The Lost Stage of Grief: Purging
The Lost Stage of Grief: What is Purging?
Some may be familiar with six commonly discussed stages of grief: denial, anger, bargaining, depression, acceptance, and finding meaning. Some people may experience all of these stages; others may experience several in tandem or move among these stages over time, while still others may not identify with any of them. Grief often unfolds in a nonlinear way. The reality of a loss becomes more fully recognized as it unfolds as well; feelings of deprivation, despair, and heartache may deepen, compounding the grief and making the experience feel all the more harrowing and hollowing.
I’d like to consider—and perhaps add—another stage: purging. By purging, I mean the process of releasing, letting go, surrendering, and yielding to reality as a natural part of grief and loss. Purging is a felt experience that seems to be overlooked or does not yet have a name—one that others may recognize and resonate with as well in relation to grief and loss.
The Purging Stage
The stage of releasing, letting go, submitting, and surrendering is different from the acceptance stage or even the finding meaning and integration stage. Purging may involve relinquishing a loved one’s belongings as one example of the act of purging, but purging may also feel like the physical sensation of throwing up—heaving out something emotional, mentally, and physically nasty and awful—and expelling of a kind of poison that you can no longer contain or in a primal, raw way, will expel as your tolerance lessens to continue holding onto whatever is no longer serving, is beneficial, or is becoming harmful.
Grief can feel disgusting and distasteful, and loss revolting in nature.
Personally, when I have experienced loss and moved through grief, purging has felt as though I accumulated poison, toxicity, and a reservoir of affliction, both self-inflicted and not. Sometimes the felt sense released itself in trickles, like water from a persistently leaking faucet. Other times, the felt sense seems like the floodgates have opened, and a monsoon-like deluge followed.
This language may be rather colorful, maybe even relatable, but the wording more closely captures the felt sense and emotional intensity of the experience than a dry, crusty, crumbling, beige description that feels detached and austere.
Alongside other commonly recognized stages of grief, purging may not occur in any particular order—or be something a person experiences at all following a loss.
Life is weird that way.
The Stages of Grief: A Somewhat In-Depth Lens
Denial
Dissociation—including depersonalization and derealization—may become more apparent during this stage, but it is not synonymous with denial. Surreal or out-of-body experiences may accompany the denial stage for some people. An unfulfilled longing for the person, relationship, place, or life that has been lost may also accompany denial, although longing is not itself a form of dissociation.
Depersonalization: A sense of unreality or detachment from one’s own mind, emotions, body, identity, or actions. A person may feel as though they are observing themselves from outside their body (like a self-contained “bubble world”), functioning automatically (feeling like you’re on “autopilot”), or disconnected from their thoughts and feelings.
Derealization: A sense of unreality or detachment from one’s surroundings. Other people, objects, or the environment may seem dreamlike, foggy or fuzzy, artificial, distant, visually altered, or emotionally unfamiliar.
Experiencing dissociation does not automatically mean that someone meets the diagnostic criteria for a depersonalization/derealization diagnosis or another dissociative disorder.
Many people remain aware of reality when experiencing dissociation, and some have more severe presentations. Some people know that they and their surroundings are real, even though their experience feels unreal or altered. The pain of living within the reality of a loss may contribute to this sense of disconnection. Others experience persistent or recurrent dissociation, which may be associated with acute or complex trauma, overwhelming stress, anxiety, depression, or other psychological and medical factors.
When someone experiences depersonalization, the detachment concerns the self. Many people describe feeling as though they exist within a contained yet indistinct “bubble world.” Their internal sensations and perceptions may feel dulled or grayed out, and they may recognize that their interactions feel distant or automatic or on “autopilot”. Derealization involves detachment from the external world: the environment may feel surreal, altered, or warped. These perceptions are generally not hallucinations, because the person usually recognizes that the experience is a feeling or altered perception rather than a drastic change in external reality.
Dissociation may warrant clinical evaluation when it becomes persistent or recurrent, causes significant distress, interferes with daily functioning, and is not better explained by substance use, medication, a medical condition, or another mental health condition.
Many people experience shock and numbness following a loss. Denial can be both protective and dismissive in nature. It may involve distancing oneself from the knowledge and reality that someone has died, is dying, or will die. Denial can also arise in response to other forms of loss, such as the end of a relationship, leaving a place once called home, or changing a job or vocation.
