Mary-Frances O'Connor, THE GRIEVING BRAIN

Mary-Frances O'Connor, THE GRIEVING BRAIN

Guest host Allison Pataki speaks to renowned grief expert and neuroscientist Mary-Frances O’Connor, who combines trailblazing neuroimaging work and field research, and beautiful storytelling in her new book The Grieving Brain: The Surprising Science of How We Learn from Love and Loss. Mary-Frances discusses the myth of the five stages of grieving (it’s not linear or finite!) and the fascinating brain science behind grief and grieving (from love bonding to uncharacteristic bursts of anger to believing, for a split second, that they are still alive). She also explains how we can best support those who are grieving and shares her best advice for aspiring authors.

Transcript:

Allison Pataki: Mary-Frances O’Connor, author of The Grieving Brain: The Surprising Science of How We Learn from Love and Loss, thank you so much for being here this morning. I am so excited to speak with you about this incredible, important book. Welcome.

Mary-Frances O’Connor: Thank you. It’s so lovely to be here.

Allison: Mary-Frances, you are a writer, a researcher, a professor, a mentor. You wear many incredible hats. That makes you the perfect person to write this book. Can you tell us a little bit about the how and the why, the story behind the story of how you came to write The Grieving Brain?

Mary-Frances: This has been a passion of mine for, gosh, over two decades now, which kind of boggles my mind. I’ve been studying grief, as you say, grief and grieving, as a clinical psychologist, as a neuroscientist. I’m a professor at the University of Arizona. My lab, which is called the Grief, Loss, and Social Stress Lab, the GLASS Lab, we call it, is really devoted to understanding, just as you said, why is grieving so hard? Why does it take so long? How might it be working in the brain? Are there things about the brain that are making it easier or harder? There’s another piece of it too, which is that I feel really comfortable with people who are grieving. I think largely, that’s because when I was thirteen, my mom was diagnosed with stage-four breast cancer. We had grief at home, so to speak. She, amazingly, did not die until I was twenty-six, which her oncologist called his first miracle. It means that I just feel comfortable with people who are going through this. Maybe that made it easier for me to do the, by now, hundreds of interviews that I’ve done with grieving people and try to map that onto what their physiology is telling us.

Allison: You talk about, in your book, how when you share with people that you work with grief and grieving or when you’re telling people that you’re writing this book, a lot of us who are not as well-versed as you are, particularly in Western culture, you say we have this idea of the five stages grief. You say that it’s presented to us as sort of this linear narrative with the forward-marching heroic story where we end with acceptance. You say that’s not at all how griefs work, the science and the brain and human behavior and experience. Can you talk a little bit about that? That was so fascinating.

Mary-Frances: Many of your listeners may have heard of the five stages of grief, as it was called. Dr. Elisabeth Kübler-Ross, I have total respect for. She was a female psychiatrist when there were not a lot of female psychiatrists. She actually was prevented from taking a faculty position twice because she was pregnant. She raised children and so forth. An amazing woman. Her contribution was, she gave us this revolutionary idea you could interview people who were terminally ill, which at the time in the 1960s was unheard of, to ask them what they were feeling and how they were coping. She did what all good scientists do initially. She described what people were telling her. She gave us a very accurate description that people do experience depression. They experience anger. They even experience denial. The way I think about it now as we look back, because science has come a long way since 1969, is that she gave us a description of grief, but that the idea that grieving, that change over time, that you do all of denial and then all of anger and you never go back again to those natural human emotions is just not accurate. I think when we use it as a prescription rather than a description, then people get into trouble because they think, I haven’t had a lot of anger. Maybe I’m not doing it right. I felt a lot of acceptance, and now I’m having a day where I feel really depressed. Am I doing something wrong? We don’t think of it as doing something wrong. We have more updated models that we often use now as looking at the trajectory rather than these five stages, which are really five experiences people have.

Allison: There’s no set order. There’s no checking one off, and then you’ve graduated to the next level. Can you talk about the difference between grief and depression?

