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In “Mourning and Melancholia” (1917e [1915]), Freud famously asked why the decathexis of grief is so extraordinarily painful—and admitted, quite frankly, that he did not know. The question has been lurking in the background of academic work on grief ever since-and looming in the foreground for anyone who grieves. Empirical work by Panksepp (1998), and theoretical work by Freed and Mann (2007), has tried to address the question by keying off Freud's almost-verbalized insight that “love is a drug.” Concretely put, what if attachment involves the same neural pathways that mediate other, more banal, rewards? From this standpoint, perhaps we can understand the pain of grief. Freed and Mann have advanced the hypothesis that grief involves pain because it is, in essence, an internally generated punishment designed to cause reversal learning. Which is to say, the pain of grief helps to down-regulate the hope for reunion. Stopping chasing losses-as the preceding article might put it—is the operative imperative in grief. The obstacle to doing this, of course, is that mourners face reminders of the deceased everywhere. Memories, mementos, similarities to the deceased in living people, important holidays, birthdays—all of these are stimuli that, through conditioning, have set the mourner up to expect reunion, which is to say reward. Is it any surprise, then, that in order to stop pursuing an unattainable goal, what is needed is reversal learning? The brain needs to encode at the neural level the psychological realization that the deceased should not, cannot, be approached (even mentally). Seeking must stop. To accomplish this task, perhaps it generates a pain signal when the urge to approach is mobilized.
This model of grief—which we have referred to as an incentive salience model of bereavement—has now been used for the first time to explicitly guide an fMRI experiment. O'Connor et al. hypothesized that people unable to let go of a loss-that is, people with complicated grief—mi