Factors That Shape How We Grieve

No two people grieve identically, even within the same family mourning the same loss. Several factors influence the experience:

• Nature of the relationship: The closeness, complexity, and history of the bond with the deceased shapes the grief response. Ambivalent or strained relationships can make grief especially complicated.
• Type of loss: Sudden, traumatic deaths — accidents, suicide, homicide — often involve additional layers of shock and, for some, trauma symptoms alongside grief.
• Social support: Access to a supportive community is consistently associated with better adaptation to loss in research literature.
• Cultural and religious context: Mourning rituals, beliefs about death and the afterlife, and community norms around emotional expression all influence how grief is experienced and expressed.
• Prior mental health history: A history of depression or anxiety can interact with grief, sometimes complicating the process.

When to Seek Support

Most people adapt to loss over time, supported by relationships, community, and their own inner resources. But there are circumstances where professional help is appropriate and beneficial.

Prolonged grief disorder — recognized in the DSM-5-TR and ICD-11 — involves persistent, intense grief that disrupts functioning beyond what would typically be expected. Symptoms may include an inability to accept the loss, difficulty engaging in daily activities, feelings of meaninglessness, and deep yearning that doesn't ease with time. Evidence-based therapies, including Complicated Grief Treatment developed by researchers at Columbia University, have been shown to help.

If grief is accompanied by thoughts of suicide, self-harm, or severe depression, professional support should be sought promptly. In the United States, the 988 Suicide and Crisis Lifeline provides confidential support by call or text.

For most people navigating ordinary grief, connection — talking with trusted friends or family, joining a grief support group, or working with a counselor — can make a meaningful difference. There is no obligation to grieve alone.

This article is for general informational and educational purposes only and is not a substitute for professional mental health advice, diagnosis, or treatment. If you are experiencing grief or a mental health crisis, please consult a qualified healthcare or mental health professional.