Give sorrow words: the grief that does not speak whispers the o’er-fraught heart and bids it break. ~Shakespeare
Since beginning my study of cognitive-behavioral psychology decades ago, the idea of what constitutes acceptable topics of exploration have changed drastically. What was once limited to the reflective/passive responses and active listening promoted by cognitive therapist like Carl Rogers has given way to a more scientific approach to the emotional state of the human mind.
The last several years have witnessed significant insight into the understanding of what exactly happens in the brain when we are in emotional states. Utilizing functional MRIs and CAT scans, researchers can see firsthand how states like joy, sorrow, and grief affect our neurology. With surprising insights. While it has been a long suspected that practices like mindfulness and meditation can greatly alter our psychology and even cause physical changes to the brain, we now know that the more unwelcome mental states also have neurological equivalents. One area that is getting renewed attention is grief. Most therapists will agree that unmitigated grief often leads to depression, and left untreated, depression can greatly diminish a person’s life, both experientially and chronologically. The first question to ask, therefore, how does grief affect our physical brain?
This is not the easiest question to answer, as every person is unique just as each of our brains is slightly different. That being said, anyone we know who has lost a friend, relative, or pet can describe the feelings of loss and loneliness, of sadness and a feeling of emptiness. While these very in intensity from person to person, our shared experience of loss allows us to empathize and to understand how the other person is feeling. Now we have an insight into how their neurology is attempting to cope.
Just as the body goes into shock after a physical trauma, so does the human psyche go into shock after the impact of a major loss. ~ Anne Grant
Psychologist and author Richard Lazarus developed a scale to help understand the stress that most people feel when dealing with loss on a scale of 0-100. The death of a spouse is not surprisingly at the top of this list, but perhaps not for the reason, we might think. The death of a spouse is also the death of a dream. As cognitive beings, we live at once in the past, the present, in the future. A life partner is someone who shares a large part of that cognitive schema. People who speak of the loss of a spouse they say that a part of them has been ripped away, or, they may feel as if they are incomplete. The person who was so critical to their being is no longer there. Divorce also rates high on this scale, 73, according to Lazarus, as the loss of the dream is not quite as total as in death.
Other significant stressors include imprisonment (63), the death of a close family member or friend (63), personal injury or illness (50), Being fired from a job (47) and surprisingly, retirement (45). Marriage comes in at 50, and marital reconciliation earns a score of 45. According to Lazarus, anyone who has a total of 300 after these stressors are added up is put at a significantly elevated risk of illness. Those between 150 and 299 have a moderate risk and those under 150 only a slight risk. While Lazarus’ stress scale may cover many life altering events, it is certainly not complete, nor does it take into account other factors. Among them the death of a beloved pet, which can rate as high as 50, which may not be surprising, especially to those who have a beloved dog or cat.
It is expected that when a close relative or friend passes, the grieving process can be a lonely one, and everyone seems to grieve differently. Each of us mourns the loss of the individual relationship, and no two relationships are identical. Because of this it is impossible for anyone on the outside being able to formulate an accurate assessment of the person’s grief. Even though there may be others who are sharing in that loss, for example, siblings may share in the loss of a parent, nevertheless, each relationship is unique, and every loss is grieved differently.
Regardless of the loss, the stress that accompanies the grieving process is very real. This stress can become a burden to both the physiology and psychology; both of which are negatively impacted by the system designed to handle stress, namely the hypothalamus-pituitary-adrenal axis, or HPA. If you are a regular reader of my blog you have read a number of times about how our HPA axis system helps us survive threat or danger, but if left switched on can begin to cause significant damage, both to our bodies as well as our minds.
Lazarus’ stress scale is important because it does two things: it allows us to quantify stress from life events, and it points to how stress negatively impacts our health by weakening our immune response. A number of studies have shown that survivor groups, and grief support drastically increases overall health, lengthens life, and greatly improves the quality of life. This support in the grieving process support both psychologies (cognitive and behavioral aspects), but also greatly decreases stress, and its effect on the HPA axis and the resulting negative impact on the inflammatory process and immune response. Drs. Janice Kiecolt-Glaser, a psychologist, and Ronald Glaser, an immunologist, found that high-stress relationships impeded healing of injury; inflammatory response proteins can be released by intrapersonal stress and conflict resulting in a negative impact to our immune response system. These researchers also found that the inflammatory response worsened depression. At the same time, being in the presence of the familiar can greatly decrease these depressive symptoms through the release of oxytocin, one of the neurotransmitters often referred to as the “feel good” chemicals (If you want to learn more about these, the book pictured below is an exceptional guide).
