Season 2, Episode 6: The Grieving Body with Mary-Frances O'Connor, PhD: How the Stress of Loss Can Be an Opportunity for Healing

Season #2 February 25, 2025

Have you ever wondered what goes on in our bodies when we are grieving a loved one?

In our latest episode of Guide to After Life, I sat down with Mary Frances O'Connor, PhD, a leading expert in grief research, to explore the fascinating connection between our minds and bodies during the grieving process.

Here's a glimpse of what you'll learn:

• How our bodies physically respond to loss and signs to look out for that can save your life

• The surprising link between grief and inflammation
• Why some people find it harder to adjust after bereavement
• Practical tips for supporting your body through grief

Dr. O'Connor shares insights from her new book, "The Grieving Body," and offers a compassionate perspective on how the stress of loss can become an opportunity for healing. The book will be published on 27th February 2025 in the UK and 11th February in the USA.

Whether you're navigating your own grief journey or supporting someone who is, this conversation will shed light on the often-overlooked physical aspects of bereavement.

Useful Links:

Buy The Grieving Body book

Learn more about how your body and mind respond to loss by taking part in the Grief MOT.

Don't forget to subscribe to A Guide to After Life podcast list to be notified of more conversations about navigating grief.

- Book a free 15-consultation with me to discuss the results of your Grief MOT

- Find out about Grief Group Therapy that I offer

- Unsure whether to see a psychologist, psychotherapist or counsellor or grief coach for grief support? Read this blog post to find out more.

- Join a free Facebook Group

- Find out more about grief support

Guest BIO:

About Mary-Frances

Mary-Frances O'Connor is a Professor of Clinical Psychology and Psychiatry at the University of Arizona. Her research focuses on the physiological correlates of emotion, in particular the wide range of physical and emotional responses during bereavement, including yearning and isolation. She believes that a clinical science approach toward the experience and mechanisms of grieving can improve interventions for prolonged grief disorder, newly included in the revised DSM-5.

Connect with Mary-Frances O'Connor

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https://maryfrancesoconnor.org/

