Why Grief Is Like A Chameleon and How to Live With It — Dr. Lisa Benton-Hardy

Grief doesn’t follow a script, and it certainly doesn’t end on a schedule. Psychiatrist Dr. Lisa Benton-Hardy joins us to unpack loss—why you may be met with a flood of feeling years later, how relief and laughter can coexist with tears, and what it really takes to support someone beyond the first year when the casseroles stop coming and month 13 begins.

We dig into the crucial difference between grieving as a process and grief as the lasting state we learn to carry. Lisa shares how deeper the attachment, the greater the loss. And what about deaths like suicide and homicide? Whether a stigmatized death or the loss of a loving spouse, Lisa guides us to reach out and ask someone grieving simply where they are. Practical short check-ins, honest questions, and letting the bereaved lead the pace.

We also explore how kids understand death at different ages, why direct language matters, and the surprising ways children often sense loss before adults say it aloud. Pet loss gets real attention too: the 2 a.m. comfort of a dog can be a lifeline, which is why losing that bond can intensify anxiety, OCD, and depression. Lisa offers a compassionate micro-step strategy from a bereaved mother—on the hardest days, the job is simple and brave: just get up. The path forward isn’t closure; it’s continued connection, honest language, and care that adapts long past the first year.

If this conversation resonates, share it with someone who might need it, then subscribe, rate, and leave a review on Apple or Spotify to help more people find the show. Your support keeps these stories going.

Transcript

Sponsor And Safety Disclaimer

Janine 0:00

We are supported by the SOAR with Tapping app. Tapping is a powerful science-back tool that calms your nervous system. I've been using SOAR with Tapping nightly for insomnia, and I am sleeping well. Visit the Soar with Tapping app at Apple and Google Play Stores to start your journey towards freedom right from your phone. Welcome to Bipolar She. I'm your host, Janine Noel. The content of this show does include suicide. If you're ever in need of immediate support, please dial 988 as Suicide and Crisis Lifeline. When we think about grief and grieving the loss of a loved one, we often associate it with sadness and depression. What if you feel relief or a surge of anger or maybe a moment of joy or even laughter? In our conversation today, Dr. Lisa Benton Hardy normalizes grief. She calls it the chameleon emotion that can show up in unexpected ways. Lisa is a child adolescent, an adult psychiatrist who has worked with many different populations and cultures as they grieve. We talk about her work at Children's Hospital in Oakland and the sick sense children have when a loved one has died. She gives practical guidance on how to offer someone support when they're grieving, even when we feel awkward and don't know what to say. And Lisa shares wisdom about how to keep going through life when the weight of loss is immense. Welcome, Dr. Benton Hardy. Well, good morning, Lisa. Thank you so much for coming on the show. Good morning, Janine. It's great to see you. So I always start actually by just having my guests jump into a time when their mental health was challenged.

Grief Versus Grieving

SPEAKER_00 2:00

Definitely. Then I have kind of what I call my meatball sandwich story. And a lot of my friends and patients have even heard this story over the years. So a little backstory. I lost my mom in 2001 to uterine cancer, and it was fairly rapid. She was diagnosed around February, had a pretty intense hospitalization, and then unfortunately was gone by April. So it was a pretty rapid decline. Make it even more interesting, I was also six months pregnant at the time when she was first diagnosed. And so I was already kind of a little bit of a hormonal mess, probably. I have an older child. So this was my second child. My older child had uh just gotten to be about two and a half. So mom was diagnosed, she passed away April 11th, and then shortly thereafter, my son was born June 26th. So this is back in 2001. So flash forward, I had had a busy day at work. This was about, I'd say about three or four years later after she had passed, so not imminently after she passed. I'd had a busy day at work, decided I didn't feel like cooking dinner that evening. So I thought, well, I'll get a sandwich. That'll be easy, it'll be quick, reasonably good nutritional value. So I'll get a sandwich. So I go to Subway and I'm looking at the menu, trying to decide what I want to order. And the man in front of me orders a meatball sandwich. And all of a sudden, I just felt this wave just kind of come over me. And I felt hot and sad and confused and upset. And I thought, this man is only ordering a sandwich. What is wrong with you? And by way of additional backstory, I'm actually a psychiatrist. So if anybody should have any insight into understanding why somebody's having an emotional response, I would hope I would. But I didn't know what was happening. And so I thought, I'm hot. I think I'm gonna have a panic attack. I've got to get out of here. And so I go and I sit in the car, and I didn't feel comfortable yet to drive. And I didn't know what was going on with me. And so I finally got myself together, went home, got something to eat. And then a couple of days later, I realized, oh my goodness, when my mom was ill and she was dying of cancer, she didn't really have too much of an appetite, both because of the treatments that she was receiving and also just the process of cancer itself. And one of her favorite sandwiches that I could always get her to eat, in addition to lox and cream cheese on a bagel, was a meatball sandwich. And it all kind of came together for me then when I realized, oh my gosh, this was a grief reaction. This was me remembering my mom just from the tiniest of clues. And it just struck me again, just kind of the profound nature of grief. I think a lot of people think, well, I need to be aware of anniversaries, I need to be aware of holidays, I need to be aware of these triggering moments. But in my case, it was just a simple meatball sandwich that kind of brought everything back. And so I kind of always use that story as a reminder, I think, of just the way that people who were gone continue to touch us long after they're gone and sometimes in very surprising ways.

