Best Tools for Processing Grief & Loss | Dr. Mary-Frances O’Connor & Dr. Andrew Huberman

00:00:00.000 | for people of all ages, are there zero cost tools in the form of groups to help people

00:00:10.300 | grieve different types of grief? Because I think for some people it's like, I think we've all heard

00:00:15.780 | that the ultimate stressor is the loss of a child. And I can only think of one thing that

00:00:23.140 | might be equally stressful, if not more stressful, would be not knowing if your child is alive or

00:00:29.160 | dead. That to me just seems like the ultimate form of agony. So presumably a bereavement group for that

00:00:37.540 | is very different than a bereavement group for someone who's really truly mourning the, I don't

00:00:43.540 | know, the separation from a spouse, right? Two different scales of grief, but it's hard to tell

00:00:48.680 | someone who's really grieving deeply, like your grief isn't as bad as someone else's grief. So are

00:00:53.860 | there groups? And then I'll also ask the question I just asked, which is, why is it that knowing

00:01:02.240 | other people suffer too only provides mild support for grieving? Yeah. There's a fairly recent

00:01:11.520 | movement that we might call the public health model of bereavement support. And so the idea here is

00:01:19.800 | that, and this largely comes out of Europe, Canada, Australia, where they're trying to actually develop

00:01:26.700 | health care around bereavement. Part of this is because we can talk about how we know that the

00:01:35.080 | physical cost of the loss of a loved one is so impactful on us, it can lead to dying of a heart

00:01:44.200 | attack, right? So we know that, for example, the day that a loved one dies, you are 21 times more likely

00:01:52.140 | to have a heart attack than any other day of your life. 21 times. And we know that in the first three

00:02:00.180 | months after the death of his wife, a man is nearly twice as likely to have a fatal heart attack

00:02:07.180 | compared to a man who remains married during that same time. Wow. Even if he has other support? Yes.

00:02:12.980 | Isn't that just crazy? For women, it's about 1.8 times. So still just an astronomical number for medical

00:02:21.020 | risk. So what we know is this period of transformation is incredibly risky, right? So we can have all this

00:02:31.500 | physiological change, but if our body isn't resilient enough, where it actually breaks during that time,

00:02:39.120 | this is something we need to get ahead of. So thinking about this public health model of bereavement,

00:02:45.640 | we can think of sort of at the foundation, even just understanding in a grief literacy kind of way,

00:02:53.560 | what can I expect? What is happening to me? Why is this happening to me? That is a psychoeducation level

00:03:02.480 | that is vitally important to people, regardless of sort of how much support they have. Now, many people

00:03:09.160 | will go to bereavement support groups even just to get that, right? Even just to get good evidence-based

00:03:15.240 | information. Places that are no longer teaching the five stages of grieving, for example. And beyond that,

00:03:24.400 | we know how important support is. Social support, having loved ones around, just as you were

00:03:31.340 | describing. And I think one of the reasons, I mean, imagine in that first seven days after your spouse

00:03:38.720 | dies, if there is someone in your house sitting Shiva, they are going to notice if you have a heart

00:03:45.080 | attack, right? So think about the idea that we might outsource our physiological regulation for a while.

00:03:53.480 | Think of it this way. When we bond with someone, when you fall in love with your partner, say, for

00:03:59.800 | example, they become your external pacemaker, right? Think about co-regulation. If I go home now and I get

00:04:09.600 | a hug from my partner, just the way you were describing, I know that my blood pressure will drop a little

00:04:13.920 | bit. My heart rate will drop a little bit. Now suddenly I have to imagine walking into an empty

00:04:19.400 | house where that's not going to happen. My cardiovascular system has to figure out how am I

00:04:26.320 | going to walk into my home again and again and again and regulate my heart rate. And your brain is

00:04:33.640 | anticipating seeing the person that you lost. Yes, exactly. Like it doesn't, you can know, but the

00:04:38.980 | action systems, the go circuitry, if it were. All the subconscious processing, I should be, I'm doing

00:04:46.160 | the same motion of turning the key in the lock that I've always done. And now there's a hole in the room

00:04:53.000 | when I enter it. And often it still smells like them. Absolutely. I think people really underestimate

00:04:59.040 | this thing about smell because it's operating at an unconscious level all the time. We're like bathing in

00:05:05.140 | somebody else's chemicals and then they're gone and then it starts dissipating. But it's still there for a while.

