Grief is brutal, but there is value in it, experts say. So why do we try to "cure" it?

Cody Delistraty wanted to get good at grief. After his mother died of melanoma when he was in his early twenties, he found, as he writes in his new book “The Grief Cure: Looking for the End of Loss,” “There was no control to exert. No blueprint to follow.” So, feeling frustrated and exhausted, he did just what a mourner who’s also a journalist might do — he investigated.

After experiencing firsthand that the aftermath of loss does not progress neatly in five stages, Delistraty began exploring a variety of grief treatments, from approaches as traditional as ritual and community support and as futuristic as AI and memory deletion. His odyssey took him back to the history of our modern conceptions of grief, and coincided with a d new reassessment of the experience within the psychiatric community, with the addition of prolonged grief disorder to the DSM.

Though the loss of his mother and its aftermath “showed me how brutal pain is,” as Delistraty tells me during a recent video chat, it also showed him why grief can be something to “keep with us and to work through, as hard as it is.” Ultimately, it’s not something to be cure or reach the end of. But like a painful chronic condition, it can be managed. And Delistraty reminds, “It happens to everybody.”

This conversation has been edited and condensed for clarity.

You pose a variant of this question right at the start of the book, so let's get into it. Is grief a disorder?

No. Grief is not a disorder. I found the research interesting and I've had trouble exactly coming down on precisely where I think, but I have some broader takeaways. Prolonged grief disorder, as I write in the book, is something that came out of the DSM [Diagnostic and Statistical Manual of Mental Disorders] by the APA [American Psychiatric Association] two years ago. Clinicians who believe in it said that their reason was to differentiate it from normal grieving. They're characterizing it as lasting 12 months or more, although they say it's really more like six months.

Then it has to meet at least three of the symptoms happening every day for at least a month. That’s a sense of meaninglessness, marked sense of disbelief, identity disruption, numbness, that sort of thing, and it has to be outside your cultural contingencies. So if you're celebrating the Day of the Dead as a Mexican, you're not suffering from prolonged grief disorder. 

It's obviously had a ton of opponents. When I was on the phone with different researchers and talked to different people over Zoom, both sides were super passionate about it. I do think everyone is acting in good faith. People want the best for people who are grieving in these very intense, persistent, and as prolonged grief disorder people say, unchanging ways. What is tricky is diagnostic culture more broadly. Putting something like grief into a lens of medicine is always going to be tricky, and is always going to elicit pretty intense feedback and responses. 

I took the questionnaire to get confirmed possibly for prolonged grief disorder, but I wasn't myself confirmed. I never walked around with that label. I can see how that legitimacy would be valuable to someone, though. Just think of the fact that the average bereavement time off in the U.S. is five days. You tell your boss you’re grieving, and they say, “Sorry, deal with it.” 

If you say, “I have prolonged grief disorder,” are they going to respond differently? Are our family members going to respond differently? That is more of an indictment, though, of how we treat people who are grieving than it is of any one diagnosis. The conclusion I've come to is to be careful with how much we center grief within diagnostic culture, while still understanding that there are possibly valuable avenues within medicine to at least draw attention to this and give some credibility and legitimacy to it.

In the book where you introduce the invention of grief as we understand it in a modern sense. Tell me about what we have typically thought of grief in the modern era, and how maybe we're starting to change that. 

We have to look at it from an even broader scope. The French medievalist Philippe Ariès was giving lectures at Johns Hopkins that were somewhat controversial at the time, because he was painting with a broad brush of Western attitudes. Prior to the 18th century, his claim was that there was what he called “tamed death,” where there is a real sense of social acceptance of the normalcy of loss. And that was due in part to higher mortality rates, but it was also due to people coming together, being around the bedside, religious rituals being done. Then you fast forward to the early 20th Century. The First World War is where I put it, where you start to see how with mass death happening and with this top-down desire to privatize grief, it gets driven underground. 