The felt sense of denial may be an unwillingness—or an inability, at least for the moment—to believe that something valuable, wonderful, beautiful, life-giving, or life-affirming has ended, will end, or is already ending.
Anger
Anger can be expressed both outwardly and inwardly—externalized or internalized. When moving through grief and loss, anger may be accompanied by other emotions, such as shame, guilt, envy, jealousy, and even hatred. Anger often emerges from what we care about, love, value, or desire. Anger may validate our felt sense of justice and injustice, particularly when a loss involves a perceived betrayal of trust, safety, security, stability, or experience of abuse, neglect, and abandonment.
Another side of anger may reveal what we reject, find repellent, or experience as deeply or morally wrong—what we might understand as “evil” in opposition to “good.” The milder forms of anger may appear as irritation or frustration; at its most intense, anger may become rage or wrath. Anger can carry prolonged pain directed toward oneself, other people, the circumstances surrounding the loss, or the situation itself. Anger can tell us what mattered most. Its presence may affirm that something profoundly unjust and unwanted occurred, and recognizing that anger can itself feel validating.
Anger may also seem frightening because it affirms that what happened—and the rawness of the experience—was real. When a loss feels unjust, we may adopt a Hammurabi-like code—an “eye for an eye, tooth for a tooth” mentality—and imagine that the experience must be given its time in a court of law or actually experience that in a real court of law. We may feel compelled to weigh the evidence and arrive at an outcome that satisfies our personal sense of justice or be disappointed and disillusioned by an actual justice system.
Some people may believe that directing anger toward themselves or others is justified by an internal rule or code. The anger reveals a truth: something awful has happened or may still be happening. The question then becomes, “Who must pay for this injustice?”
Some people position themselves as the judge. Others blame God, their gods, a spiritual source, or the faith practices that once offered meaning, safety, or security. Religion, faith, and spirituality may still be sources of comfort, peace, and humanitarian goodwill while moving through grief, but grief also has a way of distorting perception, especially when paired with unchecked anger. Still others may take matters into their own hands and attempt to relieve the pain on their own terms—even when doing so causes further pain to themselves or others.
Not everyone externalizes anger to the same degree. One person’s rage may look very different from another person’s seething silence and aloofness.
Anger is neither a “bad” nor a “good” emotion; the emotional response of anger is a natural response to painful life experiences. Anger can be appropriate—even healthy—to acknowledge, experience, and witness anger in its fullest and rawest state. However, validating the emotion does not require condoning actions that cause harm.
Bargaining
Bargaining may involve an attempt to regain control, restore a sense of order, absolve oneself of guilt, or alleviate anger and sadness. We may mentally revisit and rehash the event or situation, its circumstances, or revisit aspects of the relationship with the person—living or dead. We may also imagine exchanging something of ourselves for the hope of changing the outcome.
“If only I had done this.” “If only I had said that.” “If only I had been there and hadn’t…”
Bargaining is filled with “what ifs,” “if onlys,” and questions about what we could do—or could have done—differently. Bargaining may be taking on an unnecessary burden and responsibility that wasn’t ours to take in the first place. It asks us to propose an exchange for something to which we cannot assign a price or value, and that is a frightening realization. We begin to recognize that we did not have control over the outcome and cannot go back to change it.
Control can create an illusion of security, safety, and stability. Through this lens, bargaining seems reasonable: grasping at straws may feel more bearable than admitting defeat—or accepting that the outcome cannot be changed or that perhaps control did not exist after all.
Our relationship with control may shatter and break down a person during this stage. Control may have once seemed synonymous with agency, autonomy, and free will, but it is not the same. Agency, autonomy, and free will still exist within the limitations and conditions of the human experience. These are not easy realities to acknowledge, much less live with.
Control may be another way of striving to create and maintain desired outcomes—or a personal attempt to bargain for a particular outcome—without fully considering the costs and expense of attempting to take control that may be involved. We may not recognize that a balance is accumulating and could come due at a time we neither chose nor agreed to or even asked for.
