SUMMARY - The Grieving Brain - Mary-Frances O'Connor

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Here is a summary of the key points about grief and the brain:

  • The brain creates cognitive maps to represent important people and objects in our lives spatially, temporally, and in terms of closeness/emotional proximity.

  • When someone dies, the brain struggles to update its map to account for their permanent absence. It may deny the death or continue perceiving the person as distant rather than gone.

  • Strong negative emotions like anger arise as the brain perceives the death as a form of abandonment or "ghosting." It wants to repair the relationship.

  • Maintaining a sense of continuing bond with the deceased through memories and rituals can help the brain adapt its map over time and provide comfort.

  • Grief emerges from losing the attachment figure who was represented as psychologically close in our brain maps. This feels like losing part of one's identity.

  • Cultural and religious beliefs that offer explanations for where loved ones are located after death may help the grieving process by providing answers the brain seeks to update its maps.

  • It takes time and new experiences without the person for the brain to fully reconcile the disparity between its representations of closeness and the reality of permanent loss. Continuing bonds can aid this process of updating mental maps.

    Here is a summary of the key points:

  • Mirror neurons activate both when performing an action and observing the same action in others, contributing to feelings of closeness and shared experience. This neural overlap helps represent close others.

  • However, the brain can still distinguish self from other through some neural distinction in addition to overlap when viewing social actions.

  • Witnessing others' emotions like sadness can produce emotional contagion through neural mimicry and bodily responses, allowing us to vicariously feel their emotions.

  • Empathy involves cognitive perspective-taking, emotional mimicry through mirror neurons and neural systems, and compassionate motivation to care for others.

  • Grieving adjusts interconnected neural representations of self and the deceased person that are changed by death. It requires "rewiring" these neural maps and representations in the brain.

    Here is a summary:

  • Grief is a highly individual experience that follows no set timeline or stages. While feelings of yearning, sadness, anger, and depression are common in early grief, they tend to lessen in intensity over time as the bereaved adapts to their loss through a process of acceptance.

  • Caring for someone experiencing grief can be emotionally difficult for support persons as well. It's important for caregivers to practice self-care by seeking their own social support and outlets for processing feelings.

  • Both the bereaved and support persons will experience a range of emotions, including positive ones like laughter from fond memories. It's normal and healthy to express this full range of feelings.

  • Flexibility is key in coping - different strategies are useful at different times such as ignoring grief, confronting emotions, distraction through pleasant activities, or engaging with memories. The bereaved should not feel guilty taking breaks from intense grieving.

  • Support persons can help by bearing compassionate witness to the grief experience through active listening, without judgement, and respecting each person's process and pace of grieving. Both practical and emotional support may be needed from caregivers over the long term.

    Here is a summary of the key points:

  • Rumination refers to repetitive thinking about one's mood and the causes and consequences of it. There are two types - reflection and brooding. Reflection involves problem-solving to alleviate mood while brooding is a more passive state that persists even when trying to stop.

  • Grief-related rumination focuses on causes and consequences of the death like emotions, unfairness, meaning, relationships, and "what if" thoughts. More frequent rumination predicts more intense grief symptoms.

  • Rumination may serve as a way to avoid intensely painful emotions of grief, which feels out of control. Repetitively thinking about details distances one from emotions.

  • Accepting a loss means acknowledging reality without rumination or problem-solving. It allows hope in present/future while acknowledging the past loss, not avoiding grief feelings.

  • A brain area called the PANIC/GRIEF system produces acute grief responses like distress calls. Being with caring others can relieve distress through socially-induced opioid release.

  • While medications may help in short term, relying on them long-term for sleep issues due to grief is not evidence-based and can disrupt circadian rhythms. Developing healthy sleep routines is important.

  • Mind-wandering thoughts about the deceased occur frequently in bereaved individuals. Consciously trying to suppress them is linked to more intrusive thoughts, while unconscious processing is linked to healthier grief processing.

    Here is a summary of the key points:

  • Neuroimaging research has found that grief-related rumination is associated with increased activity in the posterior cingulate cortex, a brain region involved in autobiographical memory retrieval. This provides insight into how actively recalling memories of the deceased can prolong grief.

  • A 1972 issue of LIFE magazine that focused on death and dying helped normalize public discussions about end-of-life topics. Bringing these issues into the open may help people plan and cope better.

  • Living wills allow individuals to document their end-of-life medical preferences in advance in case they become incapacitated. This provides autonomy and guidance for healthcare decisions during a potentially vulnerable time.

  • The "lock-and-key" model describes how neurotransmitters like oxytocin bind to receptors on neurons to activate pathways involved in social bonding. Understanding these biological mechanisms provides insights into human relationships and grief.

  • Longitudinal studies following the same groups of people over many years can provide valuable information about how experiences like grief may change individuals over the lifespan.

    Here is a summary of the key points:

  • Lorazepam is a benzodiazepine medication sometimes used to treat insomnia or anxiety associated with acute grief.

  • The brain has several regions involved in processing grief and conceptualizing the experience of loss.

  • Loss aversion refers to people's strong tendency to avoid losses relative to acquiring equivalent gains.

  • There are two types of loss-related rumination: loss-oriented rumination focuses on the distress of the loss, while restoration-oriented rumination centers on coping strategies and making sense of the loss.

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