Episode 183: Why Is Grieving a Skill? What HRV Reveals About Resilience, with Dr. David Rabin
- 6 hours ago
- 9 min read
How Do You Grieve? Why Grieving Is a Skill Your Nervous System Can Learn, with Dr. David Rabin
Most of us were told to grieve, to rest, to be present. Nobody taught us the skill. The instruction arrived without the practice, and the gap is where the struggle lives.
Heart rate variability and resilience: the measure that shows whether your body is getting stronger. Heart rate variability, or HRV, is the rate of change of your heartbeat over time. It is a proxy for vagus nerve activity, readable through the skin by most wearables. As HRV rises week over week, you recover faster and bounce back sooner.
Translational neuroscientist and psychiatrist Dr. David Rabin has studied stress for more than twenty years. He is the author of A Simple Guide to Being Alive. His work points to something surprising about HRV. Unlike almost every other biometric, it has no ceiling.
Dr. Aimie and Dr. Rabin walk through what that means in practice. Attention is a finite resource, and anxiety masks itself as focus while quietly spending it. Grief is a skill, and grieving is how a body reorganizes around safety after loss. They cover the gratitude practice Dr. Rabin returns to daily, and why feeling safe enough to feel is where the work begins.
In This Episode You'll Learn:
01:03 — Why is heart rate variability the key marker for resilience?
03:08 — What is intention, and what is it in the nervous system?
04:08 — Where does intention fit if you have lived in hypervigilance?
08:18 — What practices in therapy get in the way of healing?
11:28 — How do you apply these principles in a full, busy life?
16:33 — How do you grieve a loss, and why is grieving a skill?
This is Part 2. Listen to Part 1 here.
"Grief is a skill. Grieving is a skill." — Dr. David Rabin
Key Takeaways
HRV is a proxy for vagus nerve activity you can read through the skin
Rising HRV over weeks and months means your recovery window is shortening. Unlike most biometrics, HRV has no upper ceiling.
Attention is a finite resource, and the past and future consume it
Anxiety can present as focus while pulling attention away from the present
Breathing by choice reminds the body it has control over attention.
Grieving is the skill that lets a heavy feeling move rather than stick
After loss, the body reorganizes around where safety lives now
Gratitude practiced over time builds a feedback loop the brain rewires around
Notable Quotes
"Heart rate variability is the rate of change of our heartbeat over time, and it gives you a measure of vagus nerve activity." — Dr. David Rabin
"Anxiety masks as focus, but it's actually not real focus. It's a distraction." — Dr. David Rabin
"It's really reorganizing around what is safe now." — Dr. Aimie Apigian
Episode Takeaway
Being told to feel your feelings is not the same as being taught how. Most of us were handed the instruction and none of the skill. The gap is where so much struggle lives.
Grieving is a skill. It is how a heavy feeling moves through you rather than lodging in your body. If you are in a season of loss, I hope you heard permission to feel it.
And this is not a life sentence. A body can reorganize around safety long after the moment that first taught it to brace.
This is the part I want you to hold. Your only job is to do one thing that creates a better tomorrow for yourself. That is where agency starts.
Resources/Guides:
Get the "Is It Stress or Trauma" Guide. Know whether what your body is carrying is stress or something deeper.
The Biology of Trauma Recommended reading: chapter 2, on the difference between stress and trauma
Related Podcast Episodes:
About the Guest:
Dr. David Rabin, MD, PhD, is a translational neuroscientist and board-certified psychiatrist. He is a senior research scientist at the Florida Institute for Human and Machine Cognition (IHMC), Executive Director of The Board of Medicine, and the co-founder and Chief Medical Officer of Apollo Neuroscience. He has studied chronic stress in humans for more than twenty years, with a focus on non-invasive therapies for treatment-resistant illness. His research includes the mechanisms of psychedelic medicines and MDMA-assisted therapy for severe PTSD. He received his MD and PhD in neuroscience from Albany Medical College and trained in psychiatry at the University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic. His book, A Simple Guide to Being Alive (June 2026), is a science-backed manual for anyone who has felt overwhelmed by the modern world.
Get Dr. Rabin’s Book:
Your host: Dr. Aimie Apigian is a double board-certified physician in Preventive and Addiction Medicine, author of the national bestselling book The Biology of Trauma (foreword by Gabor Maté) and the founder of the Biology of Trauma® framework that reshapes how we understand the way the body experiences and holds trauma. She holds master's degrees in biochemistry and public health. After foster-adopting a child during medical school set her on this path, she desperately sought for answers that would only continue as she developed chronic health issues. Through her Biology of Trauma® practitioner training, podcast, YouTube channel, and international speaking, Dr. Aimie bridges functional medicine, attachment science, and trauma therapy, with a focus on facilitating accelerated repair of trauma's impact on the mind, body, and biology.
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What is heart rate variability, and why does it measure resilience?
HRV is the rate of change of your heartbeat over time. It reflects vagus nerve activity, and rising HRV means you are recovering faster.
Dr. Aimie has taught for years that regulation can be measured. Dr. Rabin points to the marker that does it.
Heart rate variability tracks how much your heartbeat shifts from beat to beat. Most wearables read it now. Oura, Apple Watch, Whoop.
The number matters because of what it stands for. Higher vagus nerve activity produces higher HRV. That activity predicts performance, longevity, and resistance to disease.
Watch it across weeks and months, not days. A rising line means you are bouncing back from stress sooner than you used to.
Does HRV have an upper limit?
In a healthy heart, HRV has no ceiling. Most biometrics have a safe range, and HRV keeps climbing as your capacity grows.
This is the detail that stopped Dr. Aimie in the conversation.