Mary-Frances: Yeah, sure. Part of it is helpful maybe to start with distinguishing — I’ve been using the word grief and the world grieving as though they’re different. Most of us, we use those interchangeably. This really came about from studying. What is it I’m studying? Am I studying grief here? I’m not getting the answers that I’m looking for about grieving, and so making this distinction became useful to me and I think has become useful to other people. Grief is that natural response when you become aware that something so important to you is missing. It’s that wave of feeling. It’s those thoughts. It’s that unbearable awfulness. It recedes. It comes in waves. Grieving, on the other hand, is the way that that feeling of grief might change over time. Think about it this way. If I’m doing a scientific study of grief, I can ask you how you’re feeling right now, for example. How much grief are you feeling? If I want to study grieving, I have to ask you, how has your feeling changed from before to now or from a long time before to — this change over time means that grieving is the way grief can become more familiar. It could become less intense. Those waves could be less frequent. That doesn’t mean that grief goes away because that’s just the natural human response when we’re aware of missing someone. I think that’s useful because people often feel like, gosh, I’m having this week where I’m just completely overwhelmed. Then they realize, oh, this is the anniversary of when a loved one died. Even in the research, we can see. Anniversaries, we see this big increase in grief. That doesn’t mean there’s anything wrong with your grieving. That doesn’t mean you’re doing anything wrong. It means this is a change in this moment of your grief.

Allison: You talk about how we as humans can hold both truths at the same time. We know that the loved one is gone. We know we miss them. We know we’re grieving. Then we have these moments where we expect them to walk back through the door or where we expect them to show up to dinner with us. How does the brain do that? How do we as people hold both of those things?

Mary-Frances: The brain is a uniquely fascinating organ that is trying to help us. The brain also has some limitations. One of those strange limitations is it can be listening to two streams of information at the same time. When we think about this in terms of bereavement, in order for us to have the feeling of grief, the feeling of loss, we first have to have the feeling of love, of bonding. That bond gets encoded in our brain. Literally, physically, your brain is changed because you love this person and they loved you. Part of what comes with that attachment is the belief, I always be there for you, and you will always be there for me. The important piece of that is the always part. It is impossible to imagine just going off to work every day if you didn’t deeply believe that you would all come back together again at the end of the day. We have this deep belief. They’re out there for me somewhere. I’m thinking about them through the day. I know how I would get ahold of them if I needed to. With attachment comes this everlasting belief, so to speak. When we have the death of a loved one, there is, of course, this other set of information that the brain encodes, which are the memories. You may have been there at the bedside when a loved one was dying or when they passed away. Even, you may have been at the funeral or memorial. You have these memories. You know that the reality is that they’re no longer on this earthly plane.

You can see, then, how these two streams of information conflict. On the one hand, because of this bond, you have this belief they’ll always be there. They’re out there somewhere. If they’re not here, it just means I need to go get them. I need to find them and bring them back. On the other hand, you also know they’re not living. I think part of why grieving takes so long is that the brain takes a very long time to make sense of these two things. Maybe the most concrete way to think about it is, the brain is always trying to make predictions for us. It’s trying to predict what happens. It makes those predictions based on what’s happened before. Say, if you wake up next to your spouse for hundreds and maybe even thousands of days — you wake up. They’re next to you. Then on the first morning that you wake up and they’re not there in the bed with you, it’s actually not a very good prediction that they’ve died. For a while for your brain, it’s as though they haven’t died. There’s a learning that has to take place to be able to predict their absence. What does that absence mean for your life as opposed to the habitual prediction of, and there they are?

Allison: Yet there will always be these triggers, like a smell or coming across a shirt or something that will tell our brain that the person is there for a minute. Then we have to re-remember, right?

Mary-Frances: That’s absolutely right. Handwriting is the thing for me. I’ll come across something my mother wrote. It’ll fall out of a book or something. Boy, in that moment, she feels so alive like she just wrote it and sent it. That is how it works. The brain permanently encodes this bond, which maybe has a sort of — I actually take great comfort in the fact that, in a way, she is a part of me. My brain is physically including the fact that we had a relationship, that we were so tightly bonded. Somehow, carrying that around with me is very comforting.

