The Thinking Practitioner Podcast:

Episode 146: Inflammation, Touch, & the Grieving Body (with Mary-Frances O'Connor) 

Til Luchau  

Books of Discovery has been a part of the massage therapy and body work world for over 25 years. Nearly 3000 schools around the globe teach with their textbooks, e textbooks and digital resources. Books of Discovery likes to say learning adventures start here. They find that same spirit here on the thinking practitioner podcast, and they're proud to support our work, knowing we share the mission to bring the massage and bodywork community thought provoking and enlivening content that advances our profession. Instructors and manual therapy education programs can request complimentary copies of books of discoveries, textbooks for review use in their programs and listeners can explore their collection of learning resources for anatomy, pathology, kinesiology, physiology, ethics and business mastery at booksofdiscovery.com where you as thinking practitioner listeners can save 15% by entering "thinking" at checkout and yes, welcome to the Thinking Practitioner podcast, where we explore the intersection of touch, movement and the human experience I'm Til Luchau and today's conversation feels especially close to my heart after the death of my wife, Loretta a year ago, I found the work of today's guest, Dr Mary Frances O'Connor and her insights and her writing on grief, on the brain and the body, have been very meaningful and transformative in my own process. And her new book, The Grieving Body, illuminates what many of us in the body work and healing fields have known for years, that grief isn't just an emotion, it's a full body, full being, experience that has effects on our biology, our mood, our behavior and our outlook on life in general. So as body workers, we encounter grief in our clients all the time, know it or not, and we deal with it in ourselves. So the question I'm sorting through in these conversations is, how can we as practitioners better understand grief, and how can we support our clients as they navigate the physical and emotional train of loss? How do they show up in our bodies, our nervous systems and even our immune and inflammatory responses? And in today's conversation, I'll be asking Mary Frances about these questions, and we'll explore the connections between her research, hands on body work, the neurobiology of attachment and even maybe polyvagal theory. Mary Frances O'Connor, you're a neuroscientist, a psychologist and the author of the grieving brain and now the grieving body, and I'm so grateful you're joining us today. Welcome.

 

Mary-Francis O'Connor  

It's so lovely to be here til and please feel free to call me Mary Frances..

 

Til Luchau  

Thank you. as I mentioned, I came across your work as I was dealing with the loss of my wife, yeah, and your grieving brain book and some of the conversations you had say with like Lisa Kefauver and different people that are on available as podcasts, yeah, really helped me give a context for what I was experiencing mentally, yeah, yeah, the kind of confusion or forgetfulness or overwhelm, for example. And now I'm really excited about your new book, The Grieving Body, for a few reasons, personal and professional ones. And before we get into that, what would you care to share about your own connection to grieving and your route into this whole topic?

 

Mary-Francis O'Connor  

You know, there's it's a little hard to divine one's own motivations entirely. But in addition to being a curious scientist, I have had, of course, grief experiences myself and, you know, I think it was really my mother's diagnosis with breast cancer when I was 13, and then her living with breast cancer for another 13 years before she died. When I was 26 that just made me really familiar with grief and and maybe a little less afraid of it as a topic, a little less afraid of engaging with people who you know might cry uncontrollably. It's, you know, part of how it goes, and so definitely part of how it goes, Yes, right? Yeah. And so I think those experiences, my own emotional reaction, but honestly, my own physical reaction, really motivated me to stick with this as a topic for research for the last well more than two decades now.

 

Til Luchau  

Well, you you wind us into your own you wind your own story into your book, especially in the grieving body. And that really also opened up a kind of readership, kinship with you in your process, and just how the different things we face shape our interests and what we learn about. I mean, you're especially you're you're writing about attachment disruption and how, like I said, How grief affects the brain, are really meaningful. Can you help us understand how the brain responds to, like, losing a loved one, and how that might show up in the body. Yeah,

 

Mary-Francis O'Connor  

I just realized my door is open, one second. Don't want a student popping in. Okay? You know, in order to talk about grief, we first have to talk about love and bonding, because you can't really understand what you've lost unless you understand how you gained this, this we right more so more than just you know, a sense of you and a sense of me, the brain really encodes this idea that there's a We, and I think through attachment theory, we can picture, you know, in your head, I often think of, you know, like the mama bear and then the two little cubs running along behind her, as though they're attached by some invisible threads. But it turns out those threads are not invisible. They are actually physically present in the brain, and we use powerful neurochemicals like dopamine and oxytocin and cortisol to motivate us to seek out our loved ones when they're not around, and to return to them again and again, or to, you know, make as much noise as possible, so they come and find us. So those attachment tethers have to be reworked, have to be understood differently, if we can't seek out that person in the, you know, in on this earthly plane and and so the brain has a lot to do. Grieving is a learning process. How do I understand the world if part of we has been amputated, that's not the same as just me walking around in the world. That's we with a piece missing. And so the brain has a lot to do to try and learn that that person is really gone, and then what does that mean for our ongoing life? 

