The Long-Term Effects of the Mourning Process


CHAPTER 15




The Long-Term Effects of the Mourning Process


 


 


In an earlier paper (Kernberg 2010), I pointed to some aspects of the mourning process that in my view had not been considered sufficiently in the literature. I proposed that mourning is a permanent process, with profound impact on the structures of the mind, on object relations in general, and on the capacity for deepening the understanding of subjective experiences of self and others. I suggested that the mourning process culminates in the consolidation of a permanent relationship with the lost object while still internalizing some aspect of the object’s characteristics as part of the self experience. This development points to the double process of identification: the incorporation of aspects of the lost object into the self and the setting up of a permanent dyadic relation of a representation of self with the representation of the lost object. This development within the ego coincides with new developments within the ego ideal, modifying superego functions in general, in the context of the internalization of the life project of the lost object—the identification within one’s own ego ideal with what the lost object would have wished to achieve in life, and what the person whose death is mourned would have said or done, reacted to or felt, expected himself or herself to achieve, and hoped for the mourner to achieve. The organization of internalized value systems, the integration of the mature superego, is thus modified and enriched.


Still, the mourning process would continue as repeated pain over the loss, with the lost object becoming a permanent painful “absent presence,” and connected with this experience, the reactivation of guilt feelings over not having fully appreciated the lost object during life and guilt feelings over having failed the loved one while they were alive. The more ambivalent the past relation with the object, the more painful are such guilt feelings, to the extent that pathological mourning may be characterized by significant pathology. In this latter case, the despair over the impossibility to repair real or fantasied guilt is reflected in depressive symptomatology, resulting in the possibility of suicidal wishes as the expression of the wish to expiate deep guilt feelings. Implicit dynamics may involve fantasies that self-elimination would permit the good parts of the self to survive, with the simultaneous destruction of all the bad parts of the self reflecting the negative feelings, including hatred of the lost object and the related unconscious introjection of the hated part of the object as part of the self. Under extreme circumstances, the despair over the permanent nature of the loss coincides with the condemnation symbolized by the words inscribed over Dante’s entrance to the Inferno, “Abandon all hope, ye who enter here.”


But the purpose of this chapter is to describe the process of mourning under the optimal conditions in which ambivalence had not been so marked or extreme, and where mourning processes reactivate what Freud (1917[1915]) and Melanie Klein (1940) described as the normal mourning processes and, in Melanie Klein’s contribution, as the reactivation and reworking through of the depressive position as the central process of such mourning.


Approximately 5 years after my initial contacts with the persons I described in my earlier contribution (Kernberg 2010)—who had lost a spouse after decades of living together, and who had remarried, and whom I had been able to interview extensively—I revisited them with the question of what further changes may have taken place in them throughout those 5 years. (I was able to contact a majority of them, in addition to further reviewing patients’ material and my own experience, having undergone similar vicissitudes in my own life.)


To begin, essentially the same processes that I summarized as the main observations communicated in my previous work continued to be present. Again, during these interviews, mourning reactions became reactivated, together with information provided regarding experiences similar to those they had reported in the original interview 5 years prior, perhaps somewhat attenuated in some cases, but nonetheless, an intense, lively upsurge of reactivation of mourning under sudden emergences of past experiences triggered by present-day life situations. In addition, however, new elements emerged that had not been so clearly observable before.


First, I found a generally changed attitude of these persons toward the potential of serious illness and death. There was a decrease of the anxiety that one might expect would be elicited by the development of symptoms of a potentially serious illness or death, both their own and those close to them. This decreased fear of death and dying at times surprised the subjects of my inquiry themselves. They made comments such as “If he was able to go through this, I shall be able to do it,” a sense of being accompanied by the beloved person who had died in the imagining of one’s own process of dying, and fantasies of the possible reencounter with the dead person after one’s own death even in persons without any religious inclination or convictions in that regard. The sense of death as a reencounter acquired an important function of dealing with one’s own death, particularly if the conviction of being loved by one’s departed partner was very powerful. From an analytic perspective, this may be rooted in both oedipal and preoedipal experiences as the assurance of the permanence of the love of the internalized mother imago. For those who had religious convictions about life after death and who had remarried, fantasies and questions emerged about what would happen to them with the competing love of two persons, the past and the present spouse. This same issue was explored by C.S. Lewis in his dramatic autobiographical essay “A Grief Observed” (Lewis 1961), in which he solved that painful question for himself in the assumption that in the love of God all other conflicts could be reconciled. From a dynamic viewpoint, one may speculate about the projection of oedipal triangulations into the fantasied world after death and the corresponding efforts of defensive denial or sublimatory resolution of conflicts around direct and reverse triangulation (Kernberg 2012).