Connect with Dr Monika Wieliczko

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Episode Transcript

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Dr Monika Wieliczko: Welcome to Guide to Afterlife, your go to podcast for young widows. I'm your host, doctor Monica Velichko, a psychologist and your fellow widow. Each episode brings you insights from world renowned grief experts and authors discussing complex grief issues and their personal experiences of loss. My aim is to challenge the way you think, empower you to face your feelings, and help you develop resilient ways to grief. Move beyond surviving each day and visit guidetoafterlife.com to take part in the Grief MOT, your first aid program for grief.\
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Dr Monika Wieliczko: Today's episode is about how our bodies grieve and why some people find it harder to adjust to life after loss. So what goes on in our minds and bodies when we lose someone close? I have a very special guest today all the way from University of Arizona, a professor of psychology, Doctor. Mary Frances O'Connor. Her research focuses on understanding the grieving process, both from psychological and physiological perspectives.\
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Dr Monika Wieliczko: She is a leader in the field of prolonged grief, which is a condition which some people develop when they struggle to adjust to their acute feelings of grief, and that might show up as increased rumination, yearning, and avoidance. Her work primarily focuses on trying to tease out the mechanism that causes this ongoing and severe reaction to loss. In particular, she's curious about the neurobiology, immune system, and cardiovascular factors that vary between individual responses to grief. And I've been really looking forward to our conversation as she's just about to release her new book, The Grieving Body, which we know will be published on the February 11 in US and on the February 27 in The UK. So welcome, Mary Frances. It's\
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Prof Mary-Frances O'Connor: so lovely to be here.\
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Dr Monika Wieliczko: Oh, I'm so happy to that we managed to to schedule this call.\
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Prof Mary-Frances O'Connor: Yeah.\
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Dr Monika Wieliczko: I would love you to maybe introduce yourself and tell us a little bit about your career and most importantly, what brought you to the fields of grief and, you know, fueled this incredible energy that you've got around you and passionate research and this such an important subject.\
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Prof Mary-Frances O'Connor: It really is such an important topic and you know, I've been doing grief research now in in my laboratory. I was trained as a clinical psychologist but also neuroscientist and psychophysiologist and I've been doing this work for over twenty five years now. I am passionate as the word trying to get the information that we know into the hands of people who are grieving, people who could actually use this information. And I think some of that is motivated by the fact that when I was young, when I was 13 years old, my mother was diagnosed with stage four breast cancer. Mhmm. And we didn't know what to think about it. I didn't know of course in the sense that I was a child, but the people around my mother as well I think really struggled to know how best to help. Mhmm. And so it meant that that I became very familiar with grief, with grieving. And she actually went on to live another thirteen years. Wow. But always with that sense that, you know, the second shoe would drop, kind of. And it meant that the feeling of ease, talking with people who are grieving, people who cry a lot, meant that in doing my own research, I haven't had to shy away from those conversations. But in addition, because of my training, was able to match up the conversations, what people were telling me they were experiencing with their neuroimaging scans and their, you know, blood draws and and immune assays. So hopefully, it's given me a bit of a unique perspective, enabling me to help people to see how the mind and body are are really integrated in our response to loss.\
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Dr Monika Wieliczko: So really coming from really your kind of early years you've been exposed to what it means to grieve and watch other people grieve I suspect your family and and yourself and that that first hand experience sounds like it really shaped your career and kind of making sense. In psychology fields, it's all about making sense of our own experiences, isn't it? That's usually why we end up in this profession. It's place. But I think there's something about that curiosity that when it's channeled in the right way can really take us to places that help us grow and develop as human beings. And I think that's really beautiful. And that's what really comes across when I read your first book, The Grieving Brain. I remember actually I told you this at the conference when I managed to to catch you for a few minutes that it was one of the best books I've read, I think, on Grief because it just told a story that helped me make sense of what was going on in my mind after I lost my husband, but also even before I lost him, because in my case, it was also a period of time when he was diagnosed with cancer and struggling with cancer and then obviously after that he died. So that that process of understanding what goes on in your mind was was fascinating. All those mental maps representing the people that we are so connected with and suddenly they disappear and how your mind is trying to make sense of that.\
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Dr Monika Wieliczko: So I remember that so vividly and we probably could do another episode just on that, to be honest,\
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Prof Mary-Frances O'Connor: But Probably.\
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Dr Monika Wieliczko: But today I really want to talk about the body because that's the subject of your newest book and also something I think no one really talks about in our communities. And, and I think something that is hugely neglected, the connection between our minds, our psychological well-being, and what goes on physiologically. So this is something that we will be focusing today because I think, I mean, just reading your book, what I was struck by is the extent of defects or how profoundly we can be affected. So maybe we could start just there, you know. How do our bodies respond to grief? What do you notice from your recent but also from your own experiences?\
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Prof Mary-Frances O'Connor: I've always thought that what's critical in understanding our response to loss, the loss of our sort of one and only, whether that's your spouse or your child or your best friend. What's important is to understand first what we have, to understand love, to understand that bond that we have with someone. Because it's only really by understanding that, even at a physiological level that then we can understand what it means to lose that. And I think it's only really just becoming clear, at least in scientific research, that when we are bonded with someone, we are physiologically bonded with them as well as psychologically bonded with them. And that is to say, our loved ones serve as our external pacemaker. Right? So we know that when we see our loved one, you know, our blood pressure drops a little or our heart rate drops a little because we're with that comforting, nurturing, safe person. And we anticipate that we will see them quite regularly, and our body has learned to anticipatory. But now I'm dealing with this stressful meeting and then later I'll be able to go home and, you know, get a hug from my best friend or from my partner. And being able to anticipate that also helps us to regulate all our physiological system. Our sleep is very much bound up with saying goodnight to someone with those rituals we have. Once we understand that our body is not being regulated entirely on its own, that is to say our physiological systems are co regulated with our loved ones, then I think it makes it a little less mysterious that when that loved one is taken, when they when they die, then suddenly our body has to figure out how to regulate without that external pacemaker. And that is our body really struggles to do that. So importantly, in the short term, what that means is that our body is is having a lot of physical symptoms just as it tries to figure out, well, how do I how do I know how to manage my blood pressure and my heart rate? We know from research, from very clear and elegant research, that for the majority of people, their blood pressure goes up a little bit, their heart rate goes up a little bit in those first weeks and months of grieving.\
