How to Fix a Broken Heart

What the book, the brain science, and the experts actually say about healing from heartbreak

By Alicia Divico, LMHC, CAP, ICADC|Personal Wellness Solutions

If you broke your arm, nobody would expect you to show up to work the next morning and perform as usual. You would get a cast, a sling, some sympathy, and time. But when your heart breaks, the cultural prescription is something closer to "give it time," "you're better off," and "there are other fish in the sea." Then you are expected to function.

That gap is the starting point of psychologist Guy Winch's TED book, How to Fix a Broken Heart (2018). Winch asks what would change if we took heartbreak as seriously as a physical injury, and he argues that because most of us don't understand how heartbreak works, we not only fail to heal it, we routinely make it worse. The book covers romantic loss and, notably, the grief of losing a beloved pet, which is another heartbreak we tend to minimize.

In this post I want to pull together three things: the core of Winch's toolkit, what the research actually shows (including where popular retellings of that research overreach), and what I see in the therapy room. The short version: heartbreak is real pain, it behaves a lot like withdrawal, and there are specific, evidence-informed things you can do that help, along with some very common instincts that quietly keep the wound open.

Why heartbreak hurts this much

Your brain is craving, not just grieving

The most cited study here comes from anthropologist Helen Fisher and colleagues, published in the Journal of Neurophysiology in 2010. They scanned 15 people who had recently been rejected by a partner but said they were still intensely in love, and had them look at a photo of the person who left them. Viewing the rejecting partner activated the ventral tegmental area, a core part of the brain's reward and motivation system, along with regions associated with craving and addiction, including the nucleus accumbens and orbitofrontal/prefrontal cortex. The authors concluded their findings were consistent with the idea that romantic rejection functions as a specific form of addiction, and suggested this may explain why the obsessive thoughts and behaviors that follow a breakup are so hard to control.

One detail from that study often gets lost: the longer it had been since the rejection, the less activity appeared in a region tied to attachment. Time does matter. It just isn't the only thing that matters.

This is the frame Winch builds on. He describes heartbreak as something closer to withdrawal than to sadness, and once you see it that way, a lot of "irrational" breakup behavior makes sense: the 2 a.m. scroll through their photos, the reread text thread, the drive past their apartment. Those aren't character flaws. They are the brain seeking a dose of something it has been cut off from. As someone who has spent years working in addiction treatment, I find this frame clinically useful, because it tells us what the work actually is. It isn't just grieving. It is also managing craving and preventing relapse.

"Heartbreak is physical pain": true, but not quite

You will often read that the brain processes heartbreak "exactly like" physical pain. This is a good example of a real finding that got oversimplified on its way to the internet.

In 2011, Ethan Kross and colleagues reported that viewing a photo of an ex who had recently broken up with you activated some of the same brain regions as painful heat on the arm. That study was widely read as proof that social pain and physical pain are the same thing in the brain. Three years later, many of the same researchers (Woo et al., 2014, Nature Communications) used more sophisticated pattern analysis and found something more nuanced: while the two experiences light up overlapping areas at a broad level, the specific patterns of activity are distinct. A pattern that identified physical pain could not detect rejection, and vice versa. Their conclusion was that rejection does not simply borrow pain circuitry; it has its own affective signature.

Why does this matter? Because both directions of error hurt people. If we understate the evidence, heartbroken people get told they are being dramatic. If we overstate it, we hand them a tidy metaphor ("it's just like a broken leg") that doesn't quite fit their experience. The accurate version is this: heartbreak is a real, body-level injury to your emotional system. It overlaps with physical pain, and it is also its own thing. You do not need a brain scan to validate your suffering, and you are not imagining it.

A related note: there is research (DeWall et al., 2010) suggesting that daily acetaminophen modestly reduced reported hurt feelings in a lab setting. It's an interesting finding about how intertwined these systems are, but it is not a treatment recommendation, and I would not suggest anyone medicate a breakup with over-the-counter painkillers.

Broken heart syndrome is real (and rare)

There is also a literal cardiac condition called takotsubo cardiomyopathy, nicknamed "broken heart syndrome," in which intense emotional or physical stress temporarily weakens the heart muscle. It most often affects older women and is usually reversible, but it can mimic a heart attack. I mention it not to alarm anyone, but because it is a powerful reminder that emotional pain and the body are not separate. If you experience chest pain or shortness of breath, treat it as a medical issue and get evaluated.

The traps that keep the wound open

One of the most useful parts of Winch's book is his catalog of the ways we unknowingly reopen the injury. In my experience, nearly everyone falls into at least one of these.