 

Til Luchau  

It was my lived experience that I didn't realize how much being married or being coupled was a part of my moment to moment awareness. Yeah, and the analogy after reading some of your writings was like, Okay, I lost my way home. Yeah, and I can't find it. 

 

Mary-Francis O'Connor  

That's it exactly. You have this sense that it's suddenly revealed by their absence, something that you didn't even it was seamless, right? You know, it's like asking a fish what water is that? What you know, but once it's once that person is is torn away from you, every you know, every grocery shopping trip, every time you do the laundry, every time you get into bed at night, there's something missing, and your brain has to deal with every situation, yeah,

 

Til Luchau  

and that so that every situation is it helps me again, appreciate the constant triggering or the constant agitation that

 

Mary-Francis O'Connor  

cause in me, and It's exhausting, and this is part of why we recognize that the body is so important in what we're doing. Because every time we're dealing with the remembering, the realization, again, that they're gone, there is an impact on the body, because the brain says, okay, mobilize, mobilize all your resources to deal with, you know, do I buy soy milk or not, you know, or whatever it is. And mobilizing your resources in every situation, through every day for a long time is really hard on the body,

 

Til Luchau  

yeah? Well, let's bring in inflammation, yeah, and it's involved in the vast majority of the physical symptoms we see as hands on body workers. And I turned, you know, I really dove into the inflammation rabbit hole a few years ago, when my wife was going through chemotherapy, and watching how that chemotherapy-induced inflammation really impacted her physical symptoms, but also her mood and behavior and realizing I needed to know more about it, even to work with my clients and myself, because it was so common. So how does grief relate to inflammation?

 

Mary-Francis O'Connor  

Yeah, so to just take one step back and say that inflammation is really important. It's it's really useful. It gets a bad reputation, right? Yes, but inflammation is really you can think of it as the, you know, if you have inflammation of your skin, you can actually see it right? It's red and it's hot and it's raised and it's painful, and those are the four hallmarks of inflammation. But what's causing that are these inflammatory markers that the immune system makes, and these are like little chemical messengers that send signals between immune cells. And primarily, the point is, hey, I'm dealing with this, you know, bacteria over here. I'm dealing with this virus over here, or I'm trying to clear out some dead cells in this part of the body. Could you give me a hand? Right? So these are just the chemical immune system messengers that that send out the call for more cells to come to this area. Well, that's all very well and good. When you have a bacteria or a virus or you need to clear out some dead cells, it works very well. The trouble is sometimes that those inflammatory markers are sometimes called interleukins, il six for people who are interleukin six is a very commonly known one. Sometimes the message gets turned on, but doesn't really get turned off, or it gets turned on more violently than maybe is good for the body. And so what we see from research in my own lab, and now confirmed in other larger samples of bereaved people in other labs, is that we see higher levels of inflammation in bereaved people compared to similar people who are non bereaved. And so we know that as the body is going through absorbing this blow of having the one's loved one torn away, that inflammation is part of the body's response. But what that means is that these immune signals affect every organ of the body, so if you have rheumatoid arthritis, more inflammation for you means you have achier joints. If you have asthma, more inflammation for you means it's harder to breathe, right? So at the level of sort of conscious awareness, one person says, I'm having more trouble breathing, and another person says, My joints hurt, and it's important to recognize that there could be some underlying cause that is actually similar.

 

Til Luchau  

That's great. And you're like I said, I spent about three years in this rabbit hole reading just about everything I could. And I gotta really hand it to your summary. I think your chapter, it wasn't inflammation. Was super clear, one of the clearest for you know us, lay, non scientist people, about understanding that process you just described and where it goes, yeah, and a message that is not bad. It's only a trouble when it doesn't find its way back to resolution, or when there's too much of it. Yes,

 

Mary-Francis O'Connor  

exactly, and,

 

Til Luchau  

and there can be many triggers and many effects,

 

Mary-Francis O'Connor  

yes, and and importantly, it doesn't. I mean what we know now, the reason I write about it, maybe so clearly, is that I, my postdoctoral work was in psychoneuroimmunology. So the idea of, how does the psych How do our psychological states get impacted by inflammation? And, of course, I teach about this so that that also probably helps with the clarity once you have to explain something to undergrads many times. 

 

Til Luchau  

But I am so interested in that has been, yeah, that's such an interesting dimension to this whole puzzle.

