The Grieving Brain: The Surprising Science of How We Learn from Love and Loss

by Mary-Frances O'Connor

For as long as there have been human relationships, we have struggled with the overwhelming nature of grief following the death of a loved one. Poets, writers, and artists have given us moving renderings of the almost indescribable nature of loss, an amputation of a part of ourselves, or an absence that weighs on us like a heavy cloak. As human beings, we seem compelled to try to communicate what our grief is like, to describe carrying this burden.

I always wanted to understand the why rather than just the what. Why does grief hurt so much? Why does the death, the permanent absence of this person with whom you are bonded, result in such devastating feelings, and lead to behavior and beliefs that are inexplicable, even to you? I felt certain that part of the answer could be found in the brain, the seat of our thoughts and feelings, motivations, and behaviors. If we could look at it from the perspective of what the brain is doing during grief, perhaps we could find the how, and that would help us understand the why.

Through my years of study and research, I eventually realized the brain has a problem to solve when a loved one has died. This is not a trivial problem. Losing our one-and-only overwhelms us, because we need our loved ones as much as we need food and water.

After decades of research, I realized that the brain devotes lots of effort to mapping where our loved ones are while they are alive, so that we can find them when we need them. And the brain often prefers habits and predictions over new information. But it struggles to learn new information that cannot be ignored, like the absence of our loved one. Grieving requires the difficult task of throwing out the map we have used to navigate our lives together and transforming our relationship with this person who has died. Grieving, or learning to live a meaningful life without our loved one, is ultimately a type of learning. Because learning is something we do our whole lives, seeing grieving as a type of learning may make it feel more familiar and understandable and give us the patience to allow this remarkable process to unfold.

You see, grief never ends, and it is a natural response to loss. You will experience pangs of grief over this specific person forever. You will have discrete moments that overwhelm you, even years after the death when you have restored your life to a meaningful, fulfilling experience. But, whereas you will feel the universally human emotion of grief forever, your grieving, your adaptation, changes the experience over time.

understanding of grieving as a form of learning. Adopting the mindset that grieving is a form of learning, and that we are all always learning, may make the winding path of grieving more familiar and hopeful.

Grief is a heart-wrenchingly painful problem for the brain to solve, and grieving necessitates learning to live in the world with the absence of someone you love deeply, who is ingrained in your understanding of the world. This means that for the brain, your loved one is simultaneously gone and also everlasting, and you are walking through two worlds at the same time. You are navigating your life despite the fact that they have been stolen from you, a premise that makes no sense, and that is both confusing and upsetting.

How, exactly, does the brain walk you through two worlds at the same time? How does the brain make you feel weird when you do not bump your hip into the missing dining room table?

If someone close to us dies, then, based on what we know about object-trace cells, our neurons still fire every time we expect our loved one to be in the room. And this neural trace persists until we can learn that our loved one is never going to be in our physical world again. We must update our virtual maps, creating a revised cartography of our new lives. Is it any wonder that it takes many weeks and months of grief and new experiences to learn our way around again?

A key problem in grief is that there is a mismatch between the virtual map we always use to find our loved ones, and the reality, after they die, that they can no longer be found in the dimensions of space and time. The unlikely situation that they are not on the map at all, the alarm and confusion that this causes, is one reason grief overwhelms us.

The idea that a person simply does not exist anymore does not follow the rules the brain has learned over a lifetime. Furniture does not magically disappear. If the person we love is missing, then our brain assumes they are somewhere else and will be found later. The action required in response to their absence is quite simple: Go look for the person, cry out, text, call, or use any possible means to get their attention. The idea that the person is simply no longer in this dimensional world is not a logical answer to their absence, as far as the brain is concerned.

Searching for our loved ones after they have died is a very common experience.

And as much as we may hope and struggle and yearn, we will never stop time. We can never go back. We must eventually walk out of that bedroom and be smacked in the face with the present reality.

In the wake of a loved one’s death, we have an overwhelming urge to reach out to them, and this urge often comes at the very same time when many people turn to religion to understand the meaning of life and their place in the universe. Religions provide answers that soothe and comfort the bereaved. They usually describe a place where the deceased now resides (Heaven, the Buddhist Pure Lands, the Underworld across the River Styx) and a time when we will see them again (Día de los Muertos, the Japanese Obon festival, Judgment Day).