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Prof Mary-Frances O'Connor: And then for the vast majority of us, you know, our body is sort of this it's a bit of this punching bag. It absorbs the blow of bereavement and allows our mind to catch up to understand what's happening. It allows our emotions to catch up as we figure out what does this mean for my life. And for most of us, the body is resilient enough to do that, although we experience these physical symptoms, difficulty sleeping, difficulty eating, and so forth. But there are people for whom their physiology doesn't catch up, or they aren't just physical symptoms, but they become actual medical issues like hypertension. Or, you know, in my own case, a little over a year after my mom passed away, I was having all these physical symptoms, these sort of pains in my arms. Mhmm. And it took a long time for us to diagnose what they were, but it turned out that I had developed multiple sclerosis or MS. Now that's very unusual. I I don't want to alarm people.\
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Prof Mary-Frances O'Connor: It's not a very common response. And I have a family history of MS. So it is it is very likely that I might have developed MS at some point regardless of my mother having passed away. But the stressful period of time in coping with my mom's death was the time that those symptoms emerged. And so we know that there are medical outcomes. Dying of a broken heart is a is a genuine phenomenon where a man is twice as likely in the first six months after the death of his wife to experience a fatal heart attack as compared to a man who remains married during that same time. And so I think we just have to be aware that bereavement is a time of increased risk, both just for physical symptoms as we navigate the grieving process, and potentially puts us at higher risk for medical outcomes as well.\
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Dr Monika Wieliczko: So it's just quite I mean, it was just quite fascinating reading about it in your book about those different changes that take place in our heart, but also, you know, throughout the body, you know, cardiovascular system is one of them, but obviously, you know, endocrinology, you know, all the, all those kind of hormonal changes that take place and they're all connected on they. So, so we, we kind of, we can't just think of one organ without thinking about the that the impact of that one might have on the others. And you know, the whole network that emerges from that is just really quite fascinating, but also how little we actually speak about this. That's right. You know, from my experience, for example, I had a massive problem with my stomach when my husband died.\
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Dr Monika Wieliczko: And that's a very common response to loss, which I've learned afterwards when I've made that connection. Partially because also his problem was bowel cancer. So it was to do with digestive system. And I was quite preoccupied with, you know, am I getting cancer? Is there something wrong with me? It's that kind of sense of being identified with a person who just died and worrying that we might die as well. But also the actual process is taking place in my stomach that, you know, it wasn't until I had my gastroscopy when the camera goes down and checks everything and they said, well, actually, there's nothing wrong. I was taking tablets actually for several months before that. But by the time they checked, everything was okay. But, you know, if I haven't done that examination, I haven't checked that everything was fine. I probably would have ruminated on it even longer and, you know, and I wouldn't have checked and I would have probably developed more symptoms. So, you know, it's just the intersection between how we think, how we feel, how we perceive. It's just fascinating.\
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Prof Mary-Frances O'Connor: This is such an important experience that you've described for people because there's multiple kinds of anxiety we have, isn't there? When the death of a loved one, there's all sorts of anxieties that come up. This person, my partner, this person I've always been intended to be with is gone. That in and of itself brings up lots of symptoms, but those symptoms can be the normal regulation of the body adjusting to this new life, this new reality. Very uncomfortable, very distressing, but actually a typical process of your body coming to regulate again. Problems with appetite, problems with stomachache are very common in early bereavement especially. But exactly as you said, it's also worth having it checked out and then understanding that you can't amplify that health anxiety. It's not going to help to amplify that anxiety once you've had it checked. And then we and then we can also focus on how do we soothe our body. Mhmm. How to calm our digestive system, our endocrine system. How to to learn to breathe in a way that helps to slow our heart rate. That becomes the focus then so that this normal process of adapting in the body can happen in a healthy way.\
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Dr Monika Wieliczko: Mhmm. Which is often something that a lot of people don't know they can have any control over, and there's no awareness. So there's no connection between how we feel, how we think, and how our body responds. So that that kind of bridge.\
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Prof Mary-Frances O'Connor: Yeah.\
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Dr Monika Wieliczko: If it's never formed, then, you know, our body has its own way of communicating and we've got our own way of thinking. And Yeah. Yeah, and that's when problems might become a bit more entrenched and difficult to\
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Prof Mary-Frances O'Connor: That's right. And they are real skills. So remembering to check-in with your body, not in a worrying way, but in a, it's seven in the morning. How is my body feeling today? Am I going to be able to do my regular work day, or is today a day I need to, you know, reduce my expectations a little bit of what I'll be able to do? And more importantly then, if I'm not feeling my best today, can I do some deep breathing? Could I go for a walk? What are the things that I can do to soothe my body and check-in while I'm doing it. Is this actually soothing?\
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Dr Monika Wieliczko: Mhmm.\
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Prof Mary-Frances O'Connor: Am I actually getting out of my head and into my body? Mhmm. And so those skills have to be practiced daily, weekly, just in the same way that if you were going to take a medication. You can't just take it one day and then, you know, assume that everything's better. You have to do it consistently. And so similarly with these skills, we have to develop habits that are healthy and support our physiology as we're breathing.\
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Dr Monika Wieliczko: Yes. And and it would be helpful to think about that, you know, what those habits could be and how we can kind of improve that process. But I really was interested in in what you've written in a book about broken heart syndrome, and I wonder whether you could say a bit more about that because I think it's such a complicated subject that often gets dismissed in a lot of the time I think in the general public, but also in medicine, often people get dismissed with cardiovascular symptoms and being told that, oh, it's just, you know, you're just somatizing. I think that's often a very dismissive message, especially sent to women. I think.\