 

Mary-Francis O'Connor  

Because it turns out that inflammation, it doesn't just make us feel physically, feel things. It changes our motivation and our behavior. So the but there's a reason for this too. We think that, you know, think about the last time you had the flu, right? Even if it was long time ago, you probably remember, Oh, I felt crummy, and I just wanted to crawl into my bed, and I didn't want to see anyone, and I didn't want to go anywhere, and I didn't want to do anything, I didn't want to eat anything, I couldn't sleep properly, right? So you could just think of those as physical symptoms, or you could think about that as a shift in your motivational state, and the shift is toward what we call sickness behavior, and it enables us to withdraw and conserve our resources while we handle whatever bacteria or virus or whatever we're dealing with. And to some degree, because we socially withdraw you. It prevents us from spreading whatever we have to other human beings. And so we think that the shift in motivation can get sort of turned on and then not fully resolve. And that actually those things I describe, feeling wanting to socially withdraw, not being able to eat and sleep properly. Those all sound like a lot like depression too. And so some forms of depression we now know also are associated with higher levels of inflammation in a sort of chronic turned on kind of way,

 

Til Luchau  

and just maybe less chronic, or could be more chronic, irritability, yes, or reactivity, absolutely

 

Mary-Francis O'Connor  

right. So we think of depressed mood as meaning sad. It just always means sad. It means your mood is off. And for some people that you know, they experience that is just feeling irritable, really just frustrated and annoyed, especially with others.

 

Til Luchau  

That insight has really helped me see irritation and others and in myself in a whole different light. Yeah, it's like, okay, this is their behavioral immune system at work. There's something here that they're don't think is good for them, and they're trying to manage it

 

Mary-Francis O'Connor  

Exactly. And, you know, I think it's, it's hard with grief to kind of walk this line of explaining that when we have loss, when when something important to us is torn away, we're going to have a reaction, right? I think of this as you know, like when the toddler's mom leaves and the babysitter arrives, there's going to be a reaction. It just that is how we are wired over time. It's not so much that we're not going to continue to have a reaction. But as you know adults, we learn how to manage that reaction, we develop a whole toolkit of strategies to cope with that feeling when we're walking into a work meeting, when we're getting into bed at night, when we're at Christmas dinner, when we're you know. So it's not so much that feelings of grief go away, but they do become more familiar, and we learn how to regulate ourselves, how to seek comfort, or what soothes us in those moments, how to make sense of this story, you know, this chapter of our life story, so that we still have grief, but it it doesn't drive the car so much anymore

 

Til Luchau  

There's so many directions we could go with this, and I'm going to write a couple of them down so if we get back to them, but where in your writing you cite studies that talk about fair I'm sorry that we're calling an example right now. But how certain approaches might have a more beneficial impact on grief than others certain practices? Yeah. How do we define a beneficial impact on grief?

 

Mary-Francis O'Connor  

This is such a good question, so I think of it in a couple of ways. First of all, only the grieving person gets to decide what counts as beneficial. Now, grief is hard on relationships. You're suddenly walking through the world where you see holes in every room that you walk into. And I don't mean that in a you know that you're making it up. I mean there are holes in every room that you walk into because they are where your loved one should be. But that's not exactly the same world that everyone else is walking around in, and that can feel really isolating that they're not seeing the holds, they're not living with amputation, you know, day to day, yeah, and the disconnect can feel so isolating that the people who are grieving are having a different experience. And so knowing that grief can be hard on relationships that it can make you more irritable, more sad, more you know, it's like the the volume dial gets turned up on all the emotions. Nonetheless, it is our right and our responsibility to decide how we're going to navigate these waves of grief. So when I think about what's a beneficial outcome, I think of both, what is the beneficial thing that you can do in this moment, while you're having a wave of grief in the very short term? What is it that might soothe you right now? What is it that might distract you right now? And those you know are things we can learn to choose. Issues. But the second question is, what's going to help in the long term as well? So, you know, I'll give you an example, the morning after my mom died. You know, she died probably one in the morning or so and and the next morning, my best friend and I went in our little, tiny hometown downtown, for breakfast, and the owner of the restaurant came by and said, Hey, I heard your mom was in the hospital. And I said, Yeah, she she died last night. And this dear woman said to me, what can I bring you? Anything? What do you want? And I said, Can I have a beer? This was 8am right? And she said, Of course you can. And brought me a beer. Now, in that moment for me, that was exactly the right coping tool to pull out of my toolbox. If I had a beer every morning for breakfast for the rest of my life, that's probably gonna have some, you know, not so good, long term impact. You see what I mean? So this is what I mean about saying that

 

Til Luchau  

the way we each moment is different. Every person's process is different. And this question of what is a resolute, what can we expect as a resolution, in quotes from grief is so important because of how we think about our own grief, but also the what's motivating our intervention to other people?

