Psychiatrist and prolonged grief expert Dr. Katherine Shear on how longing is the heart of grief

Episode 12: Center for Prolonged Grief founder, Dr. Katherine Shear untangles the differences between prolonged grief disorder and more typical integrated grief. She explains why longing is at the heart of grief and the importance in accepting a changed relationship with the lost loved one.
 

Dr. M. Katherine Shear is the Marion E. Kenworthy Professor of Psychiatry and the founding Director of the Center for Prolonged Grief at Columbia University School of Social Work. Dr. Shear is a clinical researcher who first worked in anxiety and depression. For the past 25 years, she has focused on understanding and treating people who experience persistent, intense grief, which is now an official diagnosis called Prolonged Grief Disorder in the ICD-11 and DSM-5. She developed and tested Prolonged Grief Disorder Therapy, a short-term, strength-based intervention that helps foster adaptation to loss and confirmed its efficacy in three large National Institute of Mental Health-funded studies. She’s developed several widely used assessment instruments and a Prolonged Grief Disorder Treatment instruction manual.

Learn more about Dr. Shear at https://socialwork.columbia.edu/faculty-research/faculty/full-time/m-katherine-shear/

In this episode, (in order) we talked about…

*The difference between desire and longing

*The difference between usual continuing grief (or integrated grief) and prolonged grief disorder

*The six healing milestones in adapting to loss through therapy she developed

*Why the terms for the disorder she has researched changed over time from unresolved grief to traumatic grief to complicated grief to prolonged grief

*How you learn to long for a lost loved one without it becoming debilitating

*What she learned about how grief impacts the body from studying maternal-infant separation 

*The long-term impact her first experience with grief  had on her

*Why the therapy she developed encourages people to speak to dead loved ones

*How prolonged grief disorder can show up with any meaningful loss (death, divorce, natural disaster)

*The relationship between our brain’s nucleus accumbens and the emotion of longing

 Quotes:

“Longing is the heart of grief. It’s the presence of absence and the absence of presence.”

“Prolonged grief is when acute grief dominates our mind and our life. 

“When we lose someone close there are measurable changes in our cardiovascular and neuro-endocrine systems.”

“Our close relationships are literally mapped in our brains in the form of all different kinds of memories (explicit and implicit).” 

“Grief is like a snowflake: no two experiences are exactly the same.”

 “I had been very afraid of death most of my life. But after my cousin died, shortly after I started doing this work, I thought, I don’t have to be afraid of dying…because she is there. So, wherever she is, it’s ok, because I’ll be with her...This changed relationship was interesting in that it didn’t require her to be physically present therefore it didn’t require me to be physically present, so it was easy to imagine it continuing into eternity.”

“When it (longing) takes up too much space in your mind and it interferes with your ability to restore your capacity to thrive or accept the reality you’re in, it’s like someone’s got you by the heels—you can’t move forward, you can’t connect with other people, you can’t connect with even yourself ...because you are preoccupied with something that’s gone.”

“Longing is a paradoxical emotion that contains presence and absence, and it also contains pleasure and pain.” 

Resources: Prolonged grief assessments and tools on the Center for Prolonged Grief we