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

Grief triggers dopamine wanting circuits, making loss feel like withdrawal; O'Connor maps the neuroscience and tools to navigate protest and despair.

Andrew HubermanhostDr. Mary-Frances O'Connorguest
Jun 2, 20252h 32mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 2:22

    Mary-Frances O’Connor

    1. AH

      Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Mary Francis O'Connor. Dr. O'Connor is a professor of clinical psychology and psychiatry at the University of Arizona, where she directs the Grief, Loss, and Social Stress Laboratory. Today we discuss the neuroscience of attachment and loss and why grief literally feels painful in our bodies. We also discuss the very real and serious health risks to being in a state of grief. Throughout the episode, we discuss ways to navigate and recover from grief, either from the death of a person, the death of an animal, or from the loss of a relationship, job, or other role in our lives. As you'll soon learn, Dr. O'Connor's research is both fascinating and incredibly surprising. She discovered, for instance, that grief is best understood through the lens of human attachment and that dopamine, a molecule that we normally hear about in the context of motivation and pleasure, creates a sense of yearning that is central to the grieving process. She explains that to effectively move through grief, we have to work with both our feelings of protest and our feelings of despair. Those two things, the feelings of protest that we refuse to let go or our mind and body just don't want to let go, as well as the feelings of despair, that we don't know what to do, that we feel like it's an endless sense of loss, both of those feelings have to be acknowledged and then we have to transmute those feelings into actions and feelings that maintain the memory of the person or role that we played in an active way and yet move forward. By the end of today's conversation, you'll have a much deeper understanding of grief, something that everyone goes through at some point in their lives, not just as an emotion but as a specific psychological and physiological process. The idea is not to intellectualize grief but rather to better equip you to deal with it in more direct ways so you can honor the loss more completely and be able to move forward having grown from the experience. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public. In keeping with that theme, this episode does include sponsors. And now for my discussion with Dr. Mary Francis O'Connor.

  2. 2:22 – 7:42

    Grief vs Grieving; Love & Bonding, Gone Yet Everlasting

    1. AH

      Dr. Mary Francis O'Connor, welcome.

    2. MO

      It's so lovely to be here.

    3. AH

      I'm a huge fan of your work. It's such important work.

    4. MO

      Thank you.

    5. AH

      Everybody grieves at some point.

    6. MO

      Yeah.

    7. AH

      Uh, uh, no one is immune from this process that we call grieving. And we get very mixed messages-

    8. MO

      Yeah.

    9. AH

      ... from a young age all the way up to adulthood about how best to grieve, what grieving is.

    10. MO

      Yeah.

    11. AH

      And your work has really highlighted that this is a process-

    12. MO

      Mm-hmm.

    13. AH

      ... that doesn't always play out the same way for everybody. But if we were to try and drill into some of the, say, core elements of grief-

    14. MO

      Yeah.

    15. AH

      ... not to be overly reductionist-

    16. MO

      Mm-hmm.

    17. AH

      ... but just, you know, if you could highlight for us, y- what grief really is as a process, what some of the hallmarks of grief are, perhaps some things that everyone experiences that they shouldn't be shocked-

    18. MO

      Yeah.

    19. AH

      ... at, and then we can, um, lead into what your research has taught us about grief.

    20. MO

      Perfect. I think it's good to understand that grief is the natural response to loss. It is a natural physical, emotional, mental, uh, r- just reaction to the death of someone very close to us. And I think it can be helpful for people in unwinding some of these myths to think about the, the idea that there's a difference between grief and grieving. So grief is that, in that moment, you know, I could say, "Andrew, on a scale of one to ten, how much grief are you feeling right now?" And you would be able to tell me right now, during this wave of grief, how you're doing. But grieving is the way that grief changes over time. As you were saying, it's the process part. So I think of it as sort of, you know, uh, you can imagine the stock market, right? Each day, it's up, it's down, it's up, it's down. Some days it's really down. Some days it's really up. But at the end of the year, you can still see that there's been a trajectory, right? For the year, the stock market m- might actually be up even though you had some really terrible days. I think knowing that helps us to see that grief will never go away because it is a human emotion. Whenever we're aware, whenev- whenever we remember that our loved one is gone, we're gonna have a wave of grief. And that's okay 25 years later, but it doesn't mean that there hasn't been a process of grieving. I think of grieving as a form of learning, learning how to live with the loss of this person.

    21. AH

      So I'm trying to square two things that we've all heard. One is that time heals all wounds, and the other is that absence makes the heart grow fonder.

    22. MO

      Mm-hmm.

    23. AH

      You know, part of the reason I became a biologist is because of puzzles like this.

    24. MO

      Yes.

    25. AH

      You know, you don't have to, uh, have a particularly high IQ to realize that the world is full of contradictions.

    26. MO

      Yes. (laughs)

    27. AH

      So which one is it?

    28. MO

      I think it really helps us to hone in on the idea that you can't talk about grief without talking about love and bonding. Because unless you understand what you have, you don't really understand the impact of its loss, right?

