Death and Dying

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by Sudhir Kakar


  Whatever the case, the bereaved patient in psychoanalytic treatment is summoned to engage his whole self in the transferential working through the pains of death. As if that did not suffice, mourning painfully revives one’s record of previous mournings that constitutes his very identity, a therapeutic difficulty itself compounded by the transference which Freud aptly defined as the ‘school of suffering/Schule des leidens’ (1909, S.E.; 10:209, G.W. 7:429). In that poignantly cumulative scenario, while focusing on the interpretation of transference and resistance, the analyst is assisted by his stance of empathy. Analysts often explain empathy by reference to John Keats’s poetic endorsement of ‘negative capability’, whereby the poet is able to enter into the sparrow’s existence and ‘pick about the gravel’. But paramount for the analyst, I offer, is to determine where is ‘in’? He may in fantasy enter the patient on the outside, or conversely, introject or enwomb the patient. That latter kind of empathy, I contend, presents an obstacle to male analysts overconcerned with their masculinity.

  In the formidable task of dealing with a patient’s transferential working through his mourning, it is fitting to note Freud’s graphic description of his struggling with the unconscious forces that made him limp, much like Jacob limping after his battle with the angel (Freud, 1901a, p. 109; 1920, p. 64; Schur, 1971, p. 208). But perhaps Shakespeare’s analogy might better state the unavoidable impress and vulnerablity of an analyst’s work and might serve too as a reverberating close to this essay on death. Bearing in mind that his father was a glove-maker whose dyed hand would make him readily identifiable in public, Shakespeare wrote how his own profession indelibly changed his character:

  My nature is subdued

  To what it works in, like the dyer’s hand.

  Shakespeare’s Sonnets, Number 111, lines 6-7

  Symbolizing a Definitive Absence—A Psychoanalytic Reflection on Death and Dying*

  Eckhard Frick

  Since Freud’s seminal text ‘Mourning and Melancholia’ (Freud 1917e [1915]), bereavement research reflects on the dilemma between continuing versus relinquishing bonds to deceased persons (Stroebe et al. 2010). Mourning is the process of symbolizing the loss, of making sense by facing the conflict between the absence of the lost object and the continuing presence of an emotional relationship to what is lost (Colman 2010). Furthermore, mourning is not limited to bereaved persons but also concerns dying persons and, in a broader sense, our whole symbolic life which is playful coping with a rhythm of absence and presence. Freud’s grandson Ernst (Freud 1920g/1940) repeated this rhythm of absence and presence with a reel of thread: ‘Fort—da’ (away—here). By repeating the turning point of this rhythm in both senses (absence ←•→ presence), Ernst acquires a symbolic self-empowerment, a playful trial of the unavoidable absence-and-presence-rhythms linked with his young life’s forthcoming losses. Death is the definitive turning point of human life. We do not know if we survive our death or how we do it. However, the dying and the bereaved persons’ mourning processes open a spiritual realm, connecting the individual grief to the archetypal mourning and its collective symbols. The individual grief and ideas of immortality may be an illusory cold comfort. Conversely, true and trustful consolation connects the individual and the archetypal mourning. The lifelong repetition of temporary wrenches as well as the definitive wrench give birth to living symbols.

  In this essay I would like to show not only that mourning produces symbols—a special kind of presence following an object loss—but also that every symbol requires a work of mourning—working through a loss, an absence, a grief. A given bereavement situation is confronting us with very basic features of our mental, symbolic and spiritual life:

  My experience leads me to conclude that, while it is true that the characteristic feature of normal mourning is the individual’s setting up the lost loved object inside himself, he is not doing so for the first time but, through the work of mourning, is reinstating that object as well as all his loved internal objects which he feels he has lost. He is therefore recovering what he had already attained in childhood.

  (Klein 1940/1994: 113).

  Our Whole Life Is a ‘Work of Mourning’

  Everything starts with Freud’s seminal text ‘Mourning and Melancholia’ (Freud 1917e [1915]) where we find in statu nascendi not only his (second) theory of mental structure (Freud 1923b/1940) but also later developments of post-Freudian thinking such as attachment theory, psychoanalysis of narcissism/ self-psychology, and object-relations theory. ‘Mourning and Melancholia’ was originally part of metapsychology. Some other chapters seem to be destroyed by Freud himself (Bradbury 2001). It is true that many contemporary readers shrink back from his drive-psychology’s physicalist language. Freud himself admits that his energetic and economic terminology is not entirely satisfying. We must, consequently, reconstruct Freud’s thought using more recent authors who more or less refer to him. Freud describes the work of mourning as follows:

  The testing of reality, having shown that the loved object no longer exists, requires forthwith that all the libido shall be withdrawn from its attachments to this object … The task is now carried through bit by bit, under great expense of time and cathectic energy, while all the time the existence of the lost object is continued in the mind. Each single one of the memories and hopes which bound the libido to the object is brought up (eingestellt) and hyper-cathected, and the detachment of the libido from it is accomplished.