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Dr Monika Wieliczko: Yes. Yeah, I'm just just finding it so hard, but don't worry, it's nothing serious. It gets better with time. But actually what we what you're actually saying is that it's rare, but some people die because of the stress. So could you tell us a bit more about how that develops?\
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Prof Mary-Frances O'Connor: It is still a subject we're doing a lot of research on. We've actually known about the epidemiological Monika, the finding that widowed people are at higher risk for heart attack. We've actually known about that for decades and decades. Colin Murray Parkes, who was a British psychiatrist who really studied grief, published about this in the Lancet journal in the late nineteen sixties. So we've known that the risk was high for a very very long time.\
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Prof Mary-Frances O'Connor: Higher, I should say, then when we're not bereaved. So not high in the sense that in the general population, people are falling over with this, but in the sense that compared to the risk prior to the death, your risk goes up. And so I think there's a few key pieces to understand about this. One is, this is a time of increased risk, and that's not so difficult for us to imagine. So if you become pregnant, you are in you are at higher risk for, say, gestational diabetes. Mhmm. We know that being pregnant is just a risk factor for that. It is a time in our life when that medical outcome becomes more probable. It doesn't mean everyone gets it. It doesn't mean everyone needs to worry about it, but it is worth having a test while you're pregnant to see if you're having gestational diabetes. And then if you are, just simply do the treatments that we do for diabetes. There's nothing special. You just need to know and treat it. Well, it's not dissimilar actually with the risk that is increased during bereavement. If you have hypertension, it will be easily detected through regular cardiovascular exam. And then you just do the treatment that you would do for hypertension. It's not special because it's bereavement. It simply needs to be that we go to our doctor and say, hey, could I get a test? Yeah, exactly. And so I think that, of course, because our body is evolving as we're grieving, of course, then we also need to go back for a checkup. Do I still have hypertension? Perhaps actually, as is most common, blood pressure has come down after six months or a year. And so then maybe you don't need the same treatment because you no longer have hypertension just in the same way that after pregnancy, you probably don't have gestational diabetes anymore. So I think that from the perspective of doctors, it's not so difficult to just do the normal process of assessing and treating medical illnesses. But what is unique is that we come in assuming that it might be because of the grief and that somehow that makes it different. On the other hand, I think there's the very acute things that happen. So one of the confusing things I find when I read about the broken heart phenomenon in the newspaper or in social media is there are two different phenomena we discuss. One is what we call takotsubo stress cardiomyopathy. Sometimes this is what is called the broken heart. This is a condition where on the day that you learn about some terrible, terrible news like the death of a loved one, there's a ballooning, a physical ballooning of the heart, and it needs medical treatment, and and you should go to the doctor, to the emergency room when you're having, heart problems. But it is not a heart attack. So that is one phenomenon that happens. But the increased rate of heart attacks, both fatal and non fatal heart attacks, is distinct from the Taketsubo cardiomyopathy. But we are at increased risk for heart attack when we are bereaved. And so that also needs medical treatment.\
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Prof Mary-Frances O'Connor: So the difficulty is these two things, I think, get mixed up together, and they are both responses to loss. But the first one usually happens in the day or week of a loss, and the other one can continue for months. Your increased risk is for many Monika. And I should say it is an increased risk for women as well. So the increased risk for heart attack is about one and a half times in women as opposed to twice almost twice as high in men. Lots of reasons for that, but most importantly, listeners should know that it does happen in both sexes. Yeah.\
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Dr Monika Wieliczko: Mhmm. Yes. And I actually read somewhere recently, I think there's research that's been published, I think, that mentioned from University of Aberdeen that, yes, there is an increased risk, especially for women in perimenopausal or after menopause or during menopause. So I was thinking, is this something to do with the hormonal changes? And because we know that, obviously, the reproductive hormones, they often have a protective function over the heart, isn't it? So there's something about That's right. Certain age when it happens and the impact you might be more likely to actually develop that. Is that correct? Is that what you think?\
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Prof Mary-Frances O'Connor: That is absolutely correct. Brilliant study recently out of University of Aberdeen. And you're exactly right. Estrogen is very protective for the heart. And so we see lower rates of cardiovascular, incidence of heart attacks, for example, in women until menopause.\
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Prof Mary-Frances O'Connor: But then after menopause, a heart disease is the biggest killer of women, as well as men. And after menopause, we really see a rise in women's cardiovascular health incidence. So it is important to know that. And in addition, cardiovascular, you know, the experience of having a heart attack is slightly different in women than men. And that was not understood for a very long time. I think more doctors are aware of that now, but for example, nausea can be an indicator along with other indicators of heart attack in women where that's very uncommon in men, for example. But if you don't know that that's a symptom, you wouldn't necessarily associate, having these symptoms including nausea. Maybe that's putting me now in the frame of mind. I wonder if I might actually be having a heart attack. I should actually go to the emergency to get this sorted out.\
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Dr Monika Wieliczko: So often, I can see that a lot of people are thinking, oh, I'm just being anxious. I'm just grieving. That's why I get so preoccupied with my health. I remember having similar thoughts before I went to see my GP who actually twice dismissed me until I actually said, well, listen, I've lost a a 40 year old man to cancer and some and no one and and most people said he would never have cancer. And now I'm I'm 38, and you're telling me I can't have potentially something wrong going wrong with my stomach. I mean, what how many evidence do you need to to listen to what I'm saying? And until you challenge the status quo, I think it's very hard to be taken seriously at this particular age. So\
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Prof Mary-Frances O'Connor: I think you're right. This this Absolutely. I think you you genuinely have to advocate for yourself. And I mean, my feeling about it is, you know, there are many pressures in the medical system, and I understand that. And at the same time, I think although we are in an emotional emotionally difficult place in our lives, it's easy to also just try to be very scientific about it. Listen, I'm having these symptoms. I wonder if we might just do the tests for the normal things that you would expect if someone had these symptoms, and then we'll know. Right? There's no reason not to do the test, just so we know, and then we can rule it out. And that to me, it both is going to put your own mind at ease. It's also going to detect something because we know people are at higher risk. But also going about it in that just very kind of matter of fact scientific way, I think can help doctors to feel like, oh, I don't necessarily have to resolve their feelings around grief. I just really need to deal with the fact that this person is at high risk right now.\
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Dr Monika Wieliczko: So both really keeping the mind and the body in mind.\