    29. AH

      Mm-hmm.

    30. MO

      So "absence makes the heart grow fonder" is a fantastic way to describe attachment, right? When you fall in love with your baby or you fall in love with the person who becomes your spouse, that bond that gets created between the two of you, when you form an us-It comes with this implicit belief, I will always be there for you, you will always be there for me, and time and distance will not change that. If you are gone, it just means I have to go find you. And so now we have this unique and terrible circumstance of death where when we have a living loved one, the correct response to absence is to think about them more, to put more energy into going to find them or, or making more noise so they come and find you. But in death, suddenly we have this circumstance that the brain is really gonna struggle to wrap itself around, which is the idea that I'm not going to find you no matter how much effort I put in. I think of this as the, as the gone but also everlasting theory, right? So of course, we know that they are gone. We know that they've died. We have a memory of being at their bedside maybe or getting that phone call or being at the funeral or whatever it is in our memory, we have it recorded. We know that they're gone. But the attachment neurobiology means there's also this implicit belief, but maybe they're out there-

  3. 7:42 – 10:29

    Sponsors: Wealthfront & BetterHelp

    1. MO

    2. AH

      I would like to take a quick break and acknowledge one of our sponsors, Wealthfront. I've been using Wealthfront for my savings and for my investing for nearly a decade, and I absolutely love it. At the start of every year, I set new goals, and one of my goals for 2025 is to focus on saving money. Since I have Wealthfront, I'll keep that savings in my Wealthfront cash account where I'm able to earn 4% annual percentage yield on my deposits, and you can as well. With Wealthfront, you can earn 4% APY on your cash from partner banks until you're ready to either spend that money or invest it. With Wealthfront, you also get free instant withdrawals to eligible accounts every day, even on weekends and holidays. The 4% APY is not a promotional rate, and there's no limit to what you can deposit and earn. And you can even get protection for up to $8 million through FDIC insurance provided through Wealthfront's partner banks. Wealthfront gives you free instant withdrawals where it takes just minutes to transfer your money to eligible external accounts. It also takes just minutes to transfer your cash from the cash account to any of Wealthfront's automated investment accounts when you're ready to invest. There are already a million people using Wealthfront to save more, earn more, and build long-term wealth. Earn 4% APY on your cash today. If you'd like to try Wealthfront, go to wealthfront.com/huberman to receive a free $50 bonus with a $500 deposit into your first cash account. That's wealthfront.com/huberman to get started now. This has been a paid testimonial of Wealthfront. Wealthfront Brokerage isn't a bank. The APY is subject to change. For more information, see the episode description. Today's episode is also brought to us by BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out entirely online. I've been doing weekly therapy for over 30 years. In fact, I consider doing regular weekly therapy just as important as getting regular exercise, which, of course, I also do every week. There are essentially three things that great therapy provides. First of all, great therapy provides a great rapport with somebody that you can trust and talk to about any and all issues with. Second of all, great therapy provides support in the form of emotional support or directed guidance. And third, expert therapy can provide useful insights. Sometimes those come from the therapist, sometimes you realize those yourself in the course of therapy, and sometimes you arrive at those insights together. Those insights can allow you to make changes to improve your life in immeasurable ways, not just your emotional life and your relationship life, but also your professional life. With BetterHelp, they make it very easy to find an expert therapist you resonate with and that can provide you these benefits that come through effective therapy. Interestingly, in a recent survey, 72% of BetterHelp members reported a reduction in negative symptoms as a result of their BetterHelp therapy sessions. If you'd like to try BetterHelp, go to betterhelp.com/huberman to get 10% off your first month. Again, that's betterhelp.com/huberman.

  4. 10:29 – 14:52

    Sudden vs Slow Death, Attachment, Reframing Relationship

    1. AH

      From what I understand about the research on stress, so much of our ability to tolerate stress is knowing that it has a defined endpoint.

    2. MO

      Yeah.

    3. AH

      So if we look at, or if you look at, from the perspective of your clinical work, because you were indeed a clinical psychologist as well as a researcher-

    4. MO

      Yeah.

    5. AH

      ... a psychologist/neuroscientist.

    6. MO

      (laughs) Yeah.

    7. AH

      You wear many hats. Is there any evidence, uh, like what are the data on people that have some time to anticipate the loss of someone or a pet or maybe even a, a certain aspect of life like a job?

    8. MO

      Yeah, yeah.

    9. AH

      Like they've been laid off, but they get some time before their final day or-

    10. MO

      Or retirement.

    11. AH

      ... or retirement or, um, somebody is slowly dying.

    12. MO

      Mm-hmm.

    13. AH

      Uh, versus a sudden death, a shock, a car accident, or worse. Um, is, what, what did the data tell us about how that grief is handled? Um, is it easier in some sense when you know there's an endpoint because you can anticipate the end? Um, what's known about this?

