Dr Emily Musgrave believes we don’t need to fix grief

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It's so great to be here.

Oh, thank you for having me. Yeah, it's an, you know, all of those things that you've mentioned feel so both meaningful and important areas that we're. That we kind of keep in conversation, I think.

Yeah, it is. And yet we work so hard to avoid it. And, you know, look, it makes, it makes sense that we do because we know that as humans, we are so driven to avoid pain. And, you know, if we step into grief, it can be the most profound experience of pain. So to approach the conversations and to approach the discussions means turning towards this prospect of pain, which is a real, a real challenge and takes, I think, some kind of really skillful action.

Yeah. So I think I really want to give reference here to Dr. Mary Frances O', Connor, who is this? I'm sure you've heard about her before and I've spoken about her before. She's this incredible neuroscientist and researcher based in the States, and she has a beautiful book called the Grieving Brain and a more recent one, I believe, the Grieving Body. And she brings like this great scientific and neuroscientific perspective to the experience of grief, because grief is not actually just a feeling. It's a whole body and mind experience. And what she does is she differentiates the experience of grief from the notion of grieving and so she describes grief as the emotional experience that arises in response to a loss. So the grief is that intense, almost like wave of feeling that we get of sorrow and heartache. It might be anger, it could be rage. It could be a whole host of feelings. So that's our emotion in the moment. Yeah. And so that's where we would speak about, like, a wave of grief. It's like these emotions are rising to the surface, and they may be very intense and they could hang around for some time. But the. But grieving is how the grief changes over time. So grieving is the process. And the example that she would give is like, if you were to, I don't know, follow the stock market, and you were to track the stock market over a year, you would see, like, the ups and downs of the stock market, and that would be the grieving. That's how your grief is changing and experienced over time. But grief is the intense emotional experience that arises and that will be presenting itself in different ways at different points in time, of course. So in the early stages of grief, we might say that this is extremely intense and extremely. It has a longer duration. But we could also expect that over time that that changes. And so we may not get hit by as many waves of grief. We may go for a period of time where perhaps there's calm water and then here is a wave or here is even a tsunami of grief, and we're hit by it again.

Yeah. And I really. I think what feels so important in that is emphasizing how incredibly normal all of those experiences are. And so, you know, it might be 10 years, it could be 30 years. And you may find that on a particular day, in a particular moment, you absolutely knocked off your feet by this intense feeling. And that. That does not tell us that you haven't grieved. It tells us that that relationship is deeply important to you and that. That when this feeling is here, it's a reminder of the loss of this.

Yes, yes. And that's the part of it. Yeah.

Yeah, yeah.

Yes, it. Can you tell us a little bit about does? So I don't want to step on the toes of the neuroscientists out there. And so just, I guess, being transparent around what I know about how the brain works. But what we. What we do understand is that there is a very. Basically, when in the brain, when we experience pain, a certain area of the brain gets activated. And if we were to look at the studies around the experience of emotional pain, of grief, that those same areas in the brain are being activated as well. So it is felt physically in the same way that an actual physical pain is felt. And we don't. I don't think we give that enough attention. Yeah, yeah, yeah.

Yes.

Yeah.

Yeah. And I think it gives a gateway, too, to understanding how we would heal a physical illness. For example. So if, for example, you had. Let's just say you had a wound on your leg and you covered it up with a bandage and you expected it to heal, and then you open up the bandage and here it is, it's not healing, it's getting infected, it's getting worse. And yet that's what we will so often do with. With our emotional pain, is that we will cover it up, push it down, try hard to avoid it with. Under the guise that it will go away. And I think it really bears such an honoring that this pain is here and it's calling for your attention. And if you don't pay attention to it, there will be much greater suffering, I think.

Yeah, I mean, that's so. That's so true. I was having a conversation with a friend yesterday, actually, about how, you know, how we understand things like diagnoses, medical diagnoses, to impact upon the subsequent experience of someone's life in terms of their identity. And I think, you know, what stood out to me and that is that all of our experiences are constantly shaping who we are as people. And if we deny grief, for example, it's like we also Deny the gifts that it can offer us as well, in terms of how it shapes how we want to show up to this life we have now. And I just always think that in and amongst all of the suffering and the pain, there are. There are spaces where we can find a greater meaning and purpose. But if we work so hard to push away from that, then I think we deny that opportunity too.

I mean, it's the most unwanted gift you ever want. Exactly.

Really. But. But it is. There is. And I think there has to be. There has to be. Because what then keeps us moving forward it. And I. And I do emphasize that there will be times when it is really important to dip out of the painful work that we do need to be able to simultaneously dip into the grief and also be able to come out of it, to resource ourselves as well. So it's not that we need to be constantly pushing ourselves to feel the pain and to be with the pain, because that's actually not helpful either.

