Grieving is a learning process driven by the conflict between the explicit knowledge of death and the implicit attachment belief that the loved one is everlasting; yearning is fueled by dopamine in the nucleus accumbens, not by pleasure but by wanting.
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Bereavement carries extreme physical risk: the day a loved one dies, heart attack risk is 21x higher, and for widowers, the risk of a fatal heart attack nearly doubles in the first three months. O'Connor's lab gave low-dose aspirin and found it cardioprotective, advocating for a public health model akin to prenatal care.
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O'Connor's research found progressive muscle relaxation was more effective than mindfulness at reducing grief, likely because the grieving brain is already taxed with learning, and the somatic tool directly reduces hyperarousal linked to protest.
4
Healthy grieving involves oscillating between confronting the loss (protest/despair) and restoring life; avoidance prolongs suffering, and rituals (wakes, community support) help people navigate the physical and emotional transformation.
Protocols
Concrete recipes — what, when, how much, and why
4 items
Progressive Muscle Relaxation for Grief
WhatSystematically tense and then relax muscle groups from head to toe, paying attention to the contrast between tension and relaxation, to reduce the physiological hyperarousal of grief.
WhenCan be practiced with a guided audio session of 10-15 minutes when alone; the skill can then be used briefly in daily life whenever grief intensity spikes (e.g., at work, in a store, before sleep).
DoseTypically 10-15 minute guided sessions; in-the-moment use of tensing/releasing specific muscles as needed.
For whomAnyone experiencing the 'amped-up' protest phase of grief, especially those who find seated meditation difficult or who are cognitively overwhelmed.
WhyIn O'Connor's controlled study, PMR led to greater reductions in grief severity than mindfulness training. Grieving is a learning process that already taxes cognitive resources; PMR directly targets the body's protest hyperarousal without requiring the focus that mindfulness demands, making it a more accessible tool.
CaveatsNot a substitute for professional therapy if grief is worsening over time; it's a coping tool. People with physical injuries should adapt movements.
O'Connor's study with widows/widowers compared PMR, mindfulness, and a wait-list. PMR outperformed mindfulness, surprising the team. She explains grieving is 'a form of learning' that keeps the brain busy; thus, a simpler somatic method avoids adding cognitive load. Participants reported using the skill spontaneously: 'I'm in the grocery store... I can use this tool now to help my body get into a different state, and that helps my grief.' The technique is essentially a body scan with intentional tension-release, teaching the person to recognize and release hidden muscle tension linked to grief.
Mechanism
Voluntary muscle contraction followed by relaxation increases awareness of muscle tension and triggers parasympathetic nervous system activation, counteracting the sympathetic arousal (cortisol, adrenaline) of protest. This helps the body re-regulate its cardiovascular and emotional state without the external presence of the loved one, reducing the physical toll of waves of grief.
We did an intervention study... Turns out, mindfulness training was helpful, but progressive muscle relaxation was even more helpful for people's grief.
Also said
“People told us in any situation, I'm in the grocery store, I'm in a work meeting, I'm trying to fall asleep, can use this tool now to help my body to get into a different state, and that helps my grief.”— Highlights real-world, moment-to-moment utility.
Low-Dose Aspirin for Cardiovascular Protection in Early Bereavement (Under Investigation)
WhatTaking a baby aspirin (81 mg) daily for the first two weeks after the death of a loved one, under medical supervision, to reduce the sharply elevated risk of heart attack.
WhenWithin the first two weeks post-loss.
Dose81 mg daily (as used in the proof-of-concept study). Not a medical recommendation; requires further clinical trials.
For whomPotentially newly bereaved individuals, particularly those with existing cardiovascular risk factors, but only after consulting a physician.
WhyThe day of a loved one's death carries a 21-fold increased heart attack risk, and fatal heart attack risk doubles for widowers in the first 3 months. O'Connor's pilot study found aspirin was cardioprotective.
CaveatsThis was a proof-of-concept study, not a randomized controlled trial; it is not medical advice. Aspirin can cause bleeding and other side effects. Must be discussed with a healthcare provider.
O'Connor highlights the massive epidemiological data: '21 times more likely to have a heart attack on the day of death.' Her team then tested aspirin in a small study. She argues for a public health model of bereavement where the person standing next to the deceased becomes a patient, with blood pressure monitoring and cardiovascular risk management, akin to prenatal care. While aspirin is promising, larger trials are needed to confirm safety and efficacy.
