Enduring Loss

Mourning, Depression and Narcissism Throughout the Life Cycle

Eileen McGinley, Arturo Varchevker, Eileen McGinley, Arturo Varchevker

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9780367106331
• eBook ISBN: 9780429913242
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book comprises a selection of papers initially presented as a series of lectures organised by the Psychoanalytic Forum of the British Psychoanalytical Society. The aims of these lectures was to revisit Freud's key papers 'On Narcissism' (1914) and 'Mourning and Melancholia' (1917), and to look at how they are used in today's thinking about the different stages of life. The contributions, by well known clinicians and theoreticians in their respective fields, capture certain important themes which were put together with two main incentives in mind: firstly, to consider that mourning, depression and narcissism constitute the basic fabric of psychoanalytic theorizing. Secondly, the centrality of these concepts not only illustrate a particular way of understanding mental functioning but, by locating them at different stages of the individual development, offers a wider, more effective and at times different perspective.

Part I
Childhood

CHAPTER ONE
Melancholia and mourning in childhood and adolescence: Some reflections on the role of the internal object

Anne Alvarez

I first read Freud's 1917 paper Mourning and Melancholia after reading Melanie Klein's paper, Mourning and its Relation to Manic-depressive States (1940). It has been a joy and something of a relief, to go back again to this great work of Freud's: I have been spending much time in recent years studying phenomena in the more paranoid and schizoid states of mind of extremely disturbed children, and although that has been edifying and unfortunately necessary, it was good suddenly to find myself back home, as it were, with this subject (Freud, 1917).

I would like to discuss two very different conditions which interfere with a person’s capacity to mourn: protesting too much and protesting too little. In the years since 1917, I will suggest that five particular states of mind, all of which appear in and are foreshad-owed in Freud’s description of melancholia, have been developed further by subsequent theorists. The first feature is the nature of the paranoid state of mind, (Klein, 1935) and the second is the state of manic contempt (Klein, 1935; Segal, 1964) for devalued objects. The third, developed greatly by Rosenfeld, Kernberg, and Kohut is narcissism. Freud had made note of a narcissistic preoccupation. He does not seem to like these melancholics much. In a way, he is right, because the real mourner evokes our sympathy in a far more powerful way: on the other hand, a psychoanalysis which attends carefully to the nature of the internal object’s possible collusive role in all this might lead us to be a bit less impatient.

I shall concentrate on a fourth and a fifth feature. The fourth arises from a concept of Betty Joseph (1982), the process of addictive and perverse chuntering, which under different names was noted both by Freud and also by Abraham as a characteristic of the state of mind of the melancholic. The fifth feature, which arises from our greater understanding nowadays of the preconditions for the work of mourning, was also first described to us by Freud. This feature, which has to do with despair, and with those states which go beyond despair into apathy, concerns the question of the level of development of early introjections and internalisations of, and identifications with, a good object, and the part early development plays in the capacity to mourn. Here I shall also say a word about unvalued, as opposed to devalued objects. The findings from infant observation and infant research and also those from the clinical treatment by child psychotherapists of extremely deprived and traumatized children, support the work of Klein, Bion and the developmentalists. All the newer developments in thinking are underpinned, I suggest, by the greater attention to object relations theory and by the growing understanding of the nature of the difference between pathological and benign projective processes, and pathological and benign introjective ones.

But back to Freud. As with all his great papers, what you get in Mourning and Melancholia is Freud thinking on the hoof, telling you what he has observed, what he does know and is perfectly clear about, but always being equally clear about what he and we do not understand yet. Time and again, for example, here and in later papers, he is puzzled about why the work of mourning should be so extraordinarily painful. A theory based on libidinal economics does not explain that, he tells us. We might nowadays point out that a one-person psychology never could. Such pain was not easy to explain until there was a theory that left room for the power of our link to other people, and especially to their representations (or internal objects) set up inside us: that is, the power their sheer otherness exerts on us. (It is interesting that Freud’s paper is not painful to read, whereas with Klein, the painfulness of the subject gets further into the prose.) But this is Freud at his tough-minded best: he begins with his usual device of dropping all claims to the general validity of his findings, and then he starts to think. Freud then points out that the external precipitating conditions are the same in both mourning and melancholia: the loss of a loved person, or of some abstraction such as one’s country, liberty, or an ideal. The mental features are the same too: he says that both grief and depression involve a dejected mood, a loss of interest in the world, a loss of the capacity to love, and an inhibition of activity. Yet although mourning also involves “grave departures from the normal attitude to life”, he points out that it never occurs to us to regard it as a pathological condition, and that we rely on its being overcome after a certain lapse of time.

