128 — Mary-Frances O’Connor: Your Brain on Grief

Mary-Frances O’Connor, PhD, is author of The Grieving Brain: The Surprising Science of How We Learn from Love and Loss. She is an associate professor of psychology at the University of Arizona, where she directs the Grief, Loss and Social Stress (GLASS) Lab, which investigates the effects of grief on the brain and the body. O’Connor earned a doctorate from the University of Arizona in 2004 and completed a fellowship at UCLA. Following a faculty appointment at UCLA Cousins Center for Psychoneuroimmunology, she returned to the University of Arizona in 2012. Her work has been published in the American Journal of Psychiatry, Biological Psychiatry, and Psychological Science, and featured in Newsweek, the New York Times, and The Washington Post. Having grown up in Montana, she now lives in Tucson, Arizona. For more information go to https://www.maryfrancesoconnor.com/

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Originally published 15/12/22

Summary

In this podcast, neuroscientist and clinical psychologist Mary-Frances O’Connor discusses the topic of grief with host Dr. Marcia Sirota. Mary-Frances shares her personal motivation for studying grief, having experienced the loss of her mother at a young age. She highlights the concept of grief as a form of learning and how each person’s experience of grief is unique. The brain’s attachment neurobiology and the dimensions of “here and now” and “close” are discussed in relation to the impact of loss. Mary-Frances also explains the various emotions and reactions that can accompany grief, such as stress, difficulty concentrating, and disorientation. Additionally, she touches on the different trajectories of grief, with most individuals exhibiting resilience and a decrease in the intensity and frequency of grief over time.

In summary, this podcast provides insights into the neuroscience of grief and the ways in which individuals navigate the complex emotions and experiences associated with loss. Mary-Frances’ research and clinical experience shed light on the diverse ways people grieve and emphasizes the importance of understanding and acknowledging the individuality of each person’s grief journey. The transcript also highlights the complexity of grief and the individual nature of the grieving process. It emphasizes the need for targeted therapy and a range of coping strategies to help individuals navigate their grief and create a meaningful life while carrying the absence of their loved ones. Additionally, it emphasizes the importance of supportive relationships and compassionate listening to those who are grieving. The conversation also touches on the impact of trauma on the grieving process and the importance of recognizing and addressing trauma in conjunction with grief. Overall, the transcript offers practical suggestions for navigating the grieving process and provides insights into the complex relationship between trauma and grief.

Podcast Chapter Summary

[00:00:00]: Introduction to Ruthless Compassion podcast

[00:00:19]: Welcome Mary Francis O’Connor

[00:00:51]: Confusion around the topic of grief

[00:01:03]: Introduction of Mary-Frances and her work

[00:02:45]: Personal motivation for studying grief

[00:03:36]: Correspondence between personal and professional experiences

[00:05:03]: Grieving as a form of learning

[00:06:49]: The brain’s attachment neurobiology

[00:08:06]: Dimensions of here, now, and close in grieving

[00:09:15]: Various emotions experienced during grief

[00:10:33]: Stress and mental effort in grieving

[00:11:54]: Difficulty concentrating and disorientation in grief

[00:12:29]: Different trajectories of grief experience

[00:13:55]: Identifying those who need targeted psychotherapy

[00:15:31]: Understanding the difference between depression and grief

[00:17:12]: The yearning feature of prolonged grief

[00:18:10]: Depression does not always lead to complex grief

[00:19:06]: Coping strategies: rumination vs. avoidance

[00:21:52]: Having a toolkit of strategies for handling grief

[00:23:28]: Giving yourself permission to have a range of experiences

[00:25:05]: Supporting a grieving person by being there and witnessing their grief

[00:26:19]: Why people may say the wrong things when someone is grieving

[00:28:40]: No one-size-fits-all approach to grieving and providing support

[00:29:05]: Impact of Trauma on Grieving Process

[00:29:52]: Distinguishing Trauma and Grief

[00:32:28]: Trauma’s Effect on Managing Grief

[00:33:04]: Treating PTSD and Grief Together

[00:34:15]: Finding Meaning in Grief

[00:35:44]: Ben’s Bells: Turning Tragedy into Kindness

[00:37:00]: Thriving and Being Resilient After Loss

[00:38:06]: Where to Find Mary-Frances O’Connor

[00:38:26]: New Study on Grieving and Thoughts

[00:39:13]: Call to Action: What Am I Avoiding? What Have I Learned?

FULL TRANSCRIPT

[00:00:00.890] – Marcia
Ruthless Compassion is a podcast about how you can turn your emotional shit into fertilizer for success and see your darkest moments as opportunities to transform into a powerful kindness warrior. If you enjoy this podcast, please leave a review wherever you listen.

[00:00:19.650] – Marcia
Welcome Mary Francis O’Connor to the ruthless Compassion podcast.

[00:00:23.970] – Mary-Frances
It’s so nice to be be here, Marcia.

[00:00:26.730] – Marcia
Thanks for coming. It’s funny, I should say. I’m happy to see you, except we’re talking about grief. So it’s kind of an interesting topic to be happy to discuss, but I have a lot of interest in the topic. I’ve certainly had my fair share. I guess we all have. So it’s a very interesting and I think, important topic because I think a lot of people have a lot of confusion about it, right?

[00:00:51.300] – Mary-Frances
Yeah.

[00:00:51.820] – Marcia
So the first thing I wanted to do is for you to introduce yourself and sort of talk about who you are and what you do, and then I’d love to know why you do it.

[00:01:03.170] – Mary-Frances
Yes, these are always the important questions, aren’t they? Well, I am a neuroscientist and clinical psychologist. I’m an associate professor here at the University of Arizona in Tucson, Arizona, and I’ve been doing grief research now for over 20 years. I have been particularly interested in how the brain understands what the heck just happened when a loved one dies. And so I’ve used neuroimaging studies to do that, but always in combination with pretty in depth clinical interviews with participants who are bereaved. And I think in thinking about why I’ve done this work, I think that my own mother was diagnosed with breast cancer when I was 13. And although I didn’t know it at the time, she was only supposed to live for a year. And so she actually her oncologist called her his first miracle. She actually lived for another 13 years. But it meant that I was comfortable with people who were grieving. It doesn’t bother me if you cry uncontrollably. And so I think it meant that I could do those clinical interviews maybe in a different way than some of my colleagues. And I was very motivated to understand the reasons for the unusual experiences people were having, and the brain seemed like the natural place to look for those.

[00:02:45.330] – Marcia
It’s so interesting, you know, because as I was reading your book, I was remarking on how both as a person who’s experienced grief and also as a clinician, as a psychiatrist who did years and years as a psychotherapist, how much the things that you’ve discovered through neuroimaging and as well, your clinical interviews correspond to my own personal and professional experience of how people experience grief and how people get through grief. So it’s very interesting that what do they say? All roads lead to Rome, right? If you’re on the right track, it doesn’t matter how you’re getting there, you’re going to get there. Like things that you were talking about later in your book, like accepting and flexibility, all those kinds of things were very much things that I also recognized from my own personal and professional experience. So that was very interesting to me.

[00:03:36.790] – Mary-Frances
I’m glad.

[00:03:38.090] – Marcia
So you’ve just written this book called The Grieving Brain the Surprising Science of How We Learn From Love and Loss. And what have we learned from love and loss?

[00:03:48.870] – Mary-Frances
Well, the interesting thing about that is having this lens of the neurobiology of grief. It has become really clear to me that you can think of grieving as a form of learning, but each of us is also so individual that it doesn’t necessarily mean that I know what each person needs to learn. Simply that when we are faced with terrible loss, with the absence of this person who should be present, it is a learning curve to figure out what does that mean for my life and how do I function in the world as a person who’s grieving. And even just really basic things like learning new habits and having to deal with the things that your COVID one used to take care of. So becoming a parent when there were supposed to be two parents or figuring out what is retirement going to look like given that we’ve always planned to do this together. So in lots of different ways, at lots of different levels, you can think about grieving as a form of learning.

[00:05:03.960] – Marcia
At the very beginning of your book you talk about here now and close as the way the brain holds the image or the presence of the person who is close to them. Could you explain what you mean by that?

[00:05:18.390] – Mary-Frances
Yeah. When social mammals evolved, we had a new problem we faced once we needed to care for our little ones and we needed a partner that would stick with us and care for them with us. We had this new problem to solve, which is that of course we also need to go out and explore the world and forage or go to work every day. And the problem is how do we ensure that everyone’s going to come back together again. And so attachment neurobiology was the brain solution to this. So all these powerful neurochemicals, opioids and oxytocin and dopamine they motivate us to seek out the people who we love, the people to whom we are bonded. And that motivation is really intense and we feel some safety and comfort when we’re reunited with them. And so because of that it means that then we have to deal with the fact that if a loved one dies, it isn’t that they’re lost it’s that there is no map anymore. And so here now and close are dimensions that we use to keep track of our living loved ones. If I say to you right now, where is your partner?

[00:06:49.000] – Mary-Frances
Or how long would it take you to get to your sister or something, you probably can actually answer those questions because they’re so important that our brain keeps track of them. And so I think the here and now, I think that’s pretty clear. But a dimension that has been talked about a lot is this feeling of closeness. So, for example, my partner and I were just we went on a trip to London and we made an emergency plan, right? What if one of you gets on the tube and the other one doesn’t? How are we going to find each other again? And it’s so important that we return to each other that you actually even make an emergency plan. But I know that if we get separated, he is going to do everything he can to find me, and I would do the same. And that is because we are close. It is because the bond between us means I will always be there for you and you will always be there for me. And so it turns out that through some pretty elegant neuroimaging studies, the brain may actually be treating the dimensions of here versus there and now versus later and close versus distant.

[00:08:06.230] – Mary-Frances
The brain is actually, in some ways, treating those dimensions very similarly.

[00:08:10.630] – Marcia
That’s so fascinating the way we have kind of constructs in our circuitry for these things. Right?

[00:08:20.100] – Mary-Frances
Yeah.

[00:08:20.800] – Marcia
So you are also talking in your book about all the weird things. You mentioned it just before, all the weird things that we go through when we’re grieving. And I certainly noticed, like, some of the things that I have gone through and I’ve grieving, anger, impatience, apathy, distractedness, being super absent minded, which I am at the best of the times, but this is taking it to a whole new level. And what else? Just lethargy or agitation? So, like, all these weird things, aside from the just sadness and like you talked about yearning or longing or missing. And I just thought, isn’t it interesting? You know, it’s it’s not just being sad. How do you account for all this weird combination? It’s like a soup, right, with lots of different vegetables inside. Like, how do you account for that?

[00:09:15.440] – Mary-Frances
There are so many different reactions. And I think grief never really feels like how we expect it’s going to feel, which is disconcerting. And I think there’s reasons for lots of different emotions. But I think one way to think about it is, on the one hand, grieving is really stressful when that bond is broken between you and someone else. It was a bond that initially was set up and encoded in the brain. When you fall in love with someone, whether that’s your spouse or your baby, that changes how the proteins are folded in your brain. That bond is physiologically encoded. And so it sets you up. What that means is then if there’s separation, you necessarily are going to have that grief reaction that is that grief is just the natural response to loss. And so the fact that it is stressful means that our blood pressure goes up a little bit for a while and our cortisol hormones, our stress hormones go up. And this is why people usually find it very difficult to sleep. It’s like you’re drinking coffee all the time or they find their digestion just isn’t working right and they often lose a lot of weight.

[00:10:33.570] – Mary-Frances
And so I think on the one hand we can think about just the stress reaction that bereavement causes as being the source of some of those strange experiences we have. And on the other hand, I think, again, thinking about the fact that greeting is a form of learning. Learning isn’t so easy to do, it turns out. And it takes a lot of mental effort. And so it isn’t necessarily that. It’s always in the forefront of our mind. So when we’re experiencing difficulty concentrating, I think of it sometimes as when your computer is updating in the background, it’s updating some program and you’re trying to type in some word document and the typing is really slow and it doesn’t always come through. And I think of the brain is similar to that in the background, it’s doing a lot of work to try and update its predictions, to update what does it mean that this person is gone? And am I really sure that they’re gone? And in the background it may be doing all that, which makes it very difficult for you to focus on a task that you might be doing. So even if you’re not actively thinking about the person who’s died, it is a part of everything we do that these other people should be present.

[00:11:54.360] – Mary-Frances
And so I think that can lead to some of the difficulty concentrating and even just disorientation that people often experience.

[00:12:04.390] – Marcia
For sure. That makes a lot of sense. You are also talking in the book about different ways that people grief. So some people have kind of a more simple and straightforward experience and some people have a more challenging experience. And you talk about complex grief and you talk about the different kinds of people who might have one or the other. Could you say something about that?

[00:12:29.630] – Mary-Frances
Sure. I think one of the difficulties with thinking about this is many of us don’t really experience our first sort of tragic loss until adulthood, often until midlife even. And so I think it makes a lot of sense that in the moment of our lives, this is the worst that we’ve ever felt. And so then it makes it a little weird to hear someone say if everyone is having this experience, this is the worst I’ve ever felt, then it sounds strange to say that some people are having a different experience. But as a clinician who may have seen many, many people who are grieving, I can sort of track through the research and through my clinical experience, I can track that there are these different trajectories of experience. So while the vast majority of us actually search shows are quite resilient. We will experience grief and then over time that will become less intense and it will become less frequent. And even if that weren’t true, it becomes more familiar. We get more expert at dealing with the fact that we are a person who might be overcome with grief. And so that is pretty typical while it is also a lot of suffering.

[00:13:55.370] – Mary-Frances
But the group that we worry about are those who aren’t really showing any change over time so that you don’t see them engaging in activities that still feel meaningful to them. Many people will describe it’s just like I’m going through the motions, nothing actually means anything anymore. Or you have intense anger and bitterness that really starts to eat away at your relationships with living loved ones. And so these are more unusual experiences that happen even more than a year after the loss of someone. And those are the ones that clinicians know this might be a person for whom targeted psychotherapy could really help them. Not because it’s going to take their grief away. That’s just the natural human reaction to loss, but that it might be they can learn some skills to help them deal with the fact that they are a person who has grief and how to sort of jump into that puddle and jump out of it again, and how to create a life around the fact that they’re carrying the absence of this person. And from randomized clinical trials we know that even when people have had prolonged grief disorder for many, many years, they still can benefit from this targeted psychotherapy and over time can see that their life has seen changes now that they’ve had this intervention.

[00:15:31.590] – Marcia
You’ve talked in the book about depression versus grief and how some people think that they’re the same thing, but they’re not. So can you say a few words about that?

[00:15:43.470] – Mary-Frances
Absolutely. As psychiatrists, as psychologists, as a therapist, we haven’t had another option for what to call what people are experiencing other than depression. So it is entirely possible that we’ve been using this term depression even when we mean grief for a long time. But now really careful research by both scientific investigators and also clinicians has really come to see that they are different. Of course you can have both just like you can have comorbid depression and anxiety. That’s actually pretty common. You can have depression and prolonged grief. But here’s something that I think is really helpful as a way to distinguish them. The sort of core of prolonged grief is this yearning, this yearning for the person to be back. And it’s very focused on that loss. In depression there’s no yearning. That’s not a feature of depression. Depression has lots of other things rumination and guilt and feeling that life may not be worth living. It’s got lots of other features to it. But grief really is centered around the person who has died and really wanting them back. In the book, I give an example that I myself, after my mother died, I didn’t experience prolonged grief.

[00:17:12.390] – Mary-Frances
It was not that I was yearning to have her back, but I did experience depression. I had a lot of those intrusive thoughts that just keep going round and round and round in your head, but they weren’t just about my mom, they were about lots of things. And that sort of more global situation, that’s what we think of as depression. Certainly having had depression before a death happens to you increases the chances that the loss can bring on another episode of depression. So that’s one way that it can be useful to think about it. We now have better training for how to distinguish them.

[00:17:58.010] – Marcia
And so really what you’re saying is that just because you’re experiencing depression with your grief, it doesn’t mean that because you’re having depression, it’s going to lead to complex, persistent grief.

[00:18:08.550] – Mary-Frances
That’s right, exactly.

[00:18:10.590] – Mary-Frances
I think that’s a really important distinction and we can really parse those two experiences out. And especially when you think about the yearning feature, that’s really helpful and clear. So you mentioned rumination, and I was going to ask you about rumination because that’s a piece of what we do with grief. But I also wanted you to maybe counterpoint that with avoidance, because there are some, I think, the way you didn’t use the word but functional versus dysfunctional coping strategies for grieving. And so I just thought you might want to talk about rumination and avoidance, as opposed to, let’s say, letting go or accepting and facing. So there’s facing versus rumination and there’s letting go versus avoidance. So can you talk about those different ways of coping?

[00:19:06.190] – Mary-Frances
It is very complex and I will say this is an area of really intense research in research studies right now, and that also means we don’t have all the answers. But rumination, those are those intrusive thoughts, they just keep coming back to you. Often you’re just sitting in a stoplight and suddenly you’re flooded with all these thoughts, or you’re trying to go to sleep at night and you just can’t get this out of your head. And rumination often for people who are grieving, grief related rumination often takes the flavor of what we call the would have, should have, could have thoughts. So they’re not the only grief related rumination, but these are those if only I could have gotten them to the hospital sooner, or the doctor should have known to run another test, or if only they would have known. And the trouble with those thoughts is all of them end in. All those stories end in and then my loved one lived, but your loved one didn’t live. And that’s the painful reality that we have to learn. And so I think what’s fascinating is if we’re stuck in these rumination thoughts, the ones that just go round and round and round in our head, it often can mean that we’re avoiding our feelings.

[00:20:33.050] – Mary-Frances
So that it isn’t so much that you can come up with an answer to any of those questions. There are an infinite number of answers to those questions, but the question is, and what are you going to do now? And that is a really painful question to face. And that’s why many of us avoid it. Right. We avoid conversations around particular topics, or we avoid certain people who remind us of someone who’s died, or we drive a long way out of our way, so we don’t go by the hospital where they were, and it means we don’t think about them as much. But that kind of avoidance, unfortunately, isn’t a good long term strategy because until we learn how to cope with that painful reality, it’s going to keep sneaking up on us. Although I would make a distinction between so for me, from my perspective, I think it’s really valuable to have a really big toolkit of strategies of how to handle grief. And I don’t think of them so much as some of them are more dysfunctional or some of them are more functional, but rather, which tool do I pull out in this situation?

[00:21:52.690] – Mary-Frances
So I’ve sometimes given the example of if you’re at your daughter’s soccer game, you may think, you know what? I am just going to pretend for 45 minutes that this hasn’t happened, and I’m just going to cheer for my daughter, and I’m going to be focused on that, and I am not going to think about anything else. And in that moment, that is avoidance, but in that moment, it’s really appropriate. And so I think it’s more about if you use that strategy all the time, it’s not really going to help in the long run. And things like accepting or processing or learning how to soothe yourself or ask other people for comfort, those may be strategies that also need to be in your toolkit. And so figuring out how to find the motivation or the support to try new strategies, that can be a challenge. It takes a lot of courage.

[00:22:52.390] – Marcia
Yeah. And as you said, flexibility. It’s true because you were writing about doing some activities. Like there are four different kinds of things that people might do after grief. So it would be talking to a loved one, journaling, going to a party, or watching your favorite movie. Right. And that most people do the journaling or the talking to a loved one. But in fact, sometimes doing some fun things is good because it brings you into a happier place and it helps you kind of get out of that rut of being sad.

[00:23:28.570] – Mary-Frances
Yeah. And I think it is also there’s a lot of social messages about what’s okay that we’re allowed to do when we’re grieving. And I think some people choose those in part because they think it would be frowned upon for them to go to a party or for them to watch a comedy. And it turns out that you’re exactly right. It’s important to have lots of different experiences. Grieving is really stressful and so to have a good laugh is good medicine, if nothing else. And so connecting with other people often means doing fun things. And so connecting with our living loved ones is a part of restoring a life for ourselves. So giving yourself permission, permission to have a really full range of experiences, might help you accept that invitation to a party.

[00:24:28.230] – Marcia
Yeah. And I love the word giving yourself permission because I think you were talking about the social stress, social pressures. There’s a lot of weird stuff people tell us about how we’re supposed to grief. They tell us, you shouldn’t have a good time, go to a party, but then they say you should move on and get over it at a certain point. Right. So it’s such mixed messages. Right. So if we can have that permissiveness and that compassion with ourselves, to have the experience that we’re having because it’s our unique, as you said, our unique experience, then maybe it’s not going to be as much suffering as it would necessarily have to be.

[00:25:05.200] – Mary-Frances
That’s right. I sometimes describe it as we don’t get a choice. Grief is just if you love someone, grief is just a natural reaction if they are no longer there, eventually, over time, with grieving, we learn how to manage the fact that we have grief. Right. And I think everyone is going to learn that if everyone gets their own learning curve, they have different other situations in their life they’re trying to cope with. And I think for most people, just being supportive. I can tell you that. After my dad died, one of the best things my best friend said to me was, you’re doing really well in a really impossible situation. And just hearing you’re doing really well was so rewarding because you’re trying so hard in the midst of feeling crazy that to hear that from someone meant so much.

[00:26:11.430] – Marcia
You were talking about how people can sometimes say the wrong thing when you’re grieving. Why do you think that is?

[00:26:19.850] – Mary-Frances
As a person who has sat with a lot of grieving people, I can tell you it is hard. It is hard to sit with people who are grieving. And our natural reaction is either to say more, the right to give them advice or to try and cheer them up. And unfortunately, I think about it this way. If you’re a grieving person and you’re trying to even learn, what am I feeling? How am I supposed to function in the world? And now you’re sitting with someone who also wants you to feel differently than you do. That’s very isolating. Right. It’s very hard to connect with someone when you’re already having a difficult time connecting with them. And so I think I would say as people who are sort of grief adjacent I sometimes say it really is much more about just being there with them, witnessing what they are experiencing, asking them what they’re learning and how things change since the last time we talked. Those questions mean, I actually want to hear what your experience is, and I’m not going to try and change it. I’m not trying to dissuade you from your experience. And so witnessing their brief is, in fact, a way of supporting them.

[00:27:47.290] – Mary-Frances
Now, I think the big toolkit applies here as well. Right? So if that’s the only form of support, if you’re just going over things with them again and again and again and again, and that’s really all you do when you’re together, that’s not a very big toolkit. So I think of it as if you’re sitting at a playground and you have a toddler who’s playing on the swings or something, and they fall down and scrape their knee. It’s perfectly appropriate to run over and pick them up and kiss them and hug them. And it’s also perfectly appropriate to stay where you are and give them that encouraging look and say, it’s okay. Get out. You can do it. Drag in right. Both of them are equally compassionate, and it’s probably important that we have a range of ways that we provide support.

[00:28:40.950] – Marcia
So there’s no one size fits all way of grieving and no one size fits all way of being grief adjacent and supportive to the grieving person.

[00:28:49.320] – Mary-Frances
That’s right. And sometimes just asking them, what do you need today? Should we go out to lunch and talk about what we’ve been binge watching? Or should we go out to lunch and talk about how you don’t really want to get rid of those clothes in his side of the closet?

[00:29:05.390] – Marcia
Yeah, that’s nice. Yeah. So I do a lot of work with people. I do what’s called independent psychiatric assessments these days. So I do a lot of work with people who have significant challenges in their life, and many of them have had losses in the context of a trauma, like a car accident or a house fire or some kind of extremely traumatic event. Really dramatic and traumatic. And I’m just wondering if you’ve done any research or learned anything about how the impact of trauma affects one’s grieving process, because from my perspective, it definitely makes it more complicated and difficult to get through.

[00:29:52.430] – Mary-Frances
Yeah, you can definitely have, for example, PTSD and prolonged grief at the same time. Just like we were saying, you could have depression and prolonged grief. So I think one way that I’ve wrestled with this question for a long time, I think one of the things that I’ve learned is the way in which I sort of think of trauma and grief as different from each other, although they can result from the same event. And some of this was really motivated by a psychiatrist in the Netherlands named Manic Gilantic, who did a study of refugees. She was working at a center where many of them had experienced grief over losses, and many of them also had experienced those during trauma. And this is the way I think about it. Now. If you think of that moment that is traumatic, it is that moment where you feel utterly helpless, that whatever terrible thing is happening, you are ultimately completely helpless. And the challenge, of course, is we start to generalize that. We start to feel helpless in lots of parts of our lives. Grief, on the other hand, is about recognizing the irrevocable nature of this death.

[00:31:10.110] – Mary-Frances
This person is never coming back, that painful reality. And so you can see that grief and trauma are slightly different if you make them sort of that concretely distinct. And you can also see how those things might happen at the same moment. But I can give you this example. She worked with a young man whose cousin had been shot in the street because they were in a war zone. And in the moment of him crumbling to the ground, the man felt incredible helplessness. And then he also carried his cousin into a building, and as he sat there, he realized that he had died. And so at some level, you can distinguish the helplessness that he felt in the street and the painful reality of the end of this man’s life in the building. You can sort of distinguish those and think about how you might deal with those somewhat differently. So I know that’s a really dramatic example, but I think we often use grief and trauma interchangeably, and I’m not sure that it doesn’t just muddy the waters a little.

[00:32:28.700] – Marcia
No, I absolutely agree, because I think that trauma can affect how you deal with grief because it makes talk about stress. It’s a huge stress. And if grief is an already stressful situation, then you have, I think, fewer resources with which to deal with the stress of grief when you’re already stressed by the trauma that you’ve experienced. Right.

[00:32:51.060] – Mary-Frances
Absolutely. Totally agree.

[00:32:53.460] – Marcia
Yeah. So if someone, let’s say, has both PTSD and grief, would you suggest getting both trauma therapy and grief therapy?

[00:33:04.090] – Mary-Frances
Well, it’s interesting. Dr. Gilantic’s work was actually very focused on what do we treat first? Right. You have to pick one. And it was her experience in this particular study. I’m not aware of other studies since then that treating the grief first was actually most helpful. And I think part of that was because grief is often something it’s easier to provide and accept comfort around. And so it increased the relationship. It improved the relationship with the therapist and the person. And that sort of gave them a better foundation then to do some of the trauma work, which, as you know, is incredibly challenging.

[00:33:49.230] – Marcia
That makes a lot of sense, actually, because yeah, then that would help them build some resources to focus on the other. Yeah, I know. It’s like, which came first, right?

[00:33:58.850] – Mary-Frances
Exactly.

[00:34:00.030] – Marcia
Oh, my goodness. So do you have any interesting stories about people who are really struggling with their grief, who were able to do better with the help that understanding the process provided?

[00:34:15.390] – Mary-Frances
I think for many of us, understanding that we’re pretty normal, some of the things we think are super crazy that we’re doing, like thinking, I just feel like they’re going to walk through the door again. I know that sounds nuts, but that’s just how I feel. Knowing that there can be a cognitive or a neurobiological reason for that, I think in and of itself often makes people feel a lot better, just that they are normal, those targeted psychotherapies. There are people who have really just remarkable stories. I tell one in the book about a woman who is still grocery shopping for both herself and her husband and was still preparing meals for the two of them even though he had died. And through the course of therapy, she was really able to accept that this was a kind of avoidance, in a sense. And also what she might do in her life now that might make use of the fact that she is a wonderful cook and wants to feed people, but that is more responsive to the fact that she lives alone and how to reach out in her community. So there are many examples of I think we look to all sorts of neighbors and friends and family members and think, wow, I can’t believe how much they seem to have adjusted and how they’re managing is kind of amazing.

[00:35:44.990] – Marcia
Yeah. You talked about this little boy named Ben, the two year old who passed away, and his mother made this whole initiative called Ben’s Bells. Would you like to say something about that?

[00:35:54.630] – Mary-Frances
Yeah. Ben’s Bells is now a huge nonprofit organization here in Tucson, and it has this incredibly wide reaching impact. So the woman who began Ben Spells, Jeanette Maré, she really wanted, in her own experience of people not saying the best thing when she was grieving, she really wanted to improve communication around grief and really through kindness. What does kindness really mean? And that initiative she took to the schools, and they do lots of projects now under that umbrella of benzbells, teaching children what kindness is and why we do it and how to do it in other situations as well. But what’s amazing is there’s a particular green flower that is the logo for Ben Spells, and you see it all over on bumper stickers in Tucson. You see it on the sides of schools in mosaics that children have made. Ben’s life has really affected many of us, and he only lived to be two.

[00:37:00.470] – Marcia
And it’s a way of taking those terrible life experiences and finding meaning in them. And that’s a way to thrive and be resilient.

[00:37:09.250] – Mary-Frances
Yeah, absolutely. It’s not something everyone can do. It may be that thriving and being resilient for you is that you get dinner on the table every night, and that’s perfectly okay. You are feeding yourself. That is impressive.

[00:37:24.910] – Marcia
Yeah, absolutely. And I think it’s important I’m glad you brought that up, because it’s important to have reasonable expectations. Not everybody is going to start a huge initiative. Some people are just going to make sure that they take a shower every day or two and that they feed themselves and that they get to work every day and they talk to their loved ones periodically. I think we have to, again, have that compassion and permissiveness and have no one size fits all way of managing after grief and loss.

[00:37:54.000] – Mary-Frances
Such a good description. Yeah.

[00:37:55.820] – Marcia
So when people are looking for you, where would they find you if they’re interested in the things that you’re working on?

[00:38:06.890] – Mary-Frances
I have a lab website which is Mary Francis O’Connor. Org. And certainly you can find me there. I’m on various social media, but probably you learn most about what I’d like to say through The Grieving Brain, the book which is available everywhere.

[00:38:21.670] – Marcia
Wonderful. Are you working on any particular new projects these days?

[00:38:26.870] – Mary-Frances
I have a new graduate student who’s just about to start an MRI study. It’s always getting the next generation involved that excites me. And this will be a study of when we are just sitting there, not doing anything else and letting our thoughts roam. How do people who are grieving manage their thoughts? And what are the sort of interconnected regional activity in our brain that might look different in those who are getting stuck in their thoughts and those who are able to sort of move through them?

[00:38:56.800] – Marcia
Oh, that’s a really interesting new study. And before we end, I always like to ask my guest for a call to action for the listener. So apropos of all the interesting things we were talking about today, what do you suggest as a call to action?

[00:39:13.430] – Mary-Frances
I think if you were a person who has had loss, the question I might ask you to ask yourself is, what am I avoiding? That’s not an easy question. You have to be honest. Only you will know. But try to see if there’s something you’ve been avoiding and how you might make a strategy to engage with it. And then maybe, what am I learning as well? What have I learned? What do I think differently about the world or my loved ones or my life now since this happened to me.

[00:39:48.170] – Marcia
And since so many people, especially lately, have experienced loss? I think those are very important calls to action. Well, thank you so much, Mary Francis O’Connor, for being on the Ruthless Compassion podcast. This has been a very enlightening and meaningful conversation, I think very helpful for a lot of people.

[00:40:06.210] – Mary-Frances
I’m really glad you’re bringing this conversation to people, Marcia. Thanks for having me.

[00:40:10.420] – Marcia
My pleasure.

[00:40:12.690] – Marcia
This is Dr. Marcia, Sirota. Thank you for listening. Please leave a review and your comments wherever you listen to podcasts. And don’t forget to sign up for my free newsletter at marcia sirotamd.com, where you’ll learn about upcoming online events as well. Also, we love getting referrals from our listeners about future Podcast guests, so please email us at info at marciasirotamd.com.

 

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