Review of "The Grieving Brain," by Mary-Frances O'Connor

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

Mary-Frances O'Connor https://twitter.com/doctormfo https://thegrievingbrain.com https://www.maryfrancesoconnor.com/ mfoconnor@email.arizona.edu

978-0-06-294623-2

I am experiencing grief.  Therefore, as a systems analyst, and a lifelong learner, I am studying grief.  I am grieving.

According to O'Connor, the grief, and the grieving, are not the same thing.  Grief is the feeling, possibly the emotion, possibly a syndrome of emotions, experienced when you have had a loss.  Grieving is not the experience of grief, but rather an adaptation.  It is the learning, or the relearning (or even the unlearning), of the difference between the world as you knew it with the loved one and the new world without the loved one in it.

I am finding the book extremely interesting.  As a teacher, and as a lifelong learner, anything to do with learning is of interest to me.  And so, looking at grief, or to use O'Connor's terminology, grieving, as a form of learning is an interesting speculation.

We build mental models of the world around us.  When you have a close relationship with someone, be that a parent, a spouse, a partner, or any other close relationship, our map of the world includes that person and that relationship.  When we lose that relationship our map of the world becomes flawed.  That map is still there, and that person is still there in our mental map.  But the map no longer corresponds to reality.  The disparity, discontinuity, or difference, between the two causes confusion, which we feel, in a variety of ways, as grief.

For thirty-five years, my mental map of the world had Gloria in it.  Latterly, that mental map was determined, and many aspects of my timetable, meal schedules, actions, and behaviors were determined by Gloria and to a certain extent her increasing medical needs.  Gloria is no longer here, and her medical needs are no longer here.  The determinants of my life have changed very significantly.

O'Connor speaks of cue learning and place learning, in discussing grieving.  Cue learning is the type of learning that learns a particular procedure, step by step.  Place learning learns a situation, as a whole.  Thus cue learning is less useful, in some ways, since a slight change in the situation may render the procedure inappropriate.  Place learning is more useful because it is able to adapt to some changes in situation.

This idea is interesting to me, as a teacher, because we have similar concepts in education known as field dependent, and field independent, learning.  Field dependent learning is the type that learns a procedure.  Field independent learning learns the requirements and the whole situation.  Field independent learning takes longer, but is able to adapt to slight changes in circumstance.  However, in education we know that while these two types of learning coexist in the learner, certain learners have a predilection for field dependence, as opposed to field independence.  That is, some people tend to learn, for the most part, in the procedural manner, while others tend to learn in the field independent manner.  Therefore, some people learn procedures.  They learn the procedures fairly quickly.  They make excellent line workers, because you teach them the procedure and they will follow it, exactly, again and again.  Field independent learners will have trouble with these repetitive tasks, and with learning the procedures, until they have learned the entire situation and requirements and understand why a procedure is being done this way.  Thus they take longer to learn line work.  But, by the same token, understanding the situation in a field independent manner, they are able to adapt when anything changes on the line, which field dependent learners generally do not.  Because of the difference in grief and the reaction to grief in O'Connor's definitions of cue learning and place learning, could it be that the different types of learners go through the grieving process in different ways?  Could it be that field dependent learners are the ones who grieve for a long time, while field independent learners are the ones who are able to adapt and get on with their lives?

I am experiencing grief.  I am a systems analyst so I am studying grief.  Actually, I am more studying grieving then grief, to use O'Connor's distinction. (No, don't worry.  Neither you nor I are stuck in a loop.)  I am not studying my feelings, as much as I am studying the process, and the grieving industry.

Is the fact that I am studying it helping?

I am a lifelong learner.  Gloria was always curious about things.  One of the things that we did together was to watch the Great Courses series.  Our mining engineer grandson was very impressed that we studied Geology 101 in order to better understand his field.  We learned new things all the time.

I am learning gardening.  My baby brother asks me why I am learning gardening, since Mom made sure that we all hated gardening.  I am learning by trial and error.  (Mostly error.)  During one of my early errors I had a couple of experiences that indicated that I did have a strong emotional need to do the gardening.  I couldn't figure out why (and neither could any of the grief counsellors), but I did have a need to do it.  A strong emotional need.