Nearly every other biometric has a floor and a roof. Go below one, go above the other, and something is wrong.
HRV works differently. Absent a cardiac arrhythmia, it keeps going up. If HRV stands in for human potential, then the ceiling on that potential is unknown.
This is what makes regulation measurable. You get a number that moves as your nervous system rebuilds.
What is intention, and how is it different from attention?
Intention is where your energy goes. Attention is the gateway you control in the moment, and it decides whether intention lands.
Dr. Rabin describes intention as a reflection of your energy output. Attention is the piece you can steer right now.
You can choose to be here. Or you can drift to the bird outside the window. The choice is available every moment.
That choice is what carries intention to its target. Without it, the intention is set and the energy leaks elsewhere.
Why does anxiety feel like focus?
Anxiety pulls attention into the past and future while it feels like concentration. The attention spent there is unavailable for now.
This is the line that lands hardest for high performers.
Someone with high control anxiety believes their focus is on the goal. In fact, the focus is on the regret behind them, or the fear ahead.
Attention is finite. Dr. Rabin puts numbers on it. Thirty percent on the past and thirty on the future leaves forty for the present.
So the work takes longer. Mistakes multiply. And it feels like effort the whole way.
This names the pattern of Dysregulation. A nervous system braced against threat cannot rest its attention in the present.
How do I bring my attention back to the present?
Breathe by choice. Slow, deliberate breaths remind your nervous system that your attention is yours to direct.
Dr. Rabin offers the smallest possible starting place.
Let your breath be a decision rather than a reaction to the room. No counting required. The choosing is the practice.
Each time you do it, you strengthen the pathway. He describes it as bodybuilding for attention.
As attention settles into the present, anxiety drops. You can act on what is here. The past is gone and the future has not arrived.
Why is grieving a skill?
Grieving is how the energy of sadness moves through the body. Without it, that energy stays stuck and sadness lingers.
Dr. Aimie names the moment every person meets. A loss. A gut punch from life. The body contracts.
Dr. Rabin's answer reframes what grief asks of you. Grief is a skill, and grieving is the practice of it.
Sadness carries energy. Crying moves it. So does screaming, or walking, or whatever lets it out. The moving starts with the feeling.
Skip the grieving and the energy has nowhere to go. The sadness settles in and stays far longer than it needed to.
How does the body reorganize after a loss?
After a loss, the body has to relocate safety. If a person or place held your safety, the work is finding where it lives now.
Dr. Aimie names the mechanism directly. Grieving is reorganizing around what is safe now.
When someone or something carried your sense of safety, losing it removes the anchor. The body has to build a new one.
Dr. Rabin describes what makes that possible. You feel safe enough to feel your sadness. You let it move. And you find that you can go on.
The safety starts inside you. Then it can come from the people and places around you.
This names the pattern of Disconnection. Loss severs a bond, and the body has to learn where to attach its safety next.
What daily practice does Dr. Rabin use?
Gratitude, practiced consistently. Noticing what is good builds a feedback loop, and the brain rewires around the practice over time.
Attention is finite, so Dr. Rabin spends his deliberately.
His practice is to notice what is good around him and within him. A breath. The smell of the trees. The conversation in front of him.
Practiced over time, gratitude compounds. You feel more grateful, and then you notice more to be grateful for.
Studies support it. The pathways in the brain shift with the practice. Mood improves and anxiety falls.
He carries it everywhere. It needs no gym, no phone, no equipment.
Why is grief a Biology of Trauma® issue?
Grief becomes stored when the body cannot feel it safely. The energy stays put, and the patterns show up as Dysregulation and Disconnection.
Dr. Aimie's framework holds the sequence. Safety comes first. Then the feeling can move.
Feeling safe enough to feel is where the work begins. That is the precondition, and it is what most people were never taught.
Dysregulation shows up as a body braced against its own sadness. Disconnection shows up as the bond that loss took away.
The care begins with building enough safety to feel. From there, grief can do what it was designed to do.
FAQ
What is heart rate variability?
HRV is the rate of change of your heartbeat over time. It reflects how active your vagus nerve is. Most wearables read it through the skin. Higher HRV is linked to faster recovery from stress.
What is a good HRV, and can it keep improving?
In a healthy heart, HRV has no upper ceiling. What matters is the trend over weeks and months rather than any single reading. A rising line means your body is recovering more fully, and sooner, than it used to.
Why does my anxiety feel like I am focused?
Anxiety pulls your attention into the past or the future while it feels like concentration. Your attention is finite. What you spend on regret and worry is unavailable for the task in front of you.
How do I get my attention back into the present?
Breathe by choice. Slow, deliberate breaths remind your nervous system that your attention is yours to direct. Practiced often, it strengthens the pathway and anxiety comes down.
Why is grief a skill?
Sadness carries energy that has to move. Grieving is how it moves, through crying, through the body, through letting yourself feel it. Without that, the energy stays stuck and the sadness lingers.
Why does grief feel like losing my safety?
If a person or place held your sense of safety, losing them removes the anchor. Grieving is how the body reorganizes around where safety lives now. That safety starts from inside you.
Does a gratitude practice actually change anything?
Yes. Practiced over time, gratitude builds a feedback loop. You notice more to be grateful for, and the pathways in the brain shift with the practice. Studies link it to improved mood and lower anxiety.
Helpful Research:
Thayer JF, Åhs F, Fredrikson M, Sollers JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews. 2012;36(2):747-756.
Emmons RA, McCullough ME. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology. 2003;84(2):377-389.
Zisook S, Shear K. Grief and bereavement: what psychiatrists need to know. World Psychiatry. 2009;8(2):67-74.
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