From Pain to Peace — A Journey Through Grief

Written by: Bhavya Malhotra 

1. What is grief? 

Grief is the experience of coping with loss. Most of us think of grief as happening in the painful period following the death of a loved one. But grief can accompany any event that disrupts or challenges our sense of normalcy or ourselves. This includes the loss of connections that define us. 

You may grieve the loss of: 

● A friend, family member, partner, or pet. 

● A marriage, friendship, or another form of kinship. 

● Your home, neighborhood, or community. 

● Your job or career. 

● Financial stability. 

● A dream or goal. 

● Good health. 

● Your youth. 

● Fertility. 

You may also grieve your loss of life as you prepare for death. For instance, people diagnosed with terminal illnesses often grieve no longer having the time to experience or achieve things they would’ve liked to. 

2. Five stages of grief 

Elizabeth Kubler-Ross describes the five stages of grief in her book On Death and Dying. Although it was published in 1969, it’s still the most well-known resource for understanding the grieving process. For her book, Kubler-Ross interviewed over 200 people with terminal illnesses. Through these conversations, she identified five common stages people experience as they grapple with the realities of impending death. 

Although Kubler-Ross’s work focuses on grief responses from people who are dying, many use these stages to understand grief across multiple types of loss. Stages include: 

● Kubler-Ross's 5 Stages of grief 

Denial is a common defense mechanism used to protect oneself from the hardship of considering an upsetting reality. Kubler-Ross noted that patients would often reject the reality of the new information after the initial shock of receiving a terminal diagnosis. Patients may directly deny the diagnosis, attribute it to faulty tests or an unqualified physician, or avoid the topic in conversation. While persistent denial may be deleterious, a period of denial is quite normal in the context of terminal illness and could be important for processing difficult information. In some contexts, it can be challenging to distinguish denial from a lack of

understanding, and this is one of many reasons that upsetting news should always be delivered clearly and directly 

Anger is commonly experienced and expressed by patients as they concede the reality of a terminal illness. It may be directed at blaming medical providers for inadequately preventing the illness, family members for contributing to risks or not being sufficiently supportive, or spiritual providers or higher powers for the diagnosis' injustice. The anger may also be generalized and undirected, manifesting as a shorter temper or a loss of patience. Recognizing anger as a natural response can help healthcare providers and loved ones tolerate what might otherwise feel like hurtful accusations. However, they must not disregard criticism that may be warranted by attributing it solely to an emotional stage. 

Bargaining typically manifests as patients seeking some measure of control over their illness. The negotiation could be verbalized internally, as well as medically, socially, or religiously. The patients' proffered bargains could be rational, such as committing to treatment 

recommendations or accepting help from their caregivers. It could also represent more magical thinking, such as efforts to appease misattributed guilt they may feel is responsible for their diagnosis. While bargaining may mobilize more active participation from patients, healthcare providers, and caregivers should not mislead patients about their power to fulfill the patients' negotiations 

Depression is perhaps the most immediately understandable of Kubler-Ross's stages, and patients experience it with unsurprising symptoms such as sadness, fatigue, and anhedonia. Spending time in the first 3 stages is potentially an unconscious effort to protect oneself from this emotional pain. While the patient's actions may potentially be easier to understand, they may be more jarring in juxtaposition to behaviors arising from the first 3 stages. 

Acceptance describes recognizing the reality of a difficult diagnosis while no longer protesting or struggling against it. Patients may focus on enjoying the time they have left and reflecting on their memories. They may begin to prepare for death practically by planning their funeral or helping to provide financially or emotionally for their loved ones. It is often portrayed as the last of Kubler-Ross's stages and a goal of the dying or grieving process. While caregivers and providers may find this stage less emotionally taxing, it is important to remember that it is not inherently healthier than the other stages. [ Cleveland Clinic ( 22nd February, 2023)] 

3. Criticism of the model 

The DABDA model has been increasingly criticized in recent years. The model has historical and cultural significance as 1 of the most well-known models for understanding grief and loss. Many alternative models have been developed based, at least in part, on the original DABDA model. The principal criticisms of Kubler-Ross's stages of death and dying are that the stages were developed without sufficient evidence and are often applied too strictly. Kubler-Ross and her

collaborators developed their ideas qualitatively through in-depth interviews with over 200 terminally ill patients. 

Critics have focused on the fact that her research and use of "stages" have not been empirically validated. It is also said that "stages" are applied too rigidly and linearly. Instead, she aimed to describe a set of behaviors and emotions that may be experienced by a patient facing the end of life, and by describing them, improve understanding for both the patient and caregivers. [ Patrick Tyrrell; Seneca Harberger; Caroline Schoo; Waquar Siddiqui.(26th Feburary , 2023)] 

Another important criticism of the model arises when it is viewed as prescriptive rather than descriptive, indicating that a patient must move through each stage to reach the final goal of "acceptance." This view holds many assumptions, including that progression through the stages is linear and that some stages are inherently less adaptive than others. Caregivers may view their job as helping a patient move through each stage, such as denial or anger, onto more easily palatable stages, such as bargaining or acceptance. Attempting to push the patient through the stages has the potential to cause harm, as they need to process their grief in their unique way. Dr. Kubler-Ross and others have reminded readers that many patients experience the stages fluidly, often exhibiting more than 1 at a time and moving between them non-linearly. 

4. How to cope with grief? 

While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief, and eventually, find a way to pick up the pieces and move on with your life. [Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.(13th March 2025)] 

● Acknowledge your pain. 

● Accept that grief can trigger many different and unexpected emotions. 

● Understand that your grieving process will be unique to you. 

● Seek out face-to-face support from people who care about you. 

● Support yourself emotionally by taking care of yourself physically. 

● Recognize the difference between grief and depression. 

5. References: 

Smith, M., Robinson, L., & Segal, J. (2025, March 13). Coping with grief and loss. HelpGuide.org. https://www.helpguide.org/mental-health/grief/coping-with-grief-and-loss 

Tyrrell, P., Harberger, S., Schoo, C., & Siddiqui, W. (2023, February 26). Kubler-Ross stages of dying and subsequent models of grief. In StatPearls. StatPearls Publishing. 

https://www.ncbi.nlm.nih.gov/books/NBK507885/ 

Cleveland Clinic. (2023, February 22). Grief. https://my.clevelandclinic.org/health/diseases/24787-grief