Grief has five stages

What actually happened

The origin is a category error. On Death and Dying was based on Kübler-Ross's interviews with terminally ill patients facing their own deaths. It was never a study of grief after loss, it involved no control group and no systematic measurement, and she later objected that the stages were being taken as a prescriptive sequence rather than a loose description.

The empirical work points elsewhere. George Bonanno's research, summarized in The Other Side of Sadness, found the single most common response to loss is resilience, with roughly half of bereaved people showing relatively stable functioning, which the stage model has no room for. The 2007 JAMA study by Maciejewski and colleagues is often cited as supporting the stages, and it is worth being precise: it found the indicators peaked in roughly the predicted order, but acceptance was the most-endorsed state from the very first measurement and yearning dominated over the negative emotions, which is not the model schools taught.

The harm is not academic. People who did not feel the prescribed emotions concluded they were grieving incorrectly, and clinicians looked for stages that were not there. The DSM-5-TR added prolonged grief disorder in 2022 with criteria based on evidence rather than stages. Kübler-Ross's contribution was real: she made dying speakable in medicine. The five-step ladder is not what she should be remembered for.