Death and Dying

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by Sudhir Kakar


  Depression (melancholia): If an adult had an ambivalent relationship with the deceased, he/she ends up identifying totally (Ritvo and Solnit, 1958) with the mental representation of the lost object, making ‘unhealthy, not enriching’ identifications with images of the deceased. The mourner wants, unconsciously, to destroy (hate) the lost object’s representation and feels guilty, whilst feeling obliged to hold on to (love) it because he/she still feels dependent on the representation of the lost object, as if it still has a ‘future’. The mourner may become suicidal due to the guilt and self-punishment arising from the wish to destroy the mental representation of the lost object.

  Perennial mourning: Some individuals are involved in psychological processes that lead them to postpone completion of their ‘normal’ mourning or prevent them from evolving melancholia … In a sense, these individuals put the deceased person’s mental representation in an envelope (an introject) and carry this in their minds. They have an illusion that the deceased’s images in this envelope can be brought back to life. However, if the envelope is never opened, the deceased stays ‘dead’ … When it appears that such individuals suffer hallucinations, they are not true psychotics, but perennial mourners (Volkan 2003).

  Linking Objects ‘Freeze’ or Deblock the Mourning Process

  Volkan found that perennial mourners often used symbolic items, ‘linking objects’, which stop the process of mourning at a certain point. This freezing and postponing may hinder the individual from accomplishing the process or, on the contrary, permit completing the work of mourning. Linking objects may be:

  A personal possession of the deceased

  A gift or symbolic farewell note

  Something the deceased used to extend his/her senses or body functions

  A realistic or symbolic representation of the deceased

  ‘Last-minute object’

  Created linking objects

  The personal possession of the deceased, e.g., a watch, usually needs repair. The mourner becomes preoccupied about this repair. The object remains, however, unrepaired. The gift or symbolic farewell note is the last object given before a fatal accident, or before being killed as a soldier. Something the deceased used to extend his/her senses or body functions: May be a camera or another optical instrument or a mobile phone. Again, it may be broken, waiting for repair. Realistic or symbolic representation of the deceased: a photograph, a video, a tape recording, a painting or a text. ‘Last-minute object’: ‘something at hand when the mourner learned of the death or saw the deceased’s body’. Finally, the mourner may create linking objects by painting or other representations (Volkan 2003).

  Linking objects are a frozen form of symbols, proto-symbols which may develop in the sense of symbolization. They have an ‘eerie’ character, and there may be a ‘spiritual merging’ with the dead person, including the fear to be influenced by the dead person who may actually come back into the mourner’s life. Volkan distinguishes the highly symbolized linking object from Winnicott’s ‘transitional object’ which creates the intermediate space in the infant’s development and from the fetish which is a rigid placeholder. Conversely, linking objects can initiate future mourning. In his ‘regrief therapy’ Volkan used linking objects for beginning the mourning process as if the loss had just happened. Consequently, possessing linking objects, is a double-edged sword as far as personal growth is concerned.

  Furthermore, enlarging individual psychology, he described mourning and frozen mourning processes in societies such as ex-Yugoslavia, South Africa and in the US (Volkan 2007).

  A collective linking object may be a ‘chosen trauma’ such as Serbian Prince Lazar’s death during the Battle of Kosovo (28 June 1389). In the approaches to the Serbs’ war with Bosnian Muslims in 1990—91 and again before the conflict with Kosovar Albanians in 1998, Slobodan Miloševič and his entourage ‘reactivated’ the Serbs’ chosen trauma in order to distinguish Serb and non-Serb identities in order to ‘legitimate’ Serb violence against non-Serbs.

  As the six-hundredth anniversary of the Battle of Kosovo approached, the remains of leader captured and killed at the Battle of Kosovo, were exhumed. For a whole year before the atrocities began, the coffin travelled from one Serbian village to another, and at each stop a kind of funeral ceremony took place. This ‘tour’ created a time collapse. Serbs were primed to react as if Lazar had been killed just the day before, rather than six hundred years earlier. Feelings, perceptions and anxieties about the past event were condensed into feelings, perceptions and anxieties surrounding current events, especially economic and political uncertainty in the wake of Soviet communism’s decline and collapse. Since Lazar had been killed by Ottoman Muslims, present-day Bosnian Muslims—and later present-day Kosovar Albanians (also Muslims)—came to be seen as an extension of the Ottomans, giving the Serbian people, as a group, the ‘opportunity’ to exact revenge from the group that had humiliated their large group so many centuries before. In this context, many Serbs felt ‘entitled’ to rape and murder Bosnian Muslims and Kosovar Albanians (For further details, see: Volkan 1997, 1999.)

  Consequently, a linking object is half-way between a non-symbolized and absurd beta-element and an alpha-element which is growing in a loving, understanding, containing relationship. Bion told us that such a helpful relationship metabolizes and detoxifies beta-elements.