One of the most interesting examples was President Woodrow Wilson. The war effort wasn't a popular one. His constituents weren't excited for the U.S. to enter the First World War. He kind of brokered a little deal with Dr. Anna Howard Shaw, prominent women's suffragist. He basically said, “What if instead of all of the women who you oversee marching in full black mourning to protest the war, we converted that to patriotism? What if instead, those women wore a nice band that has a star on it to memorialize if they have a dead spouse from the war?” And so you have this conversion of public grief into something that's quieted, something that's privatized.

Walter Benjamin in 1935 is writing about the covering up of grief and public spaces, how it's no longer the news of death. It's just the news. You have the British anthropologist Geoffrey Gorer, writing in 1965 off a study of about 1,600 British citizens. He says that people are weary of talking to their neighbor now about grief, weary of burdening them. He attributes that in part to happiness culture, which I thought was funny, because I thought of that as a more recent phenomenon. But even in the mid 20th Century, people are starting to think of grief as something that could be almost harmful to others. You get this vicious cycle, and you see it today, all the time. 

I saw it in my personal experience. You say, “I don't want to burden this person,” and then the person who should be there to help them says, “I don't want to open the wound by asking about it.” So you get this miscommunication when, for me, just saying, “Hey, I'm here for you. Want to have a coffee?” is one of the most valuable ways of dealing with and helping other people with grief. 

We've had this evolution from the 18th Century until the late 20th Century, and early 21st Century of public into private. But I'm optimistic because I've seen a hybrid form, starting with what Crystal Abidin, an ethnographer of internet culture, has called publicity grieving.

It sounds exploitative and not great at first. In 2013, there was a big brouhaha over funeral selfies, where people were taking photos of themselves in front of gravesites. In the most optimistic, charitable viewpoint, I see that as people trying to put their grief in the public space somehow and not knowing how to do that. We don't have the language for this anymore. We don’t want to be a burden. But what if we're able to show death in spaces that are more public? Funeral selfies? Not great. But I do think that grieving people on social media, the rise of things like the dinner party I wrote about, where you're not in the formalized therapist's office, but you're not in full public either, there's a move toward the public.

My great hope would be that, ultimately, grief is something that everyone is open to talking about. And we don't fall into that vicious cycle of thinking we're going to be a burden, it's a burden.

Want more health and science stories in your inbox? Subscribe to Salon's weekly newsletter Lab Notes.

As you say, there's the imperative to avoid grieving too much. 

I think it's being good at grief. In my sense, that was keeping it low being getting through it. People would even say, “You’re dealing with it so well,” which doesn't mean you're talking about it a lot. It means you have shut up and you're doing well at work, right?

At one point, you write about grief as a bodily experience, and how it could manifest as aggression. What were you feeling? And what was the feedback from people around you? 

I had this desperation to be good at it. I'd been an okay high school student, an okay athlete, these sorts of things. In college, my mom gets sick, and I'm like, I’ve got to be good. I was studying way harder than I'd ever studied. I was doing strength training regimens, going for really long runs, trying to push myself. I thought if I could be good enough at those things, it would somehow save my mom or somehow help her make her proud or provide some usefulness. 

Then when she died, it flipped from, be a good student, be a good athlete, to be a good griever. I think in the year of our Lord 2024, we have gotten better at men being able to have a higher EQ and be more expressive. But for me, the physicality of it and needing a catharsis, that most easily came through things like training for the Paris marathon or getting into strength training. The feedback I got was, “Wow, you're doing great with this. Your mom would be so proud of how fast you've moved on.” And so the physicality of it was fascinating. With laughter therapy, I found that to be a fun way of opening and liberating the diaphragm, as Carla Brown would say.

If I was breaking down a lot more, there might have been more questions asked or a fear that I wasn't doing as well.

When someone is sick, you’ve got something to do. In the immediate aftermath of death, even a sudden death, you’ve got something to do. And then there's nothing to do anymore. You just lost your job. The purposefulness of that relationship with that person is also something that is gone and is part of the grief. Did you experience that?

