Grief Doesn't Follow The Steps

If you've lost someone, you've probably been told grief moves through denial, anger, bargaining, depression, and acceptance, in that order. You might also have noticed that your own experience didn't feel anything like a tidy sequence. One day feels manageable. The next, a song on the radio undoes you completely, six months after the funeral.

That disconnect isn't a sign you're grieving wrong. It's a sign the popular model of grief was never designed for what you're actually going through.

At VMA Psych, we support clients across Etobicoke and the GTA navigating loss, from a recent death to grief that has lingered far longer than expected. This guide explains where the five stages actually came from, what current research says about how grief really unfolds, and when persistent grief may meet the criteria for a distinct, treatable clinical condition.

Where the Five Stages Actually Came From

The five stages of grief, denial, anger, bargaining, depression, and acceptance, come from psychiatrist Elisabeth Kübler-Ross's 1969 book On Death and Dying. It is worth noting that in her book, she was actually describing these stages based on interviews with terminally ill patients as they came to terms with their own approaching death, not on people grieving the loss of someone else.

Over the following decades, the model was popularly extended to bereavement generally, despite never being validated as a description of how survivors grieve. Kübler-Ross herself later clarified that the stages were never meant to be linear, universal, or a checklist to move through in order. Grief researchers today generally agree that there is no single correct order, and that many people never experience some of these stages at all, while cycling repeatedly through others.

What Grief Actually Looks Like

Modern grief research favours more flexible models over a fixed sequence. One widely used framework is the dual process model, which describes people oscillating between two states:

• Loss-oriented coping: confronting the pain of the loss directly, such as looking at photos or talking about the person

• Restoration-oriented coping: engaging with daily life, work, and new roles.

Healthy grieving tends to involve moving back and forth between these states, rather than "completing" grief and moving on permanently.

Grief is also shaped heavily by context. Grief after a sudden or violent death often looks different from grief after a long illness. Grief for a child or partner tends to carry a higher risk of prolonged difficulty than grief for a more distant relationship. None of this makes one person's grief more or less valid. It reflects real differences in attachment, circumstance, and support.

When Grief Becomes Prolonged Grief Disorder

Most people's grief eases gradually over time, even when it never fully disappears. For a smaller number of people, intense grief symptoms persist and significantly impair daily life well beyond what's culturally expected. In 2022, the American Psychiatric Association added Prolonged Grief Disorder (PGD) to the DSM-5-TR to formally recognize this pattern.

The diagnostic criteria require:

• The death of someone close occurred at least 12 months ago for adults (6 months for children and adolescents)

• Intense yearning for the deceased, or preoccupation with thoughts of them, occurring most days for at least the past month

• At least three additional symptoms nearly every day for at least the past month, such as identity disruption (feeling like part of yourself has died), marked disbelief about the death, avoidance of reminders, intense emotional pain, difficulty reengaging with life, emotional numbness, feeling life is meaningless, or intense loneliness

• The grief response exceeds what would be culturally or socially expected, and significantly impairs functioning

Research has identified some factors associated with a higher risk of Prolonged Grief Disorder, including losing a child or spouse, a violent or sudden cause of death, emotional dependence on the person who died, and a lack of social support. This is not an exhaustive list, and PGD can affect anyone.

Common Myths About Grief

Myth: You should be "over it" within a year.

Reality: There's no fixed timeline for grief. What matters clinically isn't duration alone, but whether symptom intensity is easing over time and whether daily functioning is recovering.

Myth: Not crying means you aren't grieving properly.

Reality: Grief expresses itself differently across people and cultures. Restoration-oriented coping, like returning to work or routine, is a normal and healthy part of the process, not evidence of suppressed or "wrong" grief.

Myth: Complicated grief is just depression by another name.

Reality: While the two can overlap and even co-occur, Prolonged Grief Disorder is now recognized as its own distinct condition in the DSM-5-TR, with its own symptom profile centred specifically on yearning for and preoccupation with the person who died.

How Therapy Helps With Grief

Most people move through grief with time, support from loved ones, and their own coping resources, without needing formal treatment. Therapy tends to be most useful when grief feels stuck, is significantly interfering with daily life, or meets the criteria for Prolonged Grief Disorder.

Specialized approaches, including grief-focused Cognitive Behavioural Therapy and complicated grief treatment models, help people process the reality of the loss, work through avoidance of painful reminders, and rebuild a sense of meaning and connection to life without needing to "let go" of the relationship entirely. The goal isn't to stop missing the person who died. It's to help grief take its place alongside a life that can still hold new meaning.

Recommended Reading: It's OK That You're Not OK

Our pick: It's OK That You're Not OK: Meeting Grief and Loss in a Culture That Doesn't Understand by Megan Devine.

Why we recommend it: Devine, a psychotherapist who also experienced a sudden, traumatic loss herself, directly challenges the idea that grief is a problem to be fixed or a process with a defined endpoint. The book affirms that some losses don't get "resolved," while still offering practical, compassionate guidance for carrying grief and continuing to live alongside it.

Grab Your Copy

Support Through Loss at VMA Psych

Grief doesn't follow a script, and there's no correct way to carry a loss. Whether you're navigating a recent death or grief that has lingered far longer than you expected, you don't have to move through it alone.

At VMA Psych, our Etobicoke-based clinicians provide compassionate, evidence-based support for grief and loss, including specialized care for Prolonged Grief Disorder, helping you process the loss and rebuild a sense of meaning at your own pace.

Ready to talk to someone?

Contact VMA Psych today to book a consultation, available in-person in Etobicoke or virtually across Ontario.

FAQ: Understanding Grief

Is it normal to still feel intense grief years after a loss?

Occasional intense waves of grief, especially around anniversaries or reminders, can be normal even years later. What distinguishes typical grief from Prolonged Grief Disorder is whether these symptoms are persistent, occurring most days, and significantly impairing daily functioning well beyond what's culturally expected.

Can grief and depression happen at the same time?

Yes, and they can be difficult to tell apart without a clinical assessment. Grief tends to centre specifically on the person who died, while depression often involves more generalized low mood, worthlessness, and loss of interest across all areas of life. A clinician can help clarify which, or both, is present.

Does everyone who loses someone develop Prolonged Grief Disorder?

No. PGD affects a minority of bereaved people. Most people's grief eases gradually with time and support, even though it may never fully disappear.

Is it too late to seek support if the loss happened years ago?

No. Grief support and therapy can be genuinely helpful regardless of how much time has passed since a loss, particularly if grief still feels stuck or is affecting daily functioning.

How do I know if I need therapy versus more time?

If grief symptoms are intensifying rather than gradually easing, or are significantly interfering with work, relationships, or basic functioning well past the first year, that's a reasonable point to seek a professional assessment rather than waiting longer.