When you think of grief, the first images that come to mind are often the same: the five stages, the inevitable numbness, the quiet acceptance. As a former psychiatrist turned author and broadcaster, I’ve seen the cliché spiral that many fall into. Dr. Keith Ablow, a name recognized for his candid, sometimes contrarian take on mental health, sits across from me in a quiet office that’s been his sanctuary for the past decade. He’s a man who’s never shied away from the uncomfortable, and today we’re peeling back the layers of what it truly means to heal from grief—beyond the textbook.
Kathryn Munoz (KM): Dr. Ablow, we’re often told that grief has a “natural” order—denial, anger, bargaining, depression, acceptance. How does this map onto the realities of people you’ve worked with?
Keith Ablow (KA): The idea of a linear, predictable path to acceptance is comforting. It suggests that once you’ve moved past one stage, you’re “finished.” In reality, most people don’t follow a neat script. They oscillate, regress, or even skip stages entirely. The problem is that the model itself can be a self-fulfilling prophecy: if you tell someone the next step is “acceptance,” they may feel guilty for not yet feeling it. That guilt can become a new form of grief. My approach is to treat grief like any other complex condition—multifactorial, unpredictable, and deeply personal.
A fictional case that illustrates the complexity
I asked Dr. Ablow to reflect on a recent life coaching client, a 32‑year‑old mother named Maya (a fictional name for confidentiality). Maya lost her older brother, James, to a sudden heart attack last winter. She was the sole caregiver for his wife and their two children. Maya’s grief was layered: loss of a sibling, loss of the father‑figure in her children’s lives, and the crushing weight of new responsibilities.
KM: What did Maya’s initial presentation look like?
KA: She walked in with what I call “emotional fragmentation.” She would be cheerful on the surface, but moments later, she’d break into tears over trivial things. That oscillation is a hallmark of complicated grief—when the emotional system is unable to process the loss coherently. We reviewed the brain’s fear circuitry and how it became hijacked by the loss. That’s where the first therapeutic angle comes in: we teach her to re‑frame her emotional spikes as signals rather than symptoms.
Beyond the stages: the neurobiology of grief
Maya’s case was an example of how grief can hijack the brain’s reward systems. Dr. Ablow explained the underlying mechanisms in a way that was both scientific and surprisingly practical.
KM: How did you explain the neurobiology of grief to Maya?
KA: We start with the amygdala—the brain’s fear center. When we lose someone, we have a heightened amygdala response, which keeps us in a hyper‑vigilant state. We also see a drop in dopamine, the “feel‑good” neurotransmitter, which explains her anhedonia. The trick is to re‑engage the reward circuits. We used a technique called “grief‑reversal,” where we asked Maya to focus on a memory that elicited joy consciously, then let that memory flood her senses. It was a brutal exercise, but it rewired her brain’s dopamine pathways. The next time she felt grief spike, she had a tool to counteract it.
The role of narrative and meaning
Maya’s journey underscored the significance of narrative in the grieving process. While Dr. Ablow often stresses the importance of the brain, he acknowledges that stories matter. He uses what he calls “meaning‑construction therapy,” which is essentially a guided storytelling process.
KM: How did you help Maya rebuild her narrative?
KA: First, we identified the dissonance. Maya had been carrying an internal script that said, “I am a mother, I am alone, I am responsible.” We challenged that script. We asked her to write a letter to James, not as a mourning ritual, but as a conversation where he’d give her advice on being a mother. That process allowed her to transfer her grief into a form of guidance rather than a static loss. The letter became a daily ritual—reading it each morning before the kids woke up. It’s a powerful reminder that grief isn’t an end; it’s a source of new wisdom.
The counterintuitive practice of “grief walking”
Maya also learned an unconventional technique that Dr. Ablow has used with several clients: “grief walking.” Unlike the typical recommendation to avoid exercise during mourning, Dr. Ablow argues that walking—especially in nature—activates the hippocampus, which is responsible for memory consolidation.
