The Science of Loss and Recovery | Mary-Frances O'Connor
In this episode, Dr. Mary-Frances O'Connor, Associate Professor of Clinical Psychology and Psychiatry at the University of Arizona and author of "The Grieving Brain," explores the science of grief and grieving. She discusses brain changes during bonding and loss, coping strategies, the non-linear nature of grief, and how to support those experiencing loss.
Deep Dive Analysis
15 Topic Outline
Guest's Personal Journey and Broad Definition of Grief
Grief as a Form of Learning and Post-Traumatic Growth
Developing a Diverse Toolkit of Coping Strategies for Grief
Buddhism's Influence on Understanding Impermanence and Grief
Distinction Between Grief and Grieving
Neuroscience of Bonding and Loss: The Grieving Brain
Brain Regions Implicated in Yearning and Attachment
Grief's Impact on Cognitive Function and Concentration
Revisiting Elizabeth Kübler-Ross's Stages of Grief
Understanding Grief for Public Figures (Parasocial Grieving)
The Elasticity of Grief: Beyond the Loss of a Loved One
Grief During the Pandemic and the Importance of Rituals
The Serenity Prayer and Its Wisdom in Grief
Effective Ways to Support Someone Who is Grieving
Understanding Prolonged Grief Disorder
6 Key Concepts
Grief vs. Grieving
Grief is the overwhelming feeling or wave of emotion that can strike at any moment. Grieving, on the other hand, is the process by which grief changes over time without ever truly going away, involving learning to integrate the loss into one's understanding of the world.
Post-traumatic Growth
This psychological phenomenon describes positive changes that can occur after experiencing trauma or loss. It can manifest as a 'carpe diem' attitude, a deeper appreciation for close relationships, or a renewed focus on meaningful activities.
Nucleus Accumbens
This brain region is part of the reward network, crucial for teaching us to want and yearn for things. In grief, it's activated both during bonding and when yearning for a lost loved one, indicating the brain's persistent drive to connect with the 'special' person.
Intersubjectivity
This concept suggests that our brains and experiences are co-created in bonded relationships, forming a 'we' entity distinct from individual 'you' and 'me.' When a bonded person is lost, it feels like losing a part of oneself because the brain has encoded this 'we' representation.
Parasocial Grieving
This refers to the grief experienced for public figures, celebrities, or artists whom one has never personally met. It arises from a deep connection formed through their work or public persona, where their death can feel like the loss of a piece of oneself that connected with their art or message.
Prolonged Grief Disorder
A clinical diagnosis for a small subset of individuals whose grief does not naturally decline in frequency and intensity over time, significantly impairing their day-to-day functioning. It is distinct from depression and typically considered only after a year has passed since the loss.
11 Questions Answered
Grief fundamentally shifts how one thinks about the world, relationships, and mortality, often leading to a boost in vitality, a deeper appreciation for loved ones, and a re-evaluation of how time should be spent.
Yes, temporary avoidance can be appropriate in certain moments, such as focusing on a child's activity, to cope with overwhelming emotions. However, it is not a sustainable long-term strategy and should be part of a larger toolkit.
Buddhism's core teaching of impermanence helps in accepting that everything changes, including the presence of loved ones. This perspective aids in navigating the finality of loss and provides a framework for understanding suffering.
When a loved one dies, the brain's established bond, which encoded the person as 'special' and 'always there,' struggles to update. This can lead to a persistent yearning and a feeling that the person might still return, even when intellectually aware of their death.
No, grief is considered an evolutionary 'perk' because the pain of separation serves to keep bonded individuals together, which is crucial for survival. It only becomes a 'problem' when the separation is permanent due to death, as the system is not designed for that outcome.
No, grief is not something one 'gets over' but rather something that changes who you are and how you understand the world. It becomes integrated into your life, though the frequency and intensity of grief waves typically decrease over time.
Elizabeth Kübler-Ross described stages like denial, anger, and acceptance based on momentary observations of terminally ill patients. Modern research on 'grieving' shows it's not a linear process; these emotions can appear in any order and recur, rather than progressing through fixed stages.
Yes, the experience of grief is elastic and can extend to other significant losses, such as a job, a romantic breakup, or children leaving home, as these also involve a loss of identity or a significant bond that changes one's understanding of self and the world.
