The Grieving Brain
How our minds reckon with death
For as long as humans have existed, they have suffered when a loved one dies. Musicians and writers have written about the dark cloak of grief, the deep yearning, and how devastating heartache feels. Through paintings or sculpture, artists have shown the abyss in their hearts when a companion has passed away. Everyone sits with grief differently; sometimes, it hangs on to every cell in the body.
In February, my maternal cousin and paternal grandmother passed away one week apart from each other. One of them died in Miami, where I was born, and the other passed away in Haiti, where my parents were raised. It is impossible to put into words how their loss has impacted my immediate and extended family, especially given that my cousin prematurely passed away from a brain aneurysm at the age of forty. Their death beckons me to imagine a world where they could have lived longer and less complicated lives. My grandmother spent most of her formative years living under a dictatorship, and my cousin was a victim of the mass incarceration system in the United States. They were brought up in a world that did not see or could not appreciate their dignity. Given this, I often feel a strong sense of guilt that the hostility and marginalization that my family members have faced by being working class and Afro-Caribbean is what has led many of them to an early grave. Similar to the deaths of other family members who died from cancer, old age, or illness over the past four years, I did not attend their funerals. And yet, their permanent absence has not escaped me. I have had to reckon with how grief sits with my soul, especially given that I don’t have any kin in Europe, where I live.
Given my love of literature and the arts, I find emotional refuge in text. Two years ago, I compiled a list of books for The Atlantic Magazine that have helped me with grief. Reading can assuage the pain, but I am also aware that grief begins in the brain. When a close person dies, our brain triggers the fight-or-flight response. This heightened state stresses our organs and bodily functions, and we usually experience it for a few minutes to 48 hours. This information fascinated me, so I decided to chat with a neuroscientist to get her perspective on death, grief, and everything in between.
I spoke with neuroscientist Dr. Mary-Frances O’Connor, author of The Grieving Brain and Associate professor of Psychology at the University of Arizona. During the interview, we discussed the physiological effects of grief and the significance of looking at the brain. The conversation has been edited for length and clarity.
Edna Bonhomme: Can you describe your current research and a typical workday?
Mary-Frances O'Connor: I am currently looking at the experience of ambiguous loss in missing and murdered Indigenous women or the family members of missing and murdered Indigenous women. Moreover, I'm doing a neuroimaging study that explores how the brain encodes its understanding of the self and the understanding of other people and how similar those might be. During a typical workday, I often come to my local coffee shop first thing in the morning to get some writing done before all my other responsibilities kick in. In the afternoon, I go to campus, where I meet with students and other faculty about their work. Sometimes, I meet with other clinical psychologists, clinical psychology trainees, and national and international colleagues with whom I do research studies and provide consultation. My laboratory is in the psychology department, which includes a suite where the MRI machine is. My laboratory has several small cubicle-sized offices for my graduate students and some open spaces with computers that undergrads use. I have a place to interview research participants about their experience of grief and loss. It is a lovely setting with a comfortable chair and a little table that resembles a clinic office. Then, over at the MRI suite, we again have graduate students and other research staff, including MRI tech specialists and participants.
Bonhomme: Who is your favorite woman scientist?
O'Connor: One of my favorite female scientists is Dr. Elisabeth Kübler-Ross. She worked as a psychiatrist when it was tough to be a woman in psychiatry, starting around the 1950s. But she also wrote books for the general public, which I have aspired to do. Dr. Kübler-Ross also was willing to tackle complicated subjects. So she believed that you could interview terminally ill people and ask them what their experience was like. That was revolutionary, not only in research but in medicine at the time.
Bonhomme: What inspired you to write The Grieving Brain?
O'Connor: You know, I realized that although I was doing grief research every day, I had colleagues who were doing grief research every day. Sadly, the information wasn't getting into the hands of grieving people. Writing a book intended for the general public would be one way to jumpstart that process. What I wanted to offer in the book was not just what grief feels like, which, of course, many excellent books have been written about. Instead, I wanted to give a speculative and empirically based understanding of what we knew of the science about how and why we grieve, how the brain encodes a relationship, how it has to update its predictions when a loved one dies, and why that takes so long. I wanted the public to know that we are starting to develop answers to their distress.
Bonhomme: Do you think the book has had the impact that you initially intended?
O'Connor: It has had a more significant impact than I had imagined. It resonated with the public. People seem hungry for a scientific and even a neuroscientific lens on grieving. And it has brought me in contact with so many people that would never otherwise have ever heard of bereavement science from people like yourself who disseminate the vital information that scientists are doing to people who are clinicians who are supporting caring for people who are bereaved to bereave people themselves, who are struggling to find answers and, and figure out what what they're going through.
Edna Bonhomme: Have you ever had to grieve for a loved one?
O'Connor: Yes, a couple of times. The most profound death in my life the most critical losses in my life were my mother when I was in my early twenties and my father about eight years ago. I got to be a part of both of their final illnesses, caring for them and then trying to understand what their loss meant for my life, how I function in the world, and what it meant to carry their memory forward with me.
Bonhomme: Do you think your neuroscientist training helped you with that grieving process?
