Podcast Episode Summary

Podcast: New Books Network
Host: Renee Garfinkel
Guest: Dr. Mary-Frances O’Connor
Title: The Grieving Body: How the Stress of Loss Can be an Opportunity for Healing
Date: September 14, 2025

Episode Overview

In this episode, Renee Garfinkel interviews psychologist and professor Dr. Mary-Frances O’Connor about her forthcoming book, The Grieving Body: How the Stress of Loss Can Be an Opportunity for Healing (Harper One, 2025). The conversation delves into the physical dimension of grief, exploring how loss impacts not only the brain and emotions but also the heart, immune system, hormones, and body as a whole. Dr. O’Connor brings both scientific rigor and compassionate insight to the discussion, sharing personal experiences and groundbreaking research on integrating grief into ongoing life and finding healing in the aftermath of loss.

Key Discussion Points & Insights

1. The Opportunity in Grief

• Grief as Opportunity for Healing
  • Dr. O’Connor acknowledges the phrase can be “off putting” to those in fresh grief but explains:
    • "Grief really captures your attention… it’s making a home in your body and there is no getting around it." (03:08)
    • The “opportunity” lies in the forced attention to loss, allowing deep self-examination and integration, potentially leading to a form of healing.
• Grief’s demand for attention allows people to truly reckon with what the death of a loved one means, physically and emotionally, and to learn to incorporate these shifts into daily life.

2. What Happens to the Body During Grief?

• Physical Reactions & Metaphor
  • Dr. O’Connor compares grieving to riding a bike and suddenly losing the brakes—your body must adapt quickly to a new reality, causing physiological stress.
  • Physiological Effects:
    • Increased heart rate and blood pressure (typically normalizes after about six months for most).
    • Cortisol (stress hormone) remains elevated, often for longer, with downstream effects such as increased inflammation.
    • These changes impact individuals differently (e.g., worse arthritis, asthma flare-ups).
    • “Those changes… may look slightly different for each person.” (06:55)
• Physical Sensations
  • 90% of bereaved people report chest sensations.
  • Differentiation between “heartache” (expected adjustment) and actual “heartbreak,” which can be physically dangerous (increased risk of heart attack and stroke in first months/years).
    • “This is a medically risky time… we can intervene appropriately if we think, wow, I'm having pain now...” (07:33)

3. Sleep Disturbance in Grief

• Why Sleep is Disrupted
  • Elevated cortisol operates like constant caffeine—keeps nervous system activated.
  • Most people experience insomnia: difficulty falling, staying asleep, or early waking.
    • “It's a little bit like you're drinking coffee all the time... that makes sleep very difficult.” (09:28)
• Advice for Sleep Regulation
  • Main advice: wake up at the same time daily to re-establish circadian rhythm (even after poor sleep).
  • Avoid alcohol as a sleep aid, as it worsens sleep quality.

4. Distinguishing Grief from Depression

• Key Differences
  • Depression can accompany grief but is not inevitable.
  • Grief is focused on the loss (“waves” that come and go), while depression is a pervasive gloom that’s not limited to loss.
    • “If in grief, one is also able to tell a funny story... or feel love for other people... that's actually a sign of mental health.” (13:30)
  • Presence of positive emotions during waves of grief is normal and healthy.

5. Age, Life Stage, and Grief

• Personal account: Dr. O’Connor contrasts losing her mother at 26 (“a lot of stress…lack of certainty…disequilibrium”) with her father’s death years later, for which she was more emotionally prepared.
• Learning intentional self-soothing and acceptance between losses helped her experience grief more as a process than a crisis.
  • “When those waves of grief came, I was able to sort of recognize them and let them move through me… like a summer storm.” (17:05)
• Alludes to Buddhist concept of the “second arrow”—experiencing suffering about suffering (“the pain but not the pain about the pain”).

6. Neuroimaging and the “Grieving Brain”

• What Brain Scans Show
  • Scans of people grieving (reacting to photos of loved ones) activate memory, emotion, facial processing, and cardiac/autonomic regulation areas.
  • Most notably, yearning for the person (as measured by pre-scan interviews) is correlated with activity in a brain region crucial for bonding.
    • “The more yearning people told us they had, the more activity we saw in this area, encoding that wanting our loved one.” (20:37)
  • This validates attachment theory as a biological foundation for intense longing after loss.

