The conflict between mourning and melancholia

Conflict between facing the reality of loss on the one hand, and denying it on the other, is explored in clinical material drawn from an analysis approaching termination. The intrapsychic conflict over loss was expressed as a conflict between morality and reality, and was externalized as a conflict between patient and analyst. For the patient, giving up resentment toward the analyst became tantamount to giving up the ideal object and losing omnipotence. In the course of the analysis, his complaints became less convincing, and the conflict over loss became more conscious, allowing some moves toward mourning to take place.     

Mourning the dead,mourning the disappeared: The enigma of the absent–presence

Freud's interest in the impact of death on the living goes back further than Mourning and Melancholia (1917e, [1915]). In Totem and Taboo (1912–13) Freud noted the ambivalence of the emotions we experience in relation to the dead. In this paper, I focus on Mourning and Melancholia as a landmark in the understanding of both the normal and psychopathological aspects of mourning and depressive processes in human beings. Mourning and Melancholia bridges Freud's first and second topographic theories of the psychic apparatus and constitutes for many authors the foundation of his theory of internal object relations. With this psychoanalytic understanding of mourning as a framework, I discuss ‘special mourning processes,’ such as the those confronted by psychoanalysts in Argentina when treating the relatives of thousands of people who were ‘disappeared’ by the military dictatorship in the 1970s; they are ‘special’ in the sense that the external reality [which] constitutes the starting point of the psychic mourning process, as described by Freud, is absent. I argue that the ‘absent–presence’ of the body as an enigmatic message initiates a special mourning process that bears certain characteristics of, and is isomorphic to, Laplanche's seduction theory.     

On excess,trauma and helplessness: Repetitions and transformations

Freud's work establishes a link between an excessive amount of excitation, the infant's experience of helplessness, and trauma. The idea of excess emphasises a quantitative element, not reducible to the field of representation. In this paper I explore the notions of excess and closure in relation to two clinical examples. A patient who lived through experiences of excess and flooding is contrasted with another patient whose experience of excess is expressed through withdrawal. The complex process of elaboration and working through in their analyses takes place by bringing together affect, representation, sensorial and somatic experiences, dreams, associations and enactments as they are gathered and given meaning après coup through analytic work. Two concepts were central to the understanding of what took place in the analyses: excorporation and figurability. The paper emphasizes the place of temporality in creating a triadic space in an analysis as it relates the here and now with the there and then in the work of après‐coup. The paper also traces the roots of this modern approach that relates the analyst's work of regression, time, and the creation of a triadic space to Freud's metapsychology.     

Human and institutional transformations: Catholic hospitals becoming 'a light in the the darkness.

Catholic health care institutions in the United States and Canada face internal and external challenges to their continued existence. Confronted by these external and internal challenges, Catholic hospitals in the United States and Canada have been pressed to identify what is distinctive about the Catholic contribution to health care and to consider whether existing institutional structures and partnerships foster what is distinctive. The author looks at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman, and suggests that there is little agreement, even among Catholics, on such fundamental issues. The aim of this article is to highlight three important and often overlooked ideas raised by the authors, to relate them to the Canadian context by means of a story, and to pose questions for further discussion.     

Retrospective spiritual narratives: exploring recalled childhood and adolescent spiritual experiences

This paper draws on a collection of retrospective narratives of childhood and adolescent spiritual experiences to explore the qualities and characteristics of the spirituality of the young. They recall a range of spiritual experiences that touch on death, mortality, visions, and perceptions and connections beyond the self. Their experiences include varying intensities of emotion and invoke a range of responses in them and others. The paper considers the social, emotional and familial context of these early life experiences and their impact on spiritual experience and the possibility/impossibility and freedom/lack of freedom to express, and integrate spirituality.     

The spiritual experience index: A measure of spiritual maturity

The Spiritual Experience Index was developed to measure spiritual maturity in persons of diverse religious and spiritual beliefs. The scale was constructed from a developmental rather than a multidimensional conceptualization of faith. Initial findings from a religiously heterogeneous college sample indicated good reliability for the SEI and supported its use as a unidimensional measure. Higher scores on the SEI were significantly related to lower dogmatism and intolerance of ambiguity. The SEI was also moderately related to higher religious participation and positively correlated with intrinsicness and quest. However, compared with the intrinsic and quest scales, the SEI emerged as the strongest indicator of adaptive spiritual functioning. Directions for future research are suggested.     

