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your brain on grief: loss feels like a threat to survival

a year after their loved ones died alone, family members kept out of hospitals because of covid protocols are still 'emotionally broken.'

by vanessa hrvatin

jun 24 2021

5 minute read

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the science of grief and loss and how it impacts the brain

a look at the neuroscience of grief and losing a loved one. getty

the list of what’s been lost since coronavirus swept the globe is seemingly endless — jobs, human connection, lives — each accompanied by grief. for many, losing a loved one over the course of the last 14 months has been especially challenging, with safety measures resulting in countless people dying alone, and family left behind, unable to partake in rituals and end of life celebrations.

healthing.ca spoke to several experts about the social, psychological and neurological science behind grief and how the ways we mourn has been impacted by the pandemic.

our brain and grief
dr. lisa shulman is no stranger to grief. a neurologist at the maryland school of medicine, she lost her husband to cancer in 2012 and later wrote the book, before and after loss: a neurologist’s perspective on loss, grief, and our brain.

shulman says the brain perceives the loss of a loved one as a threat to survival, triggering a stress response known as fight or flight and strengthening the fear centre of the brain. at the same time, connections between this part of the brain and the advanced brain —which is responsible for logic and reasoning — become weakened. in other words, the fear centre of our brain takes over.

“this explains a lot of people’s experiences after a terrible loss, when there are all sorts of triggers that simply unravel your composure, such as seeing a photo of a loved one or going to a place where you had a special experience together,” says shulman. the [fear centre of the brain] maintains control over your life, sending you off into what people call waves of grief.”

the brain can get “stuck” in this state of stress response, which means someone suffering a loss must find ways to promote healthy rewiring of brain cells so the fear centre no longer has full control. schulman says there are many ways of doing this, including journaling, faith-based practices and meditation.

“it’s so important and valuable to think about how the brain responds to loss because it’s a very scary, overwhelming and isolating experience,” says shulman. “but i have found from speaking to many groups of people that everyone has more similar experiences than different and knowing this is reassuring and even therapeutic.”

getting through grief
historically, there was a notion that people grieved in five stages — denial, anger, bargaining, depression and acceptance. but over time, it’s become clear that we actually grieve in our own way at our own pace.

according to psychologist dr. stephen fleming, the idea of having five distinct stages of grief is simply an attempt to boil the grieving process down to diagnosable components. instead, he says there are several factors that affect how a person might deal with the death of a loved one.

most important is the question of who died. fleming says a person will grieve differently for a death out of time, such as the death of a child. cause of death is also important — the dynamics around an anticipated death from cancer, for example, are different than death from a car accident.

existing support networks, other life stressors and a person’s typical coping mechanisms all affect the ways in which they grieve. in the face of a pandemic, grieving can become much more complicated, with fewer people to lean on for support and more daily stressors.

“there isn’t a stone left unturned either physically or mentally in which grieving can be much more difficult in the time of a pandemic,” says fleming.

anticipating loss
the way a person grieves in the aftermath of an expected death is often very different than a sudden death, says psychiatrist dr. harvey chochinov. knowing death is looming provides the opportunity to begin the process of grieving and mourning before the person has died.

“often if there’s been a long period of anticipatory grief, the person may not have the same kind of profound shock in terms of the aftermath and their period of mourning may even be truncated,” he says.

anticipating death is a chance to get affairs in order and allows loved ones the chance to say what needs to be said, which chochinov refers to as, “the path of least regret.” these opportunities are lost when someone dies suddenly and often complicates or even prolongs the grieving process post death.

saying goodbye
there have been countless stories of people dying alone throughout the pandemic. chochinov says research has shown an association between not being able to say goodbye to a dying loved one and complicated grief, which is a chronic and impairing form of grief where a person might alienate themselves form others and have extreme difficulty accepting a death.

in his own practice, chochinov has seen family members kept out of hospitals and nursing homes because of safety protocols, forced to let their loved ones die alone. a year later, he describes them as still being “emotionally broken.”

research has also shown that a person dying alone is more likely to feel emotional distress as they near the end of their life.

“our team did a study several years ago where we looked at dying patients and their desire for death, will to live and depression, as well as the availability of family,” he says. “what we found was people who perceived their families as being less available and less supportive were significantly more likely to have a desire for death.”

after death
in the time immediately following a person’s death, those left behind attempt to view the world as a new place, one where their loved one no longer exists. according to dr. heather boynton, the pandemic has made this process much more difficult and puts people at higher risk of complicated grief.

“if you can’t go through the rituals and grieving process, it makes it harder for you to make sense of the death and what’s going on,” says boynton, an associate professor of social work at the university of calgary. “we have to understand our new world without that person in it, so the grieving process which includes rituals and traditions help with that transition and right now we can’t do any of that.”

and as we come out on the other side of this pandemic, experts fear what might be waiting for us: countless people sitting with their grief, struggling to process a variety of losses including the death of loved ones.

“as big as covid is, the problem of death, dying and grief and the ways in which it’s being affected by the pandemic go far beyond just those people who are dying of covid,” says chochinov. “each and every death has been shaped by the pandemic in some way and each and every death in terms of rituals and mourning has been tainted in some way by the pandemic.”

this story is part of healthing.ca’s series on grief. read why are people dying alone in our hospitals which explores hospital policies around death during the pandemic, and a psychotherapist’s guide to surviving grief, an interview with expert andrea harnick on her advice for surviving loss.

your brain on grief: loss feels like a threat to survival

a year after their loved ones died alone, family members kept out of hospitals because of covid protocols are still 'emotionally broken.'

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your brain on grief: loss feels like a threat to survival

a year after their loved ones died alone, family members kept out of hospitals because of covid protocols are still 'emotionally broken.'

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