00:05:11.060 | Absolutely. So I think recognizing your grieving body has to figure out how to regulate again is one reason why

00:05:22.620 | support is so important. There's a study of primates where, you know, as with other primates, there's a lot of infant

00:05:39.040 | mortality. And in this observational study, there are troops that are being observed by scientists. And with the death

00:05:48.220 | of an infant primate, the mother will often carry that deceased infant, that baby monkey, for a long time

00:05:57.200 | after their death and spend a lot of time looking at the infant. The mother doesn't groom. She doesn't

00:06:04.740 | try to nurse. She's not confused that the infant is alive. But what is interesting is she stops grooming

00:06:11.400 | herself during this time. Now, that's actually medically risky for a primate because we know that

00:06:18.620 | grooming is so important to their health to get rid of parasites and such. And, you know, usually in these

00:06:23.900 | troops, there's a really strict hierarchy. Who gets to groom who is, you know, the latest Kardashian show

00:06:29.180 | kind of thing. And during this time, when the mother is trying to understand what's happened to this

00:06:36.660 | infant, the rules go out the window. Any member of the troop can groom this mother. Now, at some point,

00:06:44.820 | wide individual variation in how long the mother holds this infant from days to months. Once she relinquishes

00:06:54.760 | the infant, the rules go back into effect. So she goes back to the troop and now she participates in

00:07:02.060 | social life, in medical social life, in the way that she did before. I think the analogy here, in addition to

00:07:10.920 | every time I think about it, it just rips my heart a little bit, right? But the idea here is that it is all of our

00:07:18.080 | jobs to groom the mourning person, to care for them, to say, hey, how long has it been since you saw your doctor

00:07:27.600 | for your regular checkup? How long has it been since you had your mammogram or got your teeth cleaned,

00:07:31.400 | right? Often we've been caring for a loved one who's dying and we're neglecting our own medical care.

00:07:36.860 | Because here's the thing. Grief is the natural response. Our bodies are resilient. Many people are

00:07:46.360 | shocked by how much pain, physical pain, how they get a lump in their throat or they feel like their chest is on

00:07:54.780 | fire when they're grieving. But actually our bodies are remarkably resilient. We do learn to re-regulate

00:08:02.040 | without this external pacemaker. But in those instances where the body isn't resilient enough

00:08:08.780 | to be able to do that, we need people around us supporting us. In a study in my own lab, we thought,

00:08:16.760 | well, probably this risk for a broken heart, this risk of dying of a heart attack, isn't, you know,

00:08:22.940 | 24-7 equally risky. So we brought people into the lab and had them experience a wave of grief while

00:08:29.420 | they were hooked up to ECG and blood pressure and so forth. And what we saw was everybody's blood

00:08:36.360 | pressure goes up during a wave of grief. That's probably not too surprising. But what we saw was

00:08:42.600 | the people who, when they walked in the door, told us they were having the most intense grief,

00:08:49.400 | their blood pressure went up the most. And then in a replication study in Germany, we saw that their

00:08:56.580 | blood pressure didn't recover. So you can see that these waves of grief that our body and our mind and

00:09:04.040 | our brain have to learn how to cope with and then eventually to adapt to. Those require a physical

00:09:15.200 | body that can sustain that. They require relationships that can support us and sustain that. And this is

00:09:22.980 | why I think support is so important, even though it doesn't take away the pain of missing your person,

00:09:29.840 | right? Because we need every resource we can muster in the midst of this moment. Now, it does also mean

00:09:37.760 | that as much as we are missing our person and it feels so isolating to try and explain that there's a

00:09:47.440 | hole in the room when no one else can see that hole, it does help at some level to talk to this other

00:09:56.320 | person who is seeing a different hole in the room, who's also going through grief, because we recognize

00:10:03.040 | grieving is a human experience. And that you're not connected because you both miss the same person,

00:10:09.640 | but you are connected because you're both missing, right? And so I think that bereavement support can be

00:10:16.300 | incredibly helpful to connect with others who are going through this same process. And frankly,

00:10:23.040 | I don't recommend and some bereavement support groups actually prohibit dating relationships from a grief

00:10:31.500 | support group. But the reality is the people that we connect with are also people potentially that we

00:10:41.160 | develop stronger attachment bonds with. That's how community works, right? And so I think bereavement

00:10:49.340 | support can be incredibly important. We do know for the one out of 10 who develop a disordered grieving who

00:11:01.500 | really are not showing any changes over time, even though time is passing, those people might need a very

00:11:10.380 | specific evidence-based psychotherapy intervention because we know that those psychology interventions

00:11:18.920 | can get us back on a normal or typical grieving trajectory.

00:11:23.640 | So,

Best Tools for Processing Grief & Loss | Dr. Mary-Frances O’Connor & Dr. Andrew Huberman

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