Mechanism
Aspirin inhibits platelet aggregation, reducing the formation of blood clots that can trigger myocardial infarction during periods of extreme stress and autonomic dysregulation following loss.
So, we gave aspirin, a baby aspirin to people in the first two weeks after the death of their loved one, and looked at whether that was cardioprotective, which of course, it was because, we understand how aspirin works.
Also said
“We know that for example, the day that a loved one dies, you are 21 times more likely to have a heart attack than any other day of your life.”— Underlines the medical urgency.
Dual Process Oscillation (Loss vs. Restoration)
WhatIntentionally alternate between engaging with grief emotions (loss orientation) and attending to practical life tasks and new connections (restoration orientation). Do not avoid one side, but also don't stay stuck in either.
WhenDaily life; for example, schedule time to look at photos or cry, then force yourself to handle finances or meet a friend. Over time, the capacity to oscillate becomes more natural.
DoseNo fixed duration; the goal is to develop flexibility. Initially, deliberately set aside time for each, perhaps a few hours for loss-focused activity and then a restoration task.
For whomAnyone grieving, especially those who feel guilty about experiencing joy or those who avoid all reminders.
WhyOscillation is the hallmark of mental health in grief. The dual process model shows that people who can move back and forth between confronting the loss and rebuilding life adapt better and feel less stuck.
CaveatsThe first attempts will be painful; expecting it to 'suck' helps. Avoidance will prolong the process. If unable to shift at all, professional help may be needed.
O'Connor shared the story of an older widower who cried when talking about his wife's death but also happily discussed dating again, saying 'it was really good then, and it's really good now.' She emphasizes that the ability to oscillate is a sign of health, not that grief goes away. Avoidance (e.g., not driving by the hospital, not opening the closet) makes adaptation harder. The brain must learn to experience the wave and then re-engage. She advises doing the actions first, even without motivation, and the feelings will follow.
Mechanism
The loss orientation allows the brain to process the absence and update the mental model, while restoration orientation builds new competencies and relationships, adjusting the attachment hierarchy. Oscillation prevents chronic hyperarousal from constant protest and also prevents the lethargy of despair from becoming a permanent withdrawal. This process utilizes the brain's capacity to toggle between circuits—go and no-go—leading to integration rather than mere recovery.
Personal experience
The older man's story: 'He told me that he had fallen in love with his high school sweetheart... it was really good then, and it's really good now.'
The capacity to oscillate back and forth between dealing with the loss of this loved person and restoring a meaningful life, being able to go back and forth is actually the sign of health.
Also said
“We call it the dual process model of bereavement. And the idea is that when people can have the loss feelings, thoughts, behaviors, barely can make cereal, and also can have the restoration stressors they have to deal with... the capacity to oscillate... is actually the sign of health.”— Defines the model clearly.
“I will tell you, it's going to suck. She is going to feel awful... And then when she does it again, it's still going to suck. But maybe she also has a conversation with her friend about a book... And then there's this slow, upward spiral.”— Realistic description of how repeated approach leads to gradual improvement.
Maintaining an Internal Relationship with the Deceased
WhatContinue a mental dialogue with the deceased, such as talking to them about your day, seeking their imagined advice, or telling them 'This one's for you.' Use this to carry forward their values and work through unfinished emotional business.
WhenWhenever you feel the yearning or find yourself thinking of them; can be done intentionally, e.g., at night or during a quiet moment, or spontaneously when reminded of them.
DoseNo prescription; it's a flexible practice. Can be woven into daily life.
For whomPeople who feel they must 'let go' and struggle with guilt, or those who want to maintain a continuing bond.
WhyThe attachment neurobiology makes the loved one 'everlasting' in the brain. Engaging the internal representation helps satisfy the homeostatic need for connection without the futile physical search, and allows the relationship to evolve. This reduces guilt about moving forward and enriches meaning.
CaveatsIf this becomes a form of protest that prevents forming new relationships or attending to current life, it may need adjustment. It should complement, not replace, living connections.
O'Connor shares personal experience with her mother: looking in the mirror and saying 'I'm doing this for you, Mama,' and later forgiving her mother internally. She notes that in many cultures, intercessory prayer or Dia de los Muertos rituals serve a similar function—acknowledging the ongoing bond. She emphasizes that 'letting go' is a misleading notion; instead, we adapt by transforming the relationship. This practice helps people feel permission to experience joy without betraying the deceased. The key is that the internal relationship stays alive and can grow.