Janine 5:19

Right. So do you consider grief being different from grieving?

SPEAKER_00 5:25

Most definitely. Most definitely. Grief to me kind of happens after the grieving process is a little bit further along when you actually realize the finality of grief and that the person is lost. I think if you think about it in terms of a verb and a noun, grieving is an active process. You're you're actively mourning the loss of the person, but you really haven't necessarily gotten your life back together again or realized how you're going to move forward and get on the other side of the grief. And so you're grieving in the early stages, but then from at least as I think about it, and especially with the Kuba Ross stages, grief happens at the very end of that when there's acceptance and you realize this person is gone. And it may not even only be a person. Grief to me is just the other side of profound love. And now you have to find someplace else to put that love because the object that it was transferred into a person, a job, a home, an object that means something important to you has been lost.

Janine 6:30

Well, I'm sorry for the loss of your mom.

SPEAKER_00 6:33

Thank you.

Janine 6:34

I'd like your opinion on this. Like if deeper the attachment, the more intense grief can be.

SPEAKER_00 6:42

Most definitely. The way I think about it is if I have, and this will sound silly, but just kind of bear with me. If I have my heart and all my feelings inside my body, when I attach to something, I pour some of my heart, some of my feelings into whatever it is that I'm attaching to. And so now my feelings aren't completely residing within myself. They're, let's just use a number, they're 50% living inside of me and 50% living inside something else. And so then when that something else is gone, half of my feelings were over there. And I think this is a useful metaphor because it explains why there are different kinds of grief. There are kind of regular grief reactions, there are complicated grief reactions, but just basically thinking about this example, if my feelings are living inside someone else, an object, a job, a home, whatever it is, and that thing is suddenly gone, I have to find a way to bring those feelings back into my body. And depending on whether you know the loss is coming, depending on if the loss is expected or anticipated, at least that gives you a little bit of warning sometimes to start pulling those feelings back inside. But that's kind of the easiest way I can think about it. Literally, my heart is divided and it's living partly someplace else. And so after grief, I have to find a way to get it back.

Attachment, Depth, And Pain

Janine 8:07

So, in your practice, how would you help someone going through that?

Normalizing Public And Private Grief

SPEAKER_00 8:11

The first thing that I will always do is usually try to at least normalize the grief process. Two things come to mind. One is grief sometimes is a very public emotion in terms of sometimes other people know as well of the loss, or there may be memorial services or funeral services if it's a person. And so not only are you experiencing the feeling yourself, but other people are watching you experience the feeling. And it's a very public emotion in the sense of people have their own ideas of what grief is supposed to look like. I've lost someone I love, so everyone is expecting me to cry. Everyone is expecting me to be sad. Everyone is expecting me to be withdrawn. But what if I'm not feeling those feelings? Or what if I'm not feeling those feelings now? Or what if I need a meatball sandwich to trigger those feelings? Well, now, in addition to going through my own grieving reaction, I have the public sentiment about if I'm grieving appropriately to kind of handle. And then the second point that I always make with my patients is grief is kind of what I would call the chameleon emotion. People typically think of grief and they equally associate that with sadness, with depression. But depending on the situation, grief might be relief. If there was someone you were involved with and they were suffering, or maybe you were in a job and you were miserable, and now that you're not there anymore, there's a sense of relief. Along with that, there can sometimes be a sense of guilt. There can be anger. Sometimes there can even be moments of joy. Somebody who maybe has a pretty strong religious faith and they know that someone they love is suffering, there might be a moment of joy to know that they're not suffering anymore. And so I think the very fact that grief is public, and so you not only have to shoulder the feelings yourself, but what everyone else is looking at to decide if they think you're having the appropriate grieving response. And then it can present in so many different ways, especially with guilt. I mean, you can imagine if I've lost someone that's important to me, my assumption is that I'm just going to be sad every single day. So then what happens that one day when I actually laugh? Well, now I kind of feel guilty because I was supposed to be sad every single day. And so I always start off with any of my patients who have gone through any kind of loss, just first kind of normalizing the grief reaction and letting them know that it sits a little different than other emotions and that you can have any emotion. And then one thing I did forget to add, I think it's important to figure out how the loss happened, who it was, what happened, what the person's relationship was, whatever that loved person or object was, because that at least gives me a clue as a psychiatrist and mental health provider to know maybe which emotions are likely to come up first. So that was a very long answer to a fairly straightforward question.

