Role of psychocultural factors in the adjustment of Soviet Jewish refugees: Applying Kleinian theory of mourning

The purpose of this paper is to show how failures of adjustment of Soviet refugees to America are to a great degree determined by their difficulties in mourning. The author argues that due to such difficulties, Soviet refugees may get fixated sometimes for long periods of time at different stages of the mourning process. Such fixations may be the causes for peculiar types of behavior, frequently exhibited by these refugees in America and attributed by various authors to their psychocultural characteristics. Melanie Klein's analysis of mourning and its relationship to manic depressive states is applied to understand the mourning process in this population. The author shows that difficulties in the mourning process experienced by Soviet refugees may be connected with the culturally acquired inhibitions of mourning. Such inhibitions are analyzed from a family, historical and cultural perspective.     

Mourning is a family affair

Mourning is a process of social disengagement. In our modern society, however, the influence of social and religious institutions on the process of mourning has significantly diminished and been partially replaced by mental health clinics. Given the latter's penchant for the intrapsychic view, the perspective on mourning has become reduced to the individual. These trends are clearly reflected in a review of current literature and research on mourning. This paper proposes an interactional, systemic view of mourning through the analysis of two different families. Findings indicate that despite contextual differences between these two families, some basic commonalities render generalizations possible: (a) The selection of the identified patient is not coincidental to the stage of the family life cycle and to the role of the deceased member in the system. (b) Although death affects each individual differently, depending upon his or her relationship with the deceased, it continues to influence all family relations with equal powers. (c) Nonresolution of mourning permits a ghost to become an integral member of the family system. Examination of the treatment process demonstrates that a systemic approach is effective, even when individuals are interviewed alone.     

Between the imaginary and the real: photographic portraits of mourning and of melancholia in Argentina

During Argentina's 'Dirty War' (1976-83), the military regime attempted to erase an entire population; today the photographs of the dead/missing stand in defiance, contradicting that attempted erasure of the desaparecidos. In this essay, I explain the connection between photography and loss, and how photography fits within Lacan's understanding of the Imaginary, the Symbolic, the Real, and the 'gaze'. I discuss complicated mourning (circumstances which inhibit/delay mourning) and the difficulties created by political disappearances: as long as the family members maintain the belief that their loved one(s) might still be alive, they cannot begin the process of mourning the permanently lost object. Beginning with the Madres de Plaza de Mayo and, using the web-based art exhibits of Marcelo Brodsky and Inés Ulanovsky, I analyze the role of the photograph in Argentina, how it serves as a linking object, how it is used to symbolize the dead/missing, and how it can function to facilitate mourning, or to serve as proof of pathological melancholia. I argue that such artistic representations of loss function to reinscribe healthy mourning rituals within the Argentine society.     

Death in the family and HIV risk-taking among intravenous drug users

The objective of this study was to ascertain the relationship among intravenous drug users between high levels of HIV risk-taking and both (a) deaths of significant others experienced before age 15, and (b) unresolved mourning; 592 out-of-treatment intravenous drug users (71.4% male; mean age = 40.5), stratified as to zip code, were recruited in San Jose, CA, as part of a CDC multisite investigation of access to sterile needles and HIV infection. HIV serostatus tests were obtained and an individual, structured interview administered covering demographics, employment, mental health, HIV risk-taking behavior, family contacts/closeness, and family deaths/mourning. Multivariate analyses indicated that the extent of HIV risk-taking in adulthood was highly and positively related to (a) the number of close-family-member deaths participants experienced as youth, (b) the extent to which respondents effectively mourned sudden family losses, (c) the extent to which those lost were emotionally close to the respondent, and (d) whether or not the respondent attended the funerals of lost relatives. Canonical correlations between sets of death/mourning and HIV risk-taking variables were .55 for the total sample (p < .001) and .70 for the subsample who experienced early and sudden family deaths (p < .001). In both analyses, it made little difference if age and gender were partialed out. These findings give credence to the importance of (a) unexpected deaths experienced early in life, and (b) related, inadequate mourning, as factors in progressively higher adult HIV risk-taking. They suggest that treatment for such individuals and their families should involve grief work dealing with unresolved losses within the family of origin. In addition, prevention efforts may have to revise their modus operandi toward both more focused and more family-based methods of outreach and engagement.     

Spouse Bereavement Processes of Holocaust Child Survivors: Can One Differentiate a Black Frame from a Black Background?

This article highlights the relation between the mourning processes of Holocaust war orphans and their expected bereavement processes in later life when a spouse dies. The relation between the two processes is explored through a clinical case study. In addition, we define the concept of subtle mourning as an adjustment in the bereavement process. We assume that orphans, who survive after genocide, suffer a lifelong sense of bereavement. They create a subtle mourning process which can be disclosed much later in their lives when they must cope with the death of a spouse.     

