Podcasts > Huberman Lab > Healing From Grief & Loss | Dr. Mary-Frances O'Connor

Healing From Grief & Loss | Dr. Mary-Frances O'Connor

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In this Huberman Lab episode, Dr. Mary-Frances O'Connor and Andrew Huberman explore the neurobiology and psychology of grief. O'Connor explains the distinction between grief as an immediate reaction to loss and grieving as an ongoing adaptation process. She describes how different brain systems process loss, including the protest response and reward systems, and presents evidence about the significant physical health risks that accompany bereavement.

The conversation covers practical approaches to managing grief, from progressive muscle relaxation techniques to the value of social support systems. O'Connor and Huberman discuss how modern society often lacks structured support for those who are grieving, and examine the potential benefits of implementing a public health model for bereavement support that includes grief literacy, psychoeducation, and health monitoring for those experiencing loss.

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

1-Page Summary

The Nature and Neurobiology of Grief

In this episode, Mary-Frances O'Connor and Andrew Huberman explore the complex neurobiological processes of grief. O'Connor explains that while grief is an intense reaction to loss, grieving is the ongoing process of adapting to that loss. She describes grieving as similar to stock market fluctuations, with daily variations but an overall upward trajectory toward healing.

The neurobiology of grief involves multiple brain systems. O'Connor explains that the brain's protest response triggers a refusal to accept reality, while the reward system, particularly the nucleus accumbens, activates when grieving individuals see photos of deceased loved ones. This activation correlates directly with the intensity of yearning they experience.

The Social and Psychological Aspects of Grieving

While grief is universal, O'Connor notes that modern society often lacks structured support systems and grief literacy. She describes grieving as an alternating process between protest (searching for what's lost) and despair (accepting the permanence of loss). The relationship with the deceased must transform internally for healthy grieving to occur, with many people finding ways to honor their loved ones while still allowing new experiences and joy in life.

Strategies and Tools For Navigating Grief

O'Connor and Huberman discuss several practical approaches to managing grief. O'Connor recommends progressive muscle relaxation, which has shown better results than mindfulness in studies with widows and widowers. Huberman describes a practice similar to yoga nidra, involving self-directed relaxation and long exhale breathing, which he calls non-sleep deep rest.

The importance of social support is emphasized, including touch, eye contact, and the presence of others. Bereavement groups can help normalize the grieving process and combat isolation.

The Medical and Healthcare Implications of Grief

The physical impact of grief can be severe. O'Connor cites studies showing that on the day of a loved one's death, a person is 21 times more likely to have a heart attack. In the three months following a spouse's death, both men and women face nearly double the risk of fatal heart attacks.

O'Connor advocates for a public health model of bereavement support, including grief literacy, psychoeducation, and physical health monitoring. She questions why enhanced care for the bereaved isn't more common, given that insurance companies have long recognized these health risks in their actuarial tables.

1-Page Summary

Additional Materials

Clarifications

  • The brain's protest response in the context of grief involves a psychological reaction where the individual initially refuses to accept the reality of the loss. This response can manifest as denial, anger, or a strong emotional resistance to acknowledging the absence of the loved one. It is a natural part of the grieving process as the brain grapples with the shock and emotional impact of the loss. Over time, as the individual progresses through grief, this protest response typically evolves into a more adaptive acceptance of the loss.
  • The nucleus accumbens is a region in the brain associated with reward, pleasure, and reinforcement learning. It plays a crucial role in motivation, addiction, and emotional responses. Activation of the nucleus accumbens is linked to the experience of pleasure and positive emotions, such as when individuals see photos of deceased loved ones during the grieving process.
  • Grief literacy involves understanding and knowledge about the grieving process, including its emotional, social, and psychological aspects. It encompasses awareness of how grief impacts individuals physically and mentally, as well as recognizing the importance of support systems and coping strategies. Grief literacy aims to enhance public understanding and support for those experiencing loss, promoting healthier grieving outcomes. It advocates for education, resources, and interventions to help individuals navigate and cope with grief effectively.
  • Progressive muscle relaxation (PMR) is a technique involving the systematic tensing and relaxing of muscle groups to promote deep relaxation. It aims to reduce muscle tension and promote a sense of calm by increasing awareness of bodily sensations. PMR is commonly used to manage conditions like anxiety, stress, insomnia, and pain, offering both immediate and long-term benefits. The practice involves a structured approach where individuals learn to release muscle tension consciously, fostering a mind-body connection for relaxation and stress relief.
  • Yoga nidra is a state of consciousness between waking and sleeping induced by guided meditation. It has roots in ancient Hindu texts and has evolved into a modern relaxation technique. It is used for stress relief and has gained popularity worldwide. The practice involves deep relaxation and is often associated with promoting mental and physical well-being.
  • Actuarial tables are statistical data used by insurance companies to assess risk and determine premiums. These tables help predict life expectancy and the likelihood of certain events, like heart attacks, based on various factors. Actuaries use actuarial tables to calculate insurance rates and reserves accurately. The tables play a crucial role in insurance underwriting and financial planning.