Yeah, yeah.

That's. That is such a great question. Because I think for many people who have never experienced it, it's so hard to grasp somatically in the body. So, you know, really hard to grasp what that feels like and what will happen when you get exposed to it. But I do think that even if they haven't lost a person, there will have been experiences of grief in there. So it might be the grieving of a relationship that ended. It might be the grieving, the loss of a pet, it could be the loss of a life that you imagined for yourself. And that whilst it may not have. I mean, for some people it may have the same emotional intensity, but if it doesn't have that same emotional intensity, we can even kind of allow this imagining here. And I mean, there's many different processes and ways in which we can do this. And there are some interesting insights from Stoic philosophy and Marcus Aurelius, for example, would. I'm sure you're probably familiar with this, Melissa, this idea of premeditating death and that every night, in order to, in some ways promote a sense of resilience, would actively imagine the death of his. Of his family and friends. And that may seem so. Oh, it may seem just so unnecessary, but there's something very useful even in that. Now when we think about our loved ones and you can step into imagining not having them, that gives you an insight. I think it gives you an insight into what this might feel like. But, you know, for many people, they will say that until you've lost someone, you won't really fully understand. And I do get that.

Yeah, absolutely. I mean, really at its heart, grief and love are two sides of the same coin. So where we love, we will grieve, and where we grieve, we have loved. And so like. That, to me, is the very foundation of why it is that we pursue relationships. So we pursue relationships as adults, for example, because we're built for connection, wired for connection, and we yearn for an intimacy and a closeness. And what we also yearn for is to feel. And what is so important about that is that with this yearning to feel, we get exposed here to joyfulness and awe and love and excitement. But with that willingness to have those emotions also opens us up to a willingness or to a vulnerability even to experience the other spectrum or the full spectrum of emotion. And yet if we. If we work again, work so hard to shut off the unpleasant emotions, we also shut off our accessibility to all the. The other end of the spectrum there.

Yeah, yeah. And I think culturally we're not accepting of it so well, at least in the Western. In a Western culture, maybe in some pockets of Western culture, are we able to give. Give a greater space for grieving and acknowledging this loss. But I think so often there can be an expectation from other people that we should be over this by now.

Yes, yeah. Yes. And then simultaneously to keep moving forward. So it's a. It's such a tricky thing.

Deny and avoid. Keep on going. It is like, it brings to mind for me, you know, again, obviously, this avoidance of pain sits at the heart of that, but the fact that we don't talk about death even with, like, in education. So there's another incredible researcher and trauma grief therapist, Megan Reardon Jarvis, and she is such an advocate for bringing in education of grief into, like, childhood learning. In the way that they learn about puberty, we also can learn about grief and that when we start to normalize and bring education into grief. So what is actually going to happen, for example, in your body in those first stages of. First early experiences of grief, so that, you know, you're armed with a toolkit to know that. Aha. Okay, so this brain fog that's here, this is not just me struggling to do stuff. This is actually a very normal, functional response to the grief that's here or I'm not sleeping. Yes, this is a normal response to this grief that's here. So, you know, if we were able to have these conversations and to normalize talking about grief from childhood, then I think that this prepares us to be able to have those bigger conversations in adulthood around. Okay, preparing for death.

Right.

Yeah, like you said, the fall, for example. Yeah. And so anticipatory grief is a real thing. It is as though we're grieving in real time the anticipated loss of this person or this attachment. And there is something deeply important about that process if we're willing to again to turn towards it. But to begin with, it is actually mimicking the experience of grief at the loss of someone at their actual death. So we will notice that we'll experience things like, you know, this great sense of despair or an emptiness or a heartache, you know, these same. And even a rage and anger shows up, irritability. So this whole range and spectrum of emotion, intense emotional experiences that arise when we recognize that this person is going to die. And it may not be in the next week, it may be in five years. But when we know that there is a terminal diagnosis or like life limiting experience in elderly, for example, we know that this is going to happen. And these little markers here tell me that this is true. And with that truthfulness, we then get exposed to these feelings. So I think that that can feel very confusing often for people that this person is still alive. And yet I'm feeling all these things.

It is, it's, it's. And if we look at again the, the work of the brain and how the brain is making sense of this when someone is declining in their functioning. And so we're no longer able to do those sorts of things that the. The brain becomes disoriented because this is not its normal prediction tool. So the brain is. Is in essence, a prediction machine. And it's constantly predicting and making expectations, attachment, relationship, or this relationship with this person based upon a history of experiences. And so if we think about it like a map, our map typically has in the past been very reliable. So I might, for example, go and have. Go for a walk with my mum every week. And that has been a reliable prediction that happens every time. And now when there is this recognition that, or this awareness that actually we can't do this anymore, that is extremely destabilizing to the brain. The brain is disoriented. And what comes with that disorientation, again, is some very, very uncomfortable feelings. And with that disorientation is this feeling of loss and sorrow and aching and yearning for what's no longer there.