When you wake up one morning and your loved one is not in the bed next to you, the idea that she has died is simply not true in terms of probability. For our brain, this is not true on day one, or day two, or for many days after her death. We need enough new lived experiences for our brain to develop new predictions, and that takes time.

In the same way, you cannot force yourself to learn overnight that your loved one is gone. However, you can allow your brain to have experiences, day after day, which will help to update that little gray computer. Taking in everything around us, which updates our virtual map and what our brain thinks will happen next, is a good start for being resilient in the face of great loss.

When a loved one has passed away, we may feel that we are no longer close, but our brain cannot believe it is because “closeness” no longer applies. Instead, our brain may believe it is because they are upset with us, or that they are being distant. If they are not responding to us, even though we logically know that they cannot, then our brain may believe we are not trying hard enough to reach them, not appealing fervently enough to them to come back to us.

When a loved one dies, we may feel many strong emotions in addition to sadness. We feel regret, or guilt, or anger, or what we might call social emotions. On a subconscious emotional level, we may feel that they have “ghosted” us, and we may feel these same intense, motivating emotions of anger or guilt. When

Why are we so angry? Who are we angry at? Sometimes our anger is directed at the person who died. But we can be angry toward a range of people, including doctors and even God. This anger is motivated by something different than anger we feel toward the person who died. If you take a toy away from a toddler, he may scream at you in anger. And sure enough, sometimes you give him the toy back, because you see how much it has upset him. But no one can return the person who died.

we run endless possible scenarios after a death. How could this have happened? Could we have stopped it? In fact, people who are grieving very commonly describe endless rumination. This “would’ve/could’ve/should’ve” loop can feel exhausting.

We might think it is simply a metaphor to say that we have lost a part of ourselves when a loved one dies, but as we have seen, representations of our loved ones are coded in our neurons. Representations of our own bodies are coded in our neurons as well, as demonstrated by the phantom limbs. These representations of the self and the other, this closeness, is mapped as a dimension in the brain. Consequently, the process of grieving is not just about psychological or metaphorical change. Grieving requires neural rewiring as well.

Didion explains that she was unable to give away her deceased husband’s shoes, because “he might need them again.” Why would we believe that our loved ones will return, if we know that’s not true? We can find answers to this paradox in the neural systems of our brain, systems that produce different aspects of knowledge and deliver them to our consciousness. If a person we love is missing, then our brain assumes they are far away and will be found later. The idea that the person is simply no longer in this dimensional world, that there are no here, now, and close dimensions, is not logical. In chapter 5, I will tell you more about the neurobiology of why we want to find them. For this chapter, however, the question to consider is, Why do we believe we will find them?

In humans as well, it is because your loved one existed that certain neurons fire together and certain proteins are folded in your brain in particular ways. It is because your loved one lived, and because you loved each other, that means when the person is no longer in the outer world, they still physically exist—in the wiring of the neurons of your brain.

Chimpanzees are humans’ closest living relatives, as both species descended from a common ape ancestor.

People experience fear, terror, pain, helplessness, or extreme anger at the moment of their loved one’s passing, especially if it occurs in violent or terrifying circumstances, in accidents or emergency rooms. During the COVID-19 pandemic, many people were unable to be with their loved ones when they were admitted to the hospital and were not at their bedside when they died. Without the opportunity for saying good-bye, for expressing love, gratitude, or forgiveness, and without the memory of seeing our loved one’s physical decline and death, ambiguity may surround the “realness” of the death. Research shows that ambiguous loss, such as when family members are disappeared by a political regime or missing and presumed dead from an airplane crash or in wartime conflict, complicates the grieving process. One reason may be that part of our brain is wired to believe that our loved one is never really gone, and without the overwhelming evidence from our memories of their decline or death, rewiring our understanding may take longer or cause greater distress.

But believing that my loved one is no longer on Earth, when part of how they are encoded in my brain as my loved one includes the information that they will be here, now, and close, takes time to understand and is not easy. Resolving incompatible beliefs interferes with learning.

When we lose a loved one, it is common to know that the person is gone and simultaneously harbor the magical belief that they will walk back in through the door again.