Mechanism
The loved one is deeply encoded in cortical and subcortical neural circuits formed during bonding. By consciously invoking the internal representation, you activate attachment-related circuits and may receive the calming benefit of co-regulation, even in their absence. This transforms the attachment from a physical search to a psychological one, integrating the loss without amputating the bond.
Personal experience
O'Connor's story: 'I can look in the mirror now, because I look a lot like her. I can look in the mirror now and be like, "I'm doing this for you, Mama." ... and forgive her. And doing that with the internal representation matters to how I function in my day-to-day life now.'
You can still adapt to a world where the person is gone, and that is incredibly painful. And also, they live on because they are deeply encoded in your brain. You cannot get rid of them.
Also said
“I can look in the mirror now and be like, 'I'm doing this for you, Mama.' ... doing that with the internal representation matters to how I function in my day-to-day life now.”— Illustrates personal application.
“So historically, we've had this way of understanding this internal relationship that is so real you could put it on film.”— Connects to cultural rituals.
What's new
Personal practice updates, fresh positions, predictions
6 items
grief_as_learning_attachment_conflict
Grieving is the process of learning to live with the permanent absence of an attachment figure, arising from the conflict between explicit knowledge of death and the implicit neurobiological belief that the person is everlasting, triggering waves of grief.
Why this matters: Moves beyond the stage model and grounds grief in attachment theory and neuroscience, explaining why grief keeps recurring and why logical awareness of death isn't enough.
Background
Traditional models like Kübler-Ross described grief as linear stages (denial, anger, bargaining, depression, acceptance), which became prescriptive. O'Connor offers a neurobiological framework: attachment creates an implicit 'everlasting' belief, leading to conflict when faced with absence.
Dr. O'Connor explains that attachment, developed through bonding, creates an implicit belief that 'I will always be there for you; you will always be there for me.' When a loved one dies, the correct biological response to absence in a living attachment is to search and protest. Death creates a unique circumstance where the brain struggles to reconcile two streams: the factual memory of the death and the neurobiological 'gone but also everlasting' belief. This conflict generates a wave of grief. She emphasizes that grief is not a disease but a natural response, and grieving is the way grief changes over time, akin to stock market fluctuations that show an overall trajectory. This reframes grief as an ongoing learning process, not something to 'get over.'
the attachment neurobiology means there's also this implicit belief, but maybe they're out there. And those two things, those two streams of information, they're gone, they're everlasting, can't both be true. And when we become aware, when we have that moment where we recognize those are in conflict, we have a wave of grief.
Also said
“I think of it as the gone but also everlasting theory, right? So, of course we know that they are gone... But the attachment neurobiology means there's also this implicit belief, but maybe they're out there.”— Illuminates the 'gone but also everlasting' concept that drives the conflict.
dopamine_yearning_nucleus_accumbens
Yearning in grief is correlated with activity in the nucleus accumbens, a brain region associated with wanting/reward learning. This positions grief as a homeostatic drive, akin to thirst, rather than an addiction.
Why this matters: Shows that grief taps fundamental survival circuits—yearning is not just sadness but an active wanting state. Challenges the older view that grief is simply a stressor added on top of existing burdens.
Background
Prior grief research often framed loss as an additional stressor. O'Connor's neuroimaging study showed that when bereaved individuals view photos of their deceased loved one, the nucleus accumbens (ventral striatum) activates proportionally to how much they yearn, not just in emotion or memory areas.
O'Connor describes using fMRI and presenting photos of the deceased versus a stranger. The nucleus accumbens activation was unique to yearning and to the loved one, not just any human picture. She compares yearning to thirst: if you're hiking in the desert without water, you become obsessed with finding water, which is a homeostatic drive, not an addiction. Similarly, yearning for a loved one is a basic survival need, not pathological. This reframes grief as a fundamental drive to restore a missing attachment figure, motivating the search and protest behaviors. The dopamine system encodes how much effort one would expend to regain the person, which explains the intense pining and wanting.
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.
Also said
“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.”— Makes the homeostatic thirst analogy, differentiating from addiction.
“Dopamine, I've heard it described as... really how much effort would you put in to get this thing you want... How much effort would you put in to see your loved one again?”— Links wanting to effort, deepening the neuroeconomic perspective.
progressive_muscle_relaxation_vs_mindfulness
In a study with widows/widowers, progressive muscle relaxation (PMR) was more effective than mindfulness training at reducing grief severity, likely because the grieving brain is already cognitively loaded and PMR directly addresses the bodily hyperarousal of protest.