Janine 11:16

No, it's really all helpful. I feel we're raised in certain ways. We either really taught to confront death and grieve, or we're really not taught that much. So we get kind of confused about what to do.

SPEAKER_00 11:31

Grief is kind of a two-sided emotion. There's the person who is grieving, and then there are the people who are trying to support the person who is grieving, but they are also potentially experiencing a loss themselves. And even though, as you mentioned, some people have traditions, they've experienced it, other people don't. And so there's this difficulty in terms of what do you say to somebody who has lost someone they love? And this is another thing that I will tell my patients because I think it helps them understand the entire cycle of grieving. A lot of times people are keeping track of time and they are keeping track of time with you, and they are looking at that 12 months that happens after the loss, and they're looking to see will there be birthdays, will there be anniversaries, will there be holidays? And a lot of times there is a great outpouring of support during that first 12 months because other people are marking time with you, but then there's this inaccurate belief that after a year, you should be fine. You've gone through all those important days. For me, in my case, Mother's Day, my mother's birthday, my children's birthdays, realizing that each one of these landmarks she wasn't going to be there for. And then a lot of people who are trying to support someone who's been grieving, you get to month 13 and they figure you're fine. And now all the support sometimes starts to drop off. The meals that may have been coming, the people that were tracking time with you and making sure to reach out on holidays. And you get to month 13 and you may not be over it. In fact, I would argue that you will never be over it. It will always live with you in some way, shape, or form. The same way if you ever have any type of a bodily injury, you almost always have a scar there. The acuteness or the intensity of that first painful injury passes, but you still do have that scar. And so sometimes I will tell my patients, let's make sure that we prepare for month 13. When everyone has gone through this timeline with you and they've been supportive, and then they think, well, you're over this, right? And then you see this support kind of dropping off. But for the person who's grieving, this is just the beginning. It's a milestone to make it through the first year, but it's even a milestone as well to kind of make it through month 13.

The Calendar Trap And Month 13

Janine 13:51

So going forward from month 13, like how do we support someone still, you know, grieving? Like any ways that you suggest?

SPEAKER_00 14:02

I will usually suggest to people to just meet the person where they're at, if that makes any sense. You know, in the sense of I would encourage you to go into this experience without any assumptions, because you don't necessarily know what the relationship was between the two people in terms of the person who is still here and the person they have lost. And in this case, if we're talking about the loss of a person and relationship, you don't really know what that relationship was. You have some clues. Was it the loss of a spouse? Was it the loss of a parent? Was it the loss of a child? How was the loss? And I think it's important for me to make a note while I'm on this topic of you can have straightforward grief reactions, and then you can kind of have complicated grief reactions. Example, in the case of my mom, she did have a terminal illness. And even though I had prayed and hoped that she would be with us longer, it was fairly short. But I did know that she had a terminal illness. And so I was somewhat prepared to know that she probably was not going to survive this. And so I knew that the loss was imminent. In situations where you do not have that kind of grace or advanced notice, someone who was lost suddenly, an accident, if if something untoward happens. And then I'd be remiss as a psychiatrist if I didn't mention the two kind of areas where grief lives very differently in terms of murder and suicide. Those are definitely areas as well where you had no idea what was going to happen. And that has a whole litany of other feelings that come with it, because in those situations, this was a death that potentially did not need to happen. And so knowing kind of what happened in terms of why the person was lost, what the relationship was, that at least gives you a starting point in terms of how to support this person. And definitely if you're close to them and you know that the relationship was one of closeness, you know how to support them. But even if you don't have that knowledge, I would suggest, and I'm coming back to your question, of you just ask them where they're at, in the sense of going up to them if they're in person or reaching out by phone or text and just say, hey, you know, I know that you lost someone in your life. You doing okay? Are you are you taking care of yourself? Is everything all right? And to try to just find out where they're at first without any assumptions, and then just kind of let them lead the conversation. They may not want to talk about it, in which case it's it's appropriate to respect the privacy. They may want to dive right in and talk a lot about it, and you may get more information than you wanted. And so I think you you arm yourself first by trying to know what the relationship was, by trying to understand how the loss came about in the sense of why this person is no longer in their life, and then just trying to figure out what kind of day they're having, meeting them where they are.