Allison: Absolutely. When we care about someone or we’re close with somebody who’s going through the grieving process — you’re very comfortable with it. It’s your world, but it can be hard. It can be challenging to see someone you love really struggling. You talk about the prongs of empathy. What can we do? What should we do to show empathy or to show up for someone who is grieving?

Mary-Frances: This is a tricky one because while I say I feel very comfortable with people who are grieving, and that is true, people who are grieving, it’s really hard. It is really hard to watch someone who’s suffering or who’s really angry. Grief brings with it, a lot of anger, quite unintentionally. It’s not like the person wants to feel angry, but there’s often nothing you can do that won’t make them angry. I think then it’s incumbent on us a little bit to recognize, ah, for this person, they’re just not themselves at the moment. The emotion dial on everything has just been turned way up. It’s interesting to think about so many of our social mourning practices. I think in some ways, we’re reminding other people — you wear a black armband, for example — reminding the people around you that they’re having a different experience day to day than you are right now. A friend of ours, a friend in my circle of friends, his mother had died maybe three months before this happened. We were in a parking lot after something we’d been doing together. He got really angry. He said something really mean to one of our friends. Everyone was sort of like, what the heck? What was that? This is very out of character. It wasn’t true.

I said later to them, “We have to remember that he is still grieving. Everything is just raw right now.” When I think about being with people who are grieving, I think one of the biggest quagmires we get ourselves into is that, as the person who wants to be supportive and wants to be kind, often, our goal is sort of to cheer them up. Think about it this way. If you’re already not feeling yourself in the world, now you also have this expectation that someone wants you to feel happy as well. That’s just a whole lot. Sometimes I think if we change our mindset to, I want to be with you, I want you to know you’re not alone and that I am open to however and whatever you want as this goes forward — a friend of mine whose little boy died, she says we think the golden rule is the most important thing. Treat others as you would like to be treated. She says there’s actually a platinum rule. Treat others as they would like to be treated.

Allison: That’s so good. You can’t put the expectation or the burden onto them to then live up to whatever they’re expecting to receive from you. That’s so good. You say grief is a door through which we will all walk, some of us earlier than others, some of us more often than others, but it is a universal human experience.

Mary-Frances: It is, but it comes at different times and in different ways. We all have different capacities for sharing and for disclosing and for supporting, even. Often, people say, it’s not even that I need to talk. It’s that I need someone to help clean out the closet. I need someone to take my kids to the park because I just need some time. I think trying to ask people — and not even just, what can I do? That’s pretty broad and doesn’t always sound like an actual offer. Saying things like, hey, I know that Thanksgiving’s coming up. That might be a really tough time for you. Is there some shopping I could do? I’m already going to be setting my own table. Could I come over and help with X? Can I take the kids on Wednesday so you can get — giving concrete examples of things that you might do and then letting them decide.

Here’s a great example. I teach a Psychology of Death and Loss class. One of the students was telling a story about — she and her boyfriend lived next door to this older couple. The husband died in this older couple. The following Christmas — he had always put up Christmas lights on the house. Her boyfriend went over and said, “Hey, I want to offer, I’d be happy to put up your Christmas lights this year if you wanted.” She got really angry and said, “I don’t need that from you,” and slammed the door. He was like, oh, god. What have I done? About twenty-four hours later, she came and knocked on the door. She said, “I’m so sorry. It is so hard for me that he’s not here that I just reacted, but I would actually really love it if you would help me put up Christmas lights.” I think that’s a great example of both offering something — it doesn’t always go well, but that’s not your last opportunity.

Allison: And extending the grace when there is anger or there is an outsized reaction you might not have felt you expected. You talk about restoration to a meaningful life as a worthwhile goal or aspiration. Can you talk about what that means and what a meaningful life means and what this restoration — can you discuss that?