Counterarguments

  • While the analogy of grief to stock market fluctuations captures the variability of the grieving process, it may oversimplify the complexity of human emotions and their unpredictability.
  • The concept of an overall upward trajectory in grieving assumes a linear progression that may not hold true for everyone; some individuals may experience prolonged or complicated grief that does not follow a predictable path toward healing.
  • The focus on the neurobiology of grief, while informative, might overshadow the importance of cultural, social, and individual factors that also play a significant role in how grief is experienced and expressed.
  • The assertion that modern society often lacks structured support systems and grief literacy could be challenged by pointing out the various cultural practices, religious rituals, and community support networks that do exist and provide significant support to the bereaved.
  • The recommendation of progressive muscle relaxation over mindfulness as a strategy for managing grief might not be universally applicable, as different individuals may respond better to different interventions based on personal preference, cultural background, or specific circumstances.
  • The emphasis on the importance of transforming the relationship with the deceased internally for healthy grieving might not resonate with all cultural or personal beliefs about death and the afterlife.
  • The claim that a person is 21 times more likely to have a heart attack on the day of a loved one's death, while based on studies, could be scrutinized for potential confounding factors or the need for more research to understand the mechanisms behind this statistic.
  • The advocacy for a public health model of bereavement support, while well-intentioned, may not take into account the complexities of implementing such a model across diverse populations and healthcare systems.
  • The suggestion that enhanced care for the bereaved should be more common might be met with counterarguments regarding the practical challenges of healthcare resource allocation and the need for evidence-based approaches to justify widespread changes in policy.

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

The Nature and Neurobiology of Grief

Grief is an intense reaction of the brain, body, and mind to loss, and Mary-Frances O'Connor alongside Andrew Huberman delve into the complex neurobiological processes that underpin this universal human experience.

Grief: A Natural Response to Loss and Death

O'Connor explains that grief is the complex reaction—physical, emotional, and mental—to the death of someone close. It differs from grieving, which is an ongoing process and the adaptation to that loss over time. She likens grieving to the stock market's fluctuations; there are daily ups and downs but there's a general trajectory towards healing over time. Sudden losses, she notes, can be harder to process due to the lack of mental preparation.

Grief Vs. Grieving: How Grief Changes Over Time

Grieving is not a process that eradicates grief; instead, people learn to understand it and learn how to live with it. O'Connor describes it as a slow upward spiral, where motivation and good feelings gradually return as one begins to reengage with life. Over time, the stark focus on the painful aspects of loss can broaden into a context that fits into the larger tapestry of one's life.

Grief Stems From Brain's Yearning and Protest Systems

O'Connor and Huberman discuss the neurobiology of grief, focusing on the protest response triggered by a loss. This response is characterized by a refusal to accept the reality, often paired with recurrent thoughts about how events could have been different. The anterior mid-singulate cortex and its network, related to tenacity and willpower, may be involved in this protest during grief.

Grief Activates the Reward System, Causing Longing for the Lost Figure

Mary-Frances O'Connor mentions that a hallmark of grieving is yearning or wanting, which is linked to the brain's [restricted term] and reward system. Neuroimaging studies have shown increased activity in the nucleus accumbens—a part of the reward learning area—when grieving individuals are shown photos of their deceased loved ones. This activation is directly correlated with the intensity of yearning a person expressed. The conversation suggests that grief can evoke addiction-like narrow focus on the lost individual. However, unlike addiction, grief requires a transition to new forms of fulfilling attachment needs.

Huberman acknowledges that the brain's protest circuitry can create false narratives or "if only" thoughts, which are integral to the protest component of grief. These narratives can give a sense of control but can also lead to feelings of guilt as a byproduct of this protest. It is all part of the body's resilience and attempt to re-regulate in the absence of the deceased.