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Prof Mary-Frances O'Connor: That's right. Well put.\
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Dr Monika Wieliczko: Yes. And and, you know, it's just so important that we're having those conversations more and more that, you know, we're not just dismissing the way our body feels and tuning into that is so important.\
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Prof Mary-Frances O'Connor: And I think, you know, I just do want to emphasize again that even in the process of, you know, going through diagnostic, you know, tests or whatever. The key is still also that we have to be learning more about how our body responds to stress. Right? So when is it that you're having the stomachache? Or when is it that your mind is going and going and going? Because there may be ways to learn how our body is responding and develop new skills around learning to comfort or soothe ourselves in those moments. And the more that you learn about that, you may come to find, you know, for example, gosh, when I'm at work at my desk right after lunch, I feel I just feel really awful. Right? And if you allow yourself, you know, five minutes, ten minutes to really just pause, try to relax, breathe deeply for a few moments, and ask yourself, what does this feel like? And then the next day, you can say, does it feel different? Does it feel better? Does it feel worse than it did yesterday? And maybe even jot that down just to sort of keep a list. So if it turns out that it's only on Monday, Tuesday, Wednesday, Thursday, Friday, that your stomach feels awful right after lunch, then maybe there is something about stress that is also incorporated into that response. And maybe you need to be taking an extra fifteen minutes at lunch. You know, a little extra time for your digestive system to manage what it needs to do after lunch. And that may ultimately be a new skill you can apply. Who knew? My body reacts now that I'm under this stress of bereavement. My body reacts differently. I need a little longer after lunch. You know, it's just one example, but the idea of pausing, really allowing yourself to accept whatever your body is experiencing and then keeping track. What makes that feel better? What makes it feel worse? How can I respond differently?\
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Dr Monika Wieliczko: So there's something about curiosity again, isn't it? You know, how curious can you live? What goes on in my stomach? What is my stomach really trying to communicate? A bit like a child that doesn't speak, you know?\
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Prof Mary-Frances O'Connor: Absolutely. Absolutely. Much of this happens below our level of conscious awareness. You may just think, oh, I feel awful. And then if you really let yourself kind of pause and allow yourself to have the physical experience, you may think, oh, I don't really just feel awful. Specifically, in my stomach, it feels this way. And, gosh if I do x y and z that passes or when I've done x y and z in advance I don't get it that day.\
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Dr Monika Wieliczko: Yes exactly and then you're learning and you're developing that language communicating with your body and and, you know, as it I think there's something specifically about having that kind of gentle caring approach, which is often missing when we grieve because there's so many expectations that we should be rushing\
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Prof Mary-Frances O'Connor: Yes. Get\
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Dr Monika Wieliczko: back to life, to get back to work, to be functioning adults who can provide for others and especially for I'm just thinking about a lot of women who are listening to this podcast who are caregivers to children and their the pressure they're under is immense to be able to function, to keep it together. And then no wonder that the body starts to play up. No wonder that the body is struggling because there's nowhere else to push it into. Like, if you can't think about it, you push it at the back of your mind and where does it go? Well, we've you know, it often goes to your body.\
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Prof Mary-Frances O'Connor: Yeah. I think that the idea that, you know, we forget the death of a loved one is ranked in empirical studies the most stressful life experience that we can have. And that stress is not only mental, it's physical as well. And so I think considering, you know, this is a unique time. This year of adaptation, it's not just about emotionally adapting to my life. It's also about physically adapting and what are the things I can do to support that process to offer myself compassion that it just does take time. I often, you know, it sort of it sounds silly, but, you know, when I think about it, people often don't even give themselves the length of time they would if they were healing from a broken bone. Right? If you broke a leg, you think about how many, you know, weeks and months of of having a cast and then doing physical therapy and right? It takes a long time. That's simply how the body works. So why are we surprised that it takes the body weeks and months and and even longer? I mean, if we've broken a leg, we carry that scar with us forever. So why is it so hard for us to wrap our head around the idea that, oh, it's going to take my body a long time to really understand how to navigate, the world now. I joke, you know, it's not like we ever say to ourselves, you know, why won't my hair grow any faster? You know? Well, hair just grows fast as it grows. I think of grieving in a similar way. We can support ourselves just like you would support your your leg through a cast or through physical therapy, but it's going to take the time it's going to take.\
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Dr Monika Wieliczko: But I think there's something so valuable about this analogy to wearing a cast because, you know, you also need that kind of protective cast for your body when you're breathing, it's the whole body could be certain areas. And, you know, often talk to my clients about developing that kind of capacity to scan your body, you know, and having an awareness of which part of your body is likely to play out because sometimes we can predict that. I've always had problems with my stomach within whenever something stressful would happen. So no wonder I'm getting those problems when my husband just died, You know, that certain things are so predictable, like our body is not that, you know, unusually wired that it plays up with something new every time you press the button, something new happens in your life.\
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Prof Mary-Frances O'Connor: Yes. You know, I think this is such an important I've said before, grieving really is a form of learning, and and you learn a lot of things, a lot of different things that I wish you didn't have to learn when you're grieving. But one of them is, how do I respond as an individual? How do I respond when I'm having such intense stress? I tell this story in the the grief body, the book, about another British person, another British author actually, Lizzie Pickering. And after her son Harry died, she had just round after round of pneumonia and bronchitis. And just as you said, her family had, you know, she had a family history of having lung problems. So we know that rates of infectious disease go up, during bereavement. And in older individuals, widowed older individuals, the vaccines are not as effective as they are for non widowed older adults. So that stress of bereavement is really challenging our immune system. And so Lizzie really had to come to understand, oh, this is the part of my body that responds to this stress. It, you know, bereavement stress, it's not, it's not completely unique. It just as you said, if your your stomach reacts to stress for Lizzie, it's her, you know, getting getting bronchitis and getting pneumonia. So those are two very different responses under the same circumstance where there's additional stress in your life. But learning that, Lizzie really adopted yoga as a way of learning to breathe deeply, which was important So\
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Dr Monika Wieliczko: how much?\
