A TERRIBLE-BEAUTIFUL ADVENTURE

Brain & Body in Grief
A Companion to Twice Widowed

In the darkest corner of the room, I tried to keep him from prying eyes. We slow danced to the music at the reception. But I couldn't hide the fact that he was half-dead. His skin was peeling off him in chunks. There was no disguising it. I was frightened they'd take him from me. I wanted him, no matter his condition. He was there and dead at the same time. I didn't care.

That was a recurring dream after the death of my first husband, Jeff. I knew Jeff had died. There was no uncertainty about the fact. Yet in my dreams, I was still trying desperately to keep him with me. The dreams continued until I went to the site of the accident where Jeff died. I stood there and encountered the reality of his death in a way I had not before. After that, the dreams stopped.

Years later, after my second husband, Darrell, died, I could know he was gone and still instinctively reach for my phone to tell him something. I knew. And some part of me still expected.

It was a curiosity to me. How could I know something so completely and still have some part of me behave as though that knowledge had not entirely arrived?

The World the Brain Learned

In the first piece, I introduced widow brain because having a name for some of what was happening helped me. What I later learned was more comprehensive than brain fog, forgetfulness, or difficulty concentrating. Grief was not happening only in my thoughts and emotions. My brain and body were responding to a world that had suddenly changed.

When we live with someone, the brain learns that person as part of ordinary life: a voice, footsteps, the place they sit, the sound of the door, the response we expect when we tell a story, the person we turn toward when something happens. We do not deliberately memorize all of this. We live it.

“Our loved ones exist in long-term memory, but there are different kinds of memory. Episodic, semantic, and implicit memory are inter-related but serve different functions, entail different brain systems, and have different properties. Close attachments are mapped in each of these systems, so each must be updated when a loved one dies.”¹

Knowing someone is gone and living in the world changed by that absence are not quite the same thing. Memories and expectations take time to update. The brain has spent years learning a world in which this person is present. Knowing the person has died does not instantly revise all of that learning. The brain needs time and experience in the new world to do that.

I used to dislike people telling me that time was my friend. It sounded like one more way of saying I'd be fine without him. But in this particular sense, time gives the brain something it needs: new experience. The empty chair. The morning they are still not there. The first time we go somewhere without them, and then another. Gradually, the brain has more information with which to update the world it learned.

That does not mean time erases love or memory. It means memory and expectation can change as the brain encounters the changed world again and again. The memory remains. The immediate sense of threat can change.

So breathe. Your brain does not have to understand this new world all at once.

When Capacity Changes

Some of what I was experiencing felt like dysfunction. I could accomplish something difficult one day and find something ordinary nearly impossible the next. When I didn't understand those changes, they could become accusations: What is wrong with me? Why can't I do this? Am I losing my mind?

The stress response is one of the ways the brain and body mobilize resources when something demands attention or action. Research shows that intense or prolonged stress can affect sleep, concentration, energy, cardiovascular functioning, inflammation, immune functioning, and other systems throughout the body.

The prefrontal cortex helps with attention, working memory, decision-making, and organizing thought. Stress can interfere with those functions.

“Even a mild stressor, if you feel out of control about it, initiates a series of chemical reactions that immediately weakens prefrontal connections.”²

My history of being capable was real. This reduced capacity was real too. Instead of being as scary as it was at first, I began to understand that it could make sense in the context of what my brain and body were carrying.

My body wasn't failing a test my former self could have passed. Some of what felt like shutting down could be part of a brain and body responding to extraordinary stress.

The Brain Keeps Learning

The brain's capacity to change in response to experience is called neuroplasticity. Stress, vigilance, uncertainty, safety, rest, movement, music, creativity, connection, and ordinary daily life are all experiences that can affect the way the brain makes and strengthens connections.

This is part of why the brain needs new experiences after loss. It has learned a world in which the person you love is present. Their absence can register again and again as something wrong - something the brain needs to notice. The new gives it information with which to update what it has learned.

The empty chair is still empty. You wake another morning and they are not there. You go somewhere without them and return home. You hear the song and survive hearing it. You laugh at something. You sleep. You eat. Someone sits beside you. None of these experiences replaces the person who died. They become part of what the brain now knows about the world in which you are living.

The brain has to keep encountering a world that no longer matches the one it learned. Over time, those encounters give it information with which to revise its expectations. At the same time, the brain and body's stress systems do not necessarily remain on the same level of alert.

The body needs support while this learning is taking place too. Sleep, nourishment, movement, medical care when it is needed, and periods of reduced demand can support a brain and body already doing an enormous amount of work.

Some Things You May Recognize

• Memory and concentration changes. Losing words, forgetting why you walked into a room, or finding decisions unusually difficult can occur when attention and other resources are under extraordinary demand.
• Reduced capacity - or surprising bursts of it. The stress response can mobilize resources when they are needed. Exhaustion or collapse afterward can be just as real.
• Changes in sleep or dreams. Falling asleep, staying asleep, dreaming, and waking can all be affected, and disrupted sleep can influence memory, concentration, mood, and energy.
• Watchfulness or a heightened sense of threat. A brain responding to profound disruption may remain alert even when you do not consciously believe you are in danger.
• Expecting the person who died. Reaching for the phone, listening for a familiar sound, or momentarily expecting them in their usual place can make sense when the brain has spent years learning a world in which they are there.
• Physical changes. Grief and prolonged stress can affect the body as well as the mind. Something new, severe, persistent, or concerning deserves medical attention rather than being assumed to be grief.

What Knowing Changed for Me

I was widowed first in my twenties and again in my fifties. My first experience could not become a template for the second. I was not the same woman. Age made a difference. Being a caretaker for my second husband made a difference. Financial burdens made a difference. The life I brought to this grief was different, and so was the body carrying it.

We bring to grief not only a soul in flux, but a body in flux.

Learning some of this helped me stop being quite so frightened. I wasn't imagining the symptoms. They were real. But real did not necessarily mean abnormal, and I did not have to make every one of them mean something terrible about me.

Instead of always asking, What is wrong with me? I could sometimes ask a different question: What has my brain and body been carrying? Understanding a little more about what grief can ask of the brain and body can offer another way to meet what is happening inside you.

As we move through my story, you will see some of this happening in my own life. You may recognize some of it in yours.

A Quiet Truth to Carry

Further Reading

• Lisa M. Shulman, Before and After Loss: A Neurologist's Perspective on Loss, Grief, and Our Brain.
• Mary-Frances O'Connor, The Grieving Brain: The Surprising Science of How We Learn from Love and Loss.
• M. Katherine Shear, “Grief and mourning gone awry: pathway and course of complicated grief,” Dialogues in Clinical Neuroscience 14, no. 2 (2012): 119-128.
• Amy F. T. Arnsten and colleagues, research on stress and the prefrontal cortex; see Yale's accessible summaries of this work.
• For readers who want to go deeper, the research behind this companion also draws from work on bereavement physiology and health, caregiving and stress, sleep, neuroplasticity, music, movement, and creative experience.

Source Notes

1. M. Katherine Shear, “Grief and mourning gone awry: pathway and course of complicated grief,” Dialogues in Clinical Neuroscience 14, no. 2 (2012): 119-128.

2. Amy Arnsten, quoted in Brita Belli, “Yale researchers size up the mental health toll of the pandemic,” Yale News, April 12, 2021.