Why this matters: Challenges the common assumption that mindfulness meditation is universally best; provides a simpler alternative that works through the body.
Background
Mindfulness-based interventions have been popular for grief. O'Connor's lab hypothesized that mindfulness would help, but a control group using PMR unexpectedly outperformed it.
O'Connor's team randomly assigned widows/widowers to mindfulness training, progressive muscle relaxation, or a wait-list control. Progressive muscle relaxation involves systematically tensing and relaxing muscle groups, paying attention to the contrast. The group doing PMR showed greater reduction in grief than the mindfulness group. O'Connor theorizes that grieving is a form of learning that requires significant cognitive effort; mindfulness, which requires sustained attention and metacognition, may be too demanding during the brain's busy attempt to learn the new reality. PMR offers a somatic route to calm the physiology without heavy cognitive demands. Participants reported using the technique in everyday situations like grocery stores or meetings to reduce tension and grief waves, providing a portable skill.
We did an intervention study... Turns out, mindfulness training was helpful, but progressive muscle relaxation was even more helpful for people's grief.
Also said
“People told us in any situation, I'm in the grocery store, I'm in a work meeting, I'm trying to fall asleep, can use this tool now to help my body to get into a different state, and that helps my grief.”— Highlights real-world utility and ease of use.
bereavement_medical_risks_cardio
The death of a loved one spikes cardiovascular risk dramatically—21x higher heart attack risk on the day of death, and a man is nearly twice as likely to die from a heart attack in the first 3 months. Grief is a physiological crisis needing medical monitoring.
Why this matters: Quantifies the 'broken heart' phenomenon and argues for treating the surviving loved one as a patient immediately, with interventions like low-dose aspirin under study.
Background
Anecdotes of people dying soon after a spouse are common, but O'Connor presents robust epidemiological data and her own study demonstrating aspirin's potential protective effect.
O'Connor references large studies showing increased all-cause mortality in newly bereaved individuals. She describes a proof-of-concept study (not a randomized trial) where they gave 81 mg aspirin to people in the first two weeks after loss and saw cardioprotection. She advocates a public health model, akin to prenatal care, where bereavement support includes physiological monitoring (blood pressure, heart health) and not just emotional support. She emphasizes that the grieving body must re-regulate without the external 'pacemaker' of the loved one, and that social support (like sitting shiva) reduces medical risk by providing external monitoring. She urges listeners to recognize that grief is a natural but risky physiological transition, and society should provide care like it does for pregnancy.
We know that for example, the day that a loved one dies, you are 21 times more likely to have a heart attack than any other day of your life. 21 times.
Also said
“In the first three months after the death of his wife, a man is nearly twice as likely to have a fatal heart attack compared to a man who remains married during that same time.”— Adds specific demographic risk.
“So, we gave aspirin, a baby aspirin to people in the first two weeks after the death of their loved one, and looked at whether that was cardioprotective, which of course, it was.”— Mention of the aspirin intervention.
protest_despair_as_adaptive_responses
Grief elicits two main responses: protest (searching, hyperarousal) and despair (withdrawal, lethargy). Both are adaptive: protest energizes to find the person, despair conserves energy when search fails and prepares for new goals. Healthy grieving requires experiencing both, not bypassing them.
Why this matters: Reframes despair not as pathology but as functional, and explains why both states are necessary for learning to adapt.
Background
John Bowlby identified protest and despair in attachment separation. O'Connor integrates this with modern neuroscience: protest activates go-circuits (dopamine, cortisol), despair involves no-go and inflammatory shifts. Grief isn't a linear stage but an oscillation between these states.
O'Connor explains that protest is the body's preparation to search—high arousal, vigilance, the sense that 'I must find them.' This is metabolically expensive. Despair, on the other hand, is the giving-up response: it stops the fruitless search, conserves resources, and enables withdrawal. She cautions that many people fear despair because it feels like permanent hopelessness. However, despair is not the end; it's a step that allows the brain to eventually generate new approaches and integrate the loss. She emphasizes that the dual process model requires moving back and forth: feeling the loss and then attending to daily life, which slowly rewires the attachment hierarchy. Without experiencing despair, one may stay stuck in protest. Tools like progressive muscle relaxation or yoga can help manage the intensity.
Protest is... 'Oh no, they're gone.' That is protest. Despair, on the other hand, despair is sitting in the living room and something arrives in the mail for your spouse and you know they are never going to open it. ... Despair has the function of stopping us from searching.
