Kathleen M. Pike, PhD

Some Reflections on Grief

As the days turn to weeks since the passing of my mother, I find myself hyper aware that grief has become a daily companion.

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Taking time to grieve has allowed me to laugh, cry, yearn, and reminisce. It’s a layered experience that includes a mix of emotions.

1. Grief is a form of love. When we lose someone we love, the attachment and affection live on. Yearning, sadness, and grief become new expressions of that love. The grieving process helps us metabolize the departure of a loved one and internalize the memories and history. It is an essential, if disquieting, affair that helps carry the relationship forward, transforming what was into something altogether new and different.

2. You Can’t Hurry Grief. In 1966, the Supremes released the Motown hit, “You Can’t Hurry Love.” The same is true for grief. Neither something pathological nor something to “get over,” grief is a process. Widespread cultural and personal differences exist in the pace at which we journey through grief. Some say the first month is the worst. Some say the first year. Some say the first of each holiday and birthday. No matter how long, the truth is that grief takes time.

3. Grief is a Whole Body Experience.  Grief can increase inflammation, which can worsen existing health problems or cause new ones. Grief can disrupt sleep. It can stress the immune system, leaving one depleted and vulnerable to infection. Changes in appetite are common. Grief is also associated with a higher incidence of a heart attack or stroke in the months after the loss.

4. Grief and Takotsubo Cardiomyopathy. Also known as broken-heart syndrome, cardiologists in Japan first described takotsubo cardiomyopathy in 1990. The hallmark symptoms are chest pain and shortness of breath. Often mistaken for a heart attack, 90% of reported cases of broken heart syndrome occur among women ages 58 to 75 following an acute trauma such as the loss of a loved one. In the case of Takotsubo cardiomyopathy, electrocardiogram abnormalities mimic those of a heart attack, but the person has no evidence of coronary artery obstruction and fully recovers within weeks of the event.

5. Complicated Grief. According to Dr. Katherine Shear, Columbia Professor and Director of the Columbia Center for Complicated Grief, we incrementally adapt to loss and move from a state of acute grief to a place of integrated grief in the natural course of grieving. Over time, our grief moves to the background of our lives, and yearning and sadness no longer dominate our everyday thoughts, feelings, and behaviors. However, this process can go awry, and we can get tangled up in grief in ways that cause considerable suffering and impairment. So much so that in the new World Health Organization ICD-11, the syndrome of complicated grief has been included for the first time as a mental disorder. According to the ICD-11, this condition is called Prolonged Grief Disorder. Its core symptoms include a longing for and preoccupation with the deceased, emotional distress, and significant functional impairment that persists for more than six months after the loss of a loved one.

If we are lucky in life, we will know love. If we know love, we will know grief. While still in the early days of mourning the loss of my mom, I am grateful to family, friends, colleagues, and even strangers, who, in one way or another, have said, “I am sorry for your loss.”

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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