  The capacity to symbolize allows an individual to represent an experience mentally rather than concretely. In the aftermath of a trauma, painful and disturbing images, thoughts and feelings are often unable to be held in the mind in a way that distinguishes them from the actual reality of the event. They cannot be contained as memories. Instead, these thoughts and images become concrete, live flashbacks that typically intrude into consciousness as a literal re-experiencing of the event. If the mental capacity is flawed or impaired in this way, there is also often an intrusion of the flashback experience into the body. This intrusion can take the form of psychosomatic illness (Lemma and Levy, 2004).

  Accordingly, a collective linking object such as the Serb ‘chosen trauma’ or an individual one, encompasses an ambivalent potential: it may provoke narcissistic identification, further trauma and violence, or, on the contrary, trigger the continuation of a ‘frozen’ mourning process.

  Living Symbols Require a Work of Mourning

  Symballein in Greek means to put or to throw together. When friends separated, they broke a bowl or a coin of money. When they met again (or their children), the joined pieces not only ‘signified’ unity, they made unity.

  According to Jung, a symbol is more than a sign which may be explained, verbalized, decoded. Deciphering ‘kills’ a symbol which is ‘the best expression of a relatively unknown cause’, better than our explanations or verbalizations. The symbol is the joint of two (separated, opposed) realities, and it generates a third which is beyond the original opposition (‘transcendent’ function of the symbol). ‘Perhaps the central task of mourning is to make sense of the conflict between the absence of the lost object and the continuing presence of an emotional relationship to that which is lost’ (Colman 2010: 278).

  My thesis is that every symbol requires an absence and, in a certain sense, a work of mourning, of sense and meaning-making. 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):

  Occasionally, however, this well-behaved child evinced the troublesome habit of flinging into the corner of the room or under the bed all the little things he could lay his hands on, so that to gather up his toys was often no light task. He accompanied this by an expression of interest and gratification, emitting a loud long-drawn-out ‘o-o-o-oh’ which, in the judgement of the mother (one that coincided with my own), was not an interjection but meant ‘go away’ (fort). I saw at last that this was a game, and that the child used all his toys only to play ‘being gone’ (fortsein) with t
hem. One day, I made an observation that confirmed my view. The child had a wooden reel with a piece of string wound round it. It never occurred to him, for example, to drag this after him on the floor and so play horse and cart with it, but he kept throwing it with considerable skill, held by the string, over the side of his little draped cot, so that the reel disappeared into it, then said his significant ‘o-o-o-oh’ and drew the reel by the string out of the cot again, greeting its reappearance with a joyful ‘Da’ (there). This was, therefore, the complete game, disappearance and return, the first act being the only one generally observed by the onlookers, and the one untiringly repeated by the child as a game for its own sake, although the greater pleasure unquestionably attached to the second act.

  Jenseits des Lustprinzips.

  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. According to Freud, his grandson’s game is for coping with powerlessness and passivity: passive in the first place, ‘overtaken by the experience’, he now ‘brings himself in as playing an active part, by repeating the experience as a game in spite of its unpleasing nature. This effort might be ascribed to the impulse to obtain the mastery of a situation (the power instinct)’. Freud adds another interpretation: The ‘gratification of an impulse of revenge suppressed in real life but directed against the mother for going away’: ‘Yes, you can go, I don’t want you. I am sending you away myself.’ Some years later, Ernst used to throw a toy on the floor and say, ‘Go to the war!’ It seems evident, that he is coping with his father’s absence as a soldier in World War I.

  Freud’s grandson’s symbolic game may be interpreted as a tried mastery when facing the rhythm of presence and absence. Living symbols which produce libido, energy, as Jung says, are quite different from signs and proto-symbols in the sense of Volkan’s linking objects.

  They come forth of a liberating ritual, a mourning which is at the same time accepting the loss and opening a space for transformation, for the ongoing game.

  Jung’s distinction between a ‘killed’ or ‘dead’ symbol and a living one has an equivalent in Hanna Segal’s distinction between ‘symbolic equation’ and ‘symbolic representation’. When asking patient A why he stopped playing the violin, this young man suffering from schizophrenia replied with some violence, ‘Why, do you expect me to masturbate in public?’ Mr A had identified violin and penis in a concretistic manner. Conversely, ‘another patient, B, dreamed one night that he and a young girl were playing a violin duet. He had associations to fiddling, masturbating, etc.’ (Segal 1957/1981: 49). In distinction from A, B is able to distinguish violin and penis (symbolic representation).

  Symbolic representations help us to cope with the loss of an (external) object. We learn that we do not possess it, that the mastery of the ‘o-o-o-oh’/’Da’ is limited. This acceptance of the uncontrollable external objects entail the possibility of an internal (symbolic) presence. ‘No breast—therefore a thought’ (Bion 1970/1975). Only when the infant can recognize the absence of the object she or he can either symbolize or think (Segal 1991; Colman 2010). There is a strong difference between lost objects (which can be symbolized, e.g., in a therapeutic relationship) and objects which are gone (nameless dread, according to Bion):

  Since the restoration of lost objects is pre-eminently a symbolic process, this cannot be achieved if absence remains in the unthinkable state of being ‘gone’ where the absence of the object is coexistent with the absence of a mind in which it can be known. In Bion’s terms, there are only beta elements without a thinker to process them. This can only occur through the internalization of a container/contained apparatus which enables the development of alpha function and the formulation of mental contents into thoughts (Colman 2010: 291).

