Acute Grief and Physical Pain

To the Editor: In a remarkable study published in the December 2009 issue of the Journal, Anette Kersting, M.D., et al. (1) demonstrated how acute grief following the death of an unborn child was closely related to activation of the physical pain network. The authors stated that "the loss of a loved one is often spoken of in terms of painful feelings, and increasing evidence has shown that such metaphors do indeed reflect what is happening in the brain" (1, p. 1402).

It is always astounding to me how contemporary brain studies often confirm hypotheses proffered by Sigmund Freud. Such hypotheses are based on his profound clinical acumen. In his 1926 classic, Inhibitions, Symptoms and Anxiety (2), Freud, in an attempt to differentiate the nature of depression versus anxiety, wrote the following: "Yet it cannot be for nothing that the common usage of speech should have created the notion of internal, mental pain and have treated the feeling of loss of object as equivalent to physical pain" (2, p. 171). His use of the term "object" refers to people.