Anxiety often accompanies the bargaining stage and may exist in tension with trust. Trust can offer relaxation, calm, and reassurance—even amid uncertainty—by allowing an outcome to be relinquished as something beyond a person’s control. Trust is often built through reliable consistency, and consistency can foster a felt sense of safety. Anxiety, by contrast, may begin to govern a person’s life and erode their well-being long before grief reveals its true name.
Depression
Depression may be felt and experienced, at its mildest, as wistfulness or prolonged melancholy. For some, fall and winter bring seasonal changes in mood. The fading light, retreat of lush landscapes, and ending of seasonal abundance may mirror our own encounters with change, cycles, and circumstances beyond our control. Through this parallel process with nature, we are reminded that things are temporary and appear to work in cycles, rhythms, and movement.
Others experience persistent—and sometimes relentless—heaviness, overwhelm, and despair that may contribute to depression. Depression, at its most intense, may be experienced as profound sadness, hopelessness, stillness, or quietness, often accompanied by sorrow. Sorrow is sadness at its most saturated and darkest. The phrase “the dark night of the soul” can be a compelling description of this experience. Although clinical definitions identify symptoms, distress, and impairment, they may not fully capture the lived essence or embodiment of depression.
The depth of these depressive feelings may reveal a profound need for rest—a response to the sheer exhaustion of existence and the unrelenting nature of difficult life experiences, circumstances, and situations. Depression may also arise as a natural response to emotional, mental, or physical overwhelm. It can feel suppressive and compressive, moving—both literal and figurative movement feel difficult. This form of sadness is often associated with heaviness, pressure, unsettling or distressing sensations, and exhaustion that may persist despite sleep—or be intensified by insomnia.
Depression within grief may involve depressive feelings without necessarily meeting the diagnostic criteria for a depressive disorder. It is also not uncommon for depressive symptoms to emerge before a person recognizes or identifies the grief beneath them.
Acceptance
Acceptance is a form of acknowledgment. Both literally as a word and figuratively in its meaning, acceptance may carry a felt sense of release. However, I would describe it as an agreement with reality rather than the process of letting go, releasing, or surrendering.
Acceptance may be understood as the antithesis of denial, while a proposed purging stage more directly reflects the experience of release, surrender, and submission.
Acceptance means recognizing and believing that the loss is real and has occurred. When the loss involves death or dying, acceptance may bring a sense that something has come full circle—not that the grief process is complete or that the person grieving has been “fixed” or “made whole again,” but that the reality of the death is no longer being resisted in the same way.
Acceptance may mean no longer fighting for what cannot be anymore. The energy and effort spent fighting were not wasted, but it is okay to experience peace—and to live with some measure of peace—instead of remaining in unending pain. Peace does not erase the pain or diminish the significance of the loss.
Acceptance is the process of meeting reality as it is, with increasing awareness of our projections, expectations, and personal biases. It means learning to live with the loss as part of a changed reality. For those who remain alive while the person who died is no longer physically present, the question becomes: “What does life look like now?”
Perhaps the question is not only how, but when: “When might I feel ready to live more fully again within this changed reality?”
Readiness is not always apparent in acceptance, but movement may be. A single step is still movement. Even a breath is movement. When embodied and integrated, acceptance may feel like a more settled sense of self and contentment with the world. Contentment may be understood as a willingness to remain present through seasons of both abundance and scarcity—to allow what is, simply to be. Continued grounding and centering may still be needed; however, acceptance may mean that something has settled enough for being and living to continue.
Nothing in this stage is forced or pressured, nor does it make demands that cannot be met. Expectations may be challenged or thoughtfully reconsidered, but readiness does not require waiting for an ideal moment to act, pause, reflect, or move. Readiness itself may not feel ideal.
When grieving, moving from significant pain toward peace can feel like a great deal to ask—even when peace appears welcoming, inviting, and warm.
Finding Meaning
Finding meaning may also be understood as the integration of grief and loss. Life can and often does change after a loss, and there is rarely a blueprint, map, or guidebook showing what that changed life will look like—or how that life will be lived.
Questions that may arise include: “How do I live without them?” or “Would my loved one want me to continue living this way?”