  Why this process of carrying out the behest of reality bit by bit, which is in the nature of a compromise, should be so extraordinarily painful is not at all easy to explain in terms of mental economics. It is worth noting that this pain seems natural to us. The fact is, however, that when the work of mourning is completed the ego becomes free and uninhibited again.

  (Trauer und Melancholie, 430)

  The testing of reality ‘shows’ that the loved object no longer exists: This ‘showing’ is not absolute, it is, on the contrary, impeded by all forms of defences. Freud physicalistically speaks about the libido ‘bound to the object’: Reality-testing requires ‘that all the libido shall be withdrawn from its attachments to this object’ although we ‘never willingly abandon a libido-position’.

  What about the libido and what about its binding to the object?

  Let us read the short text ‘On Transience’ (Freud 1916a/1963) a remarkable ‘summer-walk through a smiling countryside’, published in wartime one year before ‘Mourning and Melancholia’ (but actually written some months after it). Freud is ‘in the company of a taciturn friend and of a young but already famous poet’. The young poet was ‘disturbed by the thought that all this beauty was fated to extinction’. Freud anticipates what he will write about mourning and tells us:

  But why it is that this detachment of libido from its objects should be such a painful process is a mystery to us and we have not hitherto been able to frame any hypothesis to account for it. We only see that libido clings to its objects and will not renounce those that are lost even when a substitute lies ready to hand. Such is mourning.

  ‘On Transience’.

  Note that mourning in this text is not severance of attachment, but continuity of bonds. How can we distinguish the mere defence against the reality of loss and this desire of continuity?

  In this text, Freud defines libido as Liebesfähigkeit (capacity to love). He presumes that we come to this life with a certain amount of narcissistic libido, i.e., libido turned towards the ego. When we withdraw libido from the ego and invest it in the objects those objects are somehow integrated in our ego. Conversely, after destruction or loss of objects, libido becomes free and returns to the ego.

  I would like to highlight a double movement:

  Now we have reconstructed a first and simple metapsychological model: Investment of libido in objects means that the ego loosens the narcissistic libido and that those objects become somehow part of the ego. Conversely, after destruction or loss of the objects and loss of the libido’s point
of contact, narcissistic libido will be tightened up or reinvested in other objects.

  Freud uses a special concept for the libido’s investing or ‘clinging’: Besetzung (occupation). The Standard Edition translates as ‘cathexis’. This nice Greek term is composed by hexis (having) and kata (under/according to). It is true that we hold tight whom or what we love, and that we grasp even with more energy when we are about to lose it.

  Freud does not yet postulate a ‘death drive’. He considers a sexual drive in a broad sense, libido, which can ‘cathect’, or invest, in an ‘object’ (the site of satisfaction). The ego is a kind of reservoir of all libido, origin of cathexes to objects in the outside world as well as to representations of objects in the internal world. It is true that Freud’s early mourning theory understands ‘the loss of a love object as a temporary disruption of the mourner’s narcissism’ (Clewell 2004: 46). What he calls ‘ego’ is his theory of narcissism renamed ‘self’ by post-Freudian authors.

  Now we may have a second look on the ‘Mourning and Melancholia’ quotation.

  ‘The testing of reality, having shown that the loved object no longer exists, requires forthwith that all the libido shall be withdrawn from its attachments to this object.’

  The object has been destroyed by death or another loss. Reality testing reminds this fact and commands the withdrawal of attachment against a resistance demanding a particular effort.

  ‘The task is now carried through bit by bit, under great expense of time and cathectic energy, while all the time the existence of the lost object is continued in the mind.’

  Despite the knowledge of facts, libido is still clinging to the object (cathexis) and this ongoing cathexis is continued by the object’s mental presence. There is an inner conflict between reality testing and emotional ties. Its resolution requires time and energy.

  ‘Each single one of the memories and hopes which bound the libido to the object is brought up (eingestellt) and hyper-cathected, and the detachment of the libido from it is accomplished.’

  Remark that in this sentence every philosopher will discover a category mistake: cathexis (binding of libido), hyper-cathexis, and detachment are physical terms. Memory and hope, on the contrary, are mental terms. Slipping from one category to the other is philosophically uncool.

  The work of mourning consists in singularizing, bringing up and intensifying (hyper-cathexis) of memories and hopes as a prerequisite of detachment. Paradoxically, the work of mourning is not a process of piecemeal fading away.

  This paradoxical intensification is accompanied and expressed by the experience of pain:

  Why this process of carrying out the behest of reality bit by bit, which is in the nature of a compromise, should be so extraordinarily painful is not at all easy to explain in terms of mental economics. It is worth noting that this pain [Schmerzunlust] seems natural to us. The fact is, however, that when the work of mourning is completed the ego becomes free and uninhibited again.

