Sunday, June 29, 2008

Enduring love or just never letting go?

When it is our time to grieve, we must live each day as it comes,
dealing with both the mundane routine of living and our inner struggle.
Grieving and living through the entire experience of bereavement will
change us, and if we do it well, the change will be for the better. We
know we are becoming whole when we can look to the future with some
readiness to engage once more.
--Carolyn Jaffe "All Kinds of Love: Experiencing Hospice"

Grief, of course, has been a part of my life and thoughts this past year, both during the final months of my mother's life and the time since she died in late March. I have been surprised at the ease with which I've made this transition since her death, realizing though that she and I had ample time to say good-bye and knowing that she was ready to exit when she did. Interesting research from UCLA(1) suggests that those who experience what is termed 'complicated grief'--defined as feelings of loss that are so overwhelming that the person is debilitated and unable to resume normal life--have characteristic patterns of brain function underlying this show-stopping state of mind.

Psychologists there studied a group of women who'd experienced the loss of a mother or sister in the previous five years. The subjects were classified as either complicated or noncomplicated grievers. Using functional MRI imaging (fMRI), a technique that can identify which parts of the brain are actively at work, the researchers found that all the women lit up their pain centers when they viewed either pictures of their loved ones or words related to loss. Neutral words or pictures of strangers did not elicit this response.

They were surprised, however, to discover that those women suffering from ongoing complicated grief also activated the nucleus accumbens area of the brain. This region is the neurological command center for experiences of pleasure and reward. While it is unclear why this occurred, lead researcher Dr. Mary-Frances O'Connor theorized that intense attachment in complicated grief activates reward centers in ways similar to that experienced by contact with the loved one before death occurred. Those with fMRIs lit up in reward centers all reported 'yearning' but there was no correlation with the time that had passed since the death.
O'Connor, MF, Craving love? Enduring grief activates brain's reward center. Neuroimage 2008 May 10. [Epub ahead of print]


JeanMac said...

Except for the actual phone call saying Mom has passed, I think her years of illness, caused me to grieve before her death.
Life had to go back to normal - I had a job, husband, etc. Guess you resume Life or collapse. Good post.

Anonymous said...

Very interesting article. Hope there is more !?! As I'm in menopause, & have found it to be down right 'weird'. I also lost my best-friend/spouse 14 mos & 15 days ago. And the journey after that death, has been one of the most difficult, I've ever known.

Let me know if you would like my 3 pg e-mail letter, just on that.
Sheila Joyce Gibbs
ph. no. 250-995-1643

menopausaloldbag (MOB) said...

I lost my mother and my father exactly a month apart. No matter what age you are it is still a difficult thing to go through. I also lost an uncle 45 minutes after my father died and another uncle six days later, before losing my mother three weeks after that. I think I would have qualified for the research with ongoing complicated grief. It is 14 years now so I don't consider it ongoing - I finally managed to come to terms with it all but not until I had quite a struggle to do that.

I can empathise with your loss even though you may have been prepared for it.

KGMom said...

Most interesting--but not surprising. Grief manifests itself many ways.
Is there a correlation between complicated and uncomplicated and the amount of foreknowledge of impending death one has?

Femail doc said...

Hi Jean: I agree, life or collapse. Some people, apparently, collapse even as their lives demand their attention. I have patients like that. Interesting now to know a little bit of the brain workings behind the collapse.

Sheila: My goodness, menopause plus best friend/spouse loss = too much! I'm sorry for your difficult journey. I would love to see your e-mail letter.

MOB: How much more complicated can it get than to lose mom, dad, and two uncles in short order. What a struggle, and if I'm not mistaken, you were also in the middle of having children too. Squashed in the middle of life events and lived to tell about it, that's resilience.

KGMom: I'll bet there is a correlation, but up until now, I'd never even heard of complicated vs. un- in the grief dept. I honestly don't know how people survive a sudden, unexpected death of a loved one.

Mauigirl said...


I agree, I would think an unexpected death would be the harder one to get over; too much is left unsaid or not worked out.