Learning to live with loss

Over the past two years, many of us have sadly experienced grief, and whether that's through the personal loss of a loved one, or the general sense of loss that the pandemic and other big world events like war have brought us, or just loss of the way life was before 2020. Mary-Frances, a grief expert, explains about this area of research to Julia Ravey...

Julia - So, Mary-Frances, your new book explains the research undertaken to understand grief. What has research taught us about how grief impacts our brains and our bodies?

Mary-Frances - I think one of the things I find most fascinating is that you can't study the neurobiology of grief without also understanding the neurobiology of love, of attachment. So, the death of a loved one, it's not just a stressful life event. Of course it is that, but it isn't just like surviving an earthquake, or being robbed. The neurobiology of grief teaches us that, first, there is the encoding of your loved one in the brain, and that is what causes the feelings of loss when a loved one dies. It means that the brain then has this representation, it has this image of a "we". Then, when the person is gone and they've died, it really is like a piece of us is gone as well, just exactly the way people describe feeling like there's a hole where the loved one should be.

Julia - Why does it take so long for our brains to come to terms with loss? Are there individual differences in how extensive this time period is?

Mary-Frances - Well, you can think about the brain as a prediction machine. Your heart is there to pump blood around your body, your brain is there to try and predict what might happen next. It does this by using all the days of lived experience that it's accumulated. Say, a woman wakes up alone in bed in the morning and her husband isn't there next to her, and he has been there for thousands and thousands of days. That first morning, it's actually not a very good prediction to assume that he's died. Rather, it takes a long time and, more importantly, a lot of experiences, for the a brain to really update, to know that this is the new state of the world for you. For that reason, I think it's very helpful to think of grieving as a form of learning. We all know learning, it takes a long time, we've been doing this our whole lives, right? It can be very frustrating, it doesn't usually take a linear direction.

Julia - I really like that, thinking of it as learning, because we've all experienced grief or we will experience grief in our lives. It's bound to be a very tough time for people, but are there tools or methods which can make this process healthier for people going through it?

Mary-Frances - The most important thing is having a big toolkit of coping skills. It really is about flexibly being able to use different coping methods depending on what the situation is that you're in at the present. For example, if your son has a football game, right, it may be perfectly appropriate to just think, "I'm not going to think about this right now, I'm just going to pretend this hasn't happened, that my loved one has died, I'm just going to cheer for my son in this game for the next 40 minutes and not think about it at all." That kind of avoidance in small doses is totally appropriate because it fits the situation. It's also really important to have someone whose shoulder you might cry on that you might try to explain how you're feeling, which is often very different than what people are expecting to feel. But also, ways to physically relax. Grieving is extremely stressful for the body as well as the mind. Things like yoga and going for a walk actually help you be more resilient through this really difficult process.

Julia - The word grieving is used outside the context of losing a loved one in our life. It also describes when we lose a job, or we break up with a romantic partner. Is this type of grief different, biologically, to when you lose someone.

Mary-Frances - In terms of evolution, a loved one is as important to our survival as food and water. For that reason, this is why we have that attachment neurobiology around this bond. The grief that is evoked when that loved one is gone is very deeply conserved. It's a loss of a part of ourselves. If you think of the word daughter, even though I'm using that to describe me, it actually describes two people, doesn't it? There's this loss of a piece of yourself, and that's similar to other kinds of losses: loss of a job, or loss of health - those are both a part of a loss of yourself. So, I think the feelings of grief piggyback on this neurobiology of grief. They have evolved around the death of our loved ones but that's, I think, why it feels so familiar.

Julia - And you use neuroscience to try and understand grief. What would be the biggest question you hope neuroscience research can help us answer about grief?

Mary-Frances - I think a lot of people want to understand, "does it matter the way we think about our loved ones, the way we think about grief." All the ways we manage those intrusive thoughts that just keep coming to us: "Does it matter how much we express our grief to other people or through art?" And so, most of our neuro-imaging studies right now are of grief of that moment, but it would take multiple brain scans across the first year or two of the same person while they're grieving to see how the brain changes over time and whether some of these expressions of grief and the way we cope with our thoughts really makes a difference as to how the brain adapts over time.