The Stages of Grief
Grief is a universal experience yet a deeply personal reality. It is an invisible suffering that deeply impacts the health of individuals, communities and societal understanding (Bellet et al., 2018). The process of grief has been commonly conceptualised through the five stages of grief by Elisabeth Kubler-Ross and David Kessler. The five stages include denial, anger, bargaining, depression and acceptance (Corr, 2015). Kessler built on initial grief stages and added a sixth stage, finding meaning (Kessler, 2019). It is necessary to note that Kubler-Ross and Kessler intended these stages to normalise the process of grief as common emotions surface. All three practitioners hold a common thread in reiterating that grief is not a linear progression but is a continual process (Kessler, 2019). Despite their efforts to provide descriptive stages, these five stages have been too broadly applied in prescriptive measures.
The biomedical response to grief often pathologises and categorises and is narrow in its response (Beddoe & Maidment, 2014). This can insufficiently address an individual's needs and minimise one's experience. Grief is an undeniably unique experience that can demand our life to come to a pause in an instantaneous moment. The grieving process is multidimensional, inclusive of both negative and positive aspects (Gordon, 2013). A holistic understanding of the complexity, diversity and changing nature of grief has to be adopted to efficiently support the personal experience of grief (Gordon, 2013).
The negative aspects considered addressing grief predominately surround those that are physical and psychological. Physical expressions of grief can include exhaustion, insomnia and anhedonia whilst the psychological effects can range from anger, anxiety, and depression (Gordon, 2013). Neglected from acknowledgment are social issues that may follow such as withdrawal, which can lead to isolation, concluding in a sense of alienation. Spiritual ramifications can include a loss of purpose, meaninglessness, anger at a higher power or challenge previously held beliefs and worldviews (Gordon, 2013). This process can contain a spectrum of difficulties including mood dysregulation, impaired concentration, a disorientated sense of self and hopelessness. Simple and insignificant day to day activities can become an arduous task while processing grief (Currier et al., 2015).
It is vital to hold space for people’s emotions to be fully expressed in the process of the five stages. Kessler’s sixth stage of finding meaning aligns with the value of centralising personal discovery of their experience and making meaning in the context of their own cultural relevance. Neimeyer’s reconstruction theory supports that humans are able to construct the stories we tell ourselves and to others. Constructivism enables the maintenance of meaningful self-narratives which serves to re-establish our sense of self in grief which is key to sustaining healthy mental health (Neimeyer, 2010).