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Prof Mary-Frances O'Connor: For for her. And right? And also the stress management, the checking in regularly with her body to realize, oh, this is where I'm at today. This is what I have the capacity for. And if I push myself too far, I may end up on antibiotic again.\
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Dr Monika Wieliczko: Which creates a vicious circle because it obviously It does. Prevents you from building the good bacteria in your guts that then protect you from having another infection. So you're, you know, that's when the vicious circle gets round and round. So kind of thinking more about your immune system, because that's another fascinating story in your book. You know, how that kind of suddenly we, you know, I know you talk about inflammation as well and and that that kind of how they both come together, you know, when there is a higher inflammation in your body that has an impact on your immune system.\
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Dr Monika Wieliczko: Is that correct?\
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Prof Mary-Frances O'Connor: That is correct. So, you know, when I was a a postdoctoral fellow and I've been doing bereavement research on the cardiovascular side for a while, I realized that actually bereavement is an increased risk for what they call all cause mortality. And all that means is that the risk of almost all diseases and disorders is increased, sometimes only slightly, but all cause mortality is increased during bereavement, especially early on. So as I thought to myself, well, okay, so this isn't only about the heart. What could be affecting all these different causes? And of course, one reason could be that the immune system is involved in every organ system of the body, isn't it? It defends every organ. So in looking specifically into the immune system, and the immune system does a number of different things, it helps us fight off the flu and pneumonia that I was talking about, but it does that in part by sending out these messages in the immune system, these messages, these chemical protein messages called cytokines. And what the that's a fancy word for is just the contributor to inflammation. So these these messages, you can imagine if you cut your skin, right, you you get a cut on your hand, you can see the inflammation. And part of the reason that you get that little bit of swelling and redness is that your immune system is reacting. So it's bringing in more fluids and white blood cells to that area. So that inflammation now can happen not just on the surface of your skin where we can see it and that feels sounds familiar, but it can happen in your heart, it can happen in your liver, in any of our systems, in your lungs. So for example, when you have pneumonia, you have that inflammation in your lungs, which is part of why it's more difficult to breathe. What we discovered, and now other researchers with larger sample sizes have discovered that inflammation is increased during bereavement. And so we know that could be one reason why a number of different you know, heart disease, colds and flus and pneumonia, but also things like autoimmune disorders can be worsened with the stress of bereavement because that increased inflammation, while necessary to the immune response, also makes it difficult for our organs to do their job.\
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Dr Monika Wieliczko: So fight something else, for example, or is it that if we focus on one thing, we lose, maybe scope, you know, something else is happening elsewhere in our body. Is that what you mean?\
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Prof Mary-Frances O'Connor: Just in the sense that why would we see both increased risk for heart disease, also increased risk for flu and pneumonia? That's sort of a bizarre, you know, if you if you think of these systems as unrelated to each other, that's sort of a bizarre outcome. But if you think of the fact that in both cases, higher inflammation contributes to heart attack, it also contributes to flu and pneumonia, then you start to think, oh, so this stress response is acting on my immune system, and that's then the cause for these multiple other outcomes.\
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Dr Monika Wieliczko: So it's the chain reaction that we were talking about at the beginning. Yes. One system is playing up. It has an impact on some everything else. And that in a way this is often a fact that if you have one condition in life you're more likely to develop something else because your immune system might be already compromised a bit and you know there's just so much that it's just fascinating to think about how it's all interlinked.\
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Dr Monika Wieliczko: And, you know, something we don't obviously consciously know what our liver or our stomach is up to. So he doesn't think about having an inflammation in your body. So it's not something we can detect just by thinking about it.\
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Prof Mary-Frances O'Connor: That's it. Exactly. But the good news is, you know, there are ways then to think about health holistically so that, for example, not getting enough sleep is a contributor in in many people to having increased inflammation. And so really finding ways to address the difficulty we might be having with insomnia is important in bereavement. Now I should say upfront that insomnia is very normal, very common, in bereavement, especially in that first year and in those first few Monika. But there are better and worse ways to sort of support our circadian rhythms to sort of support our sleep system. For example, although we cannot force ourselves to go to sleep, I'm sure we've all grief, although we cannot force ourselves to go to sleep, we can force ourselves to get up at same time each day, and that helps to support the circadian rhythms that enable our sleep system to stay in its proper regulation. So learning about how to support our sleep, whether that means learning how to manage periods of being awake during the night in a way that doesn't get us overly aroused. So getting up and turning the lights on or worst of all, using your phone that has the light right in your eyes. These are problematic because your brain then is responding to the light. So my point is that by addressing healthy sleep patterns, in the bigger picture, that also supports our body creating less inflammation. So I think, you know, my main message here is not that you have to learn a lot of physiology, but more simply to be thinking about our health holistically and what are the habits we can develop that will support that.\
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Dr Monika Wieliczko: Absolutely. And I think what you're also tapping into is, as you're saying, we're not expecting anyone to to know everything, but just to kind of pay attention to what's going on. And and I think that kind of curiosity about that again is so crucial in helping you recognize. Okay. So if I spend two hours on my phone scrolling and kind of reading something interesting and, you know, I'm getting your dopamine hits hundred times in an hour, you know, and that's probably not gonna be helpful.\
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Dr Monika Wieliczko: But at the same time, I think there's also this other end of the spectrum when people become so kind of obsessed with trying to control their body that's paradoxically Yes. They they they think they do everything they can, but that actually is used in a way that's not meant to soothe their nervous system because that's another area. I mean, when you think about sleeping, isn't it? That how your nervous system, sympathetic and parasympathetic branches of your nervous system, how they regulate or or how they're dysregulated, which is a massive problem in grief, isn't it?\