It impressed me that a more general attitude of tolerance of conflicts seemed characteristic of all the persons interviewed, accompanied by a greater degree of understanding of the viewpoints of others with whom they had experienced themselves in a serious conflict, and an increased capability for forgiveness toward others who had disappointed them or treated them with hostility. This greater degree of tolerance seemed to go hand in hand with greater tolerance for the ambivalence of human relations in general, an increased curiosity in the experiences and motivations of other persons, and the sense of greater understanding and greater freedom to be of help to other persons who were undergoing a mourning process. While some of these changes might be attributed to the general emotional maturation and deepening of self-reflection as an expression of the developmental process of essentially normal individuals, the intensity of this process in the subjects I reinterviewed seemed to them clearly related to the ongoing subtle process of long-term mourning for a lost object.


This greater degree of tolerance may extend to the fantasies about the lost object. For example, in situations of unresolved, significant guilt feelings, the mourned-for object may also be experienced as more tolerant and forgiving toward the surviving partner. The fantasy of a desired reencounter upon the survivor’s own death now may include this more benign and forgiving lost object. The opposite may evolve in cases of pathological mourning: as part of depressive symptomatology, the person may experience the frightening fantasy that he or she will be rejected on such an encounter in the afterlife, resulting in an expansion of a panicky sense of abandonment.


Returning to the interviews, one other experience shared by practically all persons was the increase of thoughts and reflection regarding other losses in their lives, a review of what originally might have been almost peripheral, barely noticed processes of mourning regarding persons other than close and intimately related relatives and friends, but, of course, particularly so regarding one’s own mourned parents, children, or siblings. Revisiting past mourning processes tended to be accompanied by the emergence of the lost love objects from the past, particularly one’s parents, in the manifest content of dreams, very often in the context of scenes of early childhood or adolescence in which the dreamer is both a child and the present adult relating to a live image of the lost object. Old conflicts were relived in combination with the expression of new insights regarding these conflicts in the very interaction dreamed about, so that vivid repetition of the past in the context of present-day reflections about it were condensed into the dream experience. Vivid dreams involving dramatically realistic new experiences with the lost partner were quite frequent and were naturally followed by a painful awakening.


One subject told me that he felt that he lived in two worlds: one of daily reality, in which he felt immersed in the reality of his present human world, and one of his dreams, in which his deceased wife would appear as naturally linked to his present experiences, relating to his present network of close relationships—a scenario that would appear as perfectly realistic during his dreams.



A greater sensitivity to the nuances of present-day intimate relations and friendships seemed to evolve in parallel to the processes referred to this point: a combination of understanding in greater depth and appreciation of the importance of intimate relations and the mutuality of friendship. Octavio Paz’s statement that “friendships are the leaves of the tree of life,” mentioned by one of my subjects, was reflected in concrete experiences of the enrichment of his daily life.


Although the acceleration of the experience of time is a generalized human experience as part of the aging process, this very process seems accentuated in persons who are grieving losses of persons with whom they shared an intimate relationship over many years. The normal contrast between childhood and early adulthood, when external reality seems stable while the individual experiences himself or herself in a period of rapid change, and later life, in which the experience of changes in external reality points to the transience of existence, seems to be reinforced as a consequence of a severe loss, inducing a higher sensitivity to change, to the ephemerality of experience. That, in turn, deepened the intensity and value of relationships, and of the complex nature of one’s own and others’ personalities. It also deepened, at least in some of the persons whom I reinterviewed, the experience of art and the search for permanent values in the ethical as well as the aesthetic sphere. One person referred to Dali’s famous sculpture “Horse Saddled With Time,” in which one of Dali’s blanket-like, soft surface clocks embraces the back of a harried, tense, and frightened-looking running horse, as a reflection of the transitoriness of experience. Another person stated succinctly that the relationship with those one loved was the only stable reality in a world of constant change. Obviously, personal conflicts, anxieties, and challenges determine the vast variety of reactions to the passage of time, but the very intensity of the awareness of this passage seemed related to the long-term processes of mourning.