The hero (griever) enters an unfamiliar and terrifying world, and after an arduous journey, returns transformed, with new wisdom. The journey is composed of a series of nearly impossible obstacles (stages) to be overcome, making the hero noble when they succeed in their quest. Holland and Neimeyer put this well: “the seemingly magnetic draw of a stage-like depiction of grieving that begins with a disorienting separation from the ‘normal,’ pre-bereavement world, and that progresses heroically through a series of clearly marked emotional trials before eventuating in a triumphant stage of acceptance, recovery, or symbolic return, may owe more to its compelling coherence with a seemingly universal narrative structure than to its objective accuracy.”

The problem with this monomyth is that people feel they are not normal when they do not experience a linear set of obstacles. Or they feel like failures because they have not “overcome” grief or achieved some enlightened state. Friends, family members, and even doctors may worry when there is no clear return of a wise hero. Holland and Neimeyer conducted an empirical study that looked for the five stages and found that adaptation is not so linear or orderly. Grief distress is usually more pronounced in folks who have been grieving for a shorter period of time. But the distress includes all types of grief experiences, including disbelief, anger, depressive mood, and yearning.

Acceptance is most evident among those who have been grieving for a longer period of time. Thus, grief distress and acceptance seem to be two sides of a coin, but the rise and fall of each one tends to look like waves across days, weeks, and months. The relative increase in acceptance as compared to the relative...

In the midst of this slow inversion of acceptance over distress, there tends to be a temporary reversal around each anniversary of the death, when many people experience a normal recurrence of their grief. The journey doesn’t typically have a clear beginning, middle, and end that we may hope for, or that our loved ones may hope for us, in the midst of our distress. On the waves of grief, event...

The key to coping well after you lose someone is flexibility, attending to what is happening day-to-day, and also being able to focus on coping with whichever stressor has currently reared its ugly head. Bereaved people also have times when they are not consumed by grief, when they are simply engaged in everyday experience outside the two ovals. As time passes, they are more and more engaged in everyday life, and the difficulties of loss and of restoring a meaningful life recede gradually. The ovals representing loss disruption and striving for restoration never disappear, but these stressors evoke less intense and less frequent emotional reactions. In the second half of the book I will discuss in greater detail how this flexible approach to coping with loss works.

Bonanno and his colleagues found that there were four trajectories that could be used to categorize people’s grieving. These trajectories include resilient (those who never develop depression after the death of a loved one), chronic grieving (depression that begins after the death of a loved one and is prolonged), chronic depression (depression that began before the death of a loved one and continues or worsens after the death), and depressed improved (preexisting depression that abates after the death of a loved one).

What was remarkable, however, was how many fell into this “not depressed” resilient category: more than half of the widowed spouses. That means that resilience is the most typical pattern of grieving, showing that most people who experience the death of a loved one do not experience depression at any time point. Frankly, this surprised many people who study grief. This insight reminded us that clinicians had primarily been studying bereaved people who sought help after their loss, a smaller group than the larger “resilient” group who didn’t experience depression.

Sigmund Freud was the first to write about how similar grief and depression are.2 Though they can look the same, one difference between them is that depression often seems to come out of nowhere, whereas grief is a natural response to a loss. Since the time of Freud, we have learned that depression and grief, even severe grief, can be distinguished. For example, depression tends to pervade every aspect of life. People who have depression feel that almost all facets of their life are awful, rather than feeling that it is just the loss they are struggling with.

Prolonged grief disorder is now included in the International Classification of Diseases (ICD-11) produced by the World Health Organization. It was accepted as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) produced by the American Psychiatric Association in 2022. Characteristic symptoms include intense yearning, or preoccupying thoughts of the deceased, on a daily basis. Among other symptoms, there is intense emotional pain, a feeling of disbelief or an inability to accept the loss, difficulty engaging in activities or making plans, and a feeling that part of oneself has been lost. These symptoms occur for at least six months (or for at least a year, in the DSM-5-TR), interfere with the ability to fulfill one’s job, school, or family responsibilities, and exceed what is expected in the person’s cultural or social context.

Grief is similar, in that anyone’s life is forever changed because of loss, even when they have adjusted well. However, there can be complications with a healing bone fracture, like an infection or a second injury, and I think of prolonged and severe grieving in the same way. Usually there are complications that have interfered with the common adaptation process, and the goal is to identify and solve these complications in order to get a person back on track with typical, resilient adjustment.

