Grief

Elisabeth Kübler-Ross proposed her well-known five-stage model of grief in 1969: denial, anger, bargaining, depression, and acceptance. Despite its enormous cultural popularity, empirical research has not confirmed that people pass through these stages sequentially or universally. Kübler-Ross herself later clarified that the stages were neither linear nor prescriptive. Nevertheless, the model had the fundamental merit of making grief visible as a legitimate psychological process deserving clinical attention and social compassion.

Stroebe and Schut proposed the Dual Process Model in 1999, describing grief as an oscillation between two types of coping. Loss orientation involves confronting emotional pain, crying, and remembering the deceased. Restoration orientation focuses on adapting to practical life changes, taking on new roles, and reconstructing identity. According to this model, a healthy grieving process requires moving between both orientations, and becoming stuck in either one can be problematic.

Prolonged grief disorder was included in the DSM-5-TR in 2022 and in the ICD-11, acknowledging that a significant percentage of bereaved individuals experience persistent and disabling distress that does not resolve with time. Symptoms include intense and persistent yearning for the deceased, difficulty accepting the death, and significant functional impairment lasting at least twelve months in adults. This diagnostic category has generated debate about the boundaries between normal and pathological grief.

The continuing bonds paradigm, proposed by researchers such as Robert Neimeyer, challenges the traditional notion that successful grieving requires 'cutting ties' with the deceased. Instead, it suggests that maintaining a symbolic connection with the lost person can be adaptive and healthy. This may include internal conversations, memorial rituals, or integrating the deceased's legacy into one's own life narrative. This perspective has transformed clinical practice, moving away from models that pathologised continued attachment and recognising cultural diversity in ways of experiencing grief.