Janine 17:13

Yes, this is so interesting because you also have worked with very different populations, children and adults from different backgrounds and ethnicities. Working at children's hospital, I'm sure you saw such a range of families going through the grieving process. And I'm interested in that experience and what you learned and maybe some, you know, cross-culturally different ways that people do respond to grief.

How To Show Up For Grievers

SPEAKER_00 17:42

Oh, I love this conversation, Janine. You're bringing up so many important things, definitely different based on the age of the person in terms of with children, it's very important to kind of know what their understanding of things are. A child, for example, who is below the age of six, they don't understand that death is permanent. They don't realize that once a person is gone or once anything is over, that it is over with kind of a capital O. And so that's an important piece in terms of with very young children, again, under the ages of six, they they don't understand that this loss is permanent. And so it's very important when you're working with a child that age to tell them that whomever they are grieving, that this person isn't with us anymore and isn't going to be with us anymore. And then as you, of course, look at children as they get older and they move kind of from what's considered very concrete thinking to kind of more abstract concepts, which tends to happen around the age of 12 or 13. Now they can kind of hold this a little bit better in the sense of knowing that the person is gone, but still not quite understanding what it means. And then, of course, you can imagine once you get to the middle teen years, definitely young adults, now they are not only able to understand loss and death in the present moment, but they can think five years into the future, 10 years into the future. And so if you just look at this from a developmental arc, supporting someone, I'd say probably below the age of 25, it's really important to kind of try to figure out where they might be in terms of how they understand death. Is it permanent? Is it a condition that is going to endure? Can they look into the future? And then, you know, of course, to your point, it's also important to try to understand the resources that a person has. Is this a child who has other family members that can support them, or is it actually their parents or somebody important who was lost? I remember being shocked and kind of humbled so many times when I was at children's, a child would potentially have been in a car accident with the parent. And now the child is brought into the ICU because they've suffered significant injuries. And potentially one of the parents also suffered significant injuries, or maybe has passed from those injuries. And people tend to kind of tiptoe around because they they don't want to shock the child. They don't want to trigger something. But it was always amazing to me. The children always knew. I don't know how they knew if they just picked up that the adults or caring people in their lives were dealing with them differently or approaching them differently. But there were so many times when the children already knew. And it was myself or someone else on the psychiatric team who came upon that information. And there was such relief, I think, for the child to realize that we weren't keeping this big secret. So that was probably a lot more information than you were thinking about. But it's it's definitely different when you're supporting children because of the level of cognition and development that they have based on their age. And then their relationships sometimes need a lot more support.

Janine 21:04

That also brings up the idea of these support systems. And perhaps we just don't have as many in place for bereavement. I mean, there also is a reality that early in grief, you're more susceptible to any sort of heart attack or stroke if you've lost someone you love.

SPEAKER_00 21:23

So there are And they have certainly done studies on that in terms of spousal relationships, how depending on how long the couple was married, at what ages they got married, any health issues that either one of the members of the couple has, that it's not unusual that sometimes couples will pass within months or years of each other, in the sense of one half of the partnership, one person in that couple passes. And it is sometimes not that unusual that within six months to a year, the other one may pass as well, depending on the intensity of the connection.

Janine 22:04

Right. We have that research that says there is such a thing as a dying of a broken heart, even.

Children’s Understanding Of Death

SPEAKER_00 22:11

Oh, most definitely. And, you know, I think it's even fascinating too to see that this isn't something that only happens within humans. You know, you see grief and the reverberations through a community of loss, even in animals. You know, one of the things that I have always thought so beautiful is if you look at elephants and how they remember the ones who have passed and how they will make an effort sometimes to bury one of the members of the herd where other members of the herd are born and raised and have died. You even see this a lot of times. You can imagine if a family has two dogs and one dog passes, you will even see the remaining dog kind of go through a bit of a grief reaction. And so, in its own kind of beautiful way, the loss of someone that you love who's been close to you isn't just reserved for humans. You you see it in animals too, which I think is just a beautiful thing in terms of the profound connections that can be formed, and then how to manage that connection once it's no longer there.

Janine 23:17

Well, certainly the human-dog connection is important. I think the worst grief I've ever felt was the loss of one of my dogs. I haven't had I feel like terrible saying that, but I haven't had anyone in my immediate family die suddenly. So I haven't experienced that type of grief. But when my dog died, my depression, my anxiety, my OCD, just everything went, you know, into uh I just high speed. I couldn't even keep up with it. It was just the most awful feeling. And it just kicked up everything.

