The Five Stages and the Indian Soul: Kübler-Ross, Culture, and the Psychology of Grief.

 Title: The Five Stages and the Indian Soul: Kübler-Ross, Culture, and the Psychology of Grief.

Author: Dr. Shekhar and Team

Affiliation: Psychology Doctor's Forum for All 🏥⚖️

Abstract

Elisabeth Kübler-Ross's five stages of grief—denial, anger, bargaining, depression, acceptance—have become the most widely known model of bereavement in the world. They have also been the most widely criticized. This article examines the model through the lens of Indian psychology and culture. Drawing on published research from 2000 to 2025, it asks a simple question: does the stage model fit the way Indians grieve? The evidence is mixed. Studies from Tamil Nadu and Chhattisgarh show that Indian women experiencing perinatal loss do move through states resembling the Kübler-Ross stages. A Bollywood film, Goodbye, has been analyzed as a cinematic depiction of the stages, with the protagonist's anger directed toward her father for following Hindu death rituals. But the model has been subjected to sustained empirical critique. Research has found that grief does not follow a linear, sequential path, and that cultural context shapes both its expression and its course. In India, the 13-day mourning period, the antyesti rites, and the terahvin ceremony provide a structured container for grief that operates on a different logic than the Western stage model. The Indian psychological landscape—marked by emotional restraint, collectivist family structures, and the suppression of individual grief in service of family duty—further complicates the picture. The article argues that the Kübler-Ross model is not wrong, but it is incomplete. It describes a universal process in a culturally specific language. For Indian clinicians, the task is not to impose the stages but to listen for the ways grief actually moves—through ritual, through family, through silence, and through the body. We do not have a problem with anyone. But data is data, and truth is truth.

Keywords: Kübler-Ross, five stages of grief, Indian psychology, bereavement, antyesti, terahvin, cultural psychiatry

1. Introduction

Elisabeth Kübler-Ross did not set out to create a universal theory of grief. She set out to listen to dying people. In 1969, she published On Death and Dying, a book based on interviews with terminally ill patients at the University of Chicago. She observed patterns. Denial. Anger. Bargaining. Depression. Acceptance. She called them stages.

The word "stage" was a mistake. Kübler-Ross herself later acknowledged this. She had not meant to suggest that grief proceeds in a neat, sequential order. She had meant to describe clusters of feelings that patients moved between, often repeatedly. But the model took on a life of its own. It became a prescription. A checklist. A set of boxes to be ticked.

The model has been criticized for decades. The empirical evidence for a stage-like progression is weak. A 2018 review concluded that "data from many studies have not provided consistent support for this model" and that "affective states often overlap, and may subside and return spontaneously in a different order, thus refuting the notion of a stage theory". A 2023 paper described the model's persistence as "stubborn", noting that "bereavement professionals who keep up with current research have wisely discarded the 'five stages of grief' theory in favor of more contemporary, more functional models".

And yet the model persists. It persists in popular culture. It persists in clinical training. It persists in the minds of grieving people who find comfort in having a name for what they are feeling. There is a reason for this. The model gives language to an experience that often defies language. It says: this is normal. This is human. You are not broken.

This article asks what happens when the model travels to India. Does it fit? Does it help? Or does it obscure something essential about the way Indians grieve?

2. Method

2.1 Search Strategy

A systematic literature search was conducted using PubMed, PsycINFO, Scopus, Google Scholar, and Shodhganga. The search covered publications from January 2000 to September 2025. Keywords included: "Kübler-Ross," "five stages of grief," "India," "Hindu bereavement," "antyesti," "terahvin," "prolonged grief disorder," "cultural psychiatry," "grief counseling India," and combinations thereof.

2.2 Inclusion and Exclusion Criteria

Studies were included if they: (a) examined the application or critique of the Kübler-Ross model in Indian or Hindu contexts; (b) examined Indian bereavement practices or grief psychology; (c) employed quantitative, qualitative, or mixed-methods designs; and (d) were published in peer-reviewed journals or as scholarly books. Studies were excluded if they were purely theoretical without empirical grounding or focused exclusively on non-Indian populations.

2.3 Data Extraction and Synthesis

Data were extracted on study design, sample characteristics, cultural context, and key findings. A narrative synthesis approach was employed.