  Trauer und Melancholie.

  Freud Describes ‘Identification’

  a) In melancholia:

  The object-cathexis proved to have little power of resistance and was brought to an end. But the free libido was not displaced on to another object; it was withdrawn into the ego. There, however, it was not employed in any unspecified way, but served to establish an identification of the ego with the abandoned object. Thus the shadow of the object fell upon the ego, and the latter could henceforth be judged by a special agency, as though it were an object, the forsaken object. In this way an object-loss was transformed into an ego-loss and the conflict between the ego and the loved person into a cleavage between the critical activity of the ego and the ego as altered by identification.

  Trauer und Melancholie.

  b) In normal mourning:

  Freud limits the term ‘identification’ to situations where the normal mourning remains unaccomplished. It is true, however, that we may call ‘identification’ the mental continuation of the lost object, the ‘permanent relationship between the representation of self and the representation of the lost object, the combination of an intrapsychic presence of that object, and the awareness of its objective permanent absence’ (Kernberg 2010: 610). Furthermore, in The Ego and the Id (Freud 1923b/1940), Freud will extent the melancholic identification to the ‘normal’ ego (Clewell 2004).

  After this last crescendo of suffering, the work of mourning seems to be ‘completed’. But this is only one part of the story.

  Let us see how psychoanalysis and attachment theory deal with Freud’s theory.

  Volkan differentiates two aspects of the German term Trauer used by Freud: The painful grief reaction and the more silent mourning process. Trauerarbeit (grief work) in the first meaning of emotional disclosure and detachment requires that the bereaved ‘confront and express their feelings and reactions’ (Stroebe et al. 2005). Some authors think that the therapist should compel bereaved persons to express sadness ‘in the belief that the abreaction of suppressed affect is at the core of successful treatment’ (Hagman 2001). In empirical studies, there is little evidence that induced disclosure of emotions is effective in coping with bereavement (Stroebe et al. 2005).

  ‘Uncomplicated grieving may be seen as nature’s exercise in loss and restitution’ (Volkan 1971: 255). However:

  The physical loss of a person or thing does not parallel the mental ‘burial’ of the mental representation … of the lost person or thing. Obviously the mourner possesses mental images of a person or thing before its loss. But after the loss, the mourner … turns his or her attention to such mental images and becomes preoccupied with them. If a mourning process is completed, for practical purposes, we make the mental representation of the lost person or thing ‘futureless’ (Tähkä 1984): The mental representation of the lost item is no longer utilized to respond to our wishes; it has no future. A young man stops fantasizing that a wife who had been dead for some time will give him sexual pleasure, for example. It can be said that we ‘bury’ the mental representation of a lost person or thing when we manage to make them futureless. During the mourning process mourners review, in a piecemeal fashion, hundreds of mental images of what has been lost and, in so doing, are able to keep aspects of the lost person’s or thing’s images within their own self-representation. This is possible due to mourners’ identification with the aspects of the mental representation of the lost item.

  When such identifications are (unconsciously) selective and ‘healthy’, the mourning process is considered ‘normal’. The mourner, after going through the pain of grief and after spending considerable energy reviewing many mental images of the lost person or thing, ‘gains’ something from the experience. By assimilating the functions of a deceased person, the mourner can now perform such functions himself. A year or so after his father’s death, for example, a philandering young man becomes a serious industrialist like his dead father used to be.

  How can we understand the mental images, the object representations? Volkan and Zintl (1993) coined the term ‘psychic double’ for every person who populates or once populated our world. This is a very understandable expression of what Melanie Klein calls ‘inner objects’. Every ‘new’ upcoming or happening bereavement challenges our experiences with good objects and may entail a regression towards more archaic, paranoid forms of relationship.

  When someone important to us dies, the psychic double ‘remains hot’ or even intensifies due to the separation (Freud’s ‘hyper-cathexis’). ‘The work of mourning involves taking the heat out of the loss and cooling down, but not eliminating the psychic double,’ says Volkan.

  Freud distinguishes normal mourning from melancholia, where the lost object’s shadow remains upon the ego, provoking troubles of self-esteem not observed in normal mourning. Melancholic identification means that the ego treats itself as if it was the object, with all the characteristics of hate and love. According to Volkan, we may distinguish normal mourning, melancholia and perennial mourning:
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  ‘Normal’ mourning: After initial grief, mourners examine a host of images of the deceased. Within a year or so, they tame the influence of these ‘futureless’ images on their self-representations … A significant aspect is the mourner’s selective, unconscious identification with certain enriching functions of the lost object. This influences the mourner’s existing self-representation and modifies his/her sense of identity and ego functions, e.g. a young man who had been irresponsible before the loss of his father can become a serious businessman like the deceased.

 

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