 

Mary-Francis O'Connor  

Yeah, absolutely. And for one person, you know, your your life may shift so that you are doing a lot of things to honor your deceased loved one, to carry on their values. Or, you know, my sister and I still do this annual event for, for in honor of my parents, where we give books in my little, tiny elementary school that I, that I grew up in. And, you know, all year we kind of have a little bit of planning, and we go and do that. And one, you know, somebody might say, wow, you're still doing this. It's been, you know, 25 years. What, what you're really still this quote hung up on it. But for us, it's not what it means. It's it's a chance for my sister and I to connect to our parents, to be in the place we grew up, and remember things about them. So you know what counts as a good outcome is going to look different for different people. 

 

Til Luchau  

That's so much the answer that resonates, again, with my own experience, and was a helpful answer for me to hear all along the way. But let's get geeky for a minute. Yeah, in a research context, how would that be measured? 

 

Mary-Francis O'Connor  

Yeah, so here's a great example of this. So a couple of years ago, one of my graduate students did what we call a daily diary study. And so for each day in these widows and widowers lives, for two weeks, they told us about their day, how much grief they had had, the some of the some of the coping toolkit that they had used. And one of the things we asked them was about their interactions with their deceased loved one. So the first thing to know is that it is very common for widows, widowers, people who have experienced the death of a loved one, it's very common to have these internal conversations or experiences long after they are gone, that is not a sign that you are crazy or something is wrong with you. In fact, what we discovered was the vast majority of people did this here. Here, I'll give you two really quick examples. Woman told us that when she would drive home from work, whatever came on the radio, it felt like her deceased husband was DJing her ride home, and it was this wonderful, you know, daily sort of connection with him. Another woman told us that she was having a conversation with her son, and she felt like the words weren't coming from her, they were coming through her, from her deceased husband, because he would have been the one having this conversation with her son, and she felt really deeply connected to to her husband. So so here's so those are a couple of examples, but here's the geeky research finding. So for a while, we realized that on days that they had these interactions with their deceased loved one, they actually had more grief, more difficult emotions on those days. But round about two years, there was sort of a shift, and we saw that on days they had these interactions, they actually had better emotions on those days. And so this grieving as a form of learning means that over time, our bonds, our continuing bonds with our loved ones, get transformed. And these these people who are no longer walking. Walking around on Earth are still deeply encoded in our brain. I mean, they are physiologically in our neurons, and we develop a relationship that internal relationship with them, and it become, can become a source of joy and comfort, instead of just pain and yearning.

 

Til Luchau  

this, yeah, you're just making me think about seems to be the episode where my personal story is a big part of it, but on my own relationship with my father, who died when I was 16, and it was not an easy relationship, and I would have memories or dreams about him for a while that were not fun, either or difficult, and would bring up all those feelings. But at some point in my 20s or so, yeah, he changed. Yes. He in quotes, who knows, but in my dreams he started. He starts appearing as a much friendlier figure, yes. And at some point he's even like, coming back in my dream, and I'm showing him around, giving him a tour, and he's in wonder at this world he's returning to. And that is actually the last dream I remember having of him.

 

Mary-Francis O'Connor  

Wow, isn't that marvelous. So we see our, you know, this is, I think, what's hard to explain when we encode when we fall in love with our one and only, whether that's our baby or our spouse or whomever I believe. And we're starting to see evidence of this, but, but I believe that they are encoded as everlasting in our brain, meaning, I will always be there for you. You will always be there for me. And it doesn't matter if you're in my presence or not. I don't need you to be physically here. My husband, you know, can be at home, or I can be on a trip, and I'm still thinking about him, right? I'm still texting him or, you know, buying him a gift to take home, or whatever, right? I think that our brain doesn't really shift in that everlasting encoding of them, even though we also have a memory system in our brain, right? So in addition to our attachment neurobiology, we have this memory system. So I remember being there when my mother passed away, or I remember getting a phone call, a terrible phone call, right for when a friend died, and our memory means that we know the reality. We know that they're not here, we know that they're gone, and we believe that they're everlasting, and because those two things cannot both be true, and yet they are both in our brain. Every time we realize there's this conflict, we have a wave of grief, and eventually we come to understand, oh, I can't predict that they're going to walk through the door again, right? Or I can't pick up the phone to text them, even though that's my impulse. But it doesn't mean that we don't maintain this ongoing relationship internally with them, just as you did with your dad, and that relationship can grow and change as you grow and change, just like it does in living relationships.