In contrast to the heightened awareness of the transitory nature of experiences as well as aspects of external reality, several individuals I interviewed referred to the unexpected reactions they experienced toward objects concretely related to their mourned partner. An object that was dear to the lost person—a piece of jewelry, a painting, a song, an object of art or literature closely related to the lost person’s interest—would intensify its meaningfulness and impact, triggering brief but deep mourning reactions. These seemed to be memory “rocks” in an ever-changing sea of reality. Most subjects were surprised by the intensity of sudden mourning reactions upon encountering of one of these objects. One person mentioned the drawing of an angel by Paul Klee, produced during the late stage of his illness, that his deceased wife had given him a few months before her death. On the wall of his office, it functioned as a bridge to an immediate contact with her, the memory of their conversations about Klee’s art and life, and as a silent communion between them.


For psychoanalysts and psychoanalytic psychotherapists, the personal experience of a profound mourning process may increase their capacity to respond to their patient’s mourning process. It may increase their understanding that patients need an open space and the therapist’s capacity to fully tolerate, understand, and accompany the patient in his or her suffering, without premature reassurance or foreclosure of the process. The optimal way to help patients at this juncture is to permit them to share fully with the therapist their experience of the lost object, the very presence of this absent object in the content of the therapeutic hours. This involves the lost object becoming alive in the emotional experience of both participants, an increasing reality of the permanence of the lost object in the mental life of the patient as the memory becomes a shared reality in the therapeutic encounter. Therapists’ sensitivity to patients’ intolerance of the mourning process may increase their facilitating the diagnosis of paranoid regressions—the patient’s blaming others for the death, and reacting with rage and wishes for revenge—and of pathological mourning reactions—severe, unrealistic guilt feelings and self-blame with depressive symptomatology and potentially suicidal impulses. The analytic resolution of these manifestations of intolerance of normal mourning may help the patient tolerate and elaborate the normal mourning process. Perhaps the greatest therapeutic challenge, under such circumstances, is the dominance of denial of mourning processes as an aspect of narcissistic pathology. The patient’s apparent indifference to what from the outside appears as a dramatic loss may trigger strong negative countertransference reactions. The analyst’s deep awareness that, together with the unconscious devaluation of the lost object, the patient is also impoverishing his or her own internal life may increase the analyst’s tolerance and working through of this countertransference reaction. This radical indifference, of course, should not be confused with defensive hypomanic reaction to intolerable mourning, a denial of depression seemingly easier to integrate and work through.


In conclusion, if all true learning is essentially painful, the learning derived from the long-term effects of mourning processes probably is among the most painful contribution to learning in depth about intimate human relationships and their contribution to the richness of life. The underlying mechanisms involve the internalization of a highly significant object relation into both ego and superego structures in the context of the prevalence of love over hatred; the tolerance of the depressive position in contrast to the regressive defenses of narcissistic and paranoid structures or the condition of pathological mourning; and the corresponding capacity of working through of the depressive position, and of reinstating and deepening the relation with internalized good objects in the structure of one’s mind.


References


Freud S: Mourning and melancholia (1917[1915]), in Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol 14. Translated and edited by Strachey J. London, Hogarth Press, 1957, pp 237–260


Kernberg O: Some observations on the process of mourning. Int J Psychoanal 91(3):601–619, 2010 20590930


Kernberg OF: The Inseparable Nature of Love and Aggression: Clinical and Theoretical Perspectives. Washington, DC, American Psychiatric Publishing, 2012, pp 263–264


Klein M: Mourning and its relation to manic-depressive states. Int J Psychoanal 21:125–153, 1940


Lewis CS: A Grief Observed. San Francisco, CA, HarperCollins, 1961


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Mar 29, 2020 | Posted by in PSYCHIATRY | Comments Off on The Long-Term Effects of the Mourning Process
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