Dr. Mary-Frances O'Connor on Huberman Lab: Why Grief Hurts

O’Connor defines grief as the acute emotional, physical, and cognitive wave when we become aware that someone is gone, and grieving as the way those waves change across months and years. Like a volatile stock market graph, day-to-day can be up and down, yet there is often a longer-term trajectory toward more acceptance and less destabilizing yearning. Expecting grief to ‘end’ is misguided; instead, we learn to live with it and function alongside it.

Neuroimaging studies of bereaved people viewing photos of their deceased loved ones show activation in the nucleus accumbens and related reward-learning circuitry, correlated with self-reported yearning. This is the same system involved in motivation, effort, and homeostatic needs like thirst. O’Connor argues that we are not ‘addicted’ to loved ones; rather, attachment is like water: a basic survival need. After loss, the brain’s ‘reach out and find them’ circuit keeps firing, which explains intrusive yearning and searching behaviors.

Drawing from attachment theory, O’Connor describes protest (“No! They can’t be gone!”; high arousal, searching, agitation) and despair (collapse, withdrawal, ‘they’re really gone’) as two core responses. Protest fuels searching energy but is physiologically costly; despair dampens that searching and conserves resources, but can feel terrifying and hopeless. Healthy grieving involves oscillating through both, not getting stuck in either, and eventually transmuting those states into actions that support a meaningful life and ongoing inner bond with the deceased.

Large epidemiological studies show that within 24 hours of a loved one’s death, the risk of heart attack can increase 21-fold, and in the first three months, widowers are nearly twice as likely to die of a heart attack. Laboratory studies reveal blood pressure spikes and poor recovery during waves of grief, especially in those with more intense grief. O’Connor advocates treating the newly bereaved as medical ‘patients’ too—monitoring blood pressure, maintaining routine care (e.g., mammograms, dental visits), and building systems of physiological as well as psychological support.

People often try to outrun grief by avoiding reminders (routes, rooms, closets) or mentally rehearsing counterfactuals (“If only I’d called,” “I should’ve noticed”). Especially after suicide, this ‘would’ve-could’ve-should’ve’ thinking attempts to impose control and meaning but has no endpoint—every story ends with an impossible resurrection. O’Connor emphasizes learning to recognize these thoughts as unhelpful processes rather than problems to solve, and to shift context, activity, or environment (e.g., physically getting up and moving) instead of continuing the loop.