    14. MO

      I think there's a, a couple things there that I highlight. We, we can think about something being stressful and we can think about grieving for it, and those might be slightly different, but we can get there. But what I would say most directly to your question is, yes, it is true that sudden losses are harder for us to, to learn, to understand what's happened, because we don't even have sort of a conscious... You know, we, we've never run the scenario sort of through our minds, so of course it's more difficult for us to now imagine it. But there's something... There's more to it than that. So we do know-For example, having closure conversations with someone who's in hospice care. These are helpful, actually, after the loss because we can reflect on getting to say, "I love you," and, "Thank you," and, "I forgive you," "Please forgive me," uh, to say goodbye. We know that having that conscious process is helpful later on as we're reflecting on the loss. But I will say that it doesn't necessarily change the attachment biology. So the attachment is an implicit belief. It is an everlasting belief. And so I think it is actively trying to prevent us from learning that they are gone, and so what you see is a person... This will happen in studies. I ask a participant, you know, "Tell me about, tell me about the death of, of your loved one." And they'll tell me the story of how they were, you know, in palliative care and they had this terminal diagnosis and so forth, and then I'll say, "Was the death sudden?" And they'll say, "Oh, absolutely. I had no idea." Because I think that the belief that they will always be there does not respond to logical thinking, you see? And so you can still pick up the phone to text your loved one even though you have known they were going to go, even though you know they've been gone, because there's a piece of your brain that is still operating under the belief, "They don't have to be in my time and space for them to exist."

    15. AH

      Mm.

    16. MO

      And so I think in some ways the learning might actually be, "How do I transform my understanding of this relationship now that they're not on this earthly plane? How do I understand where they are or how that makes sense? How can I have this continuing bond in my internal relationship with them?" Right? Maybe I still tell them about my day, or maybe I... You know, like when I see things I think, "Oh, my mom would love that," right? I have this moment of connection internally with my mom-

    17. AH

      Mm-hmm.

    18. MO

      ... because that internal relationship goes on. It is everlasting. At the same time that I know, "Oh, she's not gonna be at my wedding," or, "She's not gonna be at graduation." Right? You can have both at the same time. I think that's part of why grieving is so confusing and makes people feel like they're losing their mind.

  5. 14:52 – 20:46

    Religion, Integrating the New Relationship

    1. MO

    2. AH

      Yeah. The question that immediately comes to mind is whether some people have challenges getting through the grief process because of, of a kind of deliberate refusal to enter this new reality that they're both gone and that there are elements of them that are still alive within us, as you pointed out, in the form of the attachment.

    3. MO

      Yeah.

    4. AH

      The attachment lives on.

    5. MO

      Yep.

    6. AH

      The body no longer-

    7. MO

      Yes.

    8. AH

      ... lives on.

    9. MO

      That's right.

    10. AH

      And, you know, it's, uh, difficult to decide whether or not movies like Ghost, um, I think that was-

    11. MO

      Mm-hmm.

    12. AH

      ... a movie, right?

    13. MO

      Yes.

    14. AH

      Where she loses her spouse-

    15. MO

      Mm-hmm.

    16. AH

      ... or a loved one, I don't recall if it was a spouse, and- and he's essentially still there with her.

    17. MO

      That's right.

    18. AH

      I mean, movies like that, you could imagine, are kind of a double-ed- edged blade because on the one hand, um, they give people the sense that the person they miss and are so attached to is s- still there, but, um, I mean, that's a movie-

    19. MO

      Mm-hmm.

    20. AH

      ... where they could actually write in the image of the person.

    21. MO

      Yeah.

    22. AH

      And, um, create some complications. So do people delay the grieving process? Do they protract it and just make it much harder on themselves in, in a kind of a stubborn refusal to, quote, unquote, "let go"?

    23. MO

      Mm-hmm.

    24. AH

      I could understand why that would be.

    25. MO

      Mm-hmm.

    26. AH

      I- I've been guilty of this-

    27. MO

      Yeah.

    28. AH

      ... uh, in the past. Um, is that common?

    29. MO

      I think the question is askew in the sense that there is no letting go of the attachment part. There is transforming our understanding of what that means. So for most periods of history, periods of time, cultures, we have usually a social system, often a religion, set up to explain to us, "Where did they go? Are they okay now? Will I ever see them again?" Most of us through most of history have had a way to understand, "Ah, I can't see them now. I will see them eventually." Dia de los Muertos, "I will see them once a year," right? Or, um, "They are in heaven now," or, "They're in the Pure Lands," or, "They're my ancestor." There is a relationship that I can have with them. I can ask them to, you know, uh, speak on my behalf, so to speak, right? Intercessory prayers in- in Catholicism. So historically, we've had this way of understanding this internal relationship that is so real you could put it on film.

    30. AH

      Mm-hmm.

  6. 20:46 – 27:58

    Yearning, Dopamine, Brain, Addiction

    1. MO

    2. AH

      I'm wondering if you could, um, touch on some of the work that you've done related to how grief relates to the attachment and how attachment relates to wanting.

    3. MO

      Mm-hmm.

    4. AH

      Because you've made this incredible discovery that the dopamine system, which most people associate with pleasure-

    5. MO

      Mm-hmm.