The pandemic created unique difficulties, such as the inability to be at a loved one's bedside, leading to guilt and making the death feel less real. It also disrupted traditional rituals like funerals, though people found resilient ways, like Zoom funerals, to connect and support each other.
It's okay to say 'I don't know what to say,' but follow it with a genuine desire to understand and a commitment to long-term support. Offer practical help like groceries or quiet companionship, rather than trying to 'fix' their feelings or expect them to be happier.
PGD is a diagnosis for a small percentage of people (1 in 10 or 1 in 20) whose grief does not naturally decline in frequency or intensity over time, significantly impairing their daily functioning. It is typically considered a year after the death and is treatable with psychotherapy.
25 Actionable Insights
1. Cultivate Diverse Coping Strategies
Cultivate a wide range of coping strategies for strong emotions, as no single approach will be effective in every situation. This allows for flexibility and appropriate responses to different moments.
2. Offer Presence and Practical Support
When supporting someone grieving, acknowledge your lack of words, express a desire to understand, and commit to long-term presence. Offer practical help like running errands, and be willing to sit in quiet or engage in non-verbal activities, rather than trying to fix their feelings.
3. Be Present, Don’t Fix
Shift your focus from trying to ‘fix’ or make a grieving person feel better, which often stems from your own discomfort, to simply being present with them. This approach fosters connection rather than making them feel more alone.
4. Bypass Rumination on ‘What Ifs’
When faced with unanswerable ‘would’ve, should’ve, could’ve’ questions, recognize that seeking answers is not the solution. Instead, find ways to navigate around these thoughts to avoid being stuck in virtual realities and to engage with the present moment.
5. Manage Grief While Living
Acknowledge that pangs of grief can strike at any moment, even during daily activities, and actively plan how to move in and out of these moments to continue restoring the life you want to live. This involves conscious management of emotional fluctuations.
6. Use Progressive Muscle Relaxation
Utilize progressive muscle relaxation, a concrete skill of clenching and relaxing muscle segments, to provide physical relaxation and a focal point for attention when grief feels overwhelming. This technique can be used anywhere to offer a moment’s break.
7. Practice Accepting Present Reality
Engage in the practice of ‘accepting’ the present reality of loss without immediate emotional reaction, such as anger, protest, or regret. This ongoing practice provides support and moments to ‘set down’ the pain, changing how you perceive things.
8. Distinguish Grief from Grieving
Differentiate between ‘grief’ (the overwhelming feeling) and ‘grieving’ (the process of grief changing over time). This understanding helps recognize that grief never truly goes away but becomes more familiar and manageable, allowing you to learn how to find comfort.
9. Embrace Life’s Impermanence
Apply the understanding of impermanence not just to death, but to all aspects of life and relationships, recognizing that things are constantly changing. This perspective can help in navigating various losses and gains, fostering a more fluid understanding of reality.
10. Meditate as Loss Training
Utilize meditation and Buddhist practices as a form of training for both large and small losses. These practices experientially expose you to the rapidity of change, potentially making future losses less surprising and helping you navigate them with greater ease.
11. Practice Active Grief Coping
Beyond temporary avoidance, learn and practice active coping strategies such as crying on a shoulder, journaling, praying, or going for a walk to manage strong emotions. These varied approaches contribute to mental health in different moments.
12. Utilize Strategic Avoidance
In specific situations, such as a child’s soccer game, it can be appropriate to temporarily put grief out of your mind and focus on the present activity. This is a valid coping mechanism for certain moments.
13. Cultivate Courage to Love Again
After experiencing profound loss, it takes significant courage to open yourself to loving again, despite the potential for future hurt. A mentally healthy life involves continuing to love living loved ones, even when new relationships may trigger memories of past grief.
14. Seek Psychotherapy for Prolonged Grief
If experiencing prolonged grief disorder, characterized by persistent high frequency and intensity of grief beyond a year after loss, seek psychotherapy. This is the best frontline treatment to help individuals return to a natural grieving trajectory.
15. Apply Serenity Prayer Wisdom
Use the Serenity Prayer as a guide to discern when to accept unchangeable circumstances and when to courageously act to change what is possible. This wisdom helps in navigating the balance between struggle and acceptance during difficult times.
