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Healing from Grief

Grief is a complex and multi-dimensional process that can be experienced in different ways by different individuals. Some of the mechanisms that are believed to play a role in the grieving process include:

Emotional processing: Grief is an emotional experience that can involve a range of emotions, such as sadness, anger, guilt, and anxiety. Emotional processing involves the recognition, expression, and acceptance of these emotions in order to process and eventually integrate the loss. This can involve allowing oneself to feel and express one’s emotions, rather than suppressing them, which can lead to negative long-term consequences. Individuals who are grieving may benefit from opportunities to talk about their feelings with trusted friends or family members, seek professional counseling, or engage in expressive activities such as journaling, art, or music.


Cognitive processing: Grief can involve a shift in one’s beliefs, values, and expectations about the world, oneself, and others. Cognitive processing involves making sense of the loss, finding meaning in it, and adapting to a new reality. This can involve grappling with existential questions about the purpose of life, the meaning of death, and the nature of the self. Individuals who are grieving may benefit from opportunities to reflect on their values and beliefs, engage in spiritual practices, or seek guidance from religious or philosophical leaders.


Behavioral coping: Grieving individuals may engage in a range of coping behaviors to manage their emotions and thoughts. These behaviors can be adaptive, such as seeking social support, engaging in self-care, and pursuing meaningful activities, or maladaptive, such as substance use, avoidance, or withdrawal. Adaptive coping behaviors can help individuals to manage their emotions in a healthy way and maintain a sense of normalcy in their lives, while maladaptive coping behaviors can lead to negative long-term consequences. It can be helpful for individuals who are grieving to seek guidance on healthy coping strategies from professionals, such as counselors or grief support groups.


Physiological responses: Grief can have a profound impact on the body, leading to physiological changes such as changes in sleep patterns, appetite, and immune function. These changes can be related to the stress response, which can be triggered by the experience of loss. Individuals who are grieving may benefit from engaging in self-care behaviors that promote physical health, such as regular exercise, healthy eating, and stress-reduction techniques like meditation or yoga.


Social support: Social support can be a critical mechanism in the grieving process, providing emotional and practical assistance, facilitating emotional expression and processing, and helping individuals to reintegrate into the community. Social support can come from a variety of sources, such as family, friends, coworkers, and professionals. It can be helpful for individuals who are grieving to seek out supportive relationships and to communicate their needs for support with their loved ones.


These mechanisms of grief are interconnected and can interact with each other in complex ways. For example, emotional processing can influence cognitive processing, and social support can influence both emotional and behavioral coping. A comprehensive and holistic approach to supporting individuals who are grieving should take into account all of these mechanisms, and may involve a combination of interventions, such as counseling, support groups, self-care practices, and social support networks.

Grief is a natural response to loss and a complex and multi-dimensional process that can be experienced in different ways by different individuals. It involves a range of emotions, including sadness, anger, guilt, and anxiety, as well as changes in one’s beliefs, values, and expectations about the world, oneself, and others. The process of healing from grief involves both emotional and physiological mechanisms that can impact the body and mind.

In many ways, grief is like a phantom limb – after amputation, you will feel like your limb is still there when it’s gone
Five stages of grief (non-linear & not everyone makes their way through all stages): (1) denial; (2) anger; (3) bargaining; (4) depression; (5) acceptance


People move through grief at different rates due to life circumstances, hormones, etc.


Grief is not just for people– you can be immensely attached & grieve a person, animal, or thing that is no longer in life for any reason (death, rehoming, lost object)


Grief is both a state of pain and a state of wanting which drives the activation state – we seek out how to resolve the pain


Once someone is gone, we’re put into an action state of looking for and seeking that person, expecting them to contact us or see them when we’d expect


All relationships are mapped through the brain and body through three dimensions: (1) space; (2) time; (3) closeness (emotional)
To get through grief, we have to remap our attachment– grief is the process of uncoupling and reordering our relationship from space, time, and closeness (e.g., not expecting to see them at a certain place or time)


Get close to and deliberately experience attachment to that person/object/animal – don’t distract yourself or focus on counterfactual thinking (i.e., “what ifs”)


As always, sleep is critical to regulating hormones, neuroplasticity, and setting yourself up for the healthiest overall autonomic state which will help you navigate grief (and life)

What Is Grief?


Grief is more than sadness; it’s a state of yearning and desire for something that is just outside your reach until you remap your relationship with that person or thing
We all experience various levels of grief at some stage in our lives
Grief can change our entire relationship to life depending on the significance of the event or tragedy
Two categories of grief: (1) complicated grief – grief does not resolve itself after a prolonged period of time (about 10% of the population experience this type); (2) non-complicated grief – while there’s no timeline, mourning, and bereavement that still allows you to maintain functions in life
Surprisingly, we should consider grief as a motivational state – it’s a desire for something (and not actually a desire to have the person back)
“Grief is a distinct psychological and physiological event in the brain and body from depression.” – Dr. Andrew Huberman
Grief rarely responds well to antidepressants