 

Til Luchau  

Thank you. All right. Couple weeks, Steven Porges is coming on the show, going to talk to him about his polyvagal theory. You mentioned it in your book, or at least, you mentioned the Vegas influence on these things we're talking about. And polyvagal theory, just to oversimplify it, it's suggesting that social engagement and touch can co regulate. What's the word, the nervous system. How might this apply to grief, especially when someone's lost their primary attachment figure, like I did.

 

Mary-Francis O'Connor  

Yeah, I think, you know, it's not so hard to imagine. We think of our body as ending at the edge of our skin, right? We think of ourselves as being these unique individuals. But when we're bonded with someone, we are in a relationship with them. And I don't just mean an emotional relationship with them. Our body is in a relationship with them. So that you know, when I go home at the end of the day, if I get a hug from my partner, my heart rate goes down a little bit, my blood pressure goes down a little bit. And not only that, if I think about my going home to see my partner, my heart rate goes down a little bit, my blood pressure goes down a little bit. I have more analgesia. My body makes more analgesic. We know this from research studies where we literally ask people in the lab to imagine their loved one, and then we compare that to having their loved one in the room, and we see that their pain tall. Tolerance is higher when they're thinking about their loved one and when they're with their loved one. So in this sense, your loved one is like an external pacemaker for your cardiovascular system, right? That sense of safety when you're with them can increase your your vagal tone, your vagal control of the heart. And so then we have to figure out your heart has to figure out, I don't mean this at a conscious level even I have to walk into an empty house when my husband is gone, how does my heart figure out how many beats per minute, given its external pacemaker isn't there? And so maybe it's not, you know, when we talk about it that way, maybe it's not so surprising to discover that our cardiovascular system is bound up with the cardiovascular system of the other person, with the way they look and smell and sound and 

 

Til Luchau  

The way they rhythm. 

 

Mary-Francis O'Connor  

yes, yes. And I think the most, the clearest example of this, and many of my myself and many of my colleagues who study the physiology of grief, comes from the fact that the broken heart, dying of a broken heart, is not a metaphor. We see this in the data. So for example, a very recent study just came out that showed, in absolute terms, there are eight extra deaths per 1000 people because of bereavement. You could say it a different way. There's another study that shows you are 21 times more likely to have a heart attack on the day that a loved one dies than any other day of your life, 21 times more likely, and then that risk remains elevated. So you know, at at three months, for example, your risk is still almost twice as high compared to a person who is married during that same period of time. And so there, there isn't a more, there isn't really a clearer, you know physiological outcome than mortality. So we know that this loss is tearing at the tissue in your heart and your electrical, the electrical control of your heart,

 

Til Luchau  

tearing at the tissue. That's such a graphic image. I mean, could we talk about tissue effects for a moment? I mean, a lot of our audience, including me, are interested in tissue and especially how it might relate to what we feel see effect in our hands on work.

 

Mary-Francis O'Connor  

Absolutely so in that same daily diary study, we asked widows and widowers how their loved one had helped them to cope. You know, the sort of what was the toolkit of strategies that your loved one used to help you feel better? You know, did they vent with you? Did they give you advice? And many of them, of course, reported that they hugged them or held their hand or held them. And then, when we asked about what strategies do your living friends and family and loved ones do to help you cope with your emotions, and many of them reported the same ones of you know they help, they allow me to vent, or they give me advice or but the one that we don't do as often with people we're not intimately connected with that are not that you know one and only in our life, is that they had less people who hunt them or held their hand and so that loss of that physical connection with someone is something that bereaved people talk about a lot, that they that they have just a skin hunger, as it were. And I think the idea that massage can fill some of that need, not all of because it's not coming from an attachment figure. Obviously, the relationship is entirely different. With a massage therapist. 

 

Til Luchau  

The relationship is different. Maybe we're coming in once a week, maybe it's for an hour and a half. Best case, and you're saying it can help in some ways,

 

Mary-Francis O'Connor  

yes, so all of the touch and pressure on the skin and deeper we know helps to release hormones and pieces of our immune response that that may. Help as we're trying to re regulate without our loved one. It may help for some individuals, and each person gets to decide for themselves, but it may be very useful to enable that physical process of touch and pressure through massage. 

 

Til Luchau  

It was a significant piece for me. Yes has been, continues to be same, too. You say yes, yeah. And it wasn't that it filled up my touch bucket in the way that my wife did, but it especially in the first days. There was a couple of sessions that I remember that really did help me land back in my body. 