Grief is seen as a natural learning process, with lessons varied among individuals. Some may discover newfound strength or gratefulness for the influence of th ...

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The Nature and Neurobiology of Grief

Additional Materials

Clarifications

  • The anterior mid-singulate cortex is a region in the brain involved in various cognitive and emotional functions, such as decision-making, conflict monitoring, and processing emotions related to social interactions. It plays a role in regulating responses to stress and emotional pain, including those experienced during grief. This brain region is part of a network that includes other areas involved in emotion regulation and self-control, contributing to how individuals process and cope with intense emotional experiences like grief. Understanding the activity in this network can provide insights into the neural mechanisms underlying grief responses.
  • The nucleus accumbens is a brain region involved in processing motivation, reward, pleasure, and reinforcement learning. It plays a significant role in addiction and is part of the brain's reward system. The nucleus accumbens is divided into substructures like the core and shell, each with distinct functions. It is essential for understanding how the brain responds to stimuli related to motivation, aversion, and reward.
  • The phrase "addiction-like narrow focus on the lost individual" suggests that during grief, individuals may experience an intense and singular fixation on the person they have lost, similar to how addiction can create a strong, singular focus on a substance or behavior. This focus can lead to persistent thoughts, yearning, and longing for the deceased individual, akin to the cravings experienced in addiction. It highlights how grief can temporarily alter cognitive and emotional processes, causing a hyper-focus on memories and feelings associated with the lost loved one. This comparison underscores the powerful and consuming nature of grief's impact on an individual's thoughts and emotions.
  • The brain's protest circuitry in the context of grief involves the activation of neural pathways associated with refusal to accept the reality of loss. This response often leads to recurrent thoughts about how things could have been different, creating a sense of protest against the loss. The anterior mid-singulate cortex and its network, related to tenacity and willpower, are believed to play a role in this protest response during grief. This circuitry can generate false narratives or "if only" thoughts, contributing to feelings of control and sometimes guilt as part of the grieving process.
  • In grief, false narratives or "if only" thoughts are mental constructs where individuals imagine alternative scenarios or outcomes that could have prevented the loss. These thoughts often involve feelings of regret, guilt, or a desire to change the past. They are a common part of the protest response in grief, where the brain grapples with the reality of the loss by exploring different possibilities that might have led to a different outcome. These narratives can provide a sense of control or a way to make sense of the loss, but they can also intensify feelings of sadness or gu ...

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

The Social and Psychological Aspects Of Grieving

Grieving is a complex process influenced by cultural norms and personal experiences, and understanding its social and psychological dimensions can be vital for healthy mourning.

Grief Is Universal, but Cultural Norms Shape Grief

Grief is an experience shared by all humans, yet it is experienced and expressed differently across cultures due to differing societal structures and norms.

Modern Society's Limited Social Support and Rituals Complicate Grieving

O'Connor observes that current culture often lacks grief literacy and a structured system for managing the intense emotions associated with grief. Religion may provide a community and social support during grieving, yet it can also challenge beliefs, adding stress and disruption to the grieving process. Without communal experiences to facilitate the transition after a death, people in modern society must navigate their grief largely alone.

Grieving Involves Alternating Between Protest and Despair

Grieving involves an alternating process between protest—the urgent, hormonally driven searching for what is lost—and despair— the sinking realization of a loved one's permanent absence. O'Connor describes despair as a function that halts our physically costly search. Understanding this process can aid individuals in navigating the complex emotions tied to grief.

Transforming the Relationship With t ...

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The Social and Psychological Aspects Of Grieving

Additional Materials

Clarifications

  • Grief literacy is the understanding and knowledge of how to navigate and manage the intense emotions associated with grief. It involves being aware of the different aspects of the grieving process and having the skills to cope with loss effectively. In modern society, the lack of grief literacy can complicate the mourning experience for individuals who may struggle to find adequate support and resources to help them through their grief. Developing grief literacy can help individuals better comprehend and navigate the complexities of mourning, leading to healthier grieving outcomes.
  • Memorials transitioning from death-centered events to life celebrations signifies a shift in focus from mourning the loss of a loved one to honoring their life and legacy. This transformation i ...

