Five stages of grief

[10] In her 1974 book Questions and Answers on Death and Dying, Kübler-Ross had by then observed that the stages are not experienced in a strictly linear progression.

In December 2019, The American Journal of Bioethics published a special issue (Volume 19, Number 12) dedicated to commemorating the 50th anniversary of Elisabeth Kübler-Ross's work, On Death and Dying.

[26] In a posthumously published book co-authored with David Kessler, Kübler-Ross expanded the model to address a wide range of personal losses, recognizing that it might be more about change than solely about grief.

This broader framework, more commonly known as the Kübler-Ross Change Curve,[28] encompasses various forms of loss, including the death of a loved one, job or income loss, major rejection, relationship breakups or divorce, drug addiction, the onset of illness or infertility, and even minor setbacks like losing insurance coverage..[16] Kessler has also proposed "Meaning" as a sixth stage of grief.

In his writings, Kastenbaum raised the following points:[32][33] A widely cited 2003 study of bereaved individuals conducted by Maciejewski and colleagues at Yale University obtained some findings consistent with a five-stage hypothesis but others inconsistent with it.

[34] It was pointed out, for example, that instead of "acceptance" being the final stage of grieving, the data actually showed it was the most frequently endorsed item at the first and every other time point measured;[35] that cultural and geographical bias within the sample population was not controlled for;[36] and that out of the total number of participants originally recruited for the study, nearly 40% were excluded from the analysis who did not fit the stage model.

[37] In subsequent work, Prigerson & Maciejewski focused on acceptance (emotional and cognitive) and backed away from stages, writing that their earlier results "might more accurately be described as 'states' of grief.

"[38] George Bonanno, Professor of Clinical Psychology at Columbia University, in his book The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss,[39] summarizes peer-reviewed research based on thousands of subjects over two decades and concludes that a natural psychological resilience is a principal component of grief[40] and that there are no stages of grief to pass.

[44] Misapplication can be harmful if it leads bereaved persons to feel that they are not coping appropriately or it can result in ineffective support by members of their social network and/or health care professionals.

Criticism and lack of support in peer-reviewed research or objective clinical observation by some practitioners in the field has led to the labels of myth and fallacy in the notion that there are stages of grief.

Kübler-Ross acknowledged the variability and complexity of individual experiences, using the so-called "stages" of emotional responses as a framework to describe common patterns.

She explicitly described these stages as a heuristic device, noting that they are categories artificially isolated for clarity, with the understanding that emotional responses are fluid and overlapping.