16. Find Comfort in Neurobiology
Seek comfort in understanding the scientific basis of how love changes the brain and how those connections persist even after loss. Knowing that you physically carry the imprint of loved ones can provide a sense of enduring connection.
17. Recognize Grief’s Role in Fostering Empathy
Understand that the profound pain of grief, while debilitating, is also adaptive, teaching us about shared human suffering and fostering deep empathy and compassion for others experiencing loss. This realization can transform personal grief into connection.
18. Let Grief Teach Meaning
Allow grief to be a profound teacher, revealing what truly matters in life and motivating you to live meaningfully and to ease the pain of others. This perspective can transform personal suffering into a drive for compassionate action.
19. Adapt Rituals for Connection
In times of restricted physical gatherings, adapt traditional rituals like funerals (e.g., using virtual platforms) to honor the deep human desire to connect and care for those suffering. The intention to connect and support is key, and creative solutions can foster unique forms of intimacy and honesty.
20. Be Patient with Grief-Brain
Understand that grief can significantly impair concentration, attention, and memory due to intense background brain processing. Be patient with yourself or others experiencing these cognitive difficulties, recognizing they are a natural part of the brain’s effort to adapt to loss.
21. Avoid Rigid Grief Stages
Avoid rigidly following the ‘stages of grief’ as a prescription, as grief is not a linear process and individual experiences vary greatly. Recognize that acceptance increases and yearning decreases over time, but not in a fixed order, and it’s okay not to experience all stages or in sequence.
22. Act on Intention to Connect
Honor the deep human desire to connect and care for those suffering by translating intention into action. This commitment to reaching out and supporting others, even in challenging circumstances, often leads to finding effective ways to connect.
23. Practice for Grief Respite
Engage in spiritual or meditative practices not to reduce the pain of loss, but to provide moments of understanding, accepting, and comfort where you can temporarily ‘set down’ the grief. This practice changes your perspective over time.
24. Understand Yearning’s Evolutionary Role
Recognize that the pain of yearning and separation is an evolutionary design to motivate connection and bring individuals back together. This understanding can reframe the experience of yearning as a natural, albeit painful, aspect of deep bonding.
25. Clinicians: Study Grief Responses
For clinicians, it is important to learn about typical and acute grief to understand the full spectrum of human response to loss, especially now that prolonged grief disorder is part of the medical canon. This knowledge enables better identification and support for those who need it.
6 Key Quotes
You need a really big toolkit of coping strategies because no one strategy is going to work in every situation.
Mary Frances O'Connor
Grief is that feeling that overwhelms you... Grieving, on the other hand, is the way that grief changes over time without ever going away.
Mary Frances O'Connor
When a loved one dies, then the problem is the brain's solution to someone being absent, not in our presence... doesn't work anymore.
Mary Frances O'Connor
There is no getting over. It's like asking, if I said to you, Dan, when did you get over your wedding day? You know, like, that's not really a question that makes sense, because it just changes who you are.
Mary Frances O'Connor
I don't know what to say. I'd really like to understand what you're going through. I also understand if now is not the right moment. And I want you to know that I'm going to be here, where right now I'm sure it's hard for you to even imagine what the future could be like. I want you to know I'm going to be here until we get there.
Mary Frances O'Connor
Pain is inevitable. Suffering is optional.
Dan Harris
2 Protocols
Progressive Muscle Relaxation (PMR) for Grief
Mary Frances O'Connor- Clench different segments of the muscles of your body.
- Let them relax.
- Notice the difference and what it feels like when this part of your body is relaxed.
Supporting Someone Who is Grieving
Mary Frances O'Connor- Acknowledge: Say 'I don't know what to say,' but express a genuine desire to understand what they're going through, respecting if it's not the right moment.
- Commit: State 'I'm going to be here until we get there,' signaling long-term support.
- Follow Through: Reach out repeatedly over time ('hey, checkin' in on you').
- Listen: Be quiet and allow them to share their experience and what they are learning.
- Offer Practical Help: Suggest doing concrete tasks like getting groceries or taking kids to appointments.
- Offer Companionship: Suggest activities that don't require talking, like a quiet drive or watching a movie together.