Health Risks And Broken Hearts

SPEAKER_00 23:57

I love what you said about the loss of your dog. I I forgot to mention that earlier. That is something that I will also support people with because many people would think, oh, it was just a dog. Why are you so upset? And so again, there's that judgment in terms of whether the grief is appropriate and how you respond to it. But I similarly remember grieving the loss of my dog. And I can say this because I I know my mom understands. I grieved the loss of the dog in some ways a little bit harder at different points than the loss of my mom, because the dog is there all the time. The dog was that unconditional support animal, and they talk a lot about emotional support animals and things like that. And I am a firm believer in that. And there's that, I'll just make up a word here, the unconditionality of that love and and bond, you know, at two o'clock in the morning. If I woke up and I was grieving my mom, and it's like, well, who am I gonna call at two o'clock in the morning? My dog was there. My dog was like, I'm here. My fur is waterproof. You can snuggle with me. And so that that's a different type of loss, I think, when you when you lose an animal that lives someplace else. And then most definitely, you can definitely assume and with a fair degree of confidence that if there are any underlying mental health issues, that they are definitely going to be triggered. Because a lot of times what rests at the base of a lot of health conditions and in particular mental health conditions, especially anxiety, is the feeling of control or lack of control. And you can imagine that the loss of someone is a pretty big example of not being in control. And so, pretty reliably, you can imagine that anxiety is certainly going to tick up more because if anxiety is basically represented by the acknowledgement of the fact that there are things that we can't control, and OCD sometimes being the perfect example of the coping skill for lack of control that has now become a problem in and of itself, that when you lose someone that you love, you have completely lost control. And then for obvious reasons, you can imagine if someone was already depressed and dealing with loss and disappointment and feeling overwhelmed and sad that the grief potentially could compound that.

Janine 26:26

So for you and your experience with your mom and grief over the years, was there anything said to you or any type of practice, any just words of advice that really resonated with you?

Animals, Bonds, And Bereavement

SPEAKER_00 26:40

Yeah, I had another one of my patients, and we may have been talking about this before, who unfortunately had lost her son to suicide. And I had initially been seeing her son and then lost touch with him. He went away to college and transferred care to another provider, and the mom reached out to me after he had committed suicide and wanted to connect with me to first understand as best as she could what and how and if there was anything that could have been done differently. It had been probably three or four years since I had had contact with him when she reached out to me. And along the lines of your question, we had started doing mainly therapy. I had put her on an antidepressant because she wasn't doing as well, obviously, as one would hope. But we also kind of would take some of our time to kind of do therapy. And I took that opportunity to ask her, how did you survive the loss of your son? Because I was really grappling with trying to survive the loss of my mom. And I thought, my gosh, at least I was blessed to have my mom and to have some warning that she was ill and I was potentially going to lose her, and I could kind of begin that grieving process. But here was a woman who had no warning. And anytime you have a loss that's unnatural, that always hits a little different, whether it's murder or suicide. But definitely if it's the loss of someone younger than you are, we don't have too much surprise if we lose someone who's significantly older than we are. But my goodness, the loss of a child for a parent. And so to your question, I took the opportunity one day and I said, I appreciate this may be inappropriate because I am your physician, I am your care person. But how did you do it? How do you come back from that? Because I'm really struggling. And she said to me, uh, you tell yourself I'm just gonna get up. You wake up in the morning and you tell yourself, okay, the first thing I need to do today is I just need to get up. I just need to get out of bed. And then if you actually are able to get up out of bed, then maybe you think to yourself, I think maybe I'll get something to eat. I think maybe I'll change clothes. I think maybe I'll have a couple of chores. And there was a profound sense of relief in her words, in the sense of some days you may be able to get up and function and be able to accomplish a lot of things. And other days just getting up is the hardest and the most important thing that you do. And it taught me that one of the ways I could manage grief is by giving myself grace and realizing that some days it's enough if I just get out of bed and if I'm just able to kind of take on the day.

SPEAKER_01 29:33

Well, this is such a great conversation. I'm glad we could find a time together and thank you. Yeah, thank you so much.

SPEAKER_00 29:40

Thank you.

Janine 29:42

Thank you so much for listening. Please share this episode with someone who may need to hear it. I am hard at work on our next season, and I could use your support. Please subscribe, like, rate, or leave a review on Apple or Spotify. It's the best way to keep the show going so we can make an impact and normalize mental illness. And as always, thank you for your support.