Yes, yeah. And this is complex work because if we look at, you know, if we look at what happens when someone actually dies is that their body is no longer there with us. But our attachment never dies. So our attachment to them never, never dies. But when there's an experience of anticipatory grief and we see someone deteriorating, it's like an incremental exposure to this, to the loss of the body. And so this challenge that we have is like, how do I stay here with this attachment? Because that attachment, like I said, never does. But it's very complex and very difficult work. And what often shows up in like, particularly even in mentioning the sandwich generation, is absolute exhaustion. So when the brain is trying to reimagine this new map, okay, so now mum is not able to walk, or now mum's in a home, or now we're getting this care that the brain is constantly now re updating. Constantly re updating, re updating. And if you think about the amount of energy that is required to re update information, it makes an immense amount of sense that we will feel absolutely exhausted because it's a state really of threat. And so that re updating is in essence, eliciting this stress response. So in a prolonged experience of anticipatory grief, for example, we are constantly in and quite potentially exposed to a chronic activation of the stress response. And so that is extremely hard to maintain. It's like juggling a million balls in the air.

Particularly if you're caring for younger children or children at the same time as well.

You're absolutely right. I think it can very much be a place of reckoning. And it will also bring up, in my experience, it will also bring up reflections, consciously or not, about how I was parented.

Yeah. And tell me more about this. So this is not. This is not always going to be the case, but this is. This is some people's experience that perhaps they have held some feelings of being let down by their primary caregiver, that there may have been some really difficult experiences as a child. And what shows up often for me in this space in particular is that perhaps that parent, when they were a child, wasn't providing them with the needs that they had at the time. And so that might have looked like not maybe not caring for them in the way that they really needed to. And then as they move into adulthood and their parent now becomes the one that needs the care, that brings up these big questions, like, I'm now here caring for you at the end of your life, and you were not caring for me when I was a child. And that, I think, is very complex work because it brings up a whole host of feelings. It brings up a feeling of resentment and anger. But often what sits alongside that is guilt. Like, if I don't do this, if I don't show up every day, if I don't do this, I will feel too guilty. And so it's. Gosh, it's hard.

Yes, yes.

It's. It's very complex. And again, something that we don't we don't talk about very often about the complicated process of losing our parents because our parents were human too. And they will have made many mistakes, no doubt, and in many circumstances there may be significant trauma which makes that work so much more difficult. You know, even in the space of having had estranged relationships and then kind of coming back into the fold in this end of life period. It's like I said before, probably many times, it's really complex and can be very confusing for the person that's caring. Absolutely.

Well, I mean, I think particularly what you're saying in there, Melissa, too, is the sense of loss as my role as a mother in the way that I had always known it to be, because they now no longer need you in that regard, like in that particular way. So there is a loss there. It gives way to a new relationship and a new understanding of this role of motherhood. But that's occurring so often simultaneously with this changing role as daughter or as friend or as sister, for example.

Yeah.

Yes.

It's a lot. Yes, it is. And I think what gets missed in there are what are your own needs.

Where are they? They've disappeared. Yeah.

Yes. Oh, gosh. I think that that is so important. And I absolutely agree. I don't think that we're having the conversations we need to be having around that. And you know, as, as a bit of a kind of adjunct to what you're saying there. In the same way that, you know, I was mentioning before about this kind of notion of education of children around grief, I think it's also so important that there's grief education in workplaces so that, for example, our workplaces can really understand that in those, particularly in those early stages that I'm not going to be able to show up, I'm not going to be able to attend to this in the same way that I was before, but in terms of anticipatory grief and this kind of real chronic stress that we experience. So there's the demand from maybe the people that we're caring for, maybe our parents, and there's the demand from our children, and then there's this demand from the workplace. You know, to me, what, what so often happens is that a woman will step out of the workplace because that's actually not sustainable. And then we know that we have significant costs to that financial independence and financial future. So, yes, it, it bears a significant cost, not only to the workplace, but, but most significantly to the woman if she's the. If she's the primary caregiver.

Yeah.

Yes.

Yes.

