No, Grief Does Not Have Five Mandatory Stages

Denial. Anger. Bargaining. Depression. Acceptance.

Few psychological ideas have escaped the classroom as successfully as the “five stages of grief.” They appear in hospital pamphlets, therapy websites, self-help books, films, social media posts, workplace training, and casual conversation. Someone experiences a death, and almost automatically the question appears: What stage are they in?

The idea is so familiar that it can feel less like a psychological theory than a fact about human beings.

It is not.

Grieving people do not reliably move through five emotional stages in a fixed sequence. Some experience several of the emotions associated with the famous model. Some experience them repeatedly. Some experience them simultaneously. Some barely recognize themselves in the framework at all.

And none of those responses automatically means that someone is grieving incorrectly.

The five-stage model has an important place in the history of how medicine began listening to dying people. But over several decades, a nuanced set of clinical observations about death and dying was transformed into something much more rigid: a cultural script for how grief is supposedly meant to unfold.

Modern bereavement research tells a considerably messier—and considerably more humane—story.

Where did the five stages actually come from?

The model is associated with Swiss-American psychiatrist Elisabeth Kübler-Ross, whose landmark 1969 book On Death and Dying grew out of interdisciplinary seminars at the University of Chicago in which seriously ill patients spoke directly about their experiences with clinicians, students, and clergy.

That historical context matters.

Kübler-Ross was working during an era when dying patients were often excluded from conversations about their own prognosis and when death itself could be treated almost as a medical failure that should remain politely unmentioned. Her work helped make the experiences and emotional needs of dying patients legitimate subjects of clinical attention.

From her interviews and observations came the categories that would become famous: denial, anger, bargaining, depression, and acceptance.

But the tidy sequence most people now learn is not a particularly faithful summary of what she described.

The Elisabeth Kübler-Ross Foundation notes that the framework originated in conversations with people facing terminal illness and that Kübler-Ross described more emotional responses than the five labels that survived in popular culture. Her original diagram included overlapping and recurring experiences rather than five clean boxes through which a person marched one by one. The stages could overlap, recur, coexist, or be absent.

There is another historical correction worth making. You will sometimes see the myth debunked with the claim that Kübler-Ross never intended the stages to describe bereavement at all.

That goes too far.

On Death and Dying primarily concerned people confronting their own mortality, although it also discussed their families. And in 2005, Kübler-Ross and David Kessler explicitly applied the framework to bereavement in On Grief and Grieving.

The better correction is this:

The five stages did not begin as an empirically established, universal sequence that bereaved people must complete.

That is what popular culture made them into.

How a framework became a cultural script

The remarkable part of the five-stage story is not merely that the theory became famous. It is how far it traveled.

Sociologist John Bernau examined 3,216 citations of Kübler-Ross across the New York Times and the Web of Science academic database. His historical analysis found that early scientific interest, professional adoption, and commercial promotion helped institutionalize the model far beyond its original setting. Eventually, the stages were being applied not only to death but to everything from organizational change to economic events and COVID-19.

The model had several qualities that made it extraordinarily portable. Five categories are memorable. They provide vocabulary for difficult emotions. They turn chaos into structure. And perhaps most appealingly, they imply movement.

If there is a sequence, there is presumably somewhere to go next.

But psychological neatness is not the same thing as psychological accuracy.

In 2021, researchers Kate Anne Avis, Margaret Stroebe, and Henk Schut systematically examined 72 English-language websites offering information about grief. Forty-four—61.1 percent—presented the five-stage model. Many offered little critical discussion of its limitations and instead presented it in ways that could imply that these stages represent the normal or expected course of grieving.

The researchers identified an important consequence: people whose experiences do not resemble the model may conclude that they are grieving incorrectly.

That is where a descriptive framework can quietly become a prescription.

Instead of asking, What is this person experiencing? we start asking, Why haven’t they reached acceptance yet?

The research does not show one mandatory grief trajectory

Bereavement research has repeatedly found substantial individual variation.

People differ in the intensity of their grief, the emotions they experience, how those emotions change, how much they want to speak about the loss, how much daily functioning is disrupted, and how long particular reactions remain prominent.

The psychology textbook that prompted this article is unusually explicit on this point: people experiencing bereavement do not reliably pass through identical predictable stages, and reactions to comparable losses vary widely both between individuals and across cultural contexts (Myers et al., 2024).

That conclusion is consistent with decades of bereavement research.

In a landmark 1989 review, Camille Wortman and Roxane Cohen Silver examined several assumptions that had become embedded in theories of grief: that depression is inevitable, that severe distress is necessary, that people must “work through” a loss, and that failure to display these responses suggests something has gone wrong.