Checking on them

Social media has turned "no contact" into something that requires active effort. Psychologist Tara Marshall's 2012 study of 464 people found that monitoring an ex's Facebook page was associated with more breakup distress, more negative feelings, more longing and desire for the ex, and less personal growth, even after accounting for offline contact and the characteristics of the relationship. Marshall's more recent work, using daily diaries and an experiment across newer platforms, found that seeing an ex online, whether by deliberately searching their profile or stumbling onto a story, reliably spiked sadness, jealousy, and breakup distress, and that deliberate searching predicted lingering distress into the following day.

In addiction language, every check is a small use. It relieves the craving for a moment and then strengthens it. Muting, unfollowing, or archiving photos is not petty or dramatic. It is the equivalent of not keeping alcohol in the house during early recovery.

Idealizing them

Heartbroken brains run a highlight reel. We remember the best weekend, the inside jokes, the way they looked at us, and conveniently forget the nights we cried, the needs that went unmet, or the reasons the relationship was struggling. Winch argues that this idealization is one of the biggest drivers of prolonged heartbreak, because it keeps the person on a pedestal that no new relationship can compete with.

Hunting for the "why"

Many people believe they cannot heal until they understand exactly why it ended, or until they get a closure conversation. Winch's point is that the mind can chase this answer indefinitely, and that even a direct explanation from the ex rarely satisfies. Often the explanation that would truly bring peace doesn't exist, or it isn't one the other person can give. Closure is usually something we build, not something we receive.

Quietly hoping

Keeping the hoodie, saving the voicemails, rehearsing the reconciliation conversation in the shower: hope is human, but secret hope keeps the reward system primed. Acknowledging the hope out loud, to yourself or a trusted person, often loosens its grip more than suppressing it does.

What actually helps

1. Make the "honest list"

Winch recommends writing down every negative thing about your ex and the relationship, the annoying habits, the hurtful moments, the ways you shrank yourself, and keeping it on your phone so you can pull it up when the highlight reel starts playing.

Research backs this up, with an important nuance. In a 2018 study in the Journal of Experimental Psychology: General, Sandra Langeslag and Michelle Sanchez compared three strategies among people still in love with an ex. Thinking about the ex's negative qualities was the only strategy that reduced feelings of love, but it also made participants feel worse in the moment. Distraction made people feel better but didn't change how much they loved the ex. Simply accepting the love feelings without judgment changed neither. Langeslag has also emphasized that this kind of love regulation is not an on/off switch and likely needs to be practiced repeatedly.

So here is the clinically honest version: the list works, it will sting when you use it, and its job is to bring the person back to human size, not to turn you bitter. Pair it with distraction for mood relief, and expect to return to it many times. (Worth noting: the study was small, 24 people, and measured short-term reactions, so treat it as promising rather than definitive.)

2. Rebuild who you are without them

Relationships reorganize our identity. Our routines, our friend groups, our sense of "what I like" and even our pronouns ("we love that restaurant") become shared. When the relationship ends, part of the self goes with it, which is why so many people describe feeling lost rather than just sad.

Grace Larson and David Sbarra (2015) studied 210 recently separated young adults and found that the people who regularly reflected on their breakup through repeated research check-ins showed greater recovery in self-concept clarity, a clearer sense of who they are, and that this improvement explained reductions in loneliness, intrusive breakup thoughts, and even the use of "we" language when describing the separation. Larson's advice from the study is simple and powerful: ask yourself who you are apart from the relationship.

Winch approaches this practically: identify the voids the relationship filled (companionship on weekends, someone to debrief your day with, a social life, a sense of being chosen) and deliberately fill them in new ways. Reclaim the hobby you dropped. Return to the friends you saw less of. Try the restaurant they never wanted to go to. This isn't about distraction; it is about rebuilding a self that can stand on its own.

3. Reflect, but don't ruminate

Journaling is one of the most common recommendations after a breakup, and for many people it helps. But this is a place where I want to complicate the standard advice. In a 2013 study in Clinical Psychological Science, Sbarra and colleagues found that among recently separated adults who tended to brood and search for answers, deep emotional writing about the separation actually impeded recovery. At the eight-month follow-up, those high ruminators did best in the control condition, writing that didn't dwell on feelings at all. People who weren't prone to rumination did similarly well regardless of writing type.

Taken together with the Larson and Sbarra findings, the lesson isn't "don't reflect." It is that reflection should move you forward. Writing that builds a story of who you are becoming tends to help. Writing that replays the same scene for the fortieth time, hunting for the answer, tends to deepen the groove. If you notice your journal has become a loop, that is a signal to change the format, not a sign you are failing.

4. Allow growth, but don't force it

There is genuinely good news in the research: many people report meaningful personal growth after a breakup. Tashiro and Frazier (2003) found that people commonly described becoming more self-confident, more emotionally aware, and clearer about what they want in a partner. Lewandowski and Bizzoco (2007) found that people leaving lower-quality relationships often reported positive emotions and growth that had been suppressed while they were in the relationship.

