PDF Summary:It's OK That You're Not OK, by Megan Devine

When someone you love dies, well-meaning people often tell you to move on, find closure, or look for silver linings. But grief doesn't work that way. In It's OK That You're Not OK, Megan Devine challenges the cultural expectation that grief should be fixed or overcome. She argues that grief is a natural response to loss that deserves acknowledgment rather than treatment.

Devine explores why common grief models—like the five stages—can be harmful when misunderstood as a linear process with an endpoint. She offers an alternative approach: learning to live alongside your grief rather than trying to eliminate it. This guide also covers how to support someone who's grieving by being present and listening, and provides practical techniques for managing the anxiety that often accompanies loss.

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In the following two sections, we will discuss the importance of authentic grieving and rejecting the “recovery” narrative.

Authentic Grief: Integration & Coexistence

Devine argues that grief is integrated into your life, not something you should try to overcome. You won't be who you were or heal and move forward. Your new reality will transform you, existing on the cusp of becoming. Your future life will be founded on all that preceded it: the devastation, the despair, and the existence that was and could have been. There's no going back, only continuing with: a synthesis of all that came before, and everything you're asked to live.

(Shortform note: The idea that there’s “no going back” after loss is a central tenet of the continuing-bonds and constructivist models of grief. These models, which emerged in the 1990s, challenged the prevailing view that the goal of mourning was to sever ties with the deceased and move on. Instead, they emphasized the importance of maintaining an inner relationship with the lost loved one and reconstructing meaning in the wake of loss.)

Rejecting the "Recovery" Narrative

Devine suggests that recovery from grief doesn’t mean returning to normal. Instead, it involves paying attention to your injuries and acknowledging your devastation. It’s about cultivating patience, aware that loss and grief will change you. There isn’t an endpoint—your grief will forever be a part of you. Life can be beautiful again, yet it will be built alongside your loss rather than by trying to eliminate it.

(Shortform note: In The Other Side of Sadness, clinical psychologist George A. Bonanno argues that for many people, recovery from grief does mean returning to normal. He bases this on his research, which shows that for a large proportion of bereaved people the most typical outcome is what he calls a “resilient” trajectory, in which they show only brief and relatively mild disruptions in their ability to function and then return, often within months, to roughly the same level of psychological health and everyday functioning they had before the loss, without developing persistent, life-dominating grief symptoms.)

Recovery involves creating a life that accommodates what you’ve lost, embracing what will always be a void. It’s about experiencing this as skillfully, with self-kindness, and peacefully as possible. You can embrace a fresh, beautiful life without moving past your grief. The aim is to integrate, not erase. Devine adds that healing requires patience and the readiness to sit with your heart, even when it's been shattered. At your own pace, you'll discover how to weave this experience into your world. You might develop increased empathy, recognizing that well-meaning words can nevertheless cause pain. You may also develop a quicker temper with less tolerance for others' ignorance or cruelty. When we experience loss, we frequently start safeguarding others’ pain, correcting and redirecting people who would cause more harm by trying to eliminate it.

Compassion Fatigue

If you take on the role of “safeguarding others’ pain, correcting and redirecting people who would cause more harm,” you may develop compassion fatigue. This is a state of emotional exhaustion that can occur when you’re exposed to the suffering of others for an extended period of time. It can lead to a range of symptoms, including emotional numbness, irritability, and a sense of hopelessness. When you’re constantly exposed to the pain of others, it can be difficult to maintain your own emotional well-being. This can make it harder to create a life that accommodates what you’ve lost, as you may find it difficult to engage with the world in a meaningful way.

Witnessing and Offering Support

Devine explains that bearing witness to someone's pain involves being present and offering support without attempting to resolve it. Support people are meant to provide recognition and be present for people who are hurting, rather than attempting to improve things. These skills are advanced and can be challenging to put into practice. Yet they’re straightforward: Be present. Listen. Avoid trying to resolve it. We might be awkward while developing these abilities. That’s alright. People in mourning would prefer that you fumble through showing your support rather than assuredly claiming that their situation isn't as serious as it appears.

(Shortform note: Devine’s ideas about bearing witness to pain and being present for others are not new. In his 2001 book, The Gift of Therapy, psychiatrist Irvin Yalom discusses the importance of presence in the therapeutic relationship. He explains that one of the most powerful aspects of therapy is the therapist's ability to be present with the client, without trying to fix or solve their problems. This presence allows the client to feel seen and heard, which can be incredibly healing. Yalom's emphasis on presence aligns with Devine's ideas about bearing witness to pain and being present for others.)

You can’t always change pain, but you can change how you hear and respond to it. When someone is suffering, let it happen. Create an environment where it's okay for someone to express "This hurts," without hurrying to fix things. Give one another room. When supporting someone, they ask you to be a companion in their pain. Not attempting to solve the unsolvable may improve things, even if it can't fix them.

