5 Stages of Grief®

What Elisabeth Kübler-Ross Actually Wrote

Most people know the familiar “Five Stages” as Denial, Anger, Bargaining, Depression, and Acceptance. But Kübler-Ross’s work was more complex than that simple list suggests.

Her model evolved between 1968 and 1974 as she continued interviewing dying patients and observing their emotional responses. During that period, she used several different formulations — including versions with four stages, five stages, and more than five responses. The familiar five-stage version was used for roughly a year, from 1968 into 1969, but it was never the whole of her thinking.

More Than Five
Kübler-Ross also described many other responses, including shock, partial denial, anxiety, anticipatory grief, hope, guilt, numbness, loneliness, relief, detachment, and unfinished business.

Hope was especially important. It could exist alongside anger, fear, depression, or acceptance rather than appearing as a separate step.

The Stages Were Not Linear
Kübler-Ross never intended the stages to be a rigid sequence. People could move back and forth, skip stages, return to earlier responses, or experience several at the same time. By 1974, she was explicitly describing patients as experiencing two or three stages simultaneously and emphasizing that there was no single classical pattern.

Descriptive, Not Prescriptive
The stages were intended as a clinical vocabulary, not a checklist or timetable. They helped patients, families, and caregivers recognize recurring emotional responses without suggesting that everyone must experience them, or experience them in a fixed order.

The Patient Was the Teacher
Kübler-Ross developed the stages by listening to dying patients. They grew from clinical conversations and observation—not from a theory imposed on patients. Her guiding principle was simple: the patient was the teacher.