Also said
“Many people are terrified of feeling despair. Some people are terrified of feeling protest as well... Despair says, 'They are really gone and because they're never coming back, I am going to feel like this for the rest of my life.' And that's not true either.”— Addresses fear and the need to move beyond despair.
religious_belief_predicts_lower_grief
Prospective data from 'The Changing Lives of Older Couples Study' show that having a pre-existing religious or philosophical framework for understanding death predicts lower grief severity after loss, though bereavement can also challenge faith.
Why this matters: Empirical evidence that contemplating death and having meaning frameworks helps buffer grief, suggesting that cultivating such frameworks before loss may aid adaptation.
Background
Many studies look at religion post-loss. This rare 10-year prospective study allowed comparison of pre-loss beliefs and later grief outcomes, controlling for baseline.
The study enrolled couples over 65 and measured their religious beliefs and outlook on life/death before anyone was ill. When one spouse died, the grieving survivor was re-interviewed. Those who had a way of understanding the role of death in life—whether religious or philosophical—showed less severe grief afterward. O'Connor notes that while religion often provides community and meaning, it can also be challenged by loss ('How could God let this happen?'). However, having thought through existential issues beforehand appeared to provide a cognitive structure that eased the grief process. She suggests that we might benefit from contemplating death and life's meaning proactively, not just in crisis.
For those who had a way to understand these life and death type issues, it predicted less grief severity after the loss of the specific individual.
Also said
“The Changing Lives of Older Couples Study ... we look at their religious beliefs ... and then see how that predicted how they handled grief later. ... it predicted less grief severity after the loss.”— Details the study design.
Recommendations
Products, supplements, and tools mentioned in the episode
1 item
Bereavement Support Groups
Service
O'Connor advocates for a public health model of bereavement care where support groups provide psychoeducation, social connection, and a space to learn from others' grieving experiences. She notes that groups can help normalize the chaotic process and reduce isolation.
Support groups, whether secular or religiously affiliated, offer a community of people who understand what it's like to miss someone. O'Connor points out that many people lack modern grief literacy and feel adrift without structured rituals. Groups provide evidence-based information, modeling of healthy coping, and the crucial element of being 'groomed' by the group (in analogy to primates grooming a bereaved mother). She also notes that some groups may prohibit romantic relationships initially to preserve the support structure, but acknowledges that community often leads to new attachments, which can be healthy.
vs alternatives
Compared to individual therapy alone, groups add shared experience and ongoing social monitoring, which can be critical given medical risks.
Bereavement support can be incredibly helpful, to connect with others, who are going through this same process.
Also said
“I think of it this way... It is all of our jobs to groom the mourning person, to care for them, to say, 'Hey, how long has it been since you saw your doctor...'”— Uses the primate grooming analogy to emphasize community care.
O'Connor mentions her recently published book as a source of lessons on how the body responds to grief, informed by her personal experience with multiple sclerosis and her research.
DisclosureDr. O'Connor is the author.
In the book, O'Connor explores how the grieving body manifests symptoms—lump in throat, chest on fire, fatigue—and offers insights on how to work with the body during bereavement. She draws on her own journey with MS to illustrate that we don't get to choose when our body will be functional, and that grieving similarly requires flexibility and compassion.
Personal experience
She states: 'in the book that I wrote recently, 'The Grieving Body', some of these lessons have come to me because I have multiple sclerosis... learning to live in a body that I don't know when I wake up some mornings... has meant I have a lot of empathy for people who are grieving.'
In the book that I wrote recently, 'The Grieving Body', some of these lessons have come to me because I have multiple sclerosis.
Huberman promotes BetterHelp as a source of professional therapy, noting that for the ~10% who develop disordered grieving, evidence-based psychotherapy is essential to get back on a typical trajectory.
DisclosureHuberman Lab sponsor.
Throughout the discussion, O'Connor mentions that if grief symptoms worsen over time (the stock market consistently goes down), it's important to seek professional help. Huberman's endorsement of BetterHelp as a convenient, online therapy platform fits this need, allowing grievers to find a therapist for weekly support, emotional guidance, and insights.
vs alternatives
BetterHelp provides accessible therapy but may not replicate the specific bereavement support groups or in-person rituals; it's a supplement.
Personal experience
Huberman says, '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.'
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.
Also said
“BetterHelp offers professional therapy with a licensed therapist carried out entirely online.”— Describes the service.
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Educational summary of the cited expert source — not medical advice. Open the source recording linked above and consult a qualified physician before acting on any protocol.
