There Are Five Stages of Grief

• Elisabeth Kübler-Ross was a Swiss-born psychiatrist who built her reputation in the 1960s by interviewing hundreds of terminally ill patients in Chicago hospitals. She published her bestselling book On Death and Dying in 1969, laying out the five stages of denial, anger, bargaining, depression, and acceptance as a helpful framework derived from those conversations. The book sold millions, earned her a spot on Time Magazine's list of the 100 most important thinkers of the century, and led to her induction into the National Women's Hall of Fame. She spent the rest of her life defending and extending the model to bereavement despite later noting that the stages were not strictly linear. Her charisma and accessible writing turned a clinical observation into conventional wisdom that shaped entire professions. ^[1][3][4][9]
• John Bowlby and Colin Murray Parkes were British psychiatrists who first proposed a stage theory of grief in the 1960s and 1970s based on studies of widows and separated children. Their sequence of shock-numbness, yearning-searching, disorganization-despair, and reorganization appeared in academic journals and seemed a natural extension of attachment theory. Bowlby's earlier work on maternal deprivation lent the model scientific gravitas. They never intended it as a rigid prescription, yet their framework provided the intellectual backbone that others adapted. The theory spread quietly through psychiatric circles before exploding into popular use. ^[2]
• George A. Bonanno is a psychologist at Columbia University who conducted longitudinal studies of bereaved people in the 1990s and 2000s, tracking them for years after loss. His research identified distinct trajectories such as resilience in roughly half of participants, recovery in others, and prolonged grief in about 10 percent, with no evidence of sequential stages. Bonanno published these findings in major journals and books, directly challenging the model that had dominated textbooks for decades. His work forced clinicians to confront data that contradicted what they had been taught. He became one of the most cited critics of the stage theory. ^[10]
• Margaret Stroebe, Henk Schut, and Kathrin Boerner are clinical psychologists and gerontologists at Utrecht University who spent years reviewing the empirical literature on grief. They published multiple papers cautioning health-care professionals that the five-stage model lacked validity and was causing real harm to bereaved people. Their 2017 review in Omega and related articles documented how the model was being misapplied in practice despite decades of contrary evidence. They argued that rigid expectations were leading to misdiagnosis and unnecessary guilt. Their persistent criticism helped shift professional opinion even as popular culture clung to the stages. ^[3][4][15]

Medical schools and hospitals across the United States and Europe incorporated the Kübler-Ross model into curricula and training programs starting in the 1970s. A 1997 survey found that most medical schools relied heavily on her framework when teaching about death and bereavement. Hospitals used the stages to structure support groups and staff education, turning an untested idea into standard operating procedure. By 1982 more than 125,000 courses had taught the model to nurses, social workers, and counselors. The institutions lent the theory an air of official endorsement that proved difficult to retract. ^[2][4]

The National Cancer Institute maintained an official website for years that described the five stages of grief as a normal process patients and families would experience. The page presented the model without caveats about its lack of empirical support or applicability to bereavement. It reached millions of people seeking guidance after a cancer diagnosis. The institute's institutional prestige helped cement the stages as accepted medical knowledge. Only much later did such resources begin to reflect the scientific consensus against the model. ^[2]

The Grief Recovery Institute worked directly with thousands of bereaved clients and consistently told them that no scientific study had ever established the existence of grief stages. Its executive director Russell P. Friedman repeated this message in trainings and public statements. The organization stood as a rare counterweight to the dominant narrative in popular self-help literature. It emphasized practical recovery over prescribed emotional sequences. Its stance highlighted the disconnect between academic critique and what most grieving people were still being told. ^[9]

The five stages of grief seemed like common sense to anyone who had watched a loved one die. Elisabeth Kübler-Ross had sat with more than 200 terminally ill patients and observed them moving through denial, anger, bargaining, depression, and acceptance, often in that order. The pattern appeared repeatedly in her interviews, and the simple acronym DABDA made the sequence easy to remember and teach. A thoughtful clinician in the late 1960s could reasonably conclude that these emotional landmarks represented a universal human response to loss. The model offered comfort by suggesting that even the messiest emotions had a purpose and an endpoint. ^[3][7][8][9]

Yet the foundation was thinner than it appeared. Kübler-Ross had studied dying patients, not bereaved family members, and her evidence consisted of anecdotal case notes rather than systematic data. The theory was extended to grief without testing whether the same sequence applied after actual deaths. Bowlby and Parkes had proposed similar stages for widows, but their work also lacked rigorous longitudinal verification. The assumption that everyone would progress neatly through the stages and reach acceptance became embedded despite these gaps. Smart people accepted it because it matched their clinical impressions and filled a desperate need for guidance. ^[2][3][4]

Subsequent research revealed the model's fragility. The Yale Bereavement Study followed 233 people and found that disbelief was never the dominant initial emotion and that acceptance was often highest from the beginning. Emotions oscillated wildly rather than marching in sequence. Only a small minority of participants showed anything resembling the predicted trajectory. Large-scale reviews by Stroebe, Schut, and others confirmed that no empirical study had ever established the stages as a reliable phenomenon. The original observations captured something real about emotional upheaval but had been overgeneralized into a prescriptive roadmap that did not fit the data. ^[2][8][10]

The model spread first through Elisabeth Kübler-Ross's 1969 bestseller, which was cited more than 15,000 times and assigned in medical schools, nursing programs, and counseling courses across the English-speaking world. Television shows, movies, and self-help books repeated the stages as established fact, often without mentioning that they originated in observations of the dying rather than the bereaved. By the 1980s the framework had become cultural shorthand for any kind of loss, from divorce to job termination to disappointment with a new smartphone. Its simplicity and apparent explanatory power made it irresistible to journalists and TED speakers alike. ^[4][8][9]

Professional training reinforced the idea at scale. Textbooks in psychology and medicine presented the stages as standard knowledge, frequently omitting the growing body of criticism. The National Cancer Institute and similar institutional websites described the sequence as normal and expected. Nearly half of clinicians surveyed in later years still endorsed the model even after researchers had largely abandoned it. Internet articles reached millions more, with systematic reviews finding that 61 percent of relevant websites portrayed the stages positively or without reservation. The idea persisted because it felt true and because correcting it required telling people that the comforting story they had been taught was wrong. ^[2][3][7]

Social pressure helped silence early dissent. Researchers who questioned the stages, including Wortman and Silver in 1989, found their work cited far less often than Kübler-Ross's book. Conferences and training programs continued to teach the model long after empirical support had evaporated. The theory's appeal lay in its promise that grief could be understood and managed, a message that grieving families and the professionals who served them badly wanted to hear. That desire proved more powerful than conflicting data for decades. ^[4][10]

Medical education curricula across North America and Europe adopted the Kübler-Ross model as standard content on grief and terminal illness beginning in the 1970s. Nursing programs and social work schools taught the five stages as a framework for assessing and supporting patients and families. The model became embedded in certification exams and continuing education requirements. Generations of health-care professionals learned to expect patients to move through denial, anger, bargaining, depression, and acceptance in sequence. ^[2][3][4]

Clinical practice turned the stages into a prescriptive tool. Counselors and physicians used them to guide interventions, evaluate progress, and reassure families that difficult emotions were normal and temporary. Hospitals structured bereavement support groups around the sequence. The assumption that everyone should reach acceptance shaped how grief was defined as resolved or pathological. Professionals who encountered clients who did not follow the pattern sometimes labeled them as stuck or abnormal. ^[3][4]

The model influenced public health information for years. Government and nonprofit websites listed the stages as fact, shaping expectations for millions of people facing loss. Psychoeducational materials distributed to bereaved families presented the sequence as the healthy way to grieve. These policies rested on the sincere belief that a clear roadmap would reduce suffering, yet they created new forms of distress for those whose grief refused to cooperate. ^[2]

Empirical studies began undermining the model as early as 1981, when a study of 193 widows found no evidence of sequential stages and persistent stress long after the loss. Wortman and Silver published a influential critique in 1989 pointing out the lack of evidence and the potential for harm. Their work was largely ignored by practitioners at the time. The Yale Bereavement Study in the early 2000s provided the first large-scale test and found that emotions did not follow the predicted order. ^[2][4]

Longitudinal research by George A. Bonanno and others tracked thousands of people across different types of loss, from 9/11 to divorce to illness. They consistently identified three main trajectories: resilience in about half the participants, recovery in another group, and prolonged grief in roughly 10 percent. Only 11 percent showed anything like the classic stage pattern. These studies demonstrated that most people cope without passing through discrete emotional stages. ^[8][10][16]

By the 2010s a substantial body of experts had rejected the model outright. Margaret Stroebe, Henk Schut, and colleagues published reviews showing that the theory failed basic scientific criteria and offered no clinical utility. Robert A. Neimeyer called it suspiciously simplistic and unfit for counseling. Even Elisabeth Kübler-Ross had clarified late in life that the stages were not linear or universal. Textbooks began to drop the framework or add heavy caveats. The idea that grief progresses through five fixed stages in sequence was finally recognized as wrong. ^{[3][4][9][10]}

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