(Shortform note: If someone’s pain is so severe that they’re at risk of harming themselves or others, you may need to take a more active role in their healing. In these cases, you may need to call a suicide hotline or emergency services. You can still be a companion in their pain, but you may need to take steps to ensure their safety.)

In the following two sections, we will discuss the principles of witnessing sorrow and ways to offer practical support and build skills.

Principles of Witnessing Grief

Witnessing grief involves acknowledging and respecting that loss has happened without attempting to resolve it. Devine argues that the only way to reconcile grief is to face it directly. By accepting grief as a reality, you can concentrate on aiding yourself and others to endure the pain.

(Shortform note: Facing grief directly and accepting grief as a reality can help you reconcile it because it reduces the mental strain of resisting what happened. When you stop fighting against the reality of your loss, your nervous system can gradually calm down, making the pain less overwhelming over time.)

Practical Support & Skill-Building

Supporting a Bereaved Individual

To support someone who is grieving, Devine suggests being present and listening. Grieving is an isolating journey, and the most helpful approach involves being steady and attentive. You don’t need to say much or be perfect—just showing up is a relief to the grieving person, and your effort is noticed and appreciated.

(Shortform note: In Trauma Stewardship, Laura van Dernoot Lipsky and Connie Burk warn that when we are consistently exposed to the pain, hardship, or trauma of others, we have a responsibility to notice how that exposure is affecting us. If we keep pushing past our own limits and give care as if our energy were endless, we are likely to become exhausted, numb, or resentful, and in that condition we are no longer truly able to offer the clarity, compassion, and steadiness that real support requires.)

Self-Maintenance and Coping Skills When Grieving

Devine explains that anxiety is a common response to loss and can be managed through self-care practices. Anxiety arises because the world feels unsafe, and you sense that you must protect yourself from further loss. It's a survival response that's out of control. It's not rational or helpful for building the safety you desire. Going over catastrophic scenarios won’t ensure your safety, and constantly reaching out to others to confirm their well-being will never make you feel secure long-term. You can't put all your loved ones in a safe space and always watch over them. You can't ensure your surroundings are safe.

(Shortform note: Devine’s advice to avoid reviewing catastrophic scenarios and checking on the safety of your loved ones may not be helpful if you’re grieving a loss that occurred in a dangerous environment. In The Body Keeps the Score, Bessel van der Kolk explains that people who grow up in dangerous environments develop a heightened sense of alertness to danger. This heightened alertness is a survival mechanism that helps them stay safe. If you’re still in a dangerous environment, your anxiety may be a realistic guide to your safety.)

Still, you can improve your internal feeling of safety while staying calmly vigilant. You can train yourself to become more balanced and calm, which will help prevent frequent anxiety episodes. You can also soothe yourself when stuck in a cycle of anxiety and engage in self-care for short-term relief. To manage anxiety, first recognize it as a sign of an issue, not as a forecaster of reality. Devine adds that fatigue, poor diet, and exposure to numerous stressors can heighten anxiety.

(Shortform note: Another factor that can heighten anxiety is “anxiety sensitivity,” or the tendency to view your own anxious sensations as dangerous. In The Anxiety and Phobia Workbook, Edmund J. Bourne explains that people who suffer from panic and high anxiety often become afraid of the symptoms of anxiety themselves. This “fear of fear” can greatly magnify the intensity of anxiety and turn a brief moment of nervous arousal into a full-blown panic attack.)

Recognizing that your anxiety relates to your physical and emotional state can help you spot early signals and intervene before it becomes overwhelming. When your thinking gets more worried or agitated, it signals that you should slow down and tend to your physical needs: sleeping, eating, resting, moving. Taking care of these needs first can lessen much of your anxiety. During an anxiety spike, Devine suggests it's more helpful to relax yourself than to analyze its causes. Research in neurobiology and trauma science indicates that changing your breathing can calm your agitated nervous system. Extending your exhale can reduce the flow of anxiety-causing stress hormones. In anxious moments, try extending your exhalation beyond your inhalation. This soothes the nervous system's fight-or-flight response, and concentrating on your breath provides an anchoring thought for your mind instead of letting fear-driven thoughts spiral.

Slow Breathing Reduces Anxiety

A research article published in 2018 supports Devine’s claim that changing your breathing can reduce anxiety. The researchers reviewed 15 studies on slow breathing and found that breathing at a rate of about six breaths per minute increased parasympathetic activity, which is associated with relaxation and reduced stress. The studies also showed that slow breathing led to significant reductions in self-reported anxiety levels. The researchers concluded that slow breathing techniques can be an effective way to manage anxiety and improve overall well-being.