What Neuroscience Teaches Us About Loss and Healing

Grief is something most of us will experience. It’s not a linear timeline or a set of neat emotional stages. Instead, it is a process that profoundly reshapes the brain’s perception of reality. According to Dr. Mary-Frances O’Connor, a neuroscientist, clinical psychologist, and author of The Grieving Brain, grief is a neurobiological event that reflects how our minds struggle to integrate loss into our internal model of the world.

In an interview on the APA’s Speaking of Psychology podcast, Dr. O’Connor explains how grief operates at the intersection of attachment, memory, emotion, and culture. She explores how bereavement is not just a personal experience, but a public health concern, especially for historically marginalized groups who disproportionately face early and frequent losses.

For neuroscience professionals, clinicians, educators, and advocates, her work provides crucial insight into how grief manifests not just emotionally, but neurologically, and what that means for how we support grieving individuals and communities.

The Distinction between Grief vs. Grieving

One of Dr. O’Connor’s core contributions to grief research is her distinction between grief and grieving, two terms often used interchangeably, but which she says represent fundamentally different processes.

Grief is an acute state. The pain, yearning, and mental protest we feel in the wake of a death.

Grieving, by contrast, is the ongoing, adaptive process through which the brain begins to update its internal model of the world, one that no longer includes the physical presence of a loved one.

Our brain develops internal working models,” O’Connor explains, “not just of what the world is like, but also of who our loved ones are and how we stay connected to them.

These models are powerful; even when someone isn’t physically with us, we know they’ll be back. We rely on predictability, not presence. This is why, in early grief, people report still expecting their loved one to walk through the door, or find themselves picking up the phone instinctively.

This discrepancy between what we know intellectually and what the brain expects emotionally is what makes grief so disorienting. The grieving brain has to learn, slowly and painfully, that the model no longer applies.

Neuroimaging studies confirm this. When grieving individuals are shown images of their deceased loved one, regions of the brain associated with reward, memory, and attachment, such as the nucleus accumbens and the anterior cingulate cortex, light up. In other words, the brain continues to search for the person, even when they’re gone.

Ambiguous Loss and Prolonged Grieving

Dr. O’Connor highlights how certain circumstances make grieving more complex. In cases of ambiguous loss, such as a missing person, an absence of a funeral, or sudden, unexplained death, the grieving process is delayed or complicated. The brain lacks the cues it relies on to “close the loop.”

This causes a kind of psychological vertigo,” she explains. “If you never saw a body, never attended a service, never had a space to say goodbye, then the grieving process lacks an anchor.

It’s not that the pain is greater, it’s that the recalibration takes longer, and the emotional disorientation is more severe.

These nuances are especially relevant in the wake of the COVID-19 pandemic, natural disasters, ongoing genocides, and forced displacement, where traditional mourning practices may be inaccessible.

Parasocial Grief

One surprising thread in the conversation was Dr. O’Connor’s exploration of parasocial grief, the profound sense of loss some people experience when a celebrity or public figure passes away. Though there’s no two-way relationship, these figures often serve as emotional mirrors or anchors during key stages of our development.

When an artist puts words to something you’ve felt but couldn’t express, that creates a bond,” she explains. “So when they die, it can feel like a part of you has died, too, often a version of yourself tied to that music, show, or time in your life.

Research supports this phenomenon. The brain doesn’t distinguish sharply between real and imagined relationships when it comes to emotional impact. Our limbic system, particularly the amygdala and ventromedial prefrontal cortex, responds to the felt experience of connection, regardless of reciprocity.

This kind of grief is often dismissed or misunderstood, but it’s very real and reflects how the brain encodes emotional attachments.

Bereavement as a Health Disparity

Perhaps the most urgent part of Dr. O’Connor’s message is that grief is not just a psychological state, it’s a health equity issue.

We talk about mortality disparities across racial and ethnic groups,” she says, “but we don’t often talk about the bereavement disparities that result from them.

For example, during COVID-19, Black children in the U.S. were more than twice as likely to lose a caregiver, and American Indian children were over four times as likely, compared to their white peers.

The consequences are long-term. Childhood bereavement is linked to poor academic performance, higher rates of depression and anxiety, and increased risk of substance use and suicidality. Without culturally responsive, trauma-informed support systems in place, those effects can compound over generations.

That’s why Dr. O’Connor is calling for grief to be treated as a public health priority, especially in underserved communities.

“We need more school-based counseling, more community-informed grief apps, and more public education,” she says. “Support needs to be equitable and accessible.”

How to Help

A recurring theme in the conversation was how often people feel unsure about how to support someone who is grieving.

Our cultural instinct, O’Connor notes, is to “cheer them up,” to try to distract, fix, or lighten the mood. But this often backfires.

"Trying to get someone to ‘feel better’ can make them feel more alienated,” she explains. “You’re essentially denying the reality of what they’re experiencing."

Instead, she advocates for a model of presence and companionship.

“Ask them: Do you want to talk? Do you want to do something normal? Or do you want to just sit here in silence? Let them guide what support looks like.”

She shares a personal example of a friend who lashed out in anger months after losing a parent. Others were confused by his behavior, until she reminded them of his grief.

“A little extra compassion goes a long way.”

Even professionals who are trained in grief work make mistakes, she says. The key is humility, flexibility, and a willingness to repair.

Longitudinal Neuroimaging of Grieving

Much of O’Connor’s research uses functional MRI (fMRI) to study how the brain responds to grief. Participants are shown photos of their loved one while in the scanner and compared to neutral or stranger images.

These studies have taught us much about the brain’s attachment system, but there’s still work to do. Most grief imaging studies are cross-sectional, meaning they only capture a single moment in time.

What we need, O’Connor says, are longitudinal studies that scan the same individuals at intervals over time, 3 months, 6 months, 1 year. This would help us understand how grief evolves neurologically and what factors contribute to healthy adaptation versus prolonged grief disorder.

This data could inform treatment development, from cognitive-behavioral therapy to medication to culturally adapted grief interventions.

For Clinicians, Policymakers, and the Public

Dr. O’Connor’s work sits at the crossroads of neuroscience, psychology, public health, and social justice. It challenges us to rethink grief not as a temporary emotional state to “get over,” but as a deeply human, and deeply neurological, process of adaptation.

For those in neuroscience and mental health advocacy, the implications are clear. Grief is not pathology, but it can become one without support. Healing isn’t linear, it’s an internal rewiring. Support must be personalized, cultural, and patient. And health equity includes bereavement equity.

As O’Connor concludes, “We need to start asking not just what grief is, but how we can show up better for those going through it.”

The full interview and transcript can be accessed on APA.org at https://www.apa.org/news/podcasts/speaking-of-psychology/grieving-changes-brain