Sometimes there are no simple answers or instant resolutions. Some people move with their grief by honoring a loved one’s final wishes or requests beyond the ceremonies and rituals surrounding the death. Others create their own rituals, continue searching for meaning, or simply remain with the process as it unfolds. The experience of grief and loss may hold the possibility of hope and renewal, even when neither is immediately recognizable. Grief and loss may bring unanticipated outcomes that do not necessarily carry either positive or negative meaning.
Meaning-making and finding meaning can be hopeful and purposeful endeavors in themselves. Making meaning from challenging, intense, and painful experiences may contribute to a fuller or more deeply examined life, but is not expected to be a greater outcome. Grief can sift through what once seemed important, revealing what truly matters, what now takes priority, and where life might go from here after loss.
Many people renew an existing sense of purpose, discover an additional purpose, or change course entirely. They may do so while honoring the life and memories of someone they love—living or deceased—or while discovering new connections to life after loss.
Some samples of purpose following grief and loss may look like:
Preserving a loved one’s stories, traditions, artwork, or recipes
Valuing and cherishing their beliefs without loss to your own
Caring for family members or friends, children, pets, neighbors, or the community
Attending to or making a memorial, ritual, spiritual, or faith-based tradition
Forming a scholarship, garden, or charitable fund in their name or on their behalf
Fulfilling a loved one’s requests or final wishes
Advocating for a cause connected—or entirely unrelated—to the loss
Supporting others who have experienced a similar loss as a profession, volunteer, community member, or advocate
Returning to a vocation or creative practice with renewed intention
Beginning something life-affirming again: a new relationship, different job or career, educational path, or way of living
Deepening spiritual, religious, philosophical, or cultural practices
Repairing or strengthening the relationships that matter most to you may include tending to your relationship with someone who has died. Some people inherit or choose to read journals, diaries, letters, and other personal materials left behind by the deceased. These writings may reveal more about who the person was, what they experienced, and aspects of their life that were previously unknown. Although a relationship with someone who has died cannot be repaired reciprocally, it may continue to be understood, reinterpreted, or repaired within the life of the person who remains. Such discoveries can bring comfort and connection, but they may also introduce complicated feelings or unanswered questions.
Remaining connected to someone who has died through memory and continuing bonds can offer a sense of purpose. For some, the relationship does not simply end with death, regardless of their beliefs about an afterlife. The person’s memory, influence, and the bonds formed within the relationship may continue after their death. Others may experience the death as a release and may not choose to maintain an ongoing bond or make the relationship part of their sense of purpose. Some may prefer distance, privacy, or even for the deceased person to remain forgotten or unknown—particularly when the relationship was painful, harmful, complicated, or estranged. Neither response is required or inherently more meaningful than the other.
Volunteering, mentoring, teaching, or contributing to one’s community
Engaging in the arts: art, writing, music, or other creative work
Choosing rest, health, stability, or a more sustainable life
Becoming more present in ordinary life and valuing small experiences
Living in a way that reflects what the person or relationship meant
Simply breathe, take the next step, however small, live, one moment at a time
Purpose and meaning making need not be ambitious, public, permanent, or directly connected to the loss. This may be quiet and temporary, and changes as one moves through grief.
Pain does not need to be transformed into a performance or something productive. Caring deeply and dearly for yourself as much as your loved one is part of the process too. Others may be starting to learn what that looks like again as well, to be the one cared for after caring for a dying person.
So What About Purging?
Is purging even an actual stage? I view this more as a perspective that isn’t fully encompassed by the other recognized and common stages of grief and loss.
Being a mental health professional and working in healthcare does not grant me the authority to invent a stage and present an idea as an established clinical concept. Yet, I have some awareness and understanding of my own life, and I have experienced grief and loss. I do not know what I do not know, and I may not need to know the rest. I am at peace with mystery and the unknown. I am also comfortable accompanying a client, holding space with them, and helping carry what feels difficult to carry alone. I continue to create meaning and purpose in my own life and have followed many of the samples of purpose in the above paragraph as well.
My experiences inevitably inform my art therapy practice, my artistic endeavors, and whatever my being is doing—or peacefully resting within—when no one is around except the birds and the silence.