Maybe it's not the gardening.  Maybe it's the learning.  The neuroplasticity involved in learning new things may assist with the learning that is necessary in the grieving, as O'Connor would put it.

When Gloria was in hospital the plan was to move so she would have a safer place to live after she came out.  Therefore, after Gloria died, I had to learn a new community, new streets, new shops, new churches, new social circles.  New volunteer work.  Did the learning that I was forced into provide me with the neuroplasticity and the new neural pathways that I needed (and will need), to assist me in the process of grieving?

It may be that the melange of emotions that we see as grief boils down to one emotion: confusion.  We are not grieving the loss of the loved one, or the loss of relationship, but of certainty.  It may be that we are angry, not at the loved one who has left us, or at the doctors who did not save her, but at the confusion: our loss of a correct and definitive mental map.  Our extreme loneliness may not simply be because of the loss of one relationship, but because we are afraid of approaching others because our mental map of relationship, and relationships, and how people can and will interact with us, has been damaged.

I like learning.  I am a proponent of lifelong learning.  I like to learn new things.  But I feel pretty strongly that I am in the minority in this.  Most human beings do not like to learn, at least not very much.  We have a saying: "learning experience."  This is what we say of a particularly nasty or unpleasant experience.  People will say to you, "Well it's a learning experience."  To which my usual response is, "I hate learning experiences."  And, it's true.  As much as I love learning, I hate learning experiences.

But many people don't just hate learning experiences, but learning itself.  Change is bad, and learning tends to indicate a change.  Maybe it's a change in your situation which is forcing you to learn something new, or maybe it's simply that when you learn something new you change, and change how you relate to the world around you.  Which tends to make a problem for somebody.  So, overall, human beings don't think too kindly of learning.

In regard to my move, the common wisdom has it that you should avoid making significant decisions for the first year after being bereaved.  While this is generally sound advice, particularly in regard to the degraded ability to make decisions during a time of "bereavement brain," moving, and being forced to learn a bunch of new things, may assist with the neuroplasticity needed to unlearn the presence, behaviors, and thoughts associated with the presence of the loved one, and relearn new schedules and behaviors in the absence of the loved one.

O'Connor notes the importance of being grief adjacent in regard to empathy.  This is the ability of others to mirror, not just our actions, behaviors, and possibly speech, but the way that we are feeling.  I found this interesting, particularly in view of what I have observed in my own social circle, of people withdrawing from me, or babbling when in personal conversation are on the phone, lest I should bring up the topic of Gloria.  At first I thought that this showed a weakness in O'Connor's analysis.  However O'Connor does make a distinction between empathy (feeling what we feel), and compassion (caring how we feel).  The empathy part does explain why people move away, or try to avoid or prevent situations where I might talk about Gloria and my grief.  (They don't want to feel any part of that pain.)  What is lacking here, apparently, is compassion.

The need to relearn (or unlearn) the absence of the loved one may explain the prevalence of anger as a component of grief.  Anger is very common in grief, even among those, such as women, who have been trained that they are not supposed to be angry.  Often we are most angry when we are wrong, and are demonstrated to be wrong.  We do not like to be wrong.  The strength of this dislike, and the anger that it produces, may be an evolutionary adaptation to ensure that we correct mistakes, so that our beliefs and understandings do correspond with reality.  To be a variance with reality could lead to disastrous consequences.  So, when our mental maps insist on the presence of a loved one, and there is demonstrable evidence that the loved one is not present any longer, we are wrong.  Our mental map is defective.  It must be repaired.  But we are angry at being wrong, and therefore anger is a major part of our grief.

O'Connor's book, and the major thesis, are both very interesting, but the book spends relatively little time on the supposed topic of neural imaging.  Most of the speculation on the topic of grief, and grieving, relies upon anecdotes from clinical practice. This is interesting (although the plural of anecdote is not data), but it doesn't address the central thesis on the basis of neural imaging.  The thesis of having to learn new things is supported by the anecdotes, but mention of neural imaging happens only occasionally, and then doesn't necessarily, or directly, support the thesis of grieving being a relearning of the world map without the loved one in it.