 

Mary-Francis O'Connor  

Yes, exactly. It is so terrifying, grief, for many of us, it is the worst we have ever felt. And this can happen in our third, fourth, fifth decade of life, and suddenly we're having this experience we've never had before, touch and the safety of the massage environment, the massage setup, if you will, can allow us to not be quite so afraid of our body and the reactions it's having.

 

Til Luchau  

Yeah, it gave, it gave some other body experience besides the wrenching, yes, open chested wound, wound that it was so full of at that point, yeah,

 

Mary-Francis O'Connor  

yes, just remembering, oh yeah, my body that is mostly experiencing a lot of pain and lumps and suffering and you know, discomfort right now does also still have the capacity to feel soothed and enjoyable. And you know, I don't. I don't even

 

Til Luchau  

tended to attune.

 

Mary-Francis O'Connor  

Yes, I like that. Yes, I don't even have a good word for when I'm getting a massage. I do really try to focus on the anticipating that it will feel good in the moment, and then savoring that it feels good in the moment. You know, I don't have a even good language for it, but knowing that my body can still do that even though I am grieving, can be just such a good reminder.

 

Til Luchau  

That's right. Pleasure, pleasure. 

 

Mary-Francis O'Connor  

That's the word. There you go.

 

Til Luchau  

Okay, so let's go to the body a little more. And you know, it's so often we talk about it in physical terms, like my aching chest and broken heart lump in the throat, yes, or I'm collapsed into this feeling. How do you think grief does that? How do well, what's the question? What's happening? What are the mechanisms by which we have those body experiences? Yeah,

 

Mary-Francis O'Connor  

we don't know everything about this yet, needless to say, but what we do know is that there are physical changes going on in the body, and that changes that occur when we have shifting hormone levels, that can be stress hormones, that can be sex hormones, and those, those hormones we know do shift during bereavement, things like oxytocin levels change, cortisol levels change, even prolactin levels change in at least one or two studies we've seen. And so what's difficult is that and simultaneously, we have research that tells us, you know, 90% of bereaved people, when asked, can report that they have had physical sensations in their chest that they attribute to grieving. And so I mean 90% so this means this is how it works. This is typical. This is this is normal. So What's difficult is, in order to discover these mechanisms, we have to remember that there's a lot of individual variability in how we interpret and talk about the physical sensations that we have, right? So discovering the one to one matchup of oh, this person has increased il six, and they are also reporting, you know, this sensation, there's a lot of individual variability, but what I can say is, so this is one I only came to understand very recently. I've known for a very long time that many grieving people will describe a lump in their throat. I myself after, shortly after, I was divorced, every time I lay down to take a nap or go to sleep, I felt this lump in my throat, and of course, it's terrifying, right? Lump in your throat when you've not had one before, just automatically means throat cancer, right? Like that is. What we all sort of that's where our minds go to. Well, it turns out throat cancer is incredibly rare and is primarily older white men, right? None of which I fit and and so what I came to learn just very recently is during hormonal shifts during menopause, many women report a lump in their throat. Now, isn't that interesting that this hormonal shift could be the cause of these sensations? That is not life threatening, it is not an indication of cancer, although, obviously, if you have a continuing throat lump in your throat, you should mention it to your doctor, but, but my point here is, I think we forget that bereavement has a hormonal component to it, and so seeing that the lump in the throat might be in part because of the shifting hormone levels, and that we might learn through other times in our life with shifting hormonal levels that the sensation is similar, is just, I think it's, you know, there's so much work to be done and research to be done, but it can be so validating to hear that. 

 

Til Luchau  

So validating and intriguing, because, steer me back a different direction, if I'm misinterpreting. But so much of my reading about psycho neuroimmunology looks at how the body is impacted by psychological events or experiences. Yeah, and there seems to be a lot less about how body experiences might manifest as different ways we feel, or different health outcomes even,

 

Mary-Francis O'Connor  

Yes, so we do in in the field, in the small field, we just call P and I, because it's easier in the small field of P and I, we actually have a lot of research studies that go each direct, both directions. Okay, right? So, from physical changes leading to psychological mood and behavior and motivation changes, but also how our behavior and our mood and our experiences, our emotional experiences, can then affect the body as well we do have. 

 

Til Luchau  

 Yeah, well, you probably can guess why I'm interested in that as a hands on practitioner,  I'm thinking, what are the what are the effects of my touch, or the movements that I'm encouraging people to make, or the shifts in their own movement patterns? Can what's realistic to expect in terms of that other direction of impact.