Yeah, no, absolutely. And I think again, it brings with it, you know, it's just so associated with this avoidance here, obviously of death. But also, and this is just a hunch I have, that in some way that people minimize the, the experience of grief when it is of someone who has lived a long life, that in some way we, we will minimize the Fact. Like, for example, if you've lost a parent and let's just say they're, I don't know, over 80, that we somehow don't give it the same validation that we would give the loss of someone who's younger than that. And so in our workplaces, when, you know, when we're saying something like, I have to go and attend to finding a. A. Oh, gosh, I'm losing my words. I have to go and find a new hospice, for example, or we have to find more care for my parents, is that it's not held in the same way. We would say my child is sick. And I think that what. In all the work that I do, there is no comparison of grief because the grief is so unique to your individual attachment with that person. And so whether they're 90 or whether they're 30, the grief is dependent upon what that relationship means to you. But I don't think we give it the same attention. Yes, exactly. Exactly. Yeah.

Yes, yes.

Yes, absolutely. And again, if we come back to this idea of that prediction machine, that if someone has been unwell for quite some time, the brain may have updated the map to say that I will go and visit Mum in the hospital. And so now here's my new map, and that becomes a reliable experience. And so then when they do leave, and now that part of my life is not there, me going to the hospital is not there, that will then bring about again an immense amount of intense emotion. There's a really, I think, very useful model of grief called the dual processing model. I'm not sure if you're familiar with that one.

And it really differentiates itself, I guess, from the Kubler Ross original seven stages of grief model. And I think I find it most resonant for me in this kind of grief work. And it has resonance as to whether it's anticipatory grief or whether it's like actual. Well, here is grief, and it proposes that there are Basically that we have to oscillate in the space of grief between two primary functions. The first is what's called the loss orientation. And so that is that we're coming into this feeling, this obviously deep, intense feeling of loss, of sadness, of sorrow, of aching and yearning. Yearning in particular being a very key part in there. And that is inherently, as we know, extremely stressful and distressing. And then what will happen is that we simultaneously, or in moving in between, oscillating between, we come to what's called the restoration orientation. And the restoration orientation is how we restore and become, make meaning in the life now that they're not here. And functionally what that can look like is, for example, now I'm not going to the hospital every day, so what do I do with my time? Now this person isn't here and maybe that person was in charge of the finances. Now I have to be doing this, and I don't know how to do this from, you know, in other circumstances it might be that that person's role was to do the school lunches or to do the drop offs or to. So all of the roles that that person carried and the way they live their life is now having to be rest by me. And that's also inherently stressful. So now not only am I working with the loss, I'm also trying to restore my life now that they're not here and to try and make meaning of that. And so, as I said, both are inherently stressful and both are very needed. Gosh.

Yeah, yeah, yeah.

Yeah, yeah.

Oh, Melissa, it's my pleasure. Because I'm sure it makes. I mean, it's so much sense.

Yes.

Yeah, absolutely.

Yeah.

Yeah.

Oh, I think it sits. It just sits so powerfully in it. I think because you know, from. From what I know, both personally and, you know, in my practice is so often this sense that, you know, people will come in experiencing overwhelming grief. And there is this phrase, I'm so broken. I'm so broken by this, and I will never be the same. And in some ways, first of all, yes, you will never be the same. So we can acknowledge that and that and at the same time. So rather than an either or, I will never be the same, and I will be okay. So that's one part of that. But the brokenness inherent in broken is that I need fixing, and that someone. It's almost as it implies, as though someone else has to do that because I can't do it anymore or I can't do it now. In that place of brokenness, we have no sense of agency and no sense of choice. It's just is. It is. I am broken. And yet the pull in the work that I do is actually, there is nothing about you that is broken. This pain that is here tells us that you're alive and that you're human. This pain of this grief says that you've cared so deeply and that you love this person so much, but you're stuck in this pain. You're stuck in this struggle with pain. And the beauty, I think, in stuckness is that it can be temporary if we're willing to really turn towards it. So it is, I think, particularly relevant in grief.

Oh, I love that question. You know what. What you may be aware in reading the book is that I was. I had a diagnosis of breast cancer three or four years ago, and I'm. I'm well at the moment and hope to be well for a very long time. But this grief work feels so important to me because it teaches us about living. You know, it teaches us about why I want to be here, who I want to spend my time with, what I want to do with my time, and that I think what it does is it can really, if we're willing, I think, tear down all the stories that we tell ourselves about the achievements that we should be striving for, the identities that we should be cultivating, but instead actually what truly matters deep in our heart and that may be, that will be different for different people. I know for myself in doing this grief work and you know, in my own experience that, that I, I really deeply want to make an impact, to know that, that in some way I've been impactful in a, hopefully in a positive way. But for people to know, the people that I love, to know that I loved them and that I think, you know, if, if we leave this, this planet with people knowing that, then I think I would feel very, very happy.

Yes. I love that analogy so much.

Thank you so much for having me.

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