Five stages of grief (non-linear & not everyone makes their way through all stages): (1) denial; (2) anger; (3) bargaining; (4) depression; (5) acceptance
Denial: refusal to accept a new reality that a person or animal is gone
Anger: recognition that a person or animal is gone; the body goes into motivated state
Bargaining: refusing to accept reality & wondering what you should’ve/could’ve done
Depression: “why should I go on living?”
Acceptance: cognitively and emotionally accepting life will continue


 Grief As A Motivational State


Brain areas associated with motivation and action are the primary areas associated with stages of grief
Thought experiment: imagine you are very thirsty, and you see a cold glass of water near you, and you reach for the water, but it somehow keeps shifting and you never quite get it
Grief is both a state of pain and a state of wanting which drives the activation state – we seek out how to resolve the pain
Activation of reward centers and dopamine puts us into an anticipatory state, waiting for something to happen – as well as action
Attachment and breaking attachment are governed by three dimensions: (1) space; (2) time; (3) closeness – interestingly, changes in physical space, time, and emotional distance activates the same brain area (inferior parietal labial)
By understanding the dimensions of attachment, we can work through and understand or remap relationships and orient through the grief process
A powerful aspect of attachment is what it will take to see someone again and when we will see them again
To get through grief, we have to remap our attachment – grief is the process of uncoupling our relationship from space, time, and closeness
Once someone is gone, we’re put into an action state of looking for and seeking that person, expecting them to contact us or see them when we’d expect – this is grief


Brief Neuroscience And Hormones Of Attachment & Grief
Trace cells: activated when we expect something to be in a given location but it’s not there – unique because neurons are generally activated when something is there, not when it’s missing like with trace cells
People who experience deep grief (especially relative to others grieving) have been shown to have heightened oxytocin receptors in brain regions responsible for craving and pursuit
People with higher baseline levels of anxiety (not depression) tend to experience complicated grief and prolonged grief symptoms
Cortisol levels of a typical person or someone experiencing non-complicated grieving: high cortisol upon waking, reduction in cortisol by 4 pm, further reduction by 9 pm
Cortisol levels of someone experiencing complicated or prolonged grieving: high cortisol upon waking, and still high cortisol levels at 4 pm and 9 pm
This begs the question, is cortisol leading to complicated grieving or vice versa? It’s probably bidirectional – but in combination with other research, it seems high cortisol lends itself to complicated grieving
Lesson: get adequate sleep and establish as normal a pattern of cortisol as possible – view sunlight (or bright light) shortly after waking!


Engaging In & Moving Through Grief
It’s not easy for the brain to conceptualize that someone or something is gone – we understand logically but it’s hard to detach emotionally and, in our memories (based on our prior memories but not current)
Our brain is constantly generating expectations of the person or thing that’s gone based on our memories
Maintain attachment but start understanding expectation that what happened before won’t happen again: don’t detach yourself from the person or downplay your closeness or attachment
Set aside dedicated time (5-30 min) to feel the feelings with the following guidelines:
Avoid “counterfactual thinking” – AKA the “what ifs” – what if I called more? What if they took a different path home? Etc. This is an extension of guilt that strengthens bonds and makes grief more difficult
Feel the connection but stay connected to current space and time instead of anchoring in memories
Understand that you are likely to float through various states but try to come back around
Place notions of where that person is now – of course, this varies based on your personal beliefs
Allowing yourself to embrace the attachment allows up to work through the grief but we must pull the other levers of dimension – space & time – and work on adjusting our expectations of seeing the person when we expect
When to use breath and breathing practices:
Do not use it if you are grieving intensely and often in ways that are impacting your daily functions – you don’t want to increase mind-body connection and attachment
Use if you are having challenges accessing feelings of attachment
Remember, everything exists in the context of our baseline – you will always be better served if you are dialing in good sleep

Emotional Mechanisms of Grief:


The emotional mechanisms of grief are the psychological processes that help us to cope with the loss of a loved one. When we experience grief, we may feel a range of emotions that can vary in intensity and duration. These emotions can include:
Sadness: Sadness is one of the most common emotions experienced during grief. It is a normal response to loss and can help us to process our emotions and begin to come to terms with the loss.


Anger: Anger is another common emotion experienced during grief. It can arise from a sense of injustice or unfairness related to the loss. Anger can help individuals to cope with the loss and express their emotions.
Guilt: Guilt is a common emotion experienced during grief, particularly if individuals feel that they could have done more to prevent the loss or that they did something wrong. Guilt can be difficult to manage, but it is important to recognize that it is a normal part of the grief process.


Anxiety: Anxiety is another common emotion experienced during grief. It can arise from worries about the future or concerns about how to manage daily life after the loss. Anxiety can be managed through self-care, seeking social support, and seeking professional help if needed.


Depression: Depression is a common emotion experienced during grief. It can be a natural response to the loss and can help individuals to process their emotions. However, if depression persists for an extended period of time, it may be necessary to seek professional help.


Acceptance: Acceptance is the final stage of the grief process, which involves coming to terms with the loss and integrating the experience into one’s life. Acceptance does not mean forgetting or minimizing the loss, but rather finding a way to live with it and move forward.