 

Mary-Francis O'Connor  

There are, you know, there are some I would, I would describe them as sort of early studies that look at things like touch and bereavement, but, you know, mostly right now, with small samples and maybe not as rigorously designed as a scientist might hope for. But here's an example that is example that is is very clear in clinical care now, what we call kangaroo care, right? So putting an infant skin to skin on a caregiver, means that the infant is better able to regulate their digestion, better able to regulate their temperature and and has lower levels of pain. And so, you know, more analgesic effect. So here's a case where we've done so much research about it that we know that skin to skin contact helps that infant to thrive, and so, 

 

Til Luchau  

 and it was the infant, infant that was studied and monitored. I wondered about the caregiver. Of course, yes,

 

Mary-Francis O'Connor  

there are caregiver effects as well, but in these cases, it was the concern about the infant's capacity to thrive that that that were the reason that you're being done, sure, but absolutely, it definitely has an effect than on the caregiver as well. Well,

 

Til Luchau  

maybe out of context, I'm thinking Robert Sapolsky is finding that the grooming baboon had more cortisol change than the groomed baboon. 

 

Mary-Francis O'Connor  

yes, that's right. And and you will, you will find this fascinating. So there's these observational studies of chimp troops, groups that that have stable, you know, sort of social hierarchy, and who gets to groom who is, you know, like the political era of the day. You know, the people with higher dominance get to groom the people with lower dominance. Here's how it's related to grief. As with all primates, there's a lot of infant mortality, and we now have numerous observations of chimp mothers whose infants have died, and they will carry that infant after death for a really variable. Length of time, from days to even months. But here's the fascinating part, scientists have observed many times now that when that mother is grieving, she will stop grooming herself, which is really dangerous for a chimp, because those parasites are bad for their health. And it's during this time when when the mother is really focused on this deceased infant, the social hierarchy rules are suspended so that anyone in the troop can go and groom the mother while she's not doing it for herself. Is that just so touching?

 

Til Luchau  

It's a heartbreaking picture, and then a heartwarming possibility,

 

Mary-Francis O'Connor  

exactly, that we are the medicine you know, we are the external pacemakers and regulators for for this, for this grieving person who cannot yet do things for themselves. And the observation is that when the mother relinquishes the infant's body, eventually she goes back to the troop to back to social life, and all the rules get reinstated, right? It's you know, that that that it is an it is a moment we need to sort of take time and acknowledge and accept that there's a lot that has to adapt because of the loss of one of us, and

 

Til Luchau  

we can take the idea that we're co regulating with a significant other one step farther beyond the skin of our coupling, into the community or the family, and realize that not only is the caretaker being held and maybe cared for, but it's been really helpful for me to be in contact with the people that are also grieving my wife, and realize that we're doing that together exactly.

 

Mary-Francis O'Connor  

And imagine, you know, I think about there's a way in which I think some aspects of religion really are public health, right? So sitting Shiva right in the Jewish community, where people come to your house every evening for seven days, whether you want it or not, whether you talk to them or not, they are in your home. Who's going to notice if you have a heart attack, the people who are sitting all around in your living room are going to notice, and are going to render aid immediately. If they are, if this grieving person is home alone, and the friends are all like, Oh, we don't want to bother them, no one is going to know heart attack. You know,

 

Til Luchau  

that was so helpful for me that first that my my friends who practice that with me, that sort of thing, yeah. And then the yards I the year later, which was just last week, oh, sitting together on

 

Mary-Francis O'Connor  

that yeah, was that? Was that a wonderful, meaningful it

 

Til Luchau  

was to take and mark that year together. Mark the year, yeah, and it was together. It was the togetherness that was helpful, exactly, to hear the impact that they she her passing had on them, and to share that together in a way that's right,

 

Mary-Francis O'Connor  

exactly. Yeah, wonderful. Yeah,

 

Til Luchau  

so much more we could talk about.

 

Mary-Francis O'Connor  

It's true.

 

Til Luchau  

There's here's one. As we wind down, you know, we we talk about body workers, just colloquially, talk about grief being held in the tissues. And there's been, I mean, I think in some ways that's really encouraging. I'm thinking like Bessel Van der Kolk's idea that trauma is a body thing, and he'll use that, or people just study the work will use that term like it's in the tissues. I actually have a little bit of a issue with that. I'm grateful that we're thinking about as a body thing, but I also have an issue with thinking about as a thing. The trauma is a thing, or grief is a thing, almost like toothpaste that could be squeezed out of the body through the right pressure and direction, or something like that. And it's I am in my own thinking it's more helpful to understand it as a process, or a series of processes, or something that we're helping move along. Yes. How do you see that?