    6. AH

      ...and thanks to the wonderful work of Anna Lembke and others, there's been more education now and people are more aware now of the fact that dopamine is, uh, much more about wanting than having-

    7. MO

      Yeah.

    8. AH

      ...more about craving than delighting in.

    9. MO

      Yeah. Yeah.

    10. AH

      Uh, but I and I think everybody else be kinda shocked to learn that dopamine and grief have a very close relationship.

    11. MO

      It's the hallmark of grieving is yearning, pining, right? These are other words for wanting, aren't they? And that dopamine, I've heard it described as dopamine and the reward system is really how much effort would you put in to get this thing you want, right?

    12. AH

      Mm. Mm-hmm.

    13. MO

      How much effort would you put in? How much effort would you put in to see your loved one again, right, one more time? And what that tells me... And- and really this came from the neuroscience, so I said earlier that you could think of stress and grief as- as somewhat distinct. We used to think of the loss of a loved one as sort of like, you can imagine you have a plate, right? You got all the things heaped on your plate you have to deal with. You've got getting the kids to school. You've got your boss. You've got blah, blah, blah, and now you've got this another thing heaped onto your plate. You have the loss of your spouse or the loss of your sister. That is one way to think about it. And in our peripheral physiology, a lot of the ways we respond look like a stress response, so that- that makes sense. That was a good way to think about it in the '80s and early '90s. But the neuroimaging research, when we asked people, "Tell me how much you're yearning for your loved one," and then we put them in the scanner and we showed them photos of their loved one, compared those to them looking at a stranger. So what part is unique? Not looking at a person, but looking at your person that you're yearning for. We saw that there was this little area in the- deep in the brain called the nucleus accumbens. Probably from other studies, we know it's sort of in a- in the neighborhood, caudate-ventral striatum sort of area. And what we saw was the more people said, "I'm yearning for my loved one," there was a direct correlation with how much activity there was in the nucleus accumbens, in this reward learning area of the brain. Now, in everyone who was bereaved, regardless of how much grief severity they were having, we saw things like memory areas. Of course, they're looking at a photo of their loved one. They're having all sorts of memories of when the photo was taken or, you know, whatever. We had lots of emotion areas, emotion regulation areas, even some areas that had to do with autonomic physiology regulation, but what made it so unique was this idea that yearning is something that varies among people who are grieving and that it might be in part instantiated in this brain-encoded region that says, "I'm looking at this photo and what that makes me want to do is reach out for you." And I think this was a very new way to understand what is lost. It isn't something new that's leap- that's heaped onto your plate. It's that a part of... It's e- it's- it's a part of us that was formed when you bonded-... has been amputated. You don't have the resources. You can't function in the world, you can't walk through the grocery store without figuring out how to do that without this other person. And then, often yearning to have them back so that you could walk through the world in the normal way again. There's nothing wrong with yearning, it's just that we understand better now how the brain is doing it. And I can tell you if you want, but I've gone on a bit here-

    14. AH

      No, please.

    15. MO

      ... I can tell you if you want, a lot of people did point out, "Wait, this is the same area of the brain that's related to addiction." A lot of people talked about, "Are we addicted to our loved ones?" And it took me, I never wrote about it the first, in, in the 2008 paper. I never wrote about it that way, but I've come up with a better maybe way to communicate, I think, what's going on. So I live in the desert southwest, in Tucson, Arizona. And I can tell you, if you forget your water bottle and you are out on a hike, (laughs) and you're halfway through, you cannot think of anything else other than water, right?

    16. AH

      Mm-hmm.

    17. MO

      You are obsessed with thinking about it, getting it, imagining it, and so forth. But no one would say you were addicted to water, right?

    18. AH

      Mm-hmm.

    19. MO

      Water is something we need, and we have a homeostatic function that says, "You need more of it." And then once we have it, we feel satiated, right? Yearning for a loved one is that kind of thirst. We need our attachment figures like we need food and water. They are basic to our survival, and I think we forget that in modern society where we can, sort of, fill in for so many needs. We need our spouse, we need our children, our parents, our siblings, and we fail to thrive when we don't have them. And so I think the activation in that area is just the cue of you really need to reach out for this person. And the process of grieving is, if I'm going to reach out, it's gonna look different than it did before. Maybe I'm gonna have a conversation, maybe I'm gonna talk to my sister. But also, you have to find another way to get your attachment needs met. There has to be someone else in your life whom you would say, "I will always be there for you. You will always be there for me," because this person who's left this earthly plane cannot be that anymore.

    20. AH

      So interesting. I loosely define addiction as a progressive narrowing of the things that bring you pleasure.

    21. MO

      Yes.

    22. AH

      And you beautifully described how on a hike in the desert southwest when you need water, the narrowing-

    23. MO

      Yes.

    24. AH

      ... of what brings you pleasure comes down to what you need for survival.

    25. MO

      Absolutely.

    26. AH

      And presumably, once you have that water, then your, your notion of what's pleasurable expands again.

    27. MO

      Yes.