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Prof Mary-Frances O'Connor: Yes. I think you make such an excellent point. You know, part of what I've realized is there is a level of just accepting, this is how my health is right now. This is what my sleep is right now. And just feeling compassion for yourself. Gosh. My body is really, really struggling right now to adapt to this terrible situation. And just to have that compassion, to just let it be true, yes, it is really having a difficult time right now. And to not necessarily be trying to control it. That's the word. So so I often say, going back to the example of the broken bone, you're not actually doing anything to knit those osteoclasts. You know? You're not actually doing something to knit the bone cells back together. But you can support the environment in which your body can do that naturally. So similarly with your sleep, you cannot control whether you're going to sleep, but you can control is my bedroom dark? Is it warm? Is it comfortable? Is it feel secure? And am I getting up at the same time each day to sort of help remind my brain, oh yes, this is the schedule we're on. Right? So you can do the things to support your body being healthy, your body managing what it has to deal with, while also just accepting and and being, you know, kind to yourself for the fact that your body is working really hard to keep you upright through this whole grieving process.\
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Dr Monika Wieliczko: Right. Exactly. And I suppose there's also, you know, there's just so much there, isn't there, about us being conscious of what what how we might be contributing either way whether it's neglecting our bodies or like not paying attention to what's going on or overly trying to control our body and where do we sit on this spectrum, but also, you know, accepting that this is this is where where we are right now and we it might take a while, but obviously, there's also I think there's that basic rule, which I think applies to most people, that, you know, if you become a bit more accepting, if you're more curious, if you begin to apply different strategies and see if it helps. If it doesn't, well, it might not work for you. For me, for example, breathing was one of the most important elements that helped me regulate my sleep.\
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Dr Monika Wieliczko: So breathing in for four and breathing out for five, so that kind of exhales slightly longer than inhales. That was one of the most fundamental things that actually helped me get through those most stressful times because it really helps you regulate. It's just that the brake pedal of your nervous system just kind of helps you calm down and I always recommend it to everyone because that was just one simple thing I was able to do no matter where I was, no matter what was happening, And it immediately kind of put me doesn't always have to be a long lasting result, but it's enough sometimes just to let your body relax a bit, feel safe, and get back to sleep.\
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Prof Mary-Frances O'Connor: And I think, you know, using analogies to other living adaptations. So in my laboratory, we actually plant seeds, in in little plant pots. And the reason is you have to water them even when you can't see any plant yet. Right? If you just if you stop watering them, it's never going to sprout. So you have to do that consistently day after day after day, and then eventually, you see a little sprout. So you have to have this belief, this faith that doing healthy things that fit with how living systems work will help eventually, and you have to be consistent. Not, again, in a controlling way. Obviously, each day is also different. But to the degree that you can consider how long it takes for a seed to sprout. Right? How long it takes for that plant to grow from two leaves into whatever plant it's going to become. You know, in many Native American traditions, people will cut their braid off. They'll cut their long hair when they've had the death of someone close to them. And it's such a great reminder. Hair grows very slowly. And and I just it's such a good reminder, you know, that sense of, like, each time I see myself, my hair is is still short. I'm doing my body is doing all the right things to grow hair, and my hair is still short.\
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Dr Monika Wieliczko: It takes time. Absolutely. I I really like this analogy because it just reminds it again as you're saying that grief takes time. And But I'm also mindful that for some people, and that's what your research is focusing on, isn't that easy to adjust to life after loss and kind of move on from that kind of acute state of grief when we're talking about, especially when the body is more active and the body kind of plays up and lets us know what we're experiencing, that their emotions can be experienced physiologically as much as psychologically. And then, you know and for some people it's really hard and that's the kind of most people I'm working with it those who are on this kind of stuck in this acute state of grief where it's very hard to regulate the nervous system, regulate your heart rate, regulate your stomach functioning, everything just feels they might be trying to do the right things but you know at which point do you decide you know maybe I can't do it myself. There are other forces at play that usually psychological that, obviously interfere with this normal kind of healing process that would take place, especially when you think about not having connections in our lives. If we're isolated, I think from my experience that's probably the biggest risk factor from what I've observed. I wonder what you think about how that\
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Prof Mary-Frances O'Connor: Yeah. It's funny. I have this experience of sort of, in psychology, we often call this both and. Mhmm. So the idea is I both would like to understand what's happening physically. I'm gonna pay attention and allow my body to be part of my awareness, and I'm Monika support things that are healthy. Both that and if this is the new normal, I mean, at the end of the day, I did have MS, and there is a certain level of accepting, oh, I'm not going to do all the things in my life that I thought I would because I have this illness and the reality is protesting against that reality doesn't help your system either. And so at a certain level, it's sort of, yes, what can I do to support my health holistically? And also, can I accept that this is the body I have right now?\
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Dr Monika Wieliczko: Yes. And I suppose there's also something about seeking help, isn't it? That if we are feeling and there's there's an element of acceptance. I completely agree with you that, you know, whatever's happening, I think it's easier to deal with if we accept that we don't really have any control over what's happening to us and how our body's responding, but what we do have a bit of control over is how what we do with that afterwards and how we interpret those Exactly. Experiences and and whether we actually seek that help.\
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Dr Monika Wieliczko: Because I was thinking about what you said at the beginning of our conversation about, you know, using the other person to co help us co regulate our bodies, which is such a beautiful beautiful way of putting it. And, you know, I was thinking specifically about touch and the skin contact, which is there from the beginning. You know, when the baby's born, you put it at the, you know, have skin contact with the mother's skin, and that helps the baby regulate. And, you know, we carry that throughout our lives. And, you know, one of the things I've done when my husband died, I went away Monika traveling for three months to Southeast Asia and I had a massage every day. And it was probably the most therapeutic thing I've done.\
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Prof Mary-Frances O'Connor: So we know there are these hormonal changes that happen in the body when we're grief. And we also know that skin touch has hormonal impacts on us just like you said. And I also think massage for the right person, if it feels comforting, if it feels safe, massage can just the physiological response that our body has to being touched in a safe and comforting and soothing way, can be incredibly helpful for people at a time when the very person that that we might turn to when we're stressed is no longer better.\