Mary-Frances: One of the models that we use more contemporarily that many clinicians find very useful now is what we call this dual-process model. What it suggests is that, on the one hand, we have all these stresses about the actual death, the actual loss, all these emotions and thoughts. What do we do now? All that. What do we do with those feelings? Those, we call loss stressors. We also have what they call restoration stressors, which is, what does this mean for my life now? Who am I? What is retirement supposed to look like if my spouse has died? How am I supposed to parent if my coparent is gone? All of those. What does life look like now? Given that I am a person who has grief, how do I continue to have a meaningful life, to do meaningful things? That takes a long time and a lot of courage and, frankly, a lot of support. When I think about, what is a meaningful life? what’s interesting, of course, about this for me is I think that’s a question we’re all asking ourselves all the time. That doesn’t only happen when a loved one dies. It’s just that because when a loved one dies, you get the rug ripped out from under you. Things that previously felt really meaningful sometimes don’t feel very meaningful anymore, and so trying to figure out, what is this like now? I think there’s a couple of things that people can do. They can think about what it is they value at its most basic. That can be related to the person who’s died.

What things do I know my mom would’ve been proud of me for doing? Even just, how would she have done things? My mom was British. There are things I do, like at the holidays, because it reminds me of her. It’s something she would’ve loved that I carried on. We can think about values. Maybe it is, I want to have a close family the way that my grandparents managed to do that. Coming up with things that are meaningful as a value. Then what would a person who valued that do? is both probably harder and also, again, I think often requires support. Experimenting, going out and trying something that you’re not sure if it’s going to make you very happy, but staying at home on the couch is definitely not making you happy. It may be worth trying something that could feel meaningful, and probably trying it more than once. The first time you go out to dinner with your couple friends if your spouse isn’t there, the first time is probably not going to feel really good. It’s probably going to be pretty hard. Then the second time you go, it may still be hard, but you may also think, oh, but I’ve never had that pasta before. That was pretty good. It’s this slow upward spiral of, what makes sense now? What works now? You’re only going to learn that by trying things out.

Allison: So beautiful. The Grieving Brain: The Surprising Science of How We Learn from Love and Loss, decades of research and work and expertise and interviews went into this book. If you could send readers away with one token or nugget to take with them and carry with them, what would it be about the grieving brain and from this beautiful book?

Mary-Frances: Probably, the thing I get most often as a question is, someone describes something and says, is this normal? Should I be over this by now? Should a friend be over this by now? Just really trying to give yourself some kindness. This is a door you walk through, but once you’re through the door, there’s no end point. You are now a person who understands life differently than you did before, and so remembering that what you feel is normal and that a lot of what you do is normal. We can decide, okay, I do that pretty regularly, do I want to do something different? I feel that pretty regularly. How am I going to manage the fact that I feel that? Those are really legitimate questions and things we can work with with ourselves. The fact that you feel things intensely or that you believe things or are motivated to do things that you’re surprised by, that doesn’t make them not normal, and so giving ourselves some loving kindness that this is really hard. This just is really hard. What you’re experiencing is normal. You’re going to find a way through.

Allison: Because of what you just said and because of all that, this book feels, in so many ways, like a companion and like a roadmap or a guide or a hand to hold not only as we go through the experience of grieving, but just the experience of being human. Thank you so much, Mary-Frances. What advice would you have to aspiring writers?

Mary-Frances: To aspiring writers, that’s a great question. For me, what I’ve learned is you got to write. It sounds really obvious. I write every morning, only on weekdays. I write for an hour every morning. I think this is the piece. When inspiration strikes, I will be at my desk. It will have a place to go. If you’re not at your desk, you can’t write it down.

Allison: Absolutely. As you said, first time might be hard. Keep doing it. Keep doing it. Eventually, you will get the inspiration down on the page. The Grieving Brain by Mary-Frances O’Connor, The Surprising Science of How We Learn from Love and Loss. Mary-Frances, how can readers connect with you and learn about your journey with this book?

Mary-Frances: I have a website at maryfrancesoconnor.org. Also, I’m on Twitter, @DrMFO. Reach out.

Allison: Wonderful. Mary-Frances O’Connor, The Grieving Brain. Thank you so much. Thank you for writing this book, sharing this book. Thank you for joining me today.

Mary-Frances: Thank you for bringing this conversation to people.

Allison: Have a beautiful day.

Mary-Frances: You too. Buh-bye.

Allison: Bye.

Mary-Frances O'Connor, THE GRIEVING BRAIN

THE GRIEVING BRAIN by Mary-Frances O’Connor

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