    28. AH

      Whereas addiction to, say, methamphetamine or to some, uh, you know, process addiction or behavioral addiction, it really becomes, uh, like a tunnel. There's one thing and that one thing only.

    29. MO

      Mm-hmm.

    30. AH

      And sadly, in addiction, the, the rewarding properties of that thing also become diminished with time.

  7. 27:58 – 40:09

    Culture & Grief Literacy; Protest, Despair & Hope, New Relationships

    1. AH

      the way you describe grief as a, a sort of addiction-like, like the process of, of grieving sort of addiction-like in that sense, um, raises for me a question. You said that at some point in order to move through, I don't wanna say get over because one-

    2. MO

      Integrate maybe.

    3. AH

      ... to integrate the, the grieving process, one needs to either find, um, a replacement attachment figure. I mean, we don't like to think about this when we lose someone, but if it's a spouse, sometimes people remarry or re-partner, and sometimes they don't. But it's kind of a beautiful thing really to observe that. I've seen that several times over when somebody re-partners and they seem like that attachment need is met, at least partially. It's not the same, but it's met differently again.

    4. MO

      Yeah.

    5. AH

      But sometimes people refuse.

    6. MO

      Mm-hmm.

    7. AH

      They hold onto the attachment or morph the attachment in a way that they are with that person forever, to the exclusion of replacing that attachment figure. Are there any data that speak to, uh, which one works better?

    8. MO

      Mm-hmm.

    9. AH

      Or is it just kind of who you're at and where you're at in life, and, you know, some people are really stubborn with this aspect of the grief integration process?

    10. MO

      I think recently a lot about what is a good outcome. I've spent a lot of time in my career thinking, what is a bad outcome when we're grieving? And how might we most help people who are, who are not integrating this in a way that's allowing them to restore a meaningful life? But... And I, and I've shied away a lot from the question of what is a good outcome, because I think it- it- it has a normative quality to it. But I've started thinking about it in a very open way. So the first thing I would say is, uh, I really don't think of it as addiction-like. So our need for our loved ones, much like food and water, is this homeostatic process, right? You think, "Oh," you know, like, I- I'm visiting you, right? For this podcast. And at some point, there's some push notification in my brain that says, "You should text your partner," right? And I pull out my phone and I text him, and I wait for a few minutes, and then he responds and I get that little, "Oh, he's there. He knows where I am. We're good." That's not an addiction, right? That is the normal homeostatic process, just like I also got up and ate breakfast, 'cause I knew that I needed that, right? So I- I think with addiction, the problem is those drugs of abuse override exactly these circuits that work in a homeostatic way. And by overriding them, they either pare down the number of, uh, receptors or, uh, mess with the affinity of the receptors in such a way that it really does narrow our what's rewarding to only this drug, because only this drug can powerfully overfill those receptors. And now we have a situation where only meth, right? Is the thing that gives, makes us feel better. But-... not, not quite the same with food, water and- and- and living loved ones. To your question of... (sighs) And I think you've actually really hit on something that our culture is really struggling with right now. We've lost, in our culture, a lot of the grief literacy that was based around an understanding of what happens during bereavement, during mourning, that was very religiously focused, religiously oriented, right? So everything from sitting shiva to, um, having, uh, the- the mass after a year, right?

    11. AH

      Or a wake.

    12. MO

      Or a wake.

    13. AH

      With the body there.

    14. MO

      With the body right there.

    15. AH

      I've been to a wake. People are laughing, people are telling jokes, they're drinking.

    16. MO

      Yeah.

    17. AH

      And I remember the first time I went to-

    18. MO

      Mm-hmm.

    19. AH

      ... a proper Irish wake.

    20. MO

      Yep.

    21. AH

      I was thinking, "This is wild."

    22. MO

      Yes.

    23. AH

      And I didn't quite know how to be.

    24. MO

      Yes.

    25. AH

      And after some period of time, I caught on.

    26. MO

      Mm-hmm.

    27. AH

      And it was remarkable.

    28. MO

      Yeah. S-

    29. AH

      It was... It's clearly effective-

    30. MO

      Yes.

