The loss of a loved one, even more if sudden, can literally represent a serious blow to the heart.

A recent Danish study, published in the magazine Open Heartshowed that the loss of the partner significantly increased the risk of atrial fibrillation, one of the cardiac arrhythmias most frequently associated with stroke, heart failure and death.

The authors collected data, between 1995 and 2014, out of 88,612 people who for the first time had been diagnosed with atrial fibrillation, comparing them with a group of 886,120 healthy individuals. In both groups, those who had suffered the loss of their partner was seen.

Well, by observing the data, the researchers found that the probability of developing a cardiac arrhythmia was 41% higher among those who had undergone a mourning than those who had not experienced this experience. This risk grew to 57% in the event that the partner’s death had taken place unexpectedly, or with the partner who enjoyed good health until a month before death.

This study also shows another result. Among those who were less than 60, the risk of atrial fibrillation was double compared to the older ones.

In all cases, the risk was higher in the first two weeks following the loss and then gradually decreased: after a year after the event, the probability of diagnosis of atrial fibrillation was the same between those who had had the loss of the partner and who had not suffered this mourning.

The results, therefore, suggest that the loss of the partner increases the risk of developing the first episode of atrial fibrillation. It is a purely observational study and so the causal mechanisms below the association between mourning and atrial fibrillation have not been the subject of the investigation.

Mourning: maladative or adaptive process?

The loss of a loved one is certainly a stressful event in the life of an individual and has been known for some time as it is accompanied by a worsening of the state of health, with increase in mortality rates, loss of appetite, depression, alcohol consumption, loss of desire and sexual function.

Numerous studies have also investigated and confirmed the impact of the death of a significant person on their immune system.

While medicine attempts to explain the reasons and mechanisms for which the mourning person runs a greater risk of getting sick in the period following the event, from an evolutionary point of view, it is to be wondered what the reasons why the phenomenon of mourning has remained in the natural selection process may be, despite its nefarious effects both physical and psychological (Onofri & La Rosa, 2015).

In other words, why did the individuals who expressed the condolence have not been replaced by those who lived with indifference to the death of a loved one?

In a strictly evolutionary logic, in fact, the latter would be more capable of increasing the advantage for survival or reproduction because more skilled in obtaining essential resources for life, in maintaining normal activities, in looking for new sexual partners thus guaranteeing a greater probability of reproducing.

The attachment theory developed by Bowlby (1980) has dedicated particular attention to the theme of mourning contributing to the understanding of the phenomena that appear after the loss of a significant figure.

The reaction to the death of a loved one seems to, at least in an initial phase, completely superimposable to what you would have in the case of a sudden and protracted separation, however temporary. And so in the context of the attachment theory, research behaviors, as well as anger, would be nothing more than reactions aimed at recovering the closeness with the beloved figure and discouragement of a further removal.

If separation is a very common event among animals, the death of another significant is statistically less frequent. Here, not being able to suffer an absence from death from a separation suffering, it is difficult to disable those mechanisms that control separation reactions and that have the adaptive function of promoting the rapprochement with the loved one. In other words, it is better to respond automatically to all separations as if they were still reversible.

According to Bowlby, therefore, the maladactive mourning response would represent the cost necessary for the most adaptive Reaction to separation (Onofri & La Rosa, 2015).

Following the studies of Parkes (1972), Bowlby (1980) and Rando (1993), mourning is a process consisting of a series of psychological, behavioral, social and physical reactions related to a personal loss experience. It is a natural process, by phases, with a variable duration and intensity also in the light of individual differences related to the specific loss.

At the beginning there is a so -called phase of stunning or disbelief, which usually lasts from a few hours to a week and in some cases it can last much longer. During this phase it is almost unable to understand what happened: there is the desire to avoid the awareness that the loved one is lost forever.

As the loss is felt as real, negation can emerge, i.e. the tendency to deny that the loss really took place and this phenomenon can allow a more gradual taking of what happened.

At a second half, the condolence is felt more intensely and the loss reactions become more acute. It emerges both the pain and it with those who have abandoned it or to anyone who could have contributed to the event (including themselves), as well as an alarm state that pushes in search of the lost person.

While recognizing its uselessness, the mourning person feels a strong impulse to seek the person who is no longer there: attention seems to be focused on parts of the environment more strictly linked to the deceased; They are frequent auditory or visual despair as if we came to hear the voice or to warn its presence.

In addition, there are persistent images or thoughts linked to the deceased as if to keep their image vivid and favor their discovery. It is in this phase that, experimenting with the failure in attempts to reunite the loved one, in fact we ” learn ‘his death.

The last phase of mourning provides for its complete processing: accept the loss of the person dear as something definitive and irreversible (the deceased will no longer return!) And the pain consequent to it.

The elaboration of mourning as acceptance

The great majority of people who face a mourning manages within about 18 months to get to this form of acceptance (Bonanno & Lilienfeld, 2008). Sometimes, as in the case of the so -called complicated mourning, certain emotional reactions do not tend to decrease and moderate themselves with the passage of time and significantly interfere with personal and social functioning.

From what is described above, in terms of phases, we could conclude that the process of acceptance of mourning represents the last act of a typical constellation of reactions that follows a specific time trend. Consequently, the non -succession of the different phases could be considered an unfavorable prognostic factor or in any case a complicated mourning prodrome.

Perdighe & Mancini (2010) instead underline how much emotional suffering and elaboration of mourning are not necessary processes for acceptance and that their absence does not represent the condition for which psychological help should be requested. If therefore some authors assert that there are no mandatory reactions to achieve the acceptance of mourning, it is also true that the loss of a significant active person of the psychological responses such as to require a change.

In fact, the elaboration of mourning involves the dissolution of the psychological ties that held the deceased together to the dear person when he was alive and the development of new ties that take into consideration the fact that the person is now dead.

However, it is important that the mourning person has clear that the processing of pain does not involve the loss of the attachment bond with the deceased.

Many people feel that a healthy elaboration of mourning is necessarily accompanied to leave the past behind and go on in life. It is legitimate to think that this assertion can curb the process of processing for fear of a breakdown of connections with the loved one, who would have lived as a forgetfulness or worse still as a sort of denial of the importance that the deceased may have had in the life of the individual.

The goal, on the other hand, is to be able to find a way of maintaining an attachment bond with your loved one by recognizing at the same time that the person natural will no longer return.

In conclusion, the mourning process highlights how much for our mind the significant affective bonds represent something indissoluble: the elaboration of mourning, in fact, does not entail the end of the bond but the development of a different bond with the deceased person (Onofri & La Rosa, 2015).

The report is transformed to allow the transition from an old relationship, which presupposes the physical presence of the other, with a new inner link in which the other is physically absent. In this way the mourning person will come to create an internal, positive and adaptive representation of the loved one, redefining himself and changing the image of himself and his life to adapt to this new reality, reorieting the emotional resources towards new and satisfactory investments (people, objects, roles …) who do not end in the relationship with the person who unfortunately has left forever.

Essential bibliography:

Graff S., Fenger-Grøn M., Christensen B., Søndergaard Pedersen H., Christensen J., Li J., & Vestergard M. (2016). Long-Term Risk of Atrial Fibrillation After The Death of A Partner. Open Heart; 3: E000367. DOI: 10.1136/OpenHRT-2013-000367.

Onofri A., & La Rosa C. (2015). Mourning. Evolutionist cognitive psychotherapy and EMDR. Giovanni Fioriti publisher.

Perdighe C., & Mancini F. (2010). Mourning: from myths to the acceptance facilitation interventions. Psychobody 3, 127-146.