 

Mary-Francis O'Connor  

Well, I think of it similarly. You know, when we talk about attachment, bonds, and then early on in the podcast, I talked about how those are invisible. Yeah, right. You can see that the mama bear is walking along, and you can see that the cubs are somehow invisibly tied to her. And you could say that that bond is a thing, and it is a thing, but in the sense that it is a process, just like you talked about, that involves the brains and bodies of those little cubs, the behaviors and habits between cub and mother, and the prediction, right, that mom will come back after she's done hunting, I should wait here, you know. Or if mom has been gone too long, I should go look for her, right? These behaviors and patterns. We can have memories that influence our behavior. We can have habits that influence our physical regulation. But I similarly, don't think of there's no grief protein, you know, as it were, there's no there's no one grief region of the brain. It is a process, a network of activations, and the process means that it can shift over time as well.

 

Til Luchau  

Well. I I'm gratified by what I'm learning in the field. I, as a part of this year passing, I went back to my wife's hospice, and they had a grief counselor there available. I had a conversation with him, a session with him, and he is. It was, uh, fond to hear him say, you know, broken heart syndrome is a real thing, and there's some really interesting recent research about this. And I knew who they're talking about. That he's talking about. You know, there's a way that, certainly my life, it's been a lot of learning. Are there things you're especially gratified about right now in the field of grief research, or how our culture is beginning to talk about this topic?

 

Mary-Francis O'Connor  

 Oh my gosh, within that 25 years, the willingness and capacity for people to talk about it, for clinicians to learn about it. For, you know, online people can connect. In addition to in person, this is all magic and and new in our culture, in a way that was just absolutely not true when I started doing these studies, and that there's so much more to know that I have, you know, I have a black graduate study student who has just been studying witnessing members of the Black community who provide a witness to another person's grief, which is more than just supporting them, but really enabling and validating their grief experience. I have another student who's Native American, who's studying ambiguous loss in in murdered and missing indigenous relatives, where we don't know what has happened to the person. How does that bereaved indigenous person cope with their grief, right? So there are so many ways that we can continue to understand and and and validate and encourage people who are going through this process

 

Til Luchau  

in our understanding of, say, the systemic levels as well, the the larger picture, they're all a part of. That's it all right. So what would you want to highlight as we wrap things up? What would you want to highlight for body workers to make sure we're thinking about with all this in mind?

 

Mary-Francis O'Connor  

I think perhaps the most important thing to me is that grief comes in waves, and so allowing that people are going to go through these moments of, you know, the wave of grief hitting them, reacting in the way that their body and mind does, And also that letting that recede is also a part of grief that we don't have to stay in the wave. We learn something with each wave. And also it's important to have time where the ocean is quiet, and so maybe thinking about it that way will help people both to support the rise and the fall of a wave of grief.

 

Til Luchau  

I like it. I like it a lot. Mary Frances O'Connor, thanks so much for this conversation, as well as for the depth, clarity and compassion you've brought to your studies and shared with all of us. And like I said, it's helped me so much personally, and I know it's going to resonate with a lot of our listeners, whether they're have clients who are obviously dealing with grief, or less obviously, or dealing with their own grief.

 

Mary-Francis O'Connor  

Thank you Til for bringing this conversation to people.

 

Til Luchau  

Listeners. If you want to learn more about Mary Francis O'Connor's work, be sure to check out her new book The Grieving Body, and her previous book The Grieving Brain, and we'll link to both of those in our show notes. Whitney will be back with us next time, and I want to thank our sponsors as well. The Thinking Practitioner podcast is proudly supported by ABMP, Associated Bodywork and Massage Professionals, the premier association for dedicated massage and body work practitioners like you. When you join ABMP, you're not just getting industry leading liability insurance, you're getting practical resources designed to support your career, from free top tier continuing education and reference apps like pocket pathology and five minute muscles ABMP equips you with the tools you need to succeed and grow in your practice. ABMP is committed to elevating the profession with expert voices, fresh perspectives and invaluable insights through CE courses, the ABMP podcast, Massage and Bodywork Magazine, which features articles from myself and Whitney Lowe. The Thinking Practitioner, listeners can get exclusive savings on ABMP membership at abmp.com/thinking. Join the best and expect more from your professional association. Thanks to you listeners, and of course, to our other sponsors. Stop by our sites for the video, show notes, transcripts and extras. Whitney's site is academyofclinical massage.com. My site is advanced-trainings.com. We want to hear from you with your ideas or feedback or input about the show. Email us at info@thethinkingpractitioner.com or look for us on social media under our names Til Luchau and Whitney Lowe, and finally, we'd really appreciate it if you would go rate us on Spotify or Apple podcasts or wherever you listen to that helps other people find the show, lets our sponsors know that their support is well placed. So please take a second to go do that. And thanks, as always, for sharing your word and telling a friend. And thank you Mary Frances O'Connor for joining us today.

 

Mary-Francis O'Connor  

Thank you so much Til