  8. 40:09 – 43:21

    Sponsors: AG1 & Helix Sleep

    1. AH

      As many of you know, I've been taking AG1 daily for more than 13 years. However, I've now found an even better vitamin mineral probiotic drink. That new and better drink is the new and improved AG1. This next gen formula from AG1 is a more advanced, clinically backed version of the product that I've been taking daily for years. It includes new bioavailable nutrients and enhanced probiotics. The next gen formula is based on exciting new research on the effects of probiotics on the gut microbiome, and it now includes several specific clinically studied probiotic strains that have been shown to support both digestive health and immune system health, as well as to improve bowel regularity and to reduce bloating. As someone who's been involved in research science for more than three decades, and in health and fitness for equally as long, I'm constantly looking for the best tools to improve my mental health, physical health, and performance. I discovered and started taking AG1 way back in 2012, long before I ever had a podcast, and I've been taking it every day since. I find that it greatly improves all aspects of my health. I just feel so much better when I take it. With each passing year, and by the way, I'm turning 50 this September, I continue to feel better and better, and I attribute a lot of that to AG1. AG1 uses the highest quality ingredients in the right combinations, and they're constantly improving their formulas without increasing the cost. So I'm honored to have them as a sponsor of this podcast. If you'd like to try AG1, you can go to drinkag1.com/huberman to claim a special offer. Right now, AG1 is giving away an AG1 welcome kit with five free travel packs and a free bottle of vitamin D3 K2. Again, go to drinkag1.com/huberman to claim the special welcome kit with five free travel packs and a free bottle of vitamin D3 K2. Today's episode is also brought to us by Helix Sleep. Helix Sleep makes mattresses and pillows that are customized to your unique sleep needs. Now, I've spoken many times before on this podcast about the fact that getting a great night's sleep is the foundation of mental health, physical health, and performance. When we aren't doing that on a consistent basis, everything suffers, and when we are sleeping well and enough, our mental health, our physical health, and our performance in all endeavors improves markedly. Now, the mattress you sleep on makes a huge difference in terms of the quality of sleep that you get each night. How soft that mattress is, how firm it is, how breathable it is, all play into how well you'll sleep, how much deep sleep you get, how much rapid eye movement sleep, and it needs to be tailored to your unique sleep needs. So if you go to the Helix website, you can take a brief two-minute quiz, and it will ask you questions such as, "Do you sleep on your back, your side, or your stomach? Do you tend to run hot or cold during the night?" Things of that sort. Maybe you know the answers to those questions, maybe you don't. Either way, Helix will match you to the ideal mattress for you. For me, that turned out to be the Dusk mattress, D-U-S-K. I started sleeping on a Dusk mattress about three and a half years ago, and it's been far and away the best sleep that I've ever had. So if you'd like to try Helix, you can go to helixsleep.com/huberman, take that two-minute sleep quiz, and Helix will match you to a mattress that is customized for your unique sleep needs. Right now, Helix is giving a special offer to Huberman Podcast listeners of up to 27% off site wide, plus free bedsheets with any luxe or elite mattress order.What

  9. 43:21 – 52:04

    Protest, Despair & Transmutation; Changing Attachment Hierarchy

    1. AH

      you just said is so critically important that, if I may, I'm just going to, uh, summarize for myself and for those listening, and I'll never pass up the opportunity to weave in a little neuroscience lesson. And since you're a fellow neuroscientist-

    2. MO

      Love that.

    3. AH

      ...hopefully you'll collaborate with me on this.

    4. MO

      Love that.

    5. AH

      So, what I heard was, um, at least two divergent responses to grief. One is a protest. The other is a despair, broadly speaking.

    6. MO

      Yeah.

    7. AH

      In protest, it's a "No, I don't accept."

    8. MO

      Yeah.

    9. AH

      But there's an action step.

    10. MO

      Yes.

    11. AH

      There's a go response.

    12. MO

      Yes.

    13. AH

      And we know in the basal ganglia, a critical structure for, uh, action generation-

    14. MO

      Yeah.

    15. AH

      ...and action suppression, we can broadly think in terms of go and no-go-

    16. MO

      Mm-hmm.

    17. AH

      ...as separate circuits, literally. So the protest circuit is a go circuit that's nested on this notion of hope-

    18. MO

      Yeah.

    19. AH

      ...that it can be resolved through action.

    20. MO

      Yeah.

    21. AH

      The despair circuit is a, "Ugh, I can't act on this. I can't hand this letter to somebody. I can't call them. I can text them, but they're not going to see it."

    22. MO

      Right.

    23. AH

      And this is a no-go pathway-

    24. MO

      Mm-hmm.

    25. AH

      ...the suppression of action. And you said that action is metabolically costly, inaction is not costly. I'm not going to challenge that, but I have a question about that, which is, it seems what's required in the despair step for it to be adaptive, functional, healing, is for that no-go to be converted into some new context.

    26. MO

      Mm-hmm.

    27. AH

      And as neuroscientists, we know that context-dependent decision-making, strategy-settiing is this prefrontal cortical, uh, activity-

    28. MO

      Mm-hmm.

    29. AH

      ...that humans are so good at. But it requires effort.

    30. MO

      Yeah.

  10. 52:04 – 1:05:27

    Bereavement Support, Medical Risk

    1. AH

      I am very struck by this idea that, uh, when an attachment is, um, hindered, l- like, in grief, that having others that are there to support us is extremely important-

    2. MO

      Yeah.

    3. AH

      ... especially nowadays in this crisis of isolation.

    4. MO

      Yeah.

    5. AH

      Um, and in this time where we can communicate about our experience, we can learn so much about others' experiences, but we often don't have the fundamentals of support like, um, uh, touch.

    6. MO

      Mm-hmm.

    7. AH

      Right? Just, like, you know, t- touch.

    8. MO

      Yeah.

    9. AH

      Those hugs, somebody sitting there.

    10. MO

      Yes.

    11. AH

      E- eye contact.

    12. MO

      Mm-hmm.