I share this with one caution: "everything happens for a reason" and "you'll be stronger for this" can feel invalidating when you are in the thick of it. Growth tends to show up on its own timeline, often looking back. You don't have to find the silver lining this week.

Heartbreak doesn't happen in a vacuum

Part of why heartbreak lingers is that we give people almost no structural room to grieve it. There is bereavement leave for death, but no leave for the end of a ten-year relationship. Grief researcher Kenneth Doka coined the term "disenfranchised grief" for losses our culture doesn't openly recognize or support, and the end of a relationship, especially one that was hidden, brief, nontraditional, or with someone others disapproved of, often falls into that category. So does the loss of a pet, which Winch deliberately includes in his book.

When people tell me they "should be over it by now," I often ask who set that timeline. Frequently it is an internalized message from a culture that measures recovery by productivity. You are not weak for hurting. You are hurting in an environment that doesn't make much space for it, which is a very different thing.

It is also worth naming that the intensity of heartbreak is shaped by what you bring into it. If you have a history of early loss or a sensitivity to rejection, a breakup can land on old bruises. We've written about attachment, abandonment, and rejection sensitivity in earlier posts, and they are worth revisiting if your reaction feels bigger than the relationship itself.

When it's more than heartbreak

Most heartbreak, however painful, gradually eases. But breakups are a well-documented trigger for depression, and sometimes the pain does not loosen with time. Consider reaching out to a licensed therapist if, after several weeks, you are still struggling to sleep, eat, work, or take care of yourself; if you find yourself drinking or using more to get through the evenings; if you cannot stop monitoring or contacting your ex despite wanting to; or if you are feeling hopeless or having thoughts of not wanting to be here.

If you are in crisis or having thoughts of suicide, you can call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States. You deserve support, not just endurance.

The bottom line

Your heart might be broken, but, as Winch puts it, you do not have to break with it. Healing isn't just waiting. It is a set of choices you get to make, repeatedly: putting down the phone, seeing the person at their real size, refusing to keep auditioning for an explanation, and slowly rebuilding a life that belongs to you. It will not be linear. Some days will feel like relapse. That is part of recovery, not proof that it isn't happening.

Treat your broken heart the way you would treat a broken arm: take it seriously, protect it from further injury, give it real care, and trust that it is built to heal.

References

DeWall, C. N., MacDonald, G., Webster, G. D., et al. (2010). Acetaminophen reduces social pain: Behavioral and neural evidence. Psychological Science, 21(7), 931–937.

Doka, K. J. (Ed.). (1989). Disenfranchised grief: Recognizing hidden sorrow. Lexington Books.

Fisher, H. E., Brown, L. L., Aron, A., Strong, G., & Mashek, D. (2010). Reward, addiction, and emotion regulation systems associated with rejection in love. Journal of Neurophysiology, 104(1), 51–60.

Kross, E., Berman, M. G., Mischel, W., Smith, E. E., & Wager, T. D. (2011). Social rejection shares somatosensory representations with physical pain. PNAS, 108(15), 6270–6275.

Langeslag, S. J. E., & Sanchez, M. E. (2018). Down-regulation of love feelings after a romantic break-up: Self-report and electrophysiological data. Journal of Experimental Psychology: General, 147(5), 720–733.

Larson, G. M., & Sbarra, D. A. (2015). Participating in research on romantic breakups promotes emotional recovery via changes in self-concept clarity. Social Psychological and Personality Science, 6(4), 399–406.

Lewandowski, G. W., & Bizzoco, N. M. (2007). Addition through subtraction: Growth following the dissolution of a low quality relationship. The Journal of Positive Psychology, 2(1), 40–54.

Marshall, T. C. (2012). Facebook surveillance of former romantic partners: Associations with postbreakup recovery and personal growth. Cyberpsychology, Behavior, and Social Networking, 15(10), 521–526.

Marshall, T. C. Social media observation of ex-partners is associated with greater breakup distress, negative affect, and jealousy. Computers in Human Behavior. [Confirm year/volume before publishing.]

Sbarra, D. A., Boals, A., Mason, A. E., Larson, G. M., & Mehl, M. R. (2013). Expressive writing can impede emotional recovery following marital separation. Clinical Psychological Science, 1(2), 120–134.

Tashiro, T., & Frazier, P. (2003). "I'll never be in a relationship like that again": Personal growth following romantic relationship breakups. Personal Relationships, 10(1), 113–128.

Winch, G. (2018). How to fix a broken heart. TED Books / Simon & Schuster.

Woo, C.-W., Koban, L., Kross, E., Lindquist, M. A., Banich, M. T., Ruzic, L., Andrews-Hanna, J. R., & Wager, T. D. (2014). Separate neural representations for physical pain and social rejection. Nature Communications, 5, 5380.