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Dr Monika Wieliczko: Exactly. And just that co regulation but also seeking that contact which is often, you know, I I think that's often what, makes such a difference between being able to develop more resilient ways of responding to loss. And and those people who really struggle is that social isolation or being overwhelmed. And we often think of it, what's this individual doing wrong or what's wrong with that person rather than thinking what is the support system they're in? Who's supporting that person? Do they have contact with other people? Can't do they have someone to go out with or is anyone reaching out to them? There's I'm not kind of trying to minimize the role of the individual in obviously seeking help, but I think there's also the the reality of those people who are extremely isolated or there's just not much awareness in the community where they are about those those factors and that can massively have an impact on their well-being. And we know especially for men how likely they are to dive in sooner when they're not married in comparison to when they are married, which is very different to women that this effect is not as strong for women because we tend to be better at seeking relationships and having more relationships in general and talking and you know and that that kind of also regulates our bodies doesn't it? You know just being able to verbalize your feelings, surprise surprise, will probably help you reduce your heart rate or eventually you will kind of just process information better.\
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Dr Monika Wieliczko: So there's just so much there isn't it, about all those intersections.\
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Prof Mary-Frances O'Connor: I think it it is important to recognize that not everyone needs to verbally process their experience. So the the benefit of support, you know, you can be sitting next to someone on a long Dr, and that can be the thing that feels safe and supportive, knowing that you don't have to talk. And so for many of us who are psychologists, verbal processing is is, you know, our bread and butter. It's what feels good to us. It's what makes sense to us. But I do also think it's important to remember that the key is do you feel supported, do you feel connected, and that isn't necessarily through verbal processing. Of course, we also see this with very young children, we see this with people who are neurodivergent, some people who are neurodivergent, And so we think it's more about what is it that makes the person feel connected, safe, that they belong at whatever context that is, including being able to verbally process our experience.\
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Dr Monika Wieliczko: But I also think that what prevents some people from processing information, as you said, is the first kind of sense of being grounded and feeling safe. So Yes. So, you know, you might often see that, you know, initially, it might be impossible to process your loss. And I would, speaking from my own experience Yes. The first six months, I wasn't interested in talking therapy. And I was, you know, in five times a week analysis. And that was the last thing I wanted to do. I needed I needed to get out to be fed, to be exposed to sunshine, to stretch my legs to do excess physical exercise. And then once I was more regulated, I came back and ended my talking therapy, which helped, you know, and still helping but, you know, I wasn't in the place to do that, in this acute stage. And I don't think that for some people that, you know, for some people that might be helpful. But for me personally, it wasn't. So I completely agree. I'm actually more and more as my grief journey evolves and more and more looking into this alternative ways of helping people grieve and kind of more holistic ways of looking at, you know, grief rather than just talking because as you're saying it's it has to be the right time with the right person in the right setting and the right setup mentally and psychologically, but also physiologically.\
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Prof Mary-Frances O'Connor: Yeah. And and this is the great irony that, you know, the subtitle of the book, The Grieving Body, is, you know, how the stress of loss can be an opportunity for healing. And it is really because you're forced to learn who you are and how you react as an individual, which may be very different than you're expecting, I will say. And so curiosity, the acceptance, the compassion and kindness of this is this is, you know, something I'm I'm gonna have to sort of feel out as I go. And while you and I might be experts on grief in general, each individual is an expert on themselves. And so they whatever you're hearing that resonates with you, tuck that away. Use that. You know, take our hope and encouragement for trying things that are difficult. But if something doesn't resonate, if it's not you, then that's okay too.\
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Dr Monika Wieliczko: Some people are Monika love yoga, some will hate it, you know, and Absolutely. It's just that simple. If it doesn't work, it doesn't work. But also, as you're saying, being curious and being open to exploring different avenues, it's so important. And that probably what defines more resilient kind of ways of coping, if you're able to take in, if you're able to accept support and, you know, and co regulate. And it's just such a beautiful theme I want to hold on to this this whole idea of attachment and how we attach ourselves to people, but also how we recover that attachment through, you know, forming new attachments and new meanings with other people, which is so fundamentally what makes us human, isn't it?\
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Prof Mary-Frances O'Connor: It is. And transforming that relationship with the person who has died. So, you know, they are still deeply embedded in our in our brain, in our memory, in our heart, and I mean that quite literally. There are scientific studies that demonstrate when you imagine a person to whom you're bonded, you know, there's this test where you put your hand or your foot in in a bucket of ice cold water. And research shows that having a person there supporting you makes it less painful. But it turns out, calling them to mind, even when they're not physically present, also changes your neural and and pain response simply by having them, you know, very real in your mind. And so, you know, part of grieving is certainly developing or creating new attachments to living loved ones, and it's also transforming so that we can call on the that person and know what they would say to us or the way they would laugh or the or the way they'd look at us and being able to derive comfort eventually from calling on that internally as well.\
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Dr Monika Wieliczko: That's a really beautiful way of putting it, and it's a beautiful way also for us to end because we could probably go on for another three hours thinking about the body and just kind of thinking what what else goes on. I mean, but I really would encourage anyone who's listening to grab your book because it's just beautifully put everything, all the research into such a easily digestible form which anyone can understand and take a lot from. And I just wanted to thank you for all your hard work over the last twenty five years and and it's been just so inspirational and I really believe that it's gonna help many people. So we'll put some links in the show notes once the book gets released in The UK and everywhere else in the world. So yes, it's been real pleasure to speak to you.\
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Prof Mary-Frances O'Connor: And thank you, Monica, for bringing this conversation to people because it it is something that we don't talk about often and talking about it knowing other people's experience is vital to understanding our own experience. So thank you as well.\
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Dr Monika Wieliczko: Thank you for joining us. I hope you found it useful. Connect with me on Facebook and Instagram under Guide to Afterlife for more grief tips and resources. Visit GuidetoAfterlife.com to send me your questions and to take part in the Grief MMT, your free first aid program for grief. See you next Tuesday for yet another stimulating conversation.\
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Season 2, Episode 6: The Grieving Body with Mary-Frances O'Connor, PhD: How the Stress of Loss Can Be an Opportunity for Healing

About Mary-Frances

The Grief MOT

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