The changing relationship between psychology and contemporary spiritual direction

As recently as the late 1970's, the relationship between spiritual direction and psychology was tentative and cautious. During the last decade, however, psychological methods and perspectives have been increasingly utilized in spiritual direction. This article examines how clinical psychology, developmental psychology, the psychology of women, and professional psychology are becoming increasingly relevant to the contemporary practice of spiritual direction in the United States, and how, in the process, the relationship between psychology and spiritual direction is changing.     

Dying to live: mourning,melancholia and the adolescent process

The author reviews the main points in Freud's 1917 paper 'Mourning and Melancholia' and relates them to the process of both normal and troubled adolescent development. Using clinical examples she illustrates the ways in which the processes Freud describes in melancholia operate in some disturbed adolescents such that instead of mourning the lost objects of their childhood, they become stuck, remaining ambivalently attached to them and incorporating them into their final adult identity and sexual organization.

L'auteur passe en revue les points essentiels du texte de Freud « Deuil et mélancolie » (1917e [1915]) et les relie aux processus du développement, normal et pathologique, de l'adolescence. À l'aide d'exemples cliniques, il illustre la manière dont les processus décrits par Freud dans la mélancolie sont mis en ?uvre chez certains adolescents perturbés?:?au lieu de faire le deuil des objets perdus de leur enfance, ils restent bloqués dans l'ambivalence de leur attachement À ceux-ci et s'efforcent de les incorporer dans leur identité adulte et leur organisation sexuelle finale.

L'autrice passa in rassegna i punti principali dell'articolo del 1917 di Freud 'Lutto e melanconia' e li mette in relazione al processo dello sviluppo adolescenziale sia normale che disturbato. Utilizzando esempi clinici l'autrice illustra i modi in cui i processi che Freud descrive nella melanconia operano in alcuni adolescenti disturbati cosi' che invece del lutto per la perdita degli oggetti dell'infanzia, gli adolescenti rimangono incastrati e ambivalentemente attaccatti ad essi, incorporandoli nella loro identita' adulta finale e nell'organizzazione sessuale.

Die Autorin rezensiert die Hauptpunkte in Freud's Abhandlung ' Trauer und Melancholie' und bezieht sie auf den Prozess sowohl der normalen als auch der gestörten adoleszenten Entwicklung. Anhand von klinischen Beispielen illustriert sie die Art und Weise, in denen die Prozesse, die Freud in der Melancholie beschreibt, in einigen gestörten Jugendlichen operieren, so dass sie anstatt die verlorenen Objekte ihrer Kindheit zu betrauern, sie festgefahren sind und ambivalent an sie gebunden bleiben und sie letztlich in ihre Erwachsenenidentität und sexuelle Organisation inkorporieren.     

The day the earth stood still: The presence of trauma in time experience

The experience of time is commonly perceived as developing within the context of the early relationship between mother and infant. The beginning of life occurs in an adapted environment, aimed to protect the child from internal and external disruptions. Through healthy development, the mind acquires a feeling of continuity that gradually becomes a cohesive sense of personal identity. However, in cases of traumatic interruptions to the primary environment, the defensive shield of the self is penetrated and the individual becomes prematurely aware and adapted to the external reality. This forced acknowledgement of time and reality could be manifested in various types of time disturbances, such as disorientation about time or difficulties in following a schedule. In therapeutic relationships, this drama would be enacted in a struggle against the psychoanalytic setting, which disrupts the continuity of being with the therapist. Importantly, these patients express a deep conscious or unconscious fantasy to live in a timeless world, in which they would not be forced to adapt themselves to others’ expectations or needs. Clinical examples are used to illustrate how traumatic history is evident in the patient’s time experience and in the psychoanalytic dialogue.     

The missing tombstone: reflections on mourning and creativity

There are differences as well as similarities between mourning occurring after the loss of a single individual under ordinary civilized conditions, and mourning after multiple losses under traumatic conditions. A brief review of the psychoanalytic theory of mourning articulated by Freud in 1917 and modified in the 1960s is followed by an equally brief review of the relationship between artistic creativity and mourning. Because survivors of major disasters who suffer multiple losses need time to recover before they can engage the emotionally demanding task of mourning, the mourning process in these cases is frequently delayed. "Memorial spaces" appear to facilitate delayed mourning because such spaces are responsive to a deeply felt need by survivors of major tragedies to articulate what they experience as unspeakable and unshareable. The memories and the pain associated with them are then welcome because mourning is not about forgetting; mourning is about remembering, a process that may take a lifetime.