  If mourning expresses the conflict between the absence of the lost object and the continuing presence of an emotional relationship a symbol is born—in the mourner’s mind, between analyst and patient, between conscious and unconscious:

  Projective identifications are gradually withdrawn and the separateness of the subject from the object becomes more firmly maintained. With that comes a greater awareness of one’s own psychic reality and the difference between internal and external. In such a situation the function of symbolism gradually acquires another meaning. Symbols are needed to overcome the loss of the object which has been experienced and accepted, and to protect the object from one’s aggressiveness. A symbol is like a precipitate of the mourning for the object (Segal 1991: 40).

  Spirituality

  When seeing a dying animal a man feels a sense of horror: substance similar to his own is perishing before his eyes. But when it is a beloved and intimate human being that is dying, besides this horror at the extinction of life there is a severance, a spiritual wound, which like a physical wound is sometimes fatal and sometimes heals, but always aches and shrinks at any external irritating touch … A spiritual wound produced by a rending of the spiritual body is like a physical wound and, strange as it may seem, just as a deep wound may heal and its edges join, physical and spiritual wounds alike can yet heal completely only as the result of a vital force from within (Tolstoy, War and Peace, 15).

  Kernberg resumes Freud’s vision of the accomplished mourning by the term ‘identification’ (with the lost object), while Freud reserves this term to the melancholic process and insists on the decathexis in normal mourning. Melanie Klein adds that normal mourning reawakens and resolves the depressive position in a process of reparation. Finally, Kernberg highlights the spiritual aspect of mourning. He proposes ‘a 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: 410). On the one hand, there is now no more forgiveness nor repair with the lost person. On the other hand, aspirations and values of the dead person may be experienced by the person in mourning as a mandate, a command: They become part of the mourner’s superego as ‘highly personalized relations with the lost object’ (Kernberg 2010: 410). Libidinal investments are ‘not a zero sum capacity’. On the contrary, ‘mourning interminably may become part of the increased capability for love and appreciation of life’ (614).

  The expansion of moral values and ethical commitments related to the mandates that reflect the desires and aspirations of the person who died, whose life project was interrupted, are frequently a powerful stimulus to reparative action of the survivor providing a sense of purpose. They become, as mentioned before, ethical commands and aspired for ideals. Reparative processes, in short, expand into spiritual demands (Kernberg 2010: 613).

  The danger of the unaccomplished, frozen mourning process is, as Volkan says, a defensive ‘spiritual merging’ between the mourning and the mourned person. However, when the reality of object loss is recognized, the power of the emotional and spiritual reality reflected in a permanent internalized relation with the lost object becomes an ‘absent presence’ as Kernberg quotes Sara Zac de Filc.

  The irresistible urge for reunion, the fantasy and concern over life after death, the expanding moral universe related to the mandate all combine in the expression of powerful religious impulses, whether they take the form of adherence to an established religious belief system, or are constructed individually as a painful yet indispensable aspect of spiritual existence and survival.

  (Kernberg 2010: 613).

  Kernberg’s spiritual bond and its structural consequences have been described as a transformative process observed in securely attached mourners (Stroebe et al. 2010). The lost person is ‘resurrected’ in terms of ‘mentally represented legacy components (e.g., what would he have said, how would he have responded)’, enriching ‘those mental representations of the lost person’s legacy that carry substitute value’ (Boerner and Heckhausen 2003: 219).
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  The analyst’s role, his or her containing function during the mourning process, encompasses ‘the transference function of reinstating and maintaining that internalized relationship’ with the lost object, while ‘bringing it to life in the relation with the analyst’. According to Kernberg, this transference aspect reflects the double function of the mourning process—superego restructuring and maintaining the relationship (Kernberg 2010: 613).

  Consolation?

  In his criticism of religion, Freud often opposes scientific enlightenment and the soothing function of religion who feeds with empty promises, with hopes of a better world. This criticism basically concerns the illusion of narcissistic perfection and fulfilling of wishes (Westerink 2010). Is a true consolation conceivable, a consolation which encompasses the work of mourning, i.e., the acknowledgement of a given object-loss? The answer will depend on the general theory of mourning: Does it consist in severance of attachment and redemptive replacement, or is a continuity of bonds conceivable as Freud suggests in his dialogue with the silent as well as in a 1929 letter to Binswanger:

  Although we know that after such a loss the acute state of mourning will subside, we also know we shall remain inconsolable and will never find a substitute. No matter what may fill the gap, even if it be filled completely, it nevertheless remains something else. And actually, this is how it should be. It is the only way of perpetuating that love which we do not want to relinquish.

  The Dual Process Model (Stroebe et al. 2010) endorses an ‘oscillation’ between loss-orientated and restoration-orientated coping. This orientation entails emotional and cognitive commitments during the mourning process which is never entirely accomplished but encompasses, as the Dual Process Model shows, a relocated presence of the absent, a transformation of mental representations. This is true for bereaved persons but also for other losses, especially for the dying person’s mourning called travail du trépas (transition work) (de M’ Uzan, 1976/1977).

 

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