Understandably, this will not be everyone’s experience, nor is this perspective making a general assumption regarding the stages of grief that were missed or overlooked. I believe there may be a phase—however long, short, defined, or indistinct—that reflects a felt sense I have known. I wonder whether others have experienced it as well: the need and process of letting go, releasing, allowing life to be, and allowing myself to be while grieving a loss. I call this experience “purging” in reference to moving through grief and loss as an act of surrender and submission that is beyond my capacity and sometimes capability.
Purging may involve releasing the poison, toxicity, or falsehoods attached to a loss, a relationship, or an experience—or to the experience of encountering death and dying. I wonder whether purging is not only a lost or unacknowledged stage, but also an experience of losing the path itself. Purging felt like being lost and lonely.
This may be where uncertainty and trust live alongside each other. Can we trust the unknown? Can we know without fully knowing? What place or purpose does uncertainty have, if any?
Feeling lost and lonely can feel deeply forlorn, yet it may also offer the solitude I need—to be by myself and with myself, to feel the feels, think the thoughts, and experience the parts of life that no one else can experience for me. Others may join me, and I hold fast to my own faith, beliefs, and values, such as I do believe in the omnipresence and omniscience of a relational, divine God who can hold the mysteries of the universe and my own life well enough so I don’t have to or need to. Like any process, grief contains unknowns. No phase or stage is singular, neat, or self-contained. Loss can create space for other possibilities, although that is not an expected outcome or universal felt sense.
A person can experience bouts of rage and sorrow while remaining an integrated, whole person who still goes to work and runs errands, creates art, and goes out and about in the world. Before stepping out the door, that person may have needed some form of catharsis: crying unexpectedly, screaming toward the birds, or feeling the urge to smash a clean dish simply because it has one small chip (or several, and it was an heirloom).
Crying, screaming at the birds, and then going to the grocery store, picking up the children from school, returning to work, or completing whatever else is on the day’s agenda may become part of the strange company of grief.
I give credit to a nurse friend who once told me about “screaming at the birds” as a coping method. It can be surprisingly cathartic, and I highly recommend it. Sometimes the birds join in; sometimes they become quiet. Perhaps, at some point, I have sounded like another bizarre, absurd bird to them. Maybe my presence in the forest is simply that—a presence among everything else, existing, being, and taking one breath at a time.
Smashing dishes and other acts of aggression, however, can cause injury, damage, and regret. Thankfully, smash rooms and other safer, intentional outlets exist for moments when frustration and pent-up anger need somewhere to go other than toward ourselves, other people, or the dishes in the kitchen. If breaking objects feels cathartic, it is safer to do so in a purpose-designed environment with appropriate protective equipment and cleanup procedures—not by rage-smashing an heirloom dish, chips and all. Your floors, loved ones, and sense of self-respect may thank you.
The process of grief and loss is often messy, unpredictable, and unknown. Sometimes the process of moving through grief and loss may feel even more frightening than death and dying themselves.
Personally, I have experienced enough overwhelming and traumatic circumstances—both in my own life and alongside family and friends—to know what it is like to live at a delicate balancing point: not knowing whether someone will remain in this life or enter the next, whether they will continue to be present or become the loved one whose absence is grieved. I also know what it means to grieve deaths that were both unexpected and anticipated.
I do not share this for tragic or dramatic effect. It is a real, lived experience—one I know well enough to recognize as a form of strange company and will likely continue to know its presence when present.
Art Therapy as Support Through All Stages
My practice supports people who are grieving and living with loss. I offer a compassionate, creative space for navigating difficult and sometimes conflicting experiences, including relational trauma, emotional overwhelm, and life transitions, as an art therapist. My work is grounded in the belief that trust, compassion, and the possibility of growth are essential parts of the therapeutic process.
There is no single way to grieve and no prescribed stage you must reach. If you are seeking support as you make sense of grief, loss, or a changed reality, art therapy can offer space for both art-making and conversation—especially when words alone do not feel like enough.
This article reflects my professional perspective and personal understanding of grief and loss. It is intended for educational purposes and is not a substitute for individualized mental health or medical care.
When you feel ready, The 3 Brushes, LLC provides in-person art therapy for children and tweens, teens, and adults in Gaithersburg, Maryland. Explore my services or schedule a complimentary 20-minute consultation to learn more.
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When words are not enough, support is still possible.
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