Shock and Testing: Two More Twists on the Road to Grief Recovery?

Gnarled, twisted tree trunks line each side of a small road.In her seminal book, On Death and Dying, psychiatrist Elisabeth Kübler-Ross identified five distinct stages of grief. Kübler-Ross worked with dying people and designed her model to describe the distinct grief of dying.

In On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, a book co-authored with David Kessler, Kübler-Ross expanded her model to include many other types of grief. A modified version of Kübler-Ross’s model adds two new stages, shock and testing. This seven-stage model of grief is familiar to many people who have grieved a loss, yet little research supports the model.

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The Seven Stages of Grief

According to Kübler-Ross, and later to her co-author David Kessler, there are five stages of grief: denial, anger, depression, bargaining, and acceptance.

Some grief experts suggest this model might leave out two additional stages. This is sometimes called the Extended Kübler-Ross Model. According to that seven-stage model, the stages of grief are as follows:

  1. Shock: This is a person’s initial sense of paralysis and shock following bad news.
  2. Denial: Denial is an attempt to avoid the pain of the loss. Sometimes people distract themselves with other pursuits.
  3. Anger: Anger is a reaction to the loss of control that often accompanies a loss. A person may experience overwhelming feelings of frustration or target their anger to a specific source, such as God, a doctor, or the person who shared the bad news.
  4. Bargaining: Bargaining is an attempt to regain control. During this stage, a person tries to find a way to escape the pain. For example, a person dying of cancer might adopt a very healthy lifestyle, or a parent whose child is dying might spend lots of time praying.
  5. Depression: When bargaining fails and a person realizes they cannot control the loss, they may enter a state of intense depression.
  6. Testing: During this stage, a person experiments with ways to better manage and cope with the loss.
  7. Acceptance: During acceptance, a person integrates and understands the loss. This does not mean they are “over” it, but they are able to move forward. The degree to which a person is able to accept the loss and move forward depends on the specific loss, personal psychological factors, a supportive environment, and more.

In his book Finding Meaning: The Sixth Stage of Grief, David Kessler argues that the quest for meaning might be the final stage of grief before acceptance.

While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order. They may also repeat or revisit stages, especially during times of intense emotional distress. For example, a person grieving the loss of their father might become angry over his loss when he is not present at their wedding, even if they already experienced the anger stage years before.

While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order.

Shock: The First Stage of Grief

Grief often begins with bad news—a stunning diagnosis, a phone call announcing a loved one’s death, or an ultrasound that reveals a baby is not developing normally. This can feel like a massive blow, sending a person into a state of emotional shock. During this earliest stage of grief, a person may feel unable to process the meaning of the news.

Shock can last just a few moments or for many days. For some people, shock reappears as the grieving process unfolds. A person grieving the death of a relative may feel another wave of shock settle in at the funeral or burial, for instance.

Some hallmarks of shock include:

  • Difficulty expressing emotions
  • Trouble processing the meaning or effect of the news. A family member might be unable to plan a funeral, while a newly diagnosed patient may feel ill-equipped to make treatment decisions.
  • Feeling numb, paralyzed, or overwhelmed
  • Feeling overstimulated and in need of a break from the weight of the grief

Testing: An Often Overlooked Stage of Grief

As a person meanders through the stages of grief, they may arrive at a period of testing. This stage of grief is similar to bargaining, but typically occurs later. During testing, a person experiments with different ways to manage their grief. For example, a person going through a divorce might contemplate joining a support group, weigh the benefits of a new hobby, or consider dating.

Testing differs from bargaining in that testing is about finding sustainable strategies for living with bad news. Bargaining is about escaping the bad news and regaining control.

A person in the testing stage may:

  • Be interested in learning about grief or their specific loss
  • Try new strategies for coping
  • Reach out to loved ones for support
  • “Try on” different philosophies or spiritual traditions

How Helpful Are the Stages of Grief?

While many grieving people report experiencing at least a few of the stages of grief, most research does not support a stage-based model of grief. A 2007 study found people grieving a death experience denial, anger, depression, and acceptance in a similar sequence to that identified by Kubler-Ross. That study, however, found no support for bargaining and found the most prevalent grief-related emotion was yearning for a lost loved one.

Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves.

Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves.

Some studies have found a person’s grief may depend on the loss. A 2016 study, for example, argues that people caring for a loved one with dementia face a unique grieving process. This is because they “lose” the person before they die but then experience another loss at death. The study proposes a dementia-specific model of grieving and argues that ambiguity is a core component of each stage of dementia grief.

The extent to which a stage-based model of grief helps people is unclear. People who experience one of the traditional stages may feel less alone when they learn their feelings are common. People who do not go through the stages of grief, however, may feel alone or stigmatized. They may even feel pressured to manifest outward signs of internal grief stages they do not actually feel.

There is no right or wrong way to grieve. Grief is the natural reaction to a loss. Cultural norms, personal factors, social support, health, religious and social values, and myriad other factors may affect how a person experiences grief. Therapy can help people manage their grief and find a way forward. The right therapist may even help a person find meaning in a loss, or a sense of purpose in persisting despite the loss.

“These models can…help people understand and explain their experience. However, grief is not predictable, linear, stable, or neat. It is an experience marked by its ferocious aliveness and proclivity for shape shifting. Models run the risk of being too prescriptive…and can render people feeling like they have a map of mere country borders and seashores, not the detail or scope to actually navigate one’s way around with any seriousness. Use the seven stages as a basic introduction to the language of grief, but when one becomes fluent in their own personal grief experience, they will realize it’s a language entirely unto its own. Therapy and other therapeutic work help hold and develop the latter,” says Jade Wood, MA, LMFT, MHSA, a Washington, D.C. therapist who specializes in managing grief.

To begin your search for a compassionate grief therapist, click here.


  1. Additional stages of grief. (n.d.). Retrieved from
  2. Blandin, K., & Pepin, R. (2016, October 15). Dementia grief: A theoretical model of a unique grief experience. Dementia (London), 16(1), 67-78. doi: 10.1177/1471301215581081
  3. Kübler-Ross, E. (2009). On death and dying. Abingdon: Routledge.
  4. Maciejewski, P. K., Zhang, B., Block, S. D., & Prigerson, H. G. (2007, February 21). An empirical examination of the stage theory of grief. JAMA, 297(7), 716. doi: 10.1001/jama.297.7.716
  5. Testing stage. (n.d.). Retrieved from
  6. The Kübler-Ross Grief Cycle. (n.d.). Retrieved from

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