O'Connor: I am trained as a neuroscientist and a clinical psychologist. And I think it was probably more my training as a clinical psychologist that helped me. But when my mom died, I was still in graduate school. And so I was still learning so many things about how psychology works, but also how my own experience of grief would feel. And when my father died, of course, 15 years later, I already had much more understanding of the grieving process and my own experience of how grief felt and how grieving worked for me. Both the knowledge that I had later in life made dealing with my father's death considerably easier.
Bonhomme: Given that you're trained in neuroscience and clinical psychology, do you see the two as opposing forces, or are they complementary?
O'Connor: I see them as incredibly complimentary. Neuroscience can be incredibly reductionistic. It is precious to put parentheses around a tiny problem and know how the brain manifests that mental function or dysfunction. However, clinical psychology zooms out and gives us a big picture, a more holistic picture of how human beings work and how their psychology works. And that psychology, of course, is impacted by brain function. But one without the other is at a real disadvantage.
Bonhomme: From a neuroscientific or clinical psychologist perspective, do you notice differences in how people grieve based on racial identity in your research?
O'Connor: In my recent research, our lab proposed that grief could be seen as a health disparity. The fact that mortality rates are different in different communities means rates of grief are different in various communities as well. What we see is that people in African American, Indigenous, and Latino communities have more losses and deaths earlier in their lives. For those reasons, the impacts on their mental and physical health might be distinct. We should think about that as we consider where to devote resources toward grief education and grief counseling because the impact of bereavement is not uniform. I believe that the ripple effects of colonialism are only just being acknowledged in our society. And that it is clear the historical trauma and current trauma that Native American populations are experiencing make their grief distinct. The collective grief of both Black Americans and Indigenous populations influences their individual grief experiences. But I think that our research in this area is new and, to some degree, suffers from a lack of Black and Indigenous researchers who can carry out the best methods to study it and the best ways to interpret the data comprehensively. So, I hope we'll see more partnerships between Indigenous leaders and academic researchers because we've gotten science wrong in the past. By assuming that a white researcher can look at it from their lens, can look at data from their lens, and come to the same conclusions that an Indigenous scholar might come to or even a tribal community themselves.
Bonhomme: Do you think grieving from a distance makes a difference to the brain? That is to say, if a person cannot attend a funeral, will their stages of grief be distinct from those of someone who participates in a funeral rite?
O'Connor: I don't know; we don't have an answer regarding neuroscientific studies. From a psychological lens, rituals are often significant to human beings. They're an opportunity to pause and reflect, to receive support from friends, family, loved ones community and those things can what's the word, reinforce the reality of the loss for a person when it is tough to believe that a person has died. This is something that the brain uniquely struggles with. On the one hand, we need these memories of being there or being at a funeral to make it seem natural that the person is gone. Our attachment neurobiology tells us that even when they're not in our presence, we have this implicit belief that they're still out there, which works well when they're alive and keeps us motivated to seek them out. But we struggle with when they've died because that belief gets in the way of our coming to accept the reality of our loss.
Bonhomme: Neuroscientific research can examine the neurochemicals activated in a grieving person, but recognition doesn't necessarily lead to treatment per se. Do you think that neuroscientific approaches are effective at treating grief?
O'Connor: I think that we can separate the neuroscientific understanding of grief and grieving from what is the right way to treat people who have, say, prolonged grief disorder or even to support people who have typical, challenging experiences of grief. As a method, science is essential to understanding why and how we're losing or how we're struggling with grief. We can try to understand which brain networks and regions are activated, chemicals are changed, or neurochemicals are changed. However, that does not necessarily imply the right way to treat grief is to try to alter those brain circuits or neurochemicals. So psychology has developed effective psychotherapeutic, targeted empirically based psychotherapeutic interventions that do help people who are grieving, even struggling with prolonged grief disorder, to help them to get back on their natural trajectory of improvement over time. And so, to my mind, given that those are the ones that have empirical evidence, psychotherapy interventions are what we should be doing. There is research going on now as to whether there might be medications that might be helpful for prolonged grief disorder. Those remain unproven, and we'll see what the study shows. Still, I think the holistic perspective of how a person's grieving fits in with their relationships and community is essential to consider along with the changes in their neurochemicals. We can take a psychotherapy intervention and see if brain circuitry has changed before and after that intervention, demonstrating that psychotherapy itself may change brain functioning positively without actually mucking around with chemicals or circuits.
Bonhomme: What aspect of your research are you most proud of?
O'Connor: I think what I'm probably most proud of is that because of some of the FMRI studies I've done on grief, there's been a bit of a shift in bereavement research, more specifically, from focusing on the loss of a loved one as a stressor to concentrating on the idea that the loss of an attachment figure is a loss of how we function in the world. The loss of that relationship changes our lives. The rewarding aspects of a relationship and what that tells us about how the world works shift after the death of a loved one.
Bio: Mary-Frances O'Connor is a Clinical Psychology and Psychiatry Professor at the University of Arizona. Her research focuses on the physiological correlates of emotion, mainly the wide range of physical and emotional responses during bereavement, including yearning and isolation. She believes that a clinical science approach toward the experience and mechanisms of grieving can improve interventions for prolonged grief disorder, newly included in the revised DSM-5.
Closing Thoughts
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