The Body Is Always in the Present Moment

Reimagine has been holding free virtual gatherings since March 2020 — thousands of them now — and a good number have circled the same question from different directions: what is grief, actually, and where does it live? On Thursday morning we put that question to someone who has spent a career answering it with data.

Dr. Mary-Frances O'Connor is a professor of psychology at the University of Arizona, where she directs the Grief, Loss and Social Stress Lab. She joined us to celebrate the paperback release of The Grieving Body: How the Stress of Loss Can Be an Opportunity for Healing, alongside two friends whose own bodies have kept the record: Hope Edelman, whose Motherless Daughters named an experience that had gone unnamed for a generation, and Lizzie Pickering, a grief educator in the UK and the author of When Grief Equals Love.

The question the hour asked was not whether grief hurts. It was what your body is doing about it while you are busy thinking about something else.

This is what unfolded.

The Handbrakes That Aren't There

Mary-Frances began by reading the opening pages of her book aloud — the metaphor she says her readers and Lizzie's clients reach for most often.

Imagine cycling down a tree-lined street, approaching an intersection, reaching for the handbrakes. There are no brakes there. Only bare handlebar. Your heart rate climbs, your muscles tense, the intersection keeps coming — and then you remember this is a beach cruiser with coaster brakes, and you pedal backwards, and you stop. The crisis lasts a second and a half. Your heart pounds for a while afterwards anyway.

"The key to this metaphor," she said, "is that it is the absence of something, something built into the way we naturally operate in the world, that causes our body to react."

That is the whole argument, in one image. Grief is not only the presence of pain. It is the shape of a person who is no longer where your body has learned to expect them. "Our loved one is built into every action we take," Mary-Frances said, "and how we function in the world." You reach for the phone. You turn to say something to the empty side of the room. "When they are not there, our grieving body reacts" — and it reacts whether or not you consciously register the moment as anything at all.

It is a gentle metaphor for a hard finding, and it does something useful: it moves the conversation off the question of whether you are grieving correctly and onto the question of what is happening in you, dozens of times a day, below the level of noticing.

Twenty-One Times

Then she gave us the number.

"The cold statistic is that on the day that a loved one dies, we are 21 times more likely to have a heart attack than any other day of our life." The finding is Elizabeth Mostofsky's, published in Circulation — the kind of result that turns a poetic idea into an epidemiological one. Dying of a broken heart, Mary-Frances noted, is something art and poetry have described since time immemorial. What is new is that academic medicine can now put it in black and white.

And the risk does not stop at bereavement. "It isn't only in bereavement that we have this medically risky period," she said. "Losses of other types affect us as well." Divorce. Diagnosis. A job. A home.

Her framing of the task, which became a kind of refrain for the hour: what can we do to support the grieving body, to support heartache, but prevent heartbreak?

The Grief You Postpone Does Not Wait

Hope Edelman answered that question the hard way.

She was seventeen when her mother died, and her body responded with stomach pains no doctor could explain. She could barely eat for six weeks. Years later she understood: her mother's cancer had spread to her liver, and her stomach had swollen with fluid. Hope's body had been telling the story her language could not yet get to.

Decades on, in 2020, a separation arrived three weeks before lockdown. She was grieving alone, selling a house she had lived in for twenty-three years, sending a daughter to college, watching her furniture leave through the front door. So she did what capable people do. "I put all my focus into that," she said, "because I thought, I know how to do this, I can compartmentalize. I can get to the grief part later, except my body didn't agree."

She woke one morning with a strange feeling in her chest and a tingling arm and assumed it was COVID, or a pinched nerve from a long run. She worked. She did a phone interview. She set off on a ninety-minute drive, stopped for coffee with a friend, and had an arrhythmia at the table — and then remembered something her eighteen-year-old daughter had said after reading Caroline Criado Perez's Invisible Women: heart attacks in women do not look like heart attacks in men, and here are the symptoms.

She drove herself to urgent care. The nurse ran out of the room and the doctor ran in. It was a coronary spasm — not a blocked artery, not broken heart syndrome, but the muscle squeezing the vessel from outside. There are four known causes. Cold weather, diabetes, smoking, and stress. It was May, and she had none of the first three.

Mary-Frances, who has heard this story many times, kept returning to one detail: Hope believed herself. "You said, something is wrong inside," she said. That belief is what got her off the highway and into a building with an EKG in it.

Hope's own lesson was blunter. She had lost a close family member the week before our event and was freshly back from the memorial, and she said she now knows to take things off her calendar and off her plate. "There isn't anything that is more important than my health, even though I might think work is, or caring for others is." The body, she said, "is not always on that schedule."