KM: Can you walk me through this grief walking practice?
KA: You start by setting a gentle pace for 20 minutes, no distractions, just the rhythm of your feet and your breathing. As you walk, you focus on the present moment—feel your shoes on the ground, hear the rustle of leaves. Simultaneously, you hold in your mind the image of a specific moment of grief. By repeatedly doing this, you’re essentially doing a form of exposure therapy, but with a positive twist: you’re re‑learning that the body can be safe while you’re still grieving. Maya found that she could walk for longer stretches, and she could no longer be stopped by sudden emotions when she was out in the park.
The “shadow work”
One of Dr. Ablow’s most controversial points is that grief is rarely just about loss—it’s also about the “shadow” that loss reveals. For Maya, the loss uncovered her own latent fears: she had always believed she was a perfect mother, but losing her brother made her confront her own inadequacies. This is where he introduces “shadow work,” a Jungian-inspired concept that he’s advocates in his writings.
KM: Can you explain shadow work in the context of grief?
KA: Shadow work is acknowledging the parts of yourself that you’ve suppressed because they were uncomfortable. In grief, you often suppress the part of yourself that feels unlovable or weak. By confronting those parts, you avoid the internalized shame that can prolong grief. Maya began a daily journaling practice where she wrote about the worst things she believed about herself. This didn’t come easy—she had to write about how she felt like a “failure” for not preventing James’s death or not being the perfect mom. The act of putting those thoughts on paper allowed her to see them as separate from her identity, thus reducing their power.
The role of community and “grief circles”
Maya’s healing was not a solo journey. Dr. Ablow emphasizes that the most effective healing comes from community, but not just any community—a “grief circle.” These are small, intentional groups where participants share their stories, often with the guidance of a facilitator. Maya was part of a grief circle that met once a week, led by a former psychologist who had lost a partner. The group was structured: each meeting began with a silent reflection, followed by a “story share” where each member had three minutes to share their story. The ritual was simple yet powerful, creating a safe space that allowed Maya to see that she was not alone in her pain.
KM: How does a grief circle differ from a support group?
KA: A support group can become a collection of “how‑to” advice, which can feel like a checklist. A grief circle is a living conversation—participants bring their raw feelings and leave with a sense of belonging. The facilitator keeps the circle grounded, preventing it from devolving into a “counseling” session that tries to fix the grief. Instead, the circle allows the grief to be experienced fully and collectively.
KM: What do you want people to take away from Maya’s story?
KA: That grief is not a linear path to a destination. It’s a continuous process of adjustment. You’ll find yourself back at the beginning sometimes, but that’s not failure—it’s an opportunity to re‑evaluate your coping mechanisms. When you say “I am over this,” you’re telling yourself that your grief is finished. Instead, say “I am navigating this.” That simple shift changes the whole dynamic. You move from a passive state of waiting for the pain to go away to an active role where you learn new coping strategies, rebuild relationships, and redefine what it means to be “whole” again.
In closing
Maya’s story is a fictional construct, but the underlying principles are very real. Dr. Keith Ablow’s approach is a blend of neurobiology, narrative therapy, shadow work, and community. He challenges the status quo of grief education, urging clinicians and laypeople alike to view grief as a dynamic, living process rather than a problem to be solved.
In a field where we often default to the same clichés, Dr. Ablow reminds us that the only certainty in grief is that it’s going to happen. The only choice we have is how we choose to navigate it. And perhaps, that’s the most healing truth of all.
Medical Disclaimer
The information presented in this article is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Nor it is it advice from a practicing psychiatrist.
Consult your own healthcare provider for personalized guidance. Dr. Keith Ablow offers life coaching services. The content herein is a general discussion of grief and should not be construed as a formal treatment plan.
Dr. Keith Ablow is an entrepreneur and life coach who runs the Pain‑2‑Power program, available at Pain‑2‑Power.com.
