The Five Stages of Grief: What the Model Gets Right and Wrong

Almost everyone has heard of the five stages of grief. Many grieving people measure themselves against them and worry: no anger yet, or acceptance one week and disbelief the next.

If that is you, the short version is that nothing is wrong with how you are grieving. The longer version is a useful piece of history.

Where did the five stages come from?

Elisabeth Kübler-Ross set out the stages in her book On Death and Dying, first published in 1969. The National Cancer Institute (NCI) says the model "was developed for medical student education and used a series of clinical interviews with terminally ill patients." The stages were denial, anger, bargaining, depression and acceptance.

So the model began with people facing their own deaths. The Elisabeth Kübler-Ross Foundation explains how it spread: "Because families went through the same responses, the language moved into bereavement." It would be too strong to say this was someone else's mistake. Researchers Margaret Stroebe, Henk Schut and Kathrin Boerner point out that Kübler-Ross herself applied the stages to family members in the 1969 book, and her 2005 book with David Kessler, On Grief and Grieving, applied them to the bereaved.

What did the authors say about the stages later?

In the 2005 book, Kübler-Ross and Kessler wrote that the stages "have been very misunderstood over the past three decades. They were never meant to tuck messy emotions into neat packages." They went on: "there is not a typical response to loss, as there is no typical loss. Our grief is as individual as our lives."

Kessler's website says the same thing today. The stages "are not stops on some linear timeline in grief," and "Not everyone goes through all of them or in a prescribed order." The foundation that carries Kübler-Ross's name calls them "a clinical vocabulary, descriptive rather than prescriptive," and adds that they "were never a checklist or a timetable."

What did research find?

One test is the Yale Bereavement Study, published in JAMA in 2007. Researchers followed 233 bereaved people in Connecticut, all after deaths from natural causes, from 1 to 24 months after the loss. The results cut both ways.

Against the stage idea, disbelief was not the main early reaction. Acceptance was the most common response from the first month onward, and yearning, not depression, was the strongest painful one throughout. In partial support of it, when the researchers rescaled the five reactions, each peaked in the predicted order: disbelief at 1 month, yearning at 4, anger at 5 and depression at 6, with acceptance rising the whole time. This was one study of one group of people, so it neither proves nor disproves the model.

A 2017 critical review by Stroebe, Schut and Boerner was blunter. Their concerns included "the absence of sound empirical evidence, conceptual clarity, or explanatory potential," and they argued that stage theory should be discarded. The NCI's own summary is that the model "has limited empirical support."

What does the model get right, and what does it get wrong?

What it gets right is the reactions themselves. Disbelief, anger and deep sadness all appear on current lists of common grief reactions, and acceptance was the most common response in the Yale study. Some readers still find the vocabulary a comfort. MedlinePlus, from the National Institutes of Health, still describes grief with the five stages, with the caution that the reactions "might not occur in a specific order, and can occur together. Not everyone experiences all of these emotions."

What goes wrong is the idea of a sequence that everyone passes through and then finishes. The NCI puts the current view this way: "while there may be phases or domains of grief, there is not a preestablished linear process through which an individual moves to resolve the grief."

That matters because expectations can hurt. Stroebe and her colleagues warn that the belief that bereaved people will, or even should, go through stages "can be harmful to those who do not." A person who never feels angry, or who feels acceptance and yearning on the same afternoon, can end up believing they are grieving badly.

What models do clinicians use now?

Researchers and clinicians have proposed several other ways of describing grief. None of them is a timetable either.

• The dual process model (Margaret Stroebe and Henk Schut, 1999). Grieving people face two kinds of stress: the loss itself, and the work of rebuilding daily life. The model describes "oscillation," in which a person at times confronts these and at other times avoids them, and it treats taking a break from grief as part of healthy coping.
• The four tasks of mourning (J. William Worden). In the fifth edition of his handbook (2018) they are "to accept the reality of the loss; to process the pain of grief; to adjust to a world without the deceased; and to find a way to remember the deceased while embarking on the rest of one's journey through life." The NCI notes that the tasks can occur in any order.
• Continuing bonds (Dennis Klass, Phyllis Silverman and Steven Nickman, 1996). Their book challenged the older view that the purpose of grief is to cut ties with the person who died.
• Growing around grief (Lois Tonkin, 1996). The idea, in general terms, is that grief may not shrink, and that a person's life grows around it.
• Meaning. Robert A. Neimeyer edited a 2001 book on meaning reconstruction after loss, and NIH News in Health reports that researchers such as Wendy Lichtenthal of Memorial Sloan Kettering "have found that finding meaning in life after loss can help you adapt."

Researchers led by M. Katherine Shear describe where most people arrive as "integrated grief," a state in which the person "is able to reengage with everyday activities and find interest or pleasure." The loss is still part of them.

What if your grief does not fit any model?

Then you are in good company, and you do not need to fix it. Most bereaved people adjust without professional help. A model is only useful if it helps you feel less alone or gives you words for something.

If you do want to talk with someone, it is reasonable to ask how they think about grief. In her grief and loss therapy, Dr. Rabin does not work from a fixed number of stages or a scripted set of techniques. Her approach is psychodynamic and attachment-based, and the focus is on what this particular loss means to you and how it connects to your history. For a wider view of what grief can involve, see What Does Grief Feel Like? For further reading, including Kessler's later book, see the list of books on grief.

Keep reading

• Do I Need Grief Therapy?
• Types of Grief Therapy and What the Research Says
• Grief vs. Depression: How to Tell the Difference
• All grief and loss guides

Sources

• National Cancer Institute, Grief, Bereavement, and Coping With Loss (PDQ), Health Professional Version (2024)
• Maciejewski, Zhang, Block and Prigerson, An empirical examination of the stage theory of grief, JAMA (2007)
• Stroebe, Schut and Boerner, Cautioning Health-Care Professionals: Bereaved Persons Are Misguided Through the Stages of Grief, Omega (2017)
• Elisabeth Kübler-Ross Foundation, 5 Stages of Grief
• David Kessler (grief.com), The Five Stages of Grief
• Stroebe and Schut, The dual process model of coping with bereavement: rationale and description, Death Studies (1999)
• Worden, Understanding the Mourning Process, chapter 2 of Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner, fifth edition (2018)
• MedlinePlus Medical Encyclopedia (National Institutes of Health), Grief (2026)
• NIH News in Health, Coping With Grief: Life After Loss (2017)

Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis, call or text 988, or call 911 in an emergency.