But there is one important feature in melancholia which is not present in mourning, and this he identifies as the “extraordinary diminution of self-regard” which expresses itself in self-criticism and self-vilification. Freud expands, with a certain distaste, on the nature of this loss of self-respect in the melancholic: he points out that there is a terrible truth in some of the things the melancholic says about herself: she really is as lacking in interest, as petty and egoistic and as incapable of love and achievement as she says. Freud finally concludes (p. 248) that patient listening to all this leads to the impression that the self-accusations, with significant modifications, do fit someone else—someone whom the patient loves or has loved or should love. The key to the clinical picture, therefore, is what look like self-reproaches are in fact reproaches against a loved object which have been shifted away from the object on to the patient’s own ego. “The woman who loudly pities her own husband for being tied to such an incapable wife as herself is really accusing her husband of being incapable … The underlying revolt passes over into the crushed state of melancholia.”

Now I would like to turn to the fourth feature of melancholia, that of “chuntering”. Freud makes another extremely important observation (p. 247) when he points out that the melancholic does not behave quite like ordinary people crushed with remorse, because feelings of shame seem to be lacking; he is referring to the narcissism. But there is a further point. “Indeed,” he adds, “there is almost an opposite trait of insistent communicativeness which finds satisfaction in self-exposure.” Note the emphasis on the insistence of the communicativeness. He says also that the complex of melancholia behaves like an open wound, which draws to itself cathectic energies, “… from all directions and emptying the ego until it is totally impoverished”. (Later, we can ask, if there is no healing, no normal scarring, what prevents it?)

Here there is a foreshadowing, a long away ahead, of Betty Joseph’s concept of addiction to near-death, or chuntering, moaning on about misery in a way which can be both profoundly addictive, and also may be secretly quite masochistically perverse. Joseph’s 1982 paper explored not just the phenomenon of a way of talking about misery that could accompany genuine misery, but also the effects on the transference and counter-transference in the relationship with the analyst; that is, the way the analyst could get pulled down into a state of depression where the pulling down was nevertheless felt to be quite sexually and masochistically exciting to the patient. Joseph insists that she is not talking about simple over-dramatization. I think myself there are probably gradations from something which is less perverse but still quite addictive to that which is both addictive and perverse. I shall expand on this continuum later.

Klein did draw attention to sadism and the gnawing of conscience, but was busy exploring the genuine hostility and hatred that interfere with love, real grief, and real reparation toward a loved object. Abraham, however, did draw attention to the masochism accompanying the narcissism hidden in the self-reproaches (Coyne, 1985, p. 39). He refers to the omnipotence of the biggest guilt and secret pleasure, the masochistic tendencies, the pleasure from his suffering and from continuing to think about himself. “Thus even the deepest melancholic distress contains a hidden source of pleasure.” Abraham adds that it is an auto-erotic negation of life (p. 40).

I want to think a bit more later about what it is in the personality and inner world that prevents chuntering, or at least enables us to stop chuntering, to allow the processes of mourning to take their natural course and allow us to get back to life. Do our internal objects tell us they have had enough, or does our own self get weary? Either way, something happens to stop us picking and scratching at it, to allow some healing and scarring of the open wound to take place. What is it? In one way, with all the later hindsights from later theories, it is easy to protest the absence, in Freud’s description of the work of mourning, of any reference to the reinstatement of the lost object within the ego, a piece of theory so much a part of Abraham’s (1924) and Klein’s (1940) work, and also Freud’s own later work (1923). Abraham also wrote to Freud about it on reading Mourning and Melancholia and we owe to Klein the notion that the loss of the external objects awakens fears of the loss of good internal objects too. Her view was that such reinstatement depended on the balance between love and hate towards internal objects in the internal world. She also saw it as dependent on recognition of the otherness of one’s objects and a relative absence of a narcissistic identification with them.

But this was only 1917, and maybe we can look again at Freud’s more active vocabulary. What Freud emphasizes here is the way the dictates of reality determine that the libido shall “detach itself” from the object which is now gone (p. 249). He describes the normal process in what might in one way seem to be rather too active terms as: “a withdrawal of the libido from this object and a displacement of it on to a new one, or to life itself” (p. 252). He says, for example, when this work is accomplished the ego will have succeeded in “freeing its libido from the lost object”. (Perhaps we could say that even the concept of work is a fairly active one.) This next statement is not quite so active: “Each single one of the memories and situations of expectancy which demonstrates the libido’s attachment to the lost object is met by the verdict of reality that the object no longer exists; and the ego, confronted, as it were, with the question of whether it shall share this fate, is persuaded by the sum of the narcissistic satisfactions it derives from being alive, to sever its attachment to the object that has been abolished” (p. 255). He comments that it is remarkable that this painful unpleasure is taken as a matter of course by us, and that the fact is, however, that when the work of mourning is completed, the ego becomes free and uninhibited again.