The available evidence did not support those assumptions. The authors warned that treating one particular response to loss as psychologically necessary ignores the enormous variability in human adaptation—and can lead other people to respond unhelpfully when a bereaved person fails to behave as expected.

Research following bereaved people over time has likewise revealed multiple trajectories rather than one grief pathway.

George Bonanno and colleagues followed 205 adults using data gathered before their spouse's death and again six and eighteen months afterward. They identified five different patterns, including chronic grief, more typical grief reactions, pre-existing depression, improvement following bereavement, and resilience. Notably, resilience was not a bizarre exception in their sample—it was the most common trajectory they identified.

This does not mean that grief is usually easy.

It means that severe visible distress is not the only legitimate evidence that someone loved deeply.

A person who remains able to work, laugh, socialize, care for children, or experience pleasure after a death is not necessarily “in denial.” A person who feels moments of relief is not necessarily avoiding grief. A person devastated months later has not necessarily “failed to move on.”

Human attachment does not produce one standardized emotional response.

But didn’t a study prove the five stages?

This is where the literature gets more interesting.

A widely cited 2007 study published in JAMA followed 233 bereaved adults and measured disbelief, yearning, anger, depression, and acceptance during the first 24 months after a natural death.

Some of the average patterns did peak in a sequence broadly compatible with stage theory: after statistical rescaling, disbelief declined first, yearning peaked around four months, anger around five months, and depression around six months, while acceptance increased over time.

The authors interpreted these findings as providing some support for a stage-like sequence.

But there are major reasons not to turn those results into a five-step rule for individuals.

First, the study examined average patterns across a group, not evidence that every individual person traveled through five discrete internal states in the same order.

Second, disbelief—the supposedly initial stage—was not actually the dominant initial response. Acceptance was the most frequently endorsed response throughout the study, while yearning was the most prominent negative grief indicator.

And third, measuring whether different emotional indicators tend to rise and fall at different points in a population is not the same thing as demonstrating that humans must complete psychologically distinct stages.

This distinction is central.

A population average can describe a trend without describing any one person's experience.

Later critical reviews have continued to caution health professionals against treating stage theory as a prescription. Stroebe, Schut, and Boerner argued in 2017 that the stage approach suffers from problems of empirical support, conceptual clarity, and explanatory power—and becomes particularly problematic when clinicians treat its supposed sequence as something grieving people ought to follow.

You do not have to “purge” your grief

The five-stage myth often travels alongside another idea: that painful emotions must be fully expressed before healing can occur.

Cry it out.

Talk about it.

Get it all out of your system.

If you do not, the grief will remain trapped somewhere inside you.

There are circumstances in which talking, crying, storytelling, rituals, support groups, psychotherapy, or simply being witnessed by another person can be enormously meaningful.

But that is different from claiming that emotional expression is a required psychological mechanism through which grief must be expelled.

Research does not support such a universal rule.

A major review by Wolfgang Stroebe, Henk Schut, and Margaret Stroebe examined social support, emotional disclosure, experimentally induced disclosure, and grief counseling. The evidence did not support the idea that emotional disclosure itself reliably accelerates adjustment in ordinary bereavement.

The PsyMosaïque source textbook makes the same point: people who display especially intense grief immediately after a death do not necessarily “purge” it faster. At the same time, it notes an important relational nuance—actively suppressing communication in order to protect a grieving partner can sometimes create difficulties.

Those findings are not contradictory.

They point toward a much more flexible principle:

People need permission to approach grief in ways that fit them—not instructions to emote more or emote less.

Some people need to tell the story fifty times.

Some want companionship without conversation.

Some cry constantly.

Some rarely cry.

Some need to look at photographs.

Some cannot look at them yet.

The absence of a dramatic outward reaction does not automatically reveal the absence of grief.

Grief may look less like a staircase and more like oscillation

One influential alternative is the Dual Process Model of Coping with Bereavement, developed by Margaret Stroebe and Henk Schut.

Rather than imagining grief as progress through a sequence, the model describes people as moving back and forth between two broad kinds of adaptation.

At some moments, attention is loss-oriented: missing the person, remembering them, confronting the death, crying, yearning, thinking about what happened.

At others, it becomes restoration-oriented: dealing with practical changes, assuming new responsibilities, building routines, engaging with work or relationships, learning how life functions now.

Crucially, the model includes oscillation between the two. People confront grief and then turn away from it. They engage with the loss and then take respite from it.

That respite is not necessarily avoidance in the pathological sense.

