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Stages of Loss and Adaptation

Even though everyone grieves in a slightly different way, there are regular patterns that grieving people usually experience. Psychiatrist Mardi Horowitz divides the process of normal grief into the following 'stages of loss'. These stages are typical, but they don't occur for everyone, or always in this order.

  • Outcry

    People often get upset when they first appreciate that they have lost someone important. They may publicly scream and yell, cry or collapse, or they may hold it inside and not share it with others. Outcry feelings may be suppressed by the person who is feeling them so that they are not felt too strongly, or they may spill out uncontrollably. In any event, initial outcry feelings are hard to sustain and tend to not last too long.

  • Denial <-> Intrusion

    As people get a grip on themselves after the initial outcry, they will often enter a period characterized by movement between 'denial' and 'intrusion'. This means that people will experience periods where they distract themselves so thoroughly in other activities and thoughts that they don't think about the loss, and also periods where the loss is felt very strongly and acutely, perhaps even as intensely as the initial outcry stage. It is normal for people to bounce between these poles of engagement and disengagement. People may feel guilty when they realize they are disengaging from feeling the intensity of the loss, but really it is a good thing that this happens. Distraction and disengagement break up the intensity of feeling the acute pain of loss so that it is more manageable and less overwhelming.

  • Working Through

    As time goes by (days, weeks), the movement between 'denial' (not thinking about the loss) and 'intrusion' (thinking about the loss very intensely) tends to slow down and become less pronounced, with people spending more time not thinking about the loss very intensely, and less time being overwhelmed by it. During the 'working through' stage, people think and feel their loss, but also start to figure out new ways to manage without the lost relationship. Such 'new ways of managing' might include re-entering the dating game (or just starting to think about it), developing new friendships and strengthening existing ones, finding new hobbies, etc.

  • Completion

    At some point in time, the process of grieving is completed or 'completed enough' so that life has started to feel normal again. While memories remain of what has been lost, the feeling attached to the loss is less painful and no longer interferes all that much with the person's life. Temporary reactivation of grief feelings may occur on anniversaries important to the lost friendship (marriage and engagement dates, etc.), but these feelings pass.