7. Attachment Theory: “Gone But Also Everlasting”

• Explains the tension in the grieving mind:
  • The memory system "knows" the loved one is gone; the attachment system retains an implicit assumption of permanence.
  • This neural mismatch creates emotional pain (waves of grief). Over time, people learn to maintain an internal relationship (a “continuing bond”) while accepting the physical absence.
  • "They can't both be gone and everlasting. The brain has to work out why..." (22:37)

8. Ambiguous Loss

• Loss where there’s no closure (missing person, dementia, etc.) is especially difficult because the brain can’t resolve the tension between absence and possibility of return.
• Supporting people through ambiguous loss involves balancing hope with present-focused, meaningful activity.
  • “It’s difficult to figure out how to be day to day when you can’t resolve these multiple possibilities.” (26:05)

9. Prolonged/Complicated Grief and its Treatment

• Terminology: “Prolonged grief” now preferred over “complicated grief.”
• Trajectory: Most people’s grief ebbs over time; about 10-20% experience little improvement (“flat line”) after a year.
• Intervention: Evidence-based therapies (e.g., Prolonged Grief Treatment, grief-focused CBT, narrative therapies) help by inviting people to face and integrate painful memories and emotions in a supportive context.
  • “We teach them to...be able to jump into a puddle that is grief and also to be able to jump out of it again.” (32:25)

10. Do Children Grieve Like Adults?

• Dr. O’Connor is not a child grief expert but affirms that:
  • Children definitely grieve, even infants show physical reactions to separation.
  • The process is based on attachment and separation, though children have fewer regulatory resources.

11. Secondary Grief and Self-Care for Helpers

• Exposure to others' grief can risk secondary trauma.
  • Finding meaning in the work and intentionally engaging with joy and new life helps balance the weight.
    • “Because I think about death and loss almost every day… it has provided an opportunity also for great meaning in my life.” (34:33)
  • Dr. O’Connor emphasizes the need to spend time with babies or in joyful situations to “counter the physical part of grief.” (36:17)

Notable Quotes & Memorable Moments

• On opportunity in grief:
  "Grief really captures your attention… It's making a home in your body and there is no getting around it. And the opportunity part of that is that our attention is often…captured by lots of things… Grieving can be a moment where people feel like, oh no, I have to pay attention to this."
  — Dr. Mary-Frances O’Connor, (03:08)

• Metaphor for grieving:
  "You grab at the handlebars to push the brakes, but there's nothing there… your heart rate goes up and your muscles tense… In the absence of something we are used to having every day, I think many bereaved people feel this way."
  — Dr. Mary-Frances O’Connor, (04:58)

• On heartache vs. heartbreak:
  "It's both a moment where we have heartache, but we can also have heartbreak… we are at increased risk for fatal heart attack and stroke in those first months and even years of grieving."
  — Dr. Mary-Frances O’Connor, (07:33)

• On sleep and grief:
  "It's a little bit like you're drinking coffee all the time... that makes sleep very difficult… at least by setting that alarm, we're reminding our body there is a pattern here, There is a rhythm that you can find again."
  — Dr. Mary-Frances O’Connor, (09:28)

• Grief vs. depression:
  "Grief is really all about the loss. It's about this person who died. And depression, on the other hand, is kind of global...Grief also comes in waves… With depression, it's always there."
  — Dr. Mary-Frances O’Connor, (12:10)

• Personal growth through grief:
  "When those waves of grief came, I was able to sort of recognize them and let them move through me… like a summer storm."
  — Dr. Mary-Frances O’Connor, (17:05)

• On secondary trauma and meaning-making:
  "Because I think about death and loss almost every day… it has provided an opportunity also for great meaning in my life."
  — Dr. Mary-Frances O’Connor, (34:33)

Timestamps for Important Segments

| Segment | Timestamp | |-----------------------------------------------|------------------| | Introduction & main theme | 01:30 – 02:52 | | Grief as opportunity for healing | 02:55 – 04:49 | | Physiology of grief & metaphor | 04:58 – 07:25 | | Physical sensations of grief | 07:33 – 09:09 | | Sleep disruption & advice | 09:28 – 11:58 | | Grief vs. depression | 11:58 – 14:58 | | Grief at different life stages | 15:16 – 18:11 | | Neuroimaging & longing in the brain | 19:33 – 22:26 | | Attachment and the “gone but everlasting” | 22:37 – 25:04 | | Ambiguous/missing loss | 25:04 – 27:12 | | Prolonged/complicated grief & therapy | 27:21 – 32:39 | | Child and adolescent grief | 32:39 – 34:14 | | Therapist/secondary grief and self-care | 34:14 – 36:27 | | Episode close | 36:38 – 36:51 |

Overall Tone & Concluding Notes

The conversation is warm, deeply empathetic, and scientifically grounded. Dr. O’Connor combines clear explanations of research with moving personal anecdotes and practical wisdom, demystifying the physical processes of grief while framing them as a universal and ultimately survivable—and even transformative—human experience.

As Dr. O’Connor summarizes her approach:
“…the work that I’m doing is important… it has provided an opportunity also for great meaning in my life.” (34:33)

This episode is essential listening for anyone seeking to understand the lived realities of grief, whether for themselves, loved ones, or their clients.