Sometimes it is part of coping.

Anyone who has experienced grief may recognize how psychologically realistic this sounds.

You can spend the morning crying over someone's clothes and the afternoon becoming furious about an electricity bill.

You can laugh with a friend and then be ambushed by a smell.

You can go several hours without consciously thinking about the death and then suddenly remember that the world is not the world you woke up in before it happened.

The emotional movement is not necessarily forward.

It is movement.

Grief can also involve rebuilding meaning

Another influential body of research focuses less on stages and more on meaning reconstruction.

Psychologist Robert Neimeyer has described bereavement as something that can disrupt a person's assumptions about their world, identity, relationships, future, and sense of how life is supposed to work—especially when a death is traumatic or premature.

Adaptation may therefore involve constructing or reconstructing meaning: making sense of what happened where possible, reshaping one's relationship with the person who died, and gradually reorganizing a life in which the physical relationship can no longer continue in its former form.

Again, this is not another compulsory stage.

Not every bereaved person needs to discover a profound lesson in death. Not every tragedy becomes meaningful. “Meaning-making” should not become another demand imposed on someone who is suffering.

The value of these newer models is precisely that they make room for process without demanding uniformity.

Does everyone who is grieving need therapy?

No.

And saying so is not anti-therapy.

Bereavement is one of the most painful experiences human beings routinely encounter, but painful does not automatically mean pathological.

A meta-analysis by Currier, Neimeyer, and Berman reviewed 61 controlled studies of psychotherapeutic interventions for bereaved people. Across everyone offered treatment, the average immediate benefit was relatively small and was not statistically significant at follow-up. But a very different picture appeared when researchers looked at interventions specifically targeting people who were experiencing substantial difficulty adapting to their loss: those treatments performed much more favorably.

That distinction has survived newer research.

A 2019 systematic review and meta-analysis of 31 randomized controlled trials found that psychological interventions produced significant reductions in grief symptoms overall, with larger effects in some groups—including participants recruited at least six months after the death and those entering treatment with higher levels of grief symptoms.

So the evidence does not say:

Therapy does nothing for grief.

It says something far more sensible:

Ordinary bereavement does not automatically require professional treatment, while people experiencing persistent, severe, or disabling grief can benefit from targeted intervention.

The American Psychological Association similarly notes that many people adapt to loss over time with social support and ordinary coping resources, and explicitly cautions against expecting everyone to pass through progressive grief stages.

When grief does become prolonged and disabling

Rejecting mandatory stages should never become another form of minimization.

Some people suffer enormously after bereavement.

For a minority, grief remains so intense, persistent, and functionally impairing that it falls outside what would ordinarily be expected within the person's social, cultural, and religious context.

Prolonged Grief Disorder (PGD) was formally included in the DSM-5-TR in 2022.

For adults, DSM-5-TR requires that at least 12 months have passed since the death. The disorder involves persistent separation distress—such as intense yearning or preoccupation with the deceased—along with additional symptoms and clinically significant impairment. Importantly, the diagnostic framework specifically requires clinicians to consider whether the severity and duration exceed relevant cultural, social, or religious norms.

The American Psychiatric Association emphasizes that for most people, grief symptoms diminish over time and do not require mental health treatment; evidence-based treatment is available for those whose grief remains severe and disabling.

That is a much better distinction than asking whether somebody has “reached acceptance.”

The clinically relevant question is not whether they followed the right emotional sequence.

It is whether they are suffering, how their grief is functioning in their life, what they need, and whether additional support might help.

Culture matters too

Even the idea of what grief is supposed to look like is culturally situated.

Cultures differ in mourning rituals, expectations around emotional expression, relationships with the dead, acceptable mourning periods, spiritual interpretations of death, funeral practices, and ideas about what constitutes healthy adaptation.

The source textbook notes a simple but crucial example: some cultures encourage conspicuous public mourning, while others place greater value on containing grief. Variation also exists enormously within cultures.

A psychological theory that mistakes one culturally familiar style of grieving for a universal human sequence risks doing exactly what psychology should avoid: converting a local norm into a law of human nature.

The DSM-5-TR's requirement that prolonged grief be evaluated relative to cultural, social, and religious expectations is an acknowledgment of precisely this problem.

So are the five stages completely useless?

Not necessarily.

There is a difference between a vocabulary and a law.

Someone may find the language of anger useful because it names an experience they could not articulate. Another person may recognize bargaining in their obsessive if only I had… thoughts. Someone confronting terminal illness may find parts of Kübler-Ross's framework deeply validating.

A model does not have to describe every person in order to give one person language.