Regardless, grief seems to be a very natural and necessary adjustment to loss. If this grief is downplayed or ignored, the results can be depression, anxiety, or maybe manifest in physical symptoms. We all work through grief differently, but we all must work through it. And whatever our loss, refusing to acknowledge it and allowing the sadness to become clinical depression is hardly beneficial.
The stress hormones, particularly cortisol, which are beneficial in the short term, are destructive in the long term. If we become too depressed for too long, the neurology of our brain can be permanently affected. But how?
Much research over the past few years has begun to focus on the process of neurogenesis. Neuroscience has discovered that the adult brain can indeed continue the process of neurogenesis, and one area of significant interest is the hippocampus.
The hippocampus is crucial for learning and in the creation of memories, according to researcher Jessica Malberg, and works in orchestra with other parts of the brain, for example, the amygdala, to govern emotion, mood, and in the association of emotion to memories. Other researchers are discovering that some activities will increase the rate of neurogenesis in the hippocampus. They have also concluded that depression inhibits this neurogenesis by flooding the brain (and body) with stress chemicals. It has long been known that depression is unhealthy to our psychological well-being, and now we know it is unhealthy to our physiological health as well.
During periods of grief, we need to recognize that neurogenesis is incompatible with depression, and should be avoided for several reasons, one of which is that depression just does not feel very good, either physically or mentally. The headaches, the feeling as if we were punched in the stomach, these are often the result of a depressed and stressed state. What do we do when we are trapped in this grief? The seemingly natural ability of our minds to put us into a deep depression is very real, and it may seem as if there is no way to avoid the downward spiral. Yet researchers and therapists explain that the cure for this depressed mental state is may be as simple as exercise.
Reducing the effects of stress chemicals can be done through stimulating the feel-good neurochemicals like dopamine, serotonin, and oxytocin. This can be achieved through physical exercise. In fact, researchers at the Salk Institute found that sustained physical exercise promoted neurogenesis in the hippocampus, the region of the brain critical for the formation and regulation of emotions (and memories linked to emotions), as well as controlling many autonomic functions like digestion and heartbeat. What’s more, the researchers found that neurogenesis in the hippocampus improves the creation of new memories.
In his brilliant 2006 book “Making Happy People: The Nature of Happiness and Its Origins in Childhood,” biologist Paul Martin suggests that even a brief ten-minute walk can greatly elevate mood, at least for a few hours. Of course, a daily walk of 10 minutes or more will over even a short time, start to change positively effect our mood, and increase our ability to deal with stress. It has long been known that physical exercise is effective in relieving depression and anxiety. Along with exercise, shared experiences and companionship further stimulate neurogenesis and reduce feelings of grief.
Researchers at Princeton University found that social interactions and companionship are necessary components of a healthy brain. Companionship is so critical to health brain function that researchers found among people living in isolation did not experience neurogenesis despite regular exercise. Sociologist and community psychologists tell us that humans are communal mamas, and being part of a group is necessary for health and longevity. One researcher set out to prove this.
Dr. James Coan is a professor of neuroscientist who used a functional magnetic resonance imager (fMRI) to measure has shown that we need more than just an internalized idea of social roots; we need to feel as if we belong. British neuroscientists also found similar results when using an fMRI to measure neurological responses to touch, finding heightened activity n the somatosensory cortex (the hub for all sensory experiences). These finding further support the idea that personal, physical and emotional experiences of others are critical to our neurology and our psyche. We are social creatures to be sure; do we benefit from the touch of our fellow humans only? As it appears, the answer is no.
In a 2013 study of Fibromyalgia patients, those spending time with a therapy dog showed significant decreases in pain and depressed mood. Another study examined the presence of animals and found significant increases in positive social responses from children with neurological disorders, seeming to suggest that the emotional and psychological benefits of socializing extend to pets as well. And it is not just therapy animals that can have positive effects on humans, with measurable results.
Living with a pet lowers blood pressure and decreases the response to stress, and thereby boosts our immune systems. People who live with pets also seem to have a higher survival rate following a heart attack. Some researchers found the nurturing connection between humans and their pets have significant positive implications for health care, reducing costs and improving longevity, and the use of therapy animals in children’s cancer treatment improved the moods of the children.
In the end, sharing our lives with another person, or a cherished pet, helps us avoid feelings of loneliness that so often leads to depression; allows us an external focus for our attention, love, and compassion, the science seems pretty sound. Sharing our lives with others helps us worry less, have less anxiety, less depression, and as the studies discussed here, experience much less pain. Pets, much like other humans, not only make us happier, they can help make us healthier. This is why the death of a friend, or the death of a cherished pet, can often leave us sad, depressed, and devastated.
The reality is that you will grieve forever. You will not ‘get over’ the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same nor would you want to. ~ Elisabeth Kubler-Ross