    13. AH

      You know, um-

    14. MO

      Holding your hand.

    15. AH

      N- no doubt, um, smell is-

    16. MO

      Yes.

    17. AH

      ... is probably related to this. Just the smell of another person-

    18. MO

      Mm-hmm.

    19. AH

      ... even if you're not aware of it consciously-

    20. MO

      Yeah.

    21. AH

      ... it'll be signaling at, at a bodily level, there's someone else here.

    22. MO

      Yes.

    23. AH

      You know, there are a lot of people that, um, really struggle to sleep after the loss of someone.

    24. MO

      Absolutely.

    25. AH

      And just having someone else in the room-

    26. MO

      Mm-hmm.

    27. AH

      ... or a pet in the room-

    28. MO

      Yes.

    29. AH

      ... can make a big difference. So, y- you know, in, in terms of addiction-

    30. MO

      Mm-hmm.

  11. 1:05:27 – 1:13:40

    Culture, Alcohol & Death; Dying of a Broken Heart, Medical Risk

    1. MO

    2. AH

      I wanna talk about the somatic, the bodily aspect of, of this. We've been talking about the brain, which of course is connected to the body-

    3. MO

      Yeah.

    4. AH

      ...and vice versa, but, um, before I do that, I want to ask you a question, uh, about alcohol.

    5. MO

      Yeah.

    6. AH

      Uh, did an episode about alcohol a couple years ago and, um, I think I got a lot of people who wanted to stop drinking to stop drinking. I got some people who wanted to keep drinking, drinking a little less-

    7. MO

      Mm-hmm.

    8. AH

      ...and some people, uh, hate that episode-

    9. MO

      Mm-hmm.

    10. AH

      ...um, and keep drinking.

    11. MO

      (laughs)

    12. AH

      And my goal with that episode was not to change anyone's behavior, just to give them information.

    13. MO

      Yeah.

    14. AH

      I will be the last person to promote drinking-

    15. MO

      Mm-hmm.

    16. AH

      ...because we know it's basically not good for us despite the headlines that it might be.

    17. MO

      Mm-hmm.

    18. AH

      The mere disruption in sleep and microbiome probably explains, in my opinion, about 50% of the detrimental effect. But with that said, it is very customary in a lot of traditions that close to the, to the death, in the very early days and stages of grieving to actually promote alcohol use.

    19. MO

      Mm-hmm.

    20. AH

      And if I take an open-minded perspective to this, we know that alcohol at a low dose disinhibits us.

    21. MO

      Mm-hmm.

    22. AH

      It's why people start talking more. At a higher dose, it's more of a sedative.

    23. MO

      Mm-hmm.

    24. AH

      And we can all agree, I believe, that chronic alcohol use or continuing to drink to avoid one's feelings is just a bad idea.

    25. MO

      Mm-hmm.

    26. AH

      Anyone that disputes that is probably drinking while they do it. However, I am struck by the fact that so many traditions encourage the use of alcohol, and I wonder based on what you told us about the risk of heart attack-

    27. MO

      Mm-hmm.

    28. AH

      ...whether or not this is some attempt to lower blood pressure in the short term-

    29. MO

      Mm-hmm.

    30. AH

      ...and basically just keep the person from dying.

  12. 1:13:40 – 1:15:28

    Sponsor: Function

    1. AH

      I'd like to take a quick break and acknowledge one of our sponsors, Function. Last year, I became a Function member after searching for the most comprehensive approach to lab testing.Function provides over 100 advanced lab tests that give you a key snapshot of your entire bodily health. This snapshot offers you with insights on your heart health, hormone health, immune functioning, nutrient levels, and much more. They've also recently added tests for toxins such as BPA exposure from harmful plastics and tests for PFASs or forever chemicals. Function not only provides testing of over 100 biomarkers key to your physical and mental health but it also analyzes these results and provides insights from top doctors who are expert in the relevant areas. For example, in one of my first tests with Function, I learned that I had elevated levels of mercury in my blood. Function not only helped me detect that but offered insights into how best to reduce my mercury levels which included limiting my tuna consumption, I'd been eating a lot of tuna, while also making an effort to eat more leafy greens and supplementing with NAC, N-acetylcysteine, both of which can support glutathione production and detoxification. And I should say by taking a second Function test, that approach worked. Comprehensive blood testing is vitally important. There's so many things related to your mental and physical health that can only be detected in a blood test. The problem is blood testing has always been very expensive and complicated. In contrast, I've been super impressed by Function's simplicity and at the level of cost. It is very affordable. As a consequence, I decided to join their scientific advisory board and I'm thrilled that they're sponsoring the podcast. If you'd like to try Function, you can go to functionhealth.com/huberman. Function currently has a waitlist of over 250,000 people, but they're offering early access to Huberman podcast listeners. Again, that's functionhealth.com/huberman to get early access to Function.