The problem begins when we turn recognition into expectation.

When “you might experience anger” becomes “anger is stage two.”

When “acceptance may coexist with grief” becomes “you should eventually reach acceptance.”

When resilience becomes denial.

When recurring sadness becomes regression.

When someone begins measuring their grief against a diagram instead of experiencing the grief they actually have.

Research on online grief information suggests that this is not merely hypothetical: rigid presentations of the stages remain common enough that grief researchers have specifically warned about the possibility of people believing they are mourning incorrectly.

A map can be useful without being a route everyone is required to follow.

There is no test to pass

Grief does not need to unfold beautifully.

It does not need to proceed logically.

It does not need five acts.

You do not earn acceptance by completing anger. You do not fail bereavement because you laughed sooner than someone expected. You do not prove love by suffering visibly enough. You do not necessarily heal faster by expressing every feeling immediately, nor are you necessarily healthier because you remain composed.

And needing professional help does not mean that you have somehow grieved badly.

More than half a century after On Death and Dying, perhaps the most useful lesson to preserve from Kübler-Ross is not a five-word sequence at all.

It is the part of her work that helped transform medicine in the first place:

listen to the person who is actually having the experience.

Grief research has spent decades showing us why.

There is no single correct emotional itinerary after loss.

There are grieving people.

And they are not all going to take the same road.

References & further reading

• American Psychiatric Association. (2022). Prolonged grief disorder. DSM-5-TR educational materials. APA overview of Prolonged Grief Disorder

• American Psychological Association. (2020). Grief: Coping with the loss of your loved one. APA grief resource

• Avis, K. A., Stroebe, M., & Schut, H. (2021). Stages of grief portrayed on the internet: A systematic analysis and critical appraisal. Frontiers in Psychology, 12, 772696. doi:10.3389/fpsyg.2021.772696. Read the open-access study

• Bernau, J. A. (2024). The institutionalization of Kübler-Ross’s five-stage model of death and dying. OMEGA—Journal of Death and Dying, 90(1), 120–142. doi:10.1177/00302228221098893. Study abstract and publication details

• Bonanno, G. A., Wortman, C. B., Lehman, D. R., Tweed, R. G., Haring, M., Sonnega, J., Carr, D., & Nesse, R. M. (2002). Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology, 83(5), 1150–1164. doi:10.1037/0022-3514.83.5.1150. PubMed record

• Currier, J. M., Neimeyer, R. A., & Berman, J. S. (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: A comprehensive quantitative review. Psychological Bulletin, 134(5), 648–661. doi:10.1037/0033-2909.134.5.648. PubMed record

• Johannsen, M., Damholdt, M. F., Zachariae, R., Lundorff, M., Farver-Vestergaard, I., & O’Connor, M. (2019). Psychological interventions for grief in adults: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 253, 69–86. doi:10.1016/j.jad.2019.04.065. PubMed record

• Kübler-Ross, E. (1969). On death and dying. Macmillan.

• Kübler-Ross, E., & Kessler, D. (2005). On grief and grieving: Finding the meaning of grief through the five stages of loss. Scribner. Publication record

• Maciejewski, P. K., Zhang, B., Block, S. D., & Prigerson, H. G. (2007). An empirical examination of the stage theory of grief. JAMA, 297(7), 716–723. doi:10.1001/jama.297.7.716. Read the JAMA study

• Myers, D. G., DeWall, C. N., & Gruber, J. (2024). Psychology (14th ed.). Macmillan Learning. Chapter 5, Module 17.

• Neimeyer, R. A. (2019). Meaning reconstruction in bereavement: Development of a research program. Death Studies, 43(2), 79–91. doi:10.1080/07481187.2018.1456620. Article abstract and publication details

• Stroebe, M. S., & Schut, H. A. W. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–224. doi:10.1080/074811899201046. PubMed record

• Stroebe, M., Schut, H., & Boerner, K. (2017). Cautioning health-care professionals: Bereaved persons are misguided through the stages of grief. OMEGA—Journal of Death and Dying, 74(4), 455–473. doi:10.1177/0030222817691870. Read the open-access paper

• Stroebe, W., Schut, H., & Stroebe, M. S. (2005). Grief work, disclosure and counseling: Do they help the bereaved? Clinical Psychology Review, 25(4), 395–414. doi:10.1016/j.cpr.2005.01.004. PubMed record

• Wortman, C. B., & Silver, R. C. (1989). The myths of coping with loss. Journal of Consulting and Clinical Psychology, 57(3), 349–357. doi:10.1037/0022-006X.57.3.349. APA publication record