It is easy to read all this now and agree with Klein: yes, but not so free, free but changed internally, that is, to note the lack of the notion of internalization, the process that we now understand to accompany the so-called detachment of libido. But maybe we should not lose sight entirely of Freud’s more active vocabulary. For it is also true that mourning, at least in its heightened form, does not go on for ever. What stops an insistent going over and over of one’s loss and misery? Instead of an active concept such as Freud’s “severance”, we might say there is something about the importance of letting go, and being let go of by the object, which is foreshadowed in Freud’s thinking. Letting go of the object, and letting go of the grief. It is interesting that in the film Truly Madly Deeply the permanently grieving woman is as helped as much by her dead husband who returns from the grave to make her tired of him, as by her own growing desire for life. We have to let our objects go, but they have to be felt to let us go too. But maybe we could say with Freud there is also, finally, a wearying or impatience with one’s own grief. A little paternal insistence on severance is sometimes good for us.

Clinical work with a depressed adolescent where there were features of both mourning and melancholia

This is a situation where the patient and I came to learn that a type of melancholic rumination did accompany some real mourning. I want to draw, however, particular attention to the role of the internal object, in this case a paternal one, in helping to reduce the rumination. Henri Rey wrote that in borderline patients at least, it was often the case that the internal objects had to get better before the self could (Rey, 1944).

Luisa was referred at the age of 15 for depression, extreme separation difficulties, and various somatic and psychosomatic conditions. Her family was Latin American, but she herself was born and raised in the UK. She was the youngest of three daughters, and many of her extended family lived in England, too. Theirs was an affectionate and devoted family, and Luisa was particularly close to her eldest sister and to her mother. Luisa told me that her extremely happy childhood ended around the age of 13, that she had been feeling unhappy inside since then. Later she added that adolescence itself had probably upset her, because it meant the loss of her wonderful childhood. She often spoke to me very poignantly about the warmth and simplicity of her childhood days; the feeling of loss and grief was real, but it was sad to see how little pleasure she could allow herself in her current life. She did have fun, but somehow she had to steal it and hide it from other parts of herself. Later, it was also sad to see that the prospect of university and the round-the-world travels of the gap year offered no exciting adventures for Luisa: she saw the future as simply grey. She seemed like someone walking backwards into the future, looking longingly at a brightly lit past.

Luisa’s fears and griefs about separation were a great problem at the time of referral and for years afterward. Whenever her parents, or she herself, were to go away, however briefly, she imagined them dying, and therefore her own life over. At times she tried to hide her grief and panic from them, but usually failed. Sometimes, instead of the emotional upset, one of the somatic conditions would erupt. It is important to say that her anxieties, whatever unconscious aggression they may have hid, were also accompanied by real love for her parents, who were indeed devoted to her, and very bewildered and worried by the intensity of her distress. They had not had this kind of difficulty with their older girls. To me she was a reliable and cooperative patient—she brought interesting dreams, and helpful associations to them and to my interpretations. Gradually, however, it became clear that the work was being done for me rather than for herself, that she had a fantasy of parental figures as needing her, and of me as needing her confirmations of my ideas. Over the first three years, there grew some signs in dreams and in sessions that parent figures could be seen to be on the side of life—not yet really potent, but not quite so needy either.

And Luisa did seem then, by the age of 18, to be less depressed and persecuted in her outside life. But as the time of her gap year round-the-world travels approached, the phobias about separation recurred with a bang. She was experiencing real depression and grief about leaving the family home and her boyfriend. There was also real phobic and sometimes realistic fear about the dangers of travelling the globe. We had previously learned that she was, however, capable of over-dramatizing such panics and griefs. Yet it was not simple over-dramatization: we could by now both recognize a quality of ruminative dwelling upon, and morbid fascination with, her own grief, depression and panic. We had also begun to learn of the way in which other people could...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS
• CONTRIBUTORS
• INTRODUCTION
• PART I: CHILDHOOD
• PART II: ADOLESCENCE
• PART III: ADULTHOOD
• PART IV: OLD AGE
• PART V: CULTURE
• INDEX