3. Results

3.1 The Stages in Indian Clinical Research

The Kübler-Ross model has been used as a framework for understanding grief in Indian clinical populations. A 2018 qualitative study on the psycho-social impact of stillbirths in Tamil Nadu found that "grief was expressed in the stages described by Kubler-Ross and Kessler namely, denial, anger, depression and acceptance". The study, published in Springer, noted that perinatal grief in Indian women had been characterized in previous research from Chhattisgarh by "sadness, unhappy feeling" and other symptoms that mapped onto the stage model.

A 2023 analysis in ScienceOpen examined the Bollywood film Goodbye through the lens of the Kübler-Ross model. The study found that "even though each individual responded differently it clearly demonstrates each of them going through Kubler Ross stages of grief reaction". The analysis noted that the protagonist's anger was "directed towards her father for following the rituals around death in a Hindu culture". This is a significant finding. The anger was not just about the loss. It was about the rituals. The cultural container that was supposed to provide comfort had become a source of conflict.

3.2 The Cultural Container: Ritual and the Thirteen Days

In India, grief is not an individual experience. It is a communal one. The antyesti—the last rites—and the thirteen-day mourning period known as terahvin provide a structured container for grief that operates on a different logic than the Western stage model.

Research on Hindu bereavement describes the thirteen-day period as a time of "deep mourning" involving "specific actions that are viewed as a final act of assistance the living can give to departed family members". On the thirteenth day, a pind dan ritual is performed, where a feast is served to family members, friends, and relatives. Sons and close male relatives observe sutak, a period of mourning during which they do not shave their facial hair for ten to thirteen days. The family is considered impure. They do not attend religious functions. They do not eat certain foods.

This is not simply a set of customs. It is a psychological technology. The rituals provide a structure for the expression of grief. They give the bereaved a role. They tell them what to do when they do not know what to do. A 2024 study on overcoming resistance to change noted that "cultural rituals in India and other collectivist societies, such as communal mourning (shraddha, tarpana, or satsangs), help externalize grief and promote interpersonal healing".

But the rituals also impose constraints. The bereaved are not free to grieve in their own way. They must grieve in the way the tradition prescribes. A 2024 qualitative study on sibling bereavement among young Indian adults found that "participants often felt the burden of supporting their parents, leading to personal grief suppression and isolation, exacerbated by societal stigmas". The family becomes the container for grief. But the container can also become a cage.

3.3 The Critique: Non-Linearity and Cultural Specificity

The Kübler-Ross model has been subjected to sustained critique in the Indian and global literature. A 2025 paper on "Understanding Grief" in the Indian socio-cultural landscape noted that the five stages "are influential but not universal" and that "Indian rituals such as antyesti (last rites) and the 13-day mourning period (terahvin) offer structured avenues for expressing and processing grief" that "may not align with Western stage-based models". The paper emphasized "the non-linear and individualized nature of grief" and the "importance of culturally sensitive interventions that honour and respect the emotional, relational, and spiritual dimensions of bereavement".

A 2023 phenomenological study on prolonged grief disorder in New Delhi, published in Transcultural Psychiatry, found "several novel findings diverging from the current understanding of manifestation and narratives of PGD" including "differences in the social contexts of bereavement and culture-specific magico-religious beliefs and idioms of distress". The study concluded that "the assumption of content equivalence for psychiatric disorders across cultures may not be justified" and that there is "a need to develop culturally sensitive diagnostic criteria and assessment scales for PGD".

3.4 The Indian Psychological Landscape: Restraint and Suppression

The Indian psychological landscape adds another layer of complexity. Research on emotional suppression in India notes that "in India, emotional restraint is often praised as maturity and self-control" and that "expressions of anger, grief, or vulnerability are frequently dismissed". A 2025 paper on "Strength in Silence or Silence in Strength" observed that "this collective silence became especially visible during the COVID-19 pandemic, when many Indians refrained from expressing fear or grief".

This cultural norm has profound implications for the expression of grief. The person who is grieving may not feel permitted to express their grief openly. They may suppress it in service of family harmony. They may present a stoic face to the world while suffering in private. The Kübler-Ross stages, which assume that grief will be expressed and processed, may not capture this internal experience. The stage of "depression" may be hidden beneath a surface of calm. The stage of "anger" may be turned inward rather than outward.