CGT addressed the stress of loss by revisiting these intense and overwhelming emotions again and again, and teaching skills to move flexibly in and out of these feelings. Together Vivian and her therapist realized she was avoiding this memory, and they practiced strategies for revisiting it. Vivian’s therapist asked her to listen to the recording of herself telling the story every day, encouraging acceptance of the reality of her loss.

grieving does take time, and restoring a meaningful life takes time, in the most normal and natural cases. I worry about overdiagnosis, from professionals and from grieving people themselves, who are simply trying to explain their experience in a culture that does not understand the universal grieving process.

The people that clinical psychologists really worry about, however, are the group that cannot seem to pick up the pieces of their lives after the loss, those who have complicated grief. In my scientific work, I wanted to understand whether these two groups, those with a resilient trajectory and those with complicated grief, responded differently to reminders of their loved one who had died, and what might be holding those with complicated grief back from engaging more fully in their lives.

When considered from the brain’s perspective, our brain is accessing our thoughts of our loss over and over again. It does the same for important positive events. It is still unpleasant to be caught off guard and have your thoughts and feelings turn to grief. But your brain is bringing them up in order to try to understand what happened, in the same way that you may share memories and stories with friends to talk them through and gain a deeper understanding. When you think of intrusive thoughts this way, it feels more normal that they happen: your brain is doing this for a reason. They seem more functional, and less like a sign you are not handling your grief well.

I speculate that just as reminders about our loved ones spontaneously arise during our lives together, reminders will also continue to intrude on our thoughts after they are gone for a period of time. During bereavement, however, these same reminders bring the realization that they are no longer with us, and these pangs of grief catch us off guard when they arise.

As our mind wanders, we continue to get reminders from the brain to call or text our loved ones, but now these reminders conflict with reality. Seeing these intrusive thoughts from the perspective of the brain may make them less worrisome. You have always had intrusive thoughts about your spouse, your kids, or your best friend. The emotional impact of them is different now that they have died, but being reminded of our loved ones is the nature of having a relationship. You get reminders because these people are important to us. That does not change right away because the person has died. Your brain has to catch up. It is still running its regular programming of sending out notifications. You are not losing your mind; you are just in the middle of a learning curve.

At its most basic, yearning is wanting the person to be here again now. The brain is producing a mental representation, a thought, of the person who is absent. That thought produces a feeling of wanting, a desire for them to be here. The thought and the feeling together are the components of yearning, and together, these form a motivational state. Motivation, however, can lead us to do a variety of different things.

Why did you not confront him? He might never have died if only you had been more insistent, if you had acted sooner.

In the example of the daydream as a response to yearning, your brain is orchestrating an experiential simulation, a virtual reality of how things could be now, contrasted with how they actually are, sitting there alone. By generating the “what ifs” in response to yearning, your brain is imagining events that might have played out very differently than they actually did. The alternate reality your brain vividly dreams up, where he did not die but is here with you, is unfavorably contrasted with the present moment in real life. In acute grief, these “what if” responses to the pangs of grief are common and completely normal.

Confronting one’s emotions and understanding them has been considered a good coping strategy. Suppressing one’s feelings, and avoiding thoughts that bring up emotions, on the other hand, has been put in the category of bad coping. The most recent research suggests that the subject is not that straightforward, however.

The most reliable predictor of good mental health is having a large toolkit of strategies to deal with one’s emotions and deploying the right strategy at the right time. It can be exhausting to have such high emotional intensity in the initial grieving period. There are good reasons to ignore our grief some of the time, in order to give the brain and the body a break, or even to give a break to those around us who feel emotional contagion. Distraction and denial have their usefulness. Rather than asking which are the best strategies, the more appropriate question might be whether using a particular strategy is counterproductive at a given moment or in a specific situation.

If we never allow the feelings of grief to surface, and we cannot contemplate them, or accept them, or share them, they might continue to plague us. Each individual is different, and there are no rules that every single person can use to adapt during grieving. But flexibility in our approach and openness to dealing with feelings as they arise give us the best opportunity to regulate our emotions in a way that allows us to live a vibrant and meaningful life.

The last two activities, which involve confronting negative emotions in response to the death of a loved one, are often called grief work. In the Western world, they are typically considered the most appropriate and most effective ways to cope. Ironically, engaging in activities that typically raise positive emotions, such as going to a party or watching some form of entertainment, are actually more effective at reducing sadness and grief.