Counterarguments

  • While grief is indeed influenced by cultural norms, it's also important to recognize that individual differences can sometimes outweigh cultural influences, and not all individuals within a culture will grieve in the same way.
  • The assertion that modern society has limited social support and rituals may not account for the rise of online communities and virtual support networks that can provide new forms of social support for grieving individuals.
  • The role of religion in grieving can be complex; for some, it may not provide the comfort and community suggested, and for others, it may even exacerbate feelings of loss or guilt, depending on personal beliefs and the nature of the religious community.
  • The binary framing of grieving as alternating between protest and despair might oversimplify the experience, which can include a wide range of emotions and states that do not fit neatly into these categories.
  • The idea that transforming the relationship with the deceased is essential for healthy grieving may not resonate with everyone; some individuals may find that maintaining a sense of connection as it was, rather than ...

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

Strategies and Tools For Navigating Grief

Grief stress can be overwhelming, but there are various strategies and tools available to manage the process and maintain resilience.

Managing Grief Stress With Relaxation, Mindfulness, and Body Awareness

O'Connor discusses the resilience of the body and its ability to re-regulate, highlighting the usefulness of body awareness during grief. Andrew Huberman describes a practice similar to yoga nidra, which includes self-directed relaxation, long exhale breathing, and acknowledging the finiteness of time. This practice, which he calls non-sleep deep rest, rejuvenates his approach to life.

Muscle Relaxation Soothes Body and Mind During Grief

Mary-Frances O'Connor speaks about progressive muscle relaxation, which involves contracting and relaxing different muscle groups. This technique, found to be more helpful than mindfulness in a study involving widows and widowers, helps in becoming more aware of what relaxation feels like. O'Connor explains that this technique can be used in various settings to alleviate muscle tension, thereby assisting with grief management.

Toolkit Of Coping Strategies For Grief Flexibility

O'Connor suggests having a "big toolkit of strategies to deal with waves of grief," including coping strategies for dealing with repetitive thoughts that arise during grief, such as changing one's environment or simply walking outside to shift thought patterns. The text also discusses intervention strategies to help people navigate troubling memories, especially if they get worse over time, which includes professional help.

Maintaining Supportive Connections Comforts and Provides Perspective During Grief

Sharing Grief With Others Normalizes the Process and Reduces Isolation

Huberman speaks about the benefits of setting up bereavement documents to reduce confusion and sadness for loved ones after one's passing. O'Connor emphasizes the value of learning to work with the mind, brain, and body to understand how to engage with them to navigate life's challenges. This implies that supportive practices and knowledge can offer comfort and perspective during grief.

Huberman also underscores the importance of having supportive people during times of grief, noting the significance of touch, hugs, eye contact, and the presence of another person or pet. He further discusses the role of bereave ...

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Strategies and Tools For Navigating Grief

Additional Materials

Counterarguments

  • While body awareness and relaxation techniques can be helpful, they may not be suitable for everyone, and some individuals may find other methods more effective for managing grief.
  • The effectiveness of muscle relaxation and mindfulness may vary from person to person, and some may not experience the same level of relief.
  • A toolkit of coping strategies is useful, but it may take time and experimentation to find the right combination of strategies that work for an individual.
  • While sharing grief with others can be beneficial, some people may require more privacy in their grieving process and might not be comfortable with group settings or sharing their feelings openly.
  • The importance of touch, hugs, and eye contact may not resonate with everyone, as cultural differences and personal preferences can influence how people prefer to give and receive support.
  • Adaptive toolkits and coping strategies are valuable, but they may need to be tailored to individual needs, and what works for one person may not work for another.
  • The suggestion to assess sources of judgment could be challenging for some individuals who are in environments where cultural or societal norms make it difficult to grieve openly or healthily.
  • Reengaging ...

Actionables

  • Create a personalized grief mantra that you can repeat during challenging moments to foster body awareness and resilience. By crafting a mantra that resonates with your personal experience of grief, such as "With each breath, I find strength and peace," you can use it to center yourself when you feel overwhelmed. Repeat this mantra during times of stress or before engaging in activities that you find comforting.
  • Design a "grief map" to visually represent your support network and coping strategies. Draw a map with yourself at the center and branches leading to different forms of support and activities you find helpful. This could include friends who offer a listening ear, places that bring you peace, or actions like writing letters to your loved one. Having this visual aid can remind you of the resources available to you when you need them.
  • Experiment with creating a small, portabl ...