The received wisdom I had and was part of me being a good griever was going through the five stages of grief, which as you know, is so deeply misinterpreted. 

Swiss-American psychiatrist Elisabeth Kübler Ross came up with it as she was doing research on people coming to terms with their own death, not with people who are dealing with grief. There have been some interesting studies on grieving people. There's one from 2007 that found most grieving people do kind of move forward through these stages. It is a decent reflection of that.

But there's so much misinterpretation, and if I could go back, I would tell myself, that's not a blueprint, that's not a prescription. You don't get to acceptance, you don't get to a great place in grief by hitting these steps. I talked to one psychiatrist who said she had a client come to her and say, “I'm asking my husband to make me angry because I'm trying to get to the anger stage faster.” Oh, no, you've misunderstood entirely. I was in that space of thinking “closure,” thinking “five stages.” That was the work I was able to give myself. It was the part of being a good griever. Of course, I had to rethink all of those things to ever get anywhere in my grief. But early on, that was definitely the thinking. 

You went through so many different therapeutic interventions, things that I didn't know were available in the real world. What did it teach you about what other people are going through in this community of grief, and this community of seekers? 

It showed me how brutal pain is and how pain is just something that our first and understandably, evolutionary, feeling is, “Get it away, get it off, get it out of my head.” When I researched, some was for me, but also I thought things Chat GPT would be interesting to the reader.

I wanted to see what the technological recreation of my mom would be like. I was doing that in 2020, before all the media hit on it. I thought, this seems like a futuristic thing that a lot of people probably will try. A lot of it was trying to look at it as a mode through which we could, hopefully ethically, consider it before it's mainstreamed into something like optogenetics or memory deletion. I spoke to one ethicist in neuroscience who thought in 10 to 15 years this could be something that humans are dealing with. 

I wanted to look at that kind of thing and say, there are parts of grief that are hell and the pain is seemingly unbearable. What does it mean if and when we get these possibilities with something like AI? I was working with GPT-3, now we're way above that. You can have way more complex conversations. I'm sure we will have some kind of video component or even more holographic, even more human component. What does it mean to really grapple with those questions now and to say, yes, loss is brutal, grief is brutal, but there is some value in it? And there is some reason to keep it with us and to work through, as hard as it is, rather than erasing it.

What do you think would help us in it as a collective? As you say one of the problems is we don't have communities now, we don't have the social structures. We have to seek out other people who are sharing this experience because grief is isolating. It's like you're the injured animal in the herd.

It's hugely isolating. The loneliness is a big part of it. That's part of the fear of engaging with someone about it. I found throughout researching this book and going on this quest, so much grief bubbling just under the surface of people. You give them just a touch of, “I'm working on a book about grief,” and you get so much. People that people crave that license, I think. 

You're talking specifically about grief where someone you care about has died. There other ways of grieving too. You can grieve a relationship, you can grieve for a thing that you wanted that you didn't get. You’ve experienced so many different ways of looking at it and dealing with it, processing it. What works? And what works for us, in caring for each other? 

Being present was really what I found. The book ends on me finally going home and being able to get over that roadblock of talking to my dad and my brother in an open way, talking to friends from back home. I had felt isolated, and also did a lot of self-isolating.

I was living in Paris for a few years. There were several nights where I wouldn't go out, or I would sit and listen to my mom's interviews on on my laptop that I did with her at the end of her life, and feeling like, I’m not normal. I shouldn't be burdening others. I shouldn't be within the mainstream social sphere. And having the wherewithal finally to be there with my family and have that presentism and searching for that community. 

I am sanguine about the rise in communities. I think more and more people are understanding this. There has been all sorts of understanding recently about how modern society is screwing us over. We need to start reconnecting and recreating communities in real life. All these things are part and parcel of how we'll get better at facing loss and helping others through it. And just understanding that it happens to everybody. It's not abnormal, and it shouldn’t be treated as such.