  13. 1:15:28 – 1:23:57

    Navigating Grief, Emotions & Body, Tool: Progressive Muscle Relaxation

    1. AH

      I'm curious about compartmentalization. It's clear to me now that at least in this culture in the United States, we aren't taught how to grieve unless it's, you know, uh, part of our family or part of our religion. Uh, we aren't instructed how to grieve. There seems to be a- another, uh, set of contradictions in the world of psychology, health, self-help. Doesn't matter if it's the most woo, uh, sector of it-

    2. MO

      Mm-hmm.

    3. AH

      ... or the most, uh, reductionist medical sector of it and, and the conflicting message is this. On the one hand, feel your feelings.

    4. MO

      Mm-hmm.

    5. AH

      Bottling it up isn't good.

    6. MO

      Yeah.

    7. AH

      Raises your blood pressure, increases your risk of heart attack, aneurysm, makes you a miserable person to be around and to, including with yourself, et cetera.

    8. MO

      Mm-hmm.

    9. AH

      But then we also know we have to be functional.

    10. MO

      Mm-hmm.

    11. AH

      We can't dissolve into a puddle of our own tears 24 hours a day, seven days a week. Even if we're not a caretaker, we just can't.

    12. MO

      No.

    13. AH

      It's just, so, I can recall when I was a kid getting really devastating news, just-

    14. MO

      Yeah.

    15. AH

      ... it doesn't matter what the, what the news was-

    16. MO

      Yeah.

    17. AH

      ... but just devastating news for s- for any age-

    18. MO

      Yeah.

    19. AH

      ... but I think at that point I was, like, 16?

    20. MO

      Mm-hmm.

    21. AH

      It was like...

    22. MO

      Yeah.

    23. AH

      And I remember, like, my chest hurt.

    24. MO

      Yeah.

    25. AH

      My heart hurt.

    26. MO

      Yes.

    27. AH

      And I remember actively pushing it down.

    28. MO

      Yeah.

    29. AH

      And it's, I, I, I know how to do that, right? It's a skill.

    30. MO

      Yeah.

  14. 1:23:57 – 1:35:44

    Grief Stages; Permission & Coping, Judgment & Guilt; Lessons from Grief

    1. AH

      I think what you just said is, is so vitally important because I know for a number of years, the, um, the model was one in which grief progresses through some very standard stages of, um, disbelief, anger, acceptance, and no disrespect to, uh, was it, uh-

    2. MO

      Elizabeth Kubler-Ross.

    3. AH

      ... Kubler-Ross. Is there a theme of, um, of hyphenated names in her field?

    4. MO

      (laughs)

    5. AH

      So yeah, sorry. (laughs)

    6. MO

      Oh, that's funny.

    7. AH

      Yeah, the, uh, um... Incredibly important work because it cracked open the awareness of grief-

    8. MO

      Yeah.

    9. AH

      ... as a process, both psychological and to some extent biological.

    10. MO

      Yeah.

    11. AH

      So we wanna, you know, pay respect to the people that opened up these fields, and yet as an outsider to the field, I can, uh, safely say-

    12. MO

      Mm-hmm.

    13. AH

      ... uh, 'cause my grants and papers don't rely on it, that I think, uh, work such as yours and your, uh, your colleagues have really expanded on that model to really show us that in many ways, it was important but not completely true in the sense that it's not disbelief then anger then acceptance. It might be all three at once, and then they get shuffled in a different order, and then there's a bunch of other things too.

    14. MO

      Yeah.

    15. AH

      And I think it's important, uh, for people to hear because that disbelief, anger, acceptance trajectory got so much press-

    16. MO

      Yeah.

    17. AH

      ... that we were kind of taught it in an- high school and elementary school.

    18. MO

      Mm-hmm.

    19. AH

      And it, and it needs some updating.

    20. MO

      Mm-hmm.

    21. AH

      Just like the notion that dopamine is pleasure needs some updating.

    22. MO

      Absolutely. So she published on Death and Dying in 1969. And you're right. It was groundbreaking, the idea that grief is more than sadness. And she did what all good scientists do initially. Sh- it was descriptive. She did clinical interviews, and she described, but it became a prescription, didn't it? Right? Those stages. And we know now, think how far science has come, right? We know now with longitudinal studies where we're looking at the same person over and over again, that we do see trajectories. So we see that acceptance increases over time. We see that yearning decreases over time. But that it's not linear, and that it's not, just as you say, it's not one stage and then you're done with that. I've had people say to me, "Well, it's been 20 years, but I haven't felt anger yet, so I don't think I'm done grieving," and I just, my heart goes out to them. It's not a prescription. And modern grief research tells us so much more, not just about what happens but why and how.

    23. AH

      Yeah. Sometimes I wonder if, um, despite the incredibly devastating experience that grief can be, whether or not people don't, um, allow themselves to feel okay.

    24. MO

      Yeah.

    25. AH

      I mean, earlier when you were talking about this, uh, this picture of this, this monkey holding-

    26. MO

      Yeah.

    27. AH

      ... its dead infant-

    28. MO

      Yeah.

    29. AH

      I confess, I, I, like, had a vi- like, a reaction.

    30. MO

      Yes.

Episode duration: 2:32:35

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