The concept of the “stages of grief” has gradually evolved into one of the most widely recognised frameworks within modern psychology.
Developed to help rationalise and interpret the emotional experience of grief, the model was first introduced by psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying. In this, Kübler-Ross proposed that individuals confronting death, whether their own mortality or the loss of others, often experience a sequence of emotional responses as they process the reality of bereavement.
Kübler-Ross initially identified five stages within this process: denial, anger, bargaining, depression, and acceptance. These stages were intended to describe common emotional patterns observed among patients facing terminal illness. Over time, however, subsequent interpretations and adaptations of the model have expanded upon the original framework. In some modern versions, two additional phases: shock and testing, have been incorporated, resulting in the popularly referenced “seven stages of grief”.
Despite the model’s widespread cultural influence and accessibility, closer academic scrutiny has revealed several limitations in Kübler-Ross’ original formulation. Critics argue that the stages were derived primarily from clinical observations rather than systematic empirical research, raising questions about their scientific validity.
Furthermore, contemporary psychological studies suggest that grief does not necessarily follow a fixed or universal sequence of emotional states. Instead, bereavement often manifests as a highly individualised and dynamic process shaped by personal, social, and cultural factors.
Consequently, while the “stages of grief” framework remains a powerful holistic for understanding emotional responses to loss, its scientific grounding continues to be debated. This raises an important question: to what extent does the concept of the “seven stages of grief” reflect a psychosomatic narrative that helps individuals make sense of suffering, rather than a rigorously validated psychological model?
The reality of “The seven stages of grief”
Since the development of early models of “grief work”, numerous scholars have expanded, revised, and challenged stage-based understandings of grief, arguing for more subconscious reactions to grief, in comparison to poorly researched scientific testimonies.
Through the analysis of works by Sigmund Freud, Elisabeth Kübler-Ross, and Stroebe and Schut, amongst other scientific publications, a wide array of evidence can be used as a manifestation of the reality behind the human reaction to grief.
Stage 1– Shock
While not originally attested in Kübler-Ross’ “grief model”, shock is categorised as the most universal response to initial grief. Through understanding of HCF’s view on grief stages, some seem more universally noted than others; for example, more people are expected to experience initial shock than they may experience bargaining. Shock and numbness describe the phase that occurs immediately following a death.
The National Library of Medicine observes shock as a “protective, automatic, physiological response”. They explain that shock serves as an aesthetic for the mind, with the creation of a so-called “trauma membrane” being metaphorically upheld to numb the initial pain of a loss.
The trauma membrane, in accordance with Dr Jacob Lindy, is a semi-permeable boundary which operates on three different levels: intrapsychic, interpersonal, and communal. Lindy depicts the trauma membrane as a trauma-related barrier, hormonally created through the secretion of altered levels of cortisol, adrenaline, and oxytocin.
Stage 2– Denial
The initial stage of shock creates a hormonal imbalance, which steadily affects memory and association, and results in a high level of norepinephrine. Also known as the “sex hormone”, the triggering of increased secretion of norepinephrine demonstrates spiking of increased action, lack of restfulness, and intense feelings of danger. After this initial shock and fear, the brain evolves into a “grief brain” as outlined by Kübler-Ross.
The “grief brain” rationalises the stage of denial- decoding the scientific explanation behind it. Kübler-Ross observed the difficulties of the amygdala (the fear processing segment of our brain) and our prefrontal cortex (the rational thought section of our brain) from adapting to loss, thus illustrating the explanation for denial.
Stage 3– Anger
Following denial, many individuals report experiencing anger. Kübler-Ross depicted anger as the emotional response that emerges through the “trauma membrane” that is upheld by the initial shock and denial of grief.
Neuroscientific studies explored the correlation between grief and emotional pain, as well as grief and threat detection. Scientist Mary-Frances O’Connor used functional MRI to understand the stimulation of activity evoked by bereavement in the anterior cingulate cortex and amygdala.
Due to the natural attachment that the brain stores, anger and grief are expected to intertwine. When the death of a loved one occurs, researchers observe a likely triggering of biological stress, which creates high levels of cortisol and adrenaline, thus manifesting in intense emotions, like anger.
Interestingly, neuroimaging studies further the scientific explanation of anger. While the Amygdala becomes overactive, increasing due to significant levels of threat detection, this can often be misinterpreted as anger, instead of acute stress. The amygdala is linked to grief in many studies, such as the National Institute of Health’s.
Hyperproduction in the amygdala is linked to overproduction of memories, and thus feelings of despair, rage, and uncontrollable frustration. This is known as “the amygdala hijack”, explaining the biological filtering of anger caused through bereavement.
Stage 4– Bargaining
Bargaining appears as the fourth stage of this seven-stage grief process. Often described as an initiative-based attempt at regaining control, bargaining acts as a temporary buffer. Depicting a boundary between the acceptance of death, bargaining psychologically aids the bereaved person to understand the depth of their own loss. Neurobiologically, bargaining stimulates the amygdala, again conveying feelings of anger, threat, uncertainty, and shock.
Bargaining was validated as a stage through Kübler-Ross, who depicted it as a desperate attempt to revoke the grief.
It is often manifested through hopelessness and anguish, which can cause people to pray, beg, or even plead with “higher powers”.
Stage 5– Depression
While bargaining is arguably understudied, depression and its relation to grief and bereavement are extremely well measured and understood.
The depression that occurs in grief is distinct from the medical condition: depression. While grief is often categorised as fleeting waves of pain and desperation, depression is characterised as a persistent, unwavering low mood.
However, scientific studies do bridge the gap between these two definitions- suggesting that while grief and depression are distinct, they are profoundly related. The intertwining of grief and depression may be due to death triggering depressive symptoms in around 42% of bereaved individuals (according to the National Library of Medicine).
Neurobiologically, sustained tension, as would be found through grief, can alter neural pathways. This alteration leads to “neuro-inflammatory sensitivity”, forming a higher correlation between the “waves of pain and desperation” caused by grief and the “persistent, unwavering low mood” described by depression.
Stage 6 & Stage 7 – Testing & Acceptance
Unlike the previous five stages, which demonstrate scientific studies, testing and acceptance are more psychologically examined and understood, more personally, by bereaved people.
Testing depicts the process of trying to understand life without the person who has passed away, for example, through going back to work, testing out new hobbies, or going to therapy. Acceptance furthers this stage, symbolically resembling a person’s understanding and embracing of life with loss.
Often paired together, testing and acceptance demonstrate reconciliation, optimism and progression.
Conclusions
Grief is still extremely understudied and misunderstood. Through looking at scientific examinations, it is clear that bereavement manifests uniquely in each individual. Some people may be more prone to experiencing anger than they are depression, and so on. The study of grief entails a converse, intertwined examination of psychological and endocrinological processes, and it is something that is hard to quantify through science alone.