Breathing in Sync

Lizzie Pickering's son Harry was diagnosed with spinal muscular atrophy at seventeen months, when her second child was six weeks old. She left a career in television to become his full-time carer. He died at six and a half, of pneumonia, after a year in which his lungs had been failing.

What she noticed, as he was dying, was her own breath.

"As Harry was dying, I noticed that my breathing was becoming more shallow. I was breathing in sync with him. And he, of course, stopped breathing. And I honestly think that in some ways, I stopped breathing at that point, too."

She did not breathe fully again for months. Possibly years. In the meantime she did everything right, by the usual measure of it: she supported her two surviving children through their grief, went back to work at the children's hospice where Harry died, co-founded its fundraising team, and wept at night once the house was quiet. "I was thriving, in a way," she said. "I was grieving fully."

And for four years running, she had pneumonia. The same illness that took her son. Round after round of antibiotics that often would not clear it.

This is the part where the science catches up with the story. Mary-Frances explained what had puzzled her early on: it is not just the heart. The data shows all-cause mortality rising after a bereavement, every organ system implicated, which does not obviously make sense — until you look at the immune system, which touches all of them. Immune cells themselves change. The body's balance between fighting viruses and fighting bacteria shifts. People become measurably more likely to die of flu, of pneumonia, of sepsis in the months and years after a death.

Lizzie's story opens Chapter 2 of The Grieving Body, the chapter about the immune system. She told it to Mary-Frances years before the book existed.

Twenty-five years on, she does yoga five mornings a week and box breathing daily, and she still carries a reflux problem from a valve she burst during those pneumonias. "So much grief," she said, "is stored in the throat, and the lungs, and the heart, and the guts."

Connection, Not Closure

Both stories bend toward the same place, and Mary-Frances named it directly: "We need each other. We need each other."

She meant it physiologically. "The best way to survive a heart attack is to have someone else there." Not the most comforting way. The most effective one.

Lizzie found the same thing from the other side. Returning to the hospice put her among other grieving parents, and it was there she encountered the idea that reorganised her understanding of the whole thing: continuing bonds. "Connection is more important than closure," she said. "And vital, in fact." Harry's photographs are up in her house. Her friends are introduced as Harry's godmother. He did not get resolved; he got carried.

Mary-Frances put the two ideas together at the end of Lizzie's story — that carrying our loved ones forward is exactly what requires us to look after the body doing the carrying.

What Rest Actually Does

Then Lizzie stopped the conversation and asked a few hundred people to close their eyes.

She walked us down through the body — ankles, knees, pelvis, gut, lungs, heart, throat — asking where we were holding it. Then three rounds of box breathing, counted aloud, four in, four held, four out, four held. It took about three minutes. It was, by some distance, the most concrete thing that happened all hour.

Mary-Frances had the research to explain why it worked. In her own lab, a graduate student — Lindsay Knowles, now a psychologist at the University of Washington — ran a controlled trial with a hundred widowed people, comparing mindfulness meditation against progressive muscle relaxation. Mindfulness was the intervention they expected to win. Relaxation was the control condition.

Relaxation worked faster, and by the end of six weeks people's grief had eased more. Mindfulness helped too. But the mind, as Mary-Frances pointed out, is extremely busy when you are grieving — the fog, the looping, the thoughts. What participants told them was that there was something grounding about having a skill you could use sitting at a stoplight.

"I value rest," she said. "And valuing rest, that means I have to do it. If you value something, you have to engage in it."

She also told us where the science simply stops. Crying is the most common — though not universal — response to grief, and there are, in her words, "zero scientific studies about crying during grieving. There are no studies." What we know comes from crying research done on people who are not bereaved: that the tears you produce chopping an onion have a different hormonal content than the tears you produce watching a sad film, and that the second kind carry prolactin, which stimulates oxytocin — the hormones of attachment, of nursing an infant, of falling in love. She is trying to close that gap; a grant application is in with the University of Southampton as we write this.

Which is a fitting place for an hour like this to land. The most ordinary thing a grieving person does has never once been studied in a grieving person.

Brad Wolfe closed the way he likes to close, by getting everyone's voice into the room. It turns out there is exactly one word that sounds good when a few hundred people say it at once over Zoom, and on the count of three we all unmuted and said it, as many times as felt good.

Mary-Frances's last word on the body was that it is "really the container that holds us, so we can get through, so that we can grow around this loss that has happened. Not because the grief goes away."

The Grieving Body is out in paperback now.