Mourning the person one could have become: The existential transition for the psychotherapy clients experienced by abuse or neglect

Mourning the “Person One Could Have Become” (POCHB) is an existential transition for traumatized individuals. In order to survive, they tend to mystify their existence, hoping that one day they will eventually turn into POCHB. POCHB is conceptualized as personality and physical characteristics that could have emerged if an individual at the right time had received an appropriate quantity and quality of nurturing and developmental stimuli, which consequently would have enabled the person to make more mature choices. The process of mourning the POCHB is part of the group therapy. The role of the therapist in facilitating such mourning is discussed. Possible obstacles to the process of mourning are depicted. Theoretical assumptions are illustrated with cases of two clients.     

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.     

Anna Freud and the Holocaust: Mourning and survival guilt

This article explores the period of Anna Freud's life after she was informed of the deaths of her aunts in Nazi concentration camps during World War II. Understanding of this period may be enhanced by consideration of the role of the Holocaust in her complicated mourning process. A series of her dreams is re‐examined from the point of view of survivor guilt and the complicated mourning of her father in the context of the Holocaust. It is argued that unconscious reproaches against her father led to an identification with him that included his ‘decision’ to leave his sisters in Vienna. Survivor guilt in relation to her aunts’ murders is seen as one of the complicating factors in the mourning process. In addition the article discusses the possible role of this period, particularly her work with child concentration camp survivors, in her post‐war writing. The noted duality in her work between innovation and conservatism is explored in terms of an outcome of the mourning process of this period. It is argued that her views on mourning, trauma, attachment, and the widening scope of indications for psychoanalysis were influenced by the outcome of her mourning process. Finally, an irony is noted in the fact that her attitude about altruism never changed despite the role of the altruism of others in her rescue from the Nazis.     

From neurotic guilt to existential guilt as grief: the road to interiority, agency, and compassion through mourning. part I

This study proposes through a case illustration that psychoanalytic patients who can process both aggression and loss through a mourning process are able to free themselves from pathological self attack when the object relations work of attachment, psychic holding, and separation transpires. In the case of Helen discussed here, transformation through a “developmental mourning process” results in the evolution of powerful psychological capacities for interiority, self agency, and interpersonal compassion. This developmental mourning process is endowed with the assimilation and psychic fantasy symbolization of aggression.Susan Kavaler-Adler, Ph.D., ABPP, is Founder and Executive Director, Training Analyst, Faculty Member, and Supervisor at the Object Relations Institute for Psychotherapy and Psychoanalysis, New York.     

Transcending bitterness and early paternal loss through mourning and forgiveness

This paper provides an in-depth account of a clinical path to forgiveness following a complicated, delayed mourning of an early loss by a man now entering old age. The search for mourning and forgiveness in light of extreme bitterness in advancing age is highlighted. Despite the intimate connection between mourning and forgiveness, this paper attempts to highlight important differences in their dynamics and psychological aims. Forgiveness is conceived as work, unconsciously motivated, to safeguard and complement the psychological gains of mourning. The distinct features of forgiveness facilitating psychic reorganization, as well as the adaptive function of refusal to forgive as a defense against melancholia, are discussed. The paper concludes that in this case, the motivation for forgiveness was to repair a powerful narcissistic injury.     

MOURNING IN THE PSYCHOANALYTIC SITUATION AND IN SHAKESPEARE'S THE TEMPEST

Recognizing that mourning builds psychic structure, the author highlights the ubiquitous and essential nature of mourning in the psychoanalytic situation. Reality testing is intimately connected to mourning and is the warp on which psychic structure is woven in the analytic situation. Reality testing necessarily involves opportunities for mourning and thus will be present in every analytic hour. The confrontation with reality is the basis for all processes of mourning, or for creating defenses against this painful experience. The author views mourning as fundamentally a transformational process, and Shakespeare's The Tempest is used to illustrate this aspect of mourning.     

Human‐Animal Bonds II: The Role of Pets in Family Systems and Family Therapy

The vast majority of pet owners regard their companion animals as family members, yet the role of pets in family systems and family therapy has received little attention in research, training, and practice. This article first notes the benefits of family pets and their importance for resilience. It then examines their role in couple and family processes and their involvement in relational dynamics and tensions. Next, it addresses bereavement in the loss of a cherished pet, influences complicating grief, and facilitation of mourning and adaptation. Finally, it explores the ways that clients' pets and the use of therapists' companion animals in animal‐assisted therapy can inform and enrich couple and family therapy as valuable resources in healing.     

Mourning the divorce: A project in Marin County,California

A brief counseling program is described for divorcing parents and their offspring living in Marin County, California, where the divorce rate is perhaps the highest in the United States. Counseling was based on the notion that marital disruption produces a mourning which needs to be treated.This report was prepared by the American Institutes for Research on a contract from the U.S. Department of Health and Human Services, Administration for Children, Youth and Families. Jane Palches Kraft, M.S.W., was director of the project. Reprint requests should be directed to this journal's editor at Department of Psychiatry, Medical College of Georgia, Augusta, GA 30912. Reprinted with permission.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.     