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Healing From Grief & Loss | Dr. Mary-Frances O'Connor

The Medical and Healthcare Implications of Grief

Andrew Huberman and Mary-Frances O'Connor discuss the profound impact grief can have on the body and emphasize the need for systemic healthcare support to mitigate the health risks associated with bereavement.

Grief Heightens Risk of Serious Physical Health Issues

Grief's Physiological Stress Can Overwhelm the Body, Increasing Medical Vulnerability

Grieving is a medically risky time with the potential to intensify medical vulnerability due to the physiological stress it causes. On the day a loved one dies, a person is 21 times more likely to have a heart attack, and in the first three months following a spouse's death, a man is nearly twice as likely to have a fatal heart attack, with the risk for women at about 1.8 times greater. O'Connor cites large epidemiological studies showing a much higher risk of all-cause mortality for newly bereaved people, indicating a significant impact on physical health.

Grieving individuals often experience physical pain with sensations like a lump in the throat or a chest on fire. O'Connor's lab connected waves of grief with increased blood pressure, particularly in those with more intense grief, and these elevated levels of stress do not recover for them, suggesting ongoing physiological stress.

Enhancing Bereavement Care With Physical, Mental, and Social Support

Systems of care are crucial for assessing whether people are healthy during periods of grief. This approach compares grief care to monitoring health during pregnancy, suggesting that health issues like gestational diabetes or hypertension are detected and treated when they arise in expectant mothers. Aspirin was tested as a cardioprotective measure for bereaved individuals and showed positive results, but larger studies are needed to confirm this without negative side effects.

A public health model of bereavement support is discussed, which would provide grief literacy, psychoeducation, and an understanding of the grief process to ...

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The Medical and Healthcare Implications of Grief

Additional Materials

Clarifications

  • Physiological stress, triggered by grief, can overwhelm the body and increase vulnerability to medical issues. This stress response can lead to physical symptoms like increased blood pressure and chest pain. The body's inability to regulate this stress effectively can contribute to a higher risk of serious health conditions. Understanding and managing physiological stress during grief is crucial to mitigating its negative impact on overall health.
  • Grief has been associated with an increased risk of heart attacks and mortality in epidemiological studies. These studies have shown that individuals who are newly bereaved face a higher likelihood of experiencing serious cardiovascular events, such as heart attacks, especially in the immediate aftermath of a loss. The physiological stress of grief can contribute to these heightened risks, impacting the body's cardiovascular system and overall health. Understanding these connections can help highlight the importance of providing appropriate support and care for individuals experiencing grief.
  • Grief can manifest as physical pain due to the intense emotional stress it causes. This stress can lead to elevated blood pressure levels, especially in individuals experiencing profound grief. The connection between grief and physical pain, along with increased blood pressure, underscores the significant impact of emotional distress on the body during bereavement. Understanding these physiological responses is crucial in addressing the holistic healthcare needs of individuals navigating through grief.
  • Comparing grief care to monitoring health during pregnancy highlights the importance of proactive healthcare interventions during vulnerable periods. Just as pregnant individuals receive regular check-ups to detect and address potential health issues, individuals experiencing grief may benefit from similar monitoring and support to mitigate associated risks. This analogy underscores the significance of early detection and intervention in both scenarios to promote overall well-being. It emphasizes the need for a systematic approach to address physical and emotional health concerns during these critical life stages.
  • A public health model of bereavement support involves applying public health principles to address the physical and mental health needs of individuals experiencing grief. It focuses on providing education, resources, and interventions to help manage the health risks associated with bereavement on a population level. This model emphasizes preventive measures, early detection of health issues related to grief, and the importance of social support in promoting overall well-being during the grieving process. By integrating public health strategies into bereavement care, the g ...

Actionables

  • Create a personal health and wellness journal to track your physical and emotional state during times of grief. By regularly noting down your feelings, physical sensations, and any changes in your health, you can identify patterns that may indicate stress-related vulnerabilities. For example, if you notice a correlation between heightened feelings of loss and increased blood pressure, this could be a sign to seek medical advice or stress-reducing activities.
  • Develop a "grief buddy" system with a friend or family member where you check in on each other's health and well-being. This partnership can serve as a mutual support network, ensuring that both of you are attentive to potential health issues that may arise from grief. You might agree to remind each other to take medications, attend doctor's appointments, or simply engage in regular physical activity together to maintain health.
  • Organize a community skill-share workshop focused on coping mechanisms for grief. This could be a ca ...

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