Chapter one introduces the thesis of relearning.  But it then goes on to talk of a number of other issues.  Some of these issues, such as the dimension of closeness, and the attachment bond and its strength, will be raised in later chapters, and in more detail.  However the text does feel somewhat disjointed, jumping from topic to topic, and from neural studies to clinical anecdotes.

Closeness (the reason for the strength of the attachment bond), the use of closeness as a dimension, and other factors are addressed in chapter two.  Chapter two is probably the most consistent in terms of topic, although the section at the end on empathy turns in a different, and slightly weird, direction.

The title of chapter three mentions magical thinking.  The topic really addresses the remnance, persistence, and error in believing that our loved one is still in the world, as expressed by our old world map.  The issue, when you think about it, is not difficult: the jump from an error in remembering an old situation, as compared to magical thinking, or superstitious learning.  However O'Connor could make this connection more directly and specifically.

Neural imaging does re-emerge in chapter four, which deals with adaptation over time.  However, the process of adaptation is not really addressed until O'Connor deals with the problems of the five stages model and introduces, instead, the useful dual process model.  However, once again, this leads to very disjointed text and makes it difficult to know what the central thesis of the chapter actually is.

Chapter five deals with prolonged grief disorder, as it is described in the DSM, but which O'Connor prefers to refer to as complicated grief.  Unfortunately, while this chapter is longer than some of the previous ones, it does not provide much in the way of useful direction.  Certainly it doesn't help necessarily help with aids that might assist clinicians in directing counseling for those who are grieving for an extended period of time.  It does raise a number of questions that those interested in studying neuroimaging of grief may wish to attempt to work on.

Chapter six gives us much more detail on how attachment bonds form, what chemicals are involved, and where in the brain this happens.  Much of this work relies on small animal studies.  However, while all of this is interesting, it doesn't actually support the central thesis of the need to relearn, and reform the world map, after the death of the loved one.

Chapter seven is, again, somewhat disjointed.  It talks about the different ways that you can think about the loved one who has died.  However, it has relatively little to say on the topic of which types of thinking about the person are helpful, and which types are not.

Part two (of the book) turns from a description of grief and grieving, to a prescription of topics that may be helpful in getting the bereaved through the period of grief.  Unfortunately, these following chapters are rather mixed bags, more collections of random thoughts, than of definite and helpful direction.

Chapter eight talks about the past: remembering the past, ruminating on the past, dwelling on the past.  Again, there is relatively little specific prescription in this material.  Questions are raised about which types of rumination are helpful in grieving, but little in the way of answers are provided.  I did find interesting the observation that women do more ruminating than men.  This is consistent with the intuitive versus instrumental hypothesis in regard to grief, and the grieving process, and that men are more instrumental, involving more planning and listening to the future, while women do more remembering and recounting of the past.  O'Connor does not seem to be aware of this research, and it is not mentioned in this chapter.  At the same time, O'Connor does raise issues of avoidance, and accepting (as opposed to acceptance, which she sees as a more permanent state of mind).  Are men, looking to the future and planning, simply avoiding issues of grief?  Or, in planning for the future, are men accepting what has happened, and planning for what is to come without the loved one?

Being in the present, chapter nine, follows, and possibly also promotes, the current interest in the practice called mindfulness.  This material, while lyrical, is of questionable utility.  Possibly the most interesting part of this section deals with the neural research on avoidance of thoughts of the deceased, and the fact that unconscious thoughts of the deceased increase when such avoidance is practiced.  However, as O'Connor admits, the ability to increase unconscious thoughts of the deceased, and therefore process grief with less pain to the bereaved, is not something we know how to promote.  (I will say that I entirely agree with her comments on sleeplessness, insomnia, and drugs.)

Chapter ten then turns to the future.  It is wisely said that you should never make predictions, particularly about the future.  The book doesn't say very much about it, in any definitive way.

Chapter eleven talks about teaching and learning.

I have noted problems with the material in the book and with O'Connor's writing.  However, overall the book is fascinating, and raises a number of questions that can and should lead to much more research and exploration.  While this may not be a helpful tome for all of those who are, themselves, grieving, it should be required study for grief counsellors, and for any and all who are interested in the study of grief itself.