Other Models & Theories

The five and six stages of grief demonstrate a framework that helps people going through grief to understand the patterns and processes that often emerge in bereavement.

Grief is nonlinear, and as explained, there is no prescribed single right way to grieve, which is why researchers and clinicians have developed several frameworks to offer language and structure to the complex experience of grief.

The 7 stages of grief

The seven stages of grief make up an expanded adaptation of the original five-stage model by Elisabeth Kübler-Ross. They include stages of shock and denial, pain and guilt, the upward turn, and reconstruction and working through, which expand on the original model to capture the early disbelief and numbness, the intense emotional pain, the gradual improvement, and the process of rebuilding after loss (Parkes & Prigerson, 2010).

Dual-process model

The dual-process model recognizes that grief involves two processes. On one side, the grieving person has to navigate through the feelings of loss (or loss-oriented stressors), and on the other, they focus on rebuilding life after loss (restoration-oriented stressors; Stroebe & Schut, 1999).

Loss-oriented stressors encompass emotional and psychological responses directly related to the loss, such as grief work, confronting and expressing complex emotions, and accepting the reality of the loss.

Restoration-oriented stressors include managing new responsibilities and engaging in new activities and relationships, as well as forming a new sense of self (Stroebe & Schut, 1999).

Central to this model is the concept of oscillation, which means that individuals move back and forth between the domains, which allows them to engage with grief while also finding relief from it. This dynamic process allows a healthy adjustment to the new situation by balancing emotions with the demands of daily life (Stroebe & Schut, 1999).

Tasks of mourning

This concept reframes grief as a dynamic process rather than a linear series of stages. According to Worden (2018), grief involves four core tasks that individuals may revisit in various sequences over time:

Accepting the reality of the loss
Accepting reality both intellectually and emotionally involves confronting the irreversible absence of the loved one through rituals, storytelling, and reminders that support cognitive and emotional integration (Hall, 2014; Kübler-Ross & Kessler, 2005).

Experiencing the pain of grief
Feel emotions fully, such as anger, sadness, guilt, and confusion, without avoidance. Emotional bypassing can complicate or prolong the grieving process (O’Connor, 2019; Peña-Vargas et al., 2021).

Adjusting to a world without the deceased
Adjust by taking on new roles, undergoing an internal transformation, and reexamining identity, beliefs, and meaning. This aligns with the biopsychosocial complexity of bereavement (Bonanno et al., 2002; Shoo et al., 2024).

Finding an enduring connection with the deceased
Integrate the memory and impact of the loved one into a reengaged life (Kessler, 2019; Harris & Winokuer, 2019).

Worden’s model emphasizes a compassionate, nonlinear, and human-centered approach to grief, acknowledging its personal and evolving nature.

Anticipatory grief

Anticipatory grief describes the grief before we grieve (Kübler-Ross & Kessler, 2005). It often occurs before an impending loss as a result of a terminal illness or the expected death of a loved one. This grief can impact both the person facing their own death and the person in the relationship.

Feelings such as sadness, anxiety, anger, guilt, and even physical symptoms such as lack of appetite and sleep disturbances can accompany it (Biscontini, 2023). This grief entails more than the anticipation of the loss. It can involve the loss of future experiences, the inevitability of the loss, and even the gradual decline of the loved one.

Research characterizes anticipatory grief by a heightened emotional response and a sense of being static in time, meaning planning for the future feels impossible (Lee, 2016).

Continuing bonds theory

Continuing bonds theory provides an interesting twist to research on bereavement. Unlike other models that describe detachment as a healthy sign of grieving, continuing bonds theory suggests that maintaining an ongoing relationship with the deceased is normal and part of the process (Klass et al., 1996).

This connection can look like cherishing memories, engaging in rituals, talking to the deceased, and integrating their values and wisdom into everyday life. These bonds of connection aren’t static; they change over time as the bereaved person’s life changes (Klass, 2006).

Generally, the internalized continuing connection to the deceased is associated with a positive adjustment, as long as the deceased is held in memory and meaning. On the other hand, external bonds such as hallucination may be linked to complicated grief (Field et al., 2005).