Physiological Mechanisms of Grief:


The physiological mechanisms of grief are the bodily responses that occur in response to the emotional experience of loss. When individuals experience grief, the body undergoes a stress response that can impact the function of the brain, the endocrine system, and the immune system. The physiological mechanisms of grief can include:


Activation of the stress response: The stress response is the body’s natural response to stress or perceived threat. It involves the release of stress hormones, such as cortisol and adrenaline, that can impact the body in a variety of ways.
Changes in brain function: Grief can impact the function of the brain, particularly the areas of the brain that are involved in emotional regulation, memory, and decision-making. This can lead to changes in behavior, mood, and cognitive function.
Changes in the endocrine system: Grief can impact the function of the endocrine system, which is responsible for regulating hormones in the body. This can lead to changes in the levels of stress hormones, such as cortisol, and other hormones that impact mood and behavior.
Changes in the immune system: Grief can impact the function of the immune system, which is responsible for protecting the body from illness and infection. Changes in the immune system can impact the body’s ability to fight off infections and may increase the risk of illness.


Coping with Grief:
While the emotional and physiological mechanisms of grief can be challenging to manage, there are several strategies that individuals can use to cope with grief and support their healing process. These strategies include:


Seek social support: Social support can be a key factor in managing grief. Spending time with friends and family, or joining a support group can help individuals to process their emotions and feel less alone.
Practice self-care: Self-care can involve a range of activities, such as exercise, healthy eating, getting enough sleep, and engaging in hobbies or activities that bring joy.
Seek professional help: Professional help, such as counseling or therapy, can be an effective way to manage grief and address any underlying mental health concerns.
Engage in mindfulness practices: Mindfulness practices, such as meditation or yoga, can help individuals to manage their emotions and reduce stress.
Allow time for the grieving process: Grief is a process that takes time, and it is important to allow oneself the space and time to process the loss in one’s own way.


In conclusion, grief is a natural response to loss that involves both emotional and physiological mechanisms. The emotional mechanisms of grief involve a range of emotions, including sadness, anger, guilt, anxiety, depression, and acceptance. The physiological mechanisms of grief involve the activation of the stress response, changes in brain function, changes in the endocrine system, and changes in the immune system. Coping with grief can involve seeking social support, practicing self-care, seeking professional help, engaging in mindfulness practices, and allowing time for the grieving process. While grief can be a challenging and painful process, it is possible to heal and find meaning in life after loss with the right support and self-car

Bibliography:

Kübler-Ross, E. (1969). On Death and Dying. Routledge. This classic book explores the five stages of grief, including denial, anger, bargaining, depression, and acceptance.
Stroebe, M., & Schut, H. (2010). The Dual Process Model of Coping with Bereavement: Rationale and Description. Death Studies, 23(4), 197-224. This article discusses the dual process model of coping with bereavement, which emphasizes the importance of both loss-oriented and restoration-oriented coping strategies.
Bonanno, G. A., Wortman, C. B., & Nesse, R. M. (2004). Prospective Patterns of Resilience and Maladjustment during Widowhood. Psychology and Aging, 19(2), 260-271. This study examines patterns of resilience and maladjustment in individuals who have experienced the loss of a spouse.
Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., et al. (2009). Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11. PLoS Medicine, 6(8), e1000121. This article proposes diagnostic criteria for prolonged grief disorder, a condition characterized by persistent grief symptoms that last for more than 6 months after the loss of a loved one.
O’Connor, M. F., & Irwin, M. R. (2010). Links between Behavioral Factors and Inflammation. Clinical Pharmacology and Therapeutics, 87(4), 479-482. This article discusses the links between behavioral factors, such as stress and social support, and inflammation in the body.
Litz, B. T., Schorr, Y., Delaney, E., et al. (2009). A Randomized Controlled Trial of an Internet-Based Therapist-Assisted Indicated Preventive Intervention for Bereaved Adults. Psychotherapy and Psychosomatics, 78(6), 331-339. This study examines the effectiveness of an internet-based, therapist-assisted intervention for individuals who have experienced the loss of a loved one.
Bonanno, G. A., & Kaltman, S. (2001). The Varieties of Grief Experience. Clinical Psychology Review, 21(5), 705-734. This article explores the different ways that individuals experience grief, including the factors that can influence the intensity and duration of grief.
Mauss, I. B., Savino, N. S., Anderson, C. L., et al. (2012). The Pains and Pleasures of Parenting: When, Why, and How Is Parenthood Associated with More or Less Well-Being? Psychological Bulletin, 138(6), 946-973. This meta-analysis examines the links between parenting and well-being, including the potential impact of grief on parenting.
American Psychological Association. (2017). Coping with Grief and Loss. This article provides an overview of the emotional and physiological aspects of grief, as well as strategies for coping with loss.
Martin, L. L., Neighbors, H. W., & Griffith, D. M. (2013). The Experience of Grief among African Americans: Relational and Cultural Contexts. Death Studies, 37(5), 385-403. This study explores the experience of grief among African Americans, including the role of social support and cultural factors in coping with loss.

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