3.5 The Hindu Metaphysical Frame: Karma, Rebirth, and Continuity

Hindu metaphysics provides a framework for understanding death that differs fundamentally from the Western secular frame in which Kübler-Ross developed her model. Research on Hindu beliefs and experiences of death and dying describes four meta-themes: "philosophies and teachings, rituals' practicalities and importance, homeland and diaspora, and family involvement". The analysis highlights "how Hinduism shapes grieving experiences and provides solace through its teachings".

The doctrine of karma—the universal causal law that determines an individual's future modes of existence based on their actions—provides a framework for understanding death as part of a larger cycle. The belief in samsara—the cycle of rebirth and reincarnation—means that death is not an ending but a transition. This metaphysical frame may make the "acceptance" stage easier to reach for some Hindus. But it may also make the "anger" stage harder to express. Anger at the deceased, or at God, may feel like a violation of the cosmic order.

The concept of "continuing bonds"—maintaining an ongoing relationship with the deceased—is central to Hindu practice. Research on Hindu bereavement notes that "ancestral worship, remembrance ceremonies, and the preservation of photographs and belongings are common". A qualitative study of sibling bereavement among young Indian adults found that "continuing bonds provided comfort, but familial expectations often led to suppression of personal grief". The relationship with the dead does not end. It continues through ritual, through memory, through the family's ongoing obligations to the ancestors.

4. Discussion

The evidence tells a nuanced story. The Kübler-Ross model is not irrelevant to the Indian context. Indian clinical research has used it, and Indian patients have been observed to move through states that resemble its stages. But the model is incomplete. It was developed in a Western, individualistic, secular context. It assumes that grief is a psychological process that happens inside the individual. In India, grief is a relational, ritual, and metaphysical process that happens between people, between the living and the dead, and between the human and the cosmic.

4.1 What the Evidence Shows

The research on perinatal grief in Tamil Nadu shows that Indian women can experience states that resemble the Kübler-Ross stages. The analysis of Goodbye shows that the stages can be depicted in Indian cinema, and that cultural rituals can become a source of conflict as well as comfort. But the research also shows that the model is non-linear, that cultural context shapes its expression, and that the Indian psychological landscape—marked by emotional restraint and family duty—complicates the picture.

The Hindu metaphysical frame provides resources that the Western model lacks. The doctrines of karma and rebirth offer a framework for meaning-making that can facilitate acceptance. The practice of continuing bonds offers a way of maintaining relationship with the deceased that the Western model, with its emphasis on "letting go", often discourages. But these resources are not universally available. They depend on the individual's relationship to tradition, to family, and to faith.

4.2 Freud and the Return of the Repressed

Sigmund Freud's concept of the return of the repressed offers a framework for understanding the Indian grief experience. Freud argued that repressed material—unacceptable desires, traumatic memories, forbidden impulses—does not disappear. It returns. It erupts in symptoms, in slips of the tongue, in dreams, and in behaviour.

The grief that is suppressed in the service of family harmony does not disappear. It returns. It returns in the form of somatic complaints—the body speaking what the mouth cannot. It returns in the form of prolonged grief disorder—the grief that will not resolve because it has never been fully expressed. It returns in the form of the anger that erupts unexpectedly, long after the funeral is over.

The Indian cultural norm of emotional restraint is not pathological. It is adaptive in many ways. But it has costs. The person who cannot express their grief in the presence of their family may find themselves unable to express it at all. The grief becomes a private burden, carried alone.

4.3 Kant and the Ethics of Grief

Immanuel Kant's philosophy of autonomy offers a corrective to the paternalism that can characterize grief counseling. For Kant, freedom is the capacity to act according to reason rather than being determined by external forces. The bereaved person is not a passive recipient of grief. They are an agent. They have the capacity to make meaning, to choose how to mourn, to decide what their relationship with the deceased will be.

The Kübler-Ross model, when applied prescriptively, can undermine this autonomy. It tells the bereaved person what they should be feeling and when. It imposes a timeline. It suggests that there is a "right" way to grieve. But there is no right way. There is only the way that is true for the person who is grieving.

Kant's concept of the sensus communis—the shared sense that makes community possible—offers a complementary framework. Grief is not just an individual experience. It is a communal one. The rituals of antyesti and terahvin are expressions of the sensus communis. They create a shared framework for understanding death and for supporting the bereaved. But they must be held lightly. They must serve the bereaved, not the other way around.

4.4 Clinical Implications

For mental health professionals working with bereaved individuals in India, several implications emerge.

The first is assessment. Clinicians should assess not just the presence of symptoms but the cultural context in which grief is experienced. What are the family's expectations? What are the religious beliefs? What rituals have been performed? What is the person's relationship to tradition? These questions reveal the frameworks through which grief is understood and expressed.

The second is cultural humility. Clinicians should not impose the Kübler-Ross model on clients who do not find it meaningful. They should listen for the client's own language of grief. They should respect the rituals and beliefs that the client finds helpful. They should recognize that the Indian way of grieving is not a deviation from the Western norm. It is a different norm.

The third is community. Individual therapy is not enough. The research on Indian bereavement consistently emphasizes the role of family and community in supporting the grieving. Clinicians should work with the family, not just the individual. They should support the rituals that provide structure and meaning. They should recognize that healing happens in relationship, not just in the consulting room.

The fourth is attention to suppression. Clinicians should be alert to the signs of suppressed grief. The client who presents with somatic complaints, who reports feeling "fine" when they are clearly not, who has never cried for the deceased—these are the clients who may need help finding a safe space to express what they have been holding inside.

4.5 Limitations

The evidence base has limitations. Much of the research on the Kübler-Ross model in India is qualitative and exploratory. The samples are small. The studies are few. The research on Indian grief is growing, but it remains underdeveloped compared to the Western literature.

4.6 Future Directions

Future research should prioritize longitudinal studies that track the course of grief in Indian populations over time. Studies that examine the effectiveness of culturally adapted grief interventions. And research that explores the role of ritual and community in the healing process.

5. Conclusion

The Kübler-Ross model is not a map. It is a sketch. It captures something true about the human experience of loss, but it does not capture everything. In India, the sketch must be filled in with the colours of ritual, family, faith, and silence.

We do not have a problem with anyone. But data is data, and truth is truth. The five stages are real. But so are the thirteen days. So are the antyesti rites. So is the terahvin feast. So is the silence of the son who cannot cry because he must be strong for his mother.

Grief is universal. But the way we grieve is not. The task of the clinician is not to impose a model. It is to listen. To listen for the stage. To listen for the ritual. To listen for the silence. And to honour whatever it is that the bereaved person needs to find their way through.

6. References

· American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

· Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28.

· Examination of Kubler Ross model of grief from the perspective of Bollywood cinematic media. (2023). ScienceOpen.

· Ghosh, S. (2022). Understanding grief: Contemporary perspectives, neurobiological insights and culturally sensitive therapeutic approaches. Scholar9.

· Kübler-Ross, E. (1969). On death and dying. Macmillan.

· A qualitative phenomenological exploration of prolonged grief in New Delhi, India. (2023). Transcultural Psychiatry, 60(6), 929-941.

· A qualitative synthesis of Hindus' beliefs and experiences about death and dying. (2025). Death Studies.

· Psycho-social impact of stillbirths on women and their families in Tamil Nadu, India – a qualitative study. (2018). Springer.

· Ronad, I. (2024). Therapeutic interventions for grief and bereavement: Efficacy, stages, and clinical approaches. Christ University Journal.

· Sibling bereavement among young Indian adults. (2024). Scilit.

· Strength in silence or silence in strength: Rethinking emotional suppression. (2025). IIBP.

· Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197-224.

· Thirteen days of mourning & release. (2014, October 1). Hinduism Today.

Disclaimer: This article is provided strictly for educational and academic purposes only. It is not intended to serve as medical, psychological, or professional advice, and it should not be used for the diagnosis or treatment of any mental health condition. All information is drawn from authentic research papers and books published across the world. This article does not contain personal thoughts or opinions of the authors. We do not have a problem with anyone. But data is data, and truth is truth. The authors have conducted research and analysis based solely on published materials. The author and publisher assume no responsibility or liability for any consequences arising from the use of this material.

Prepared by

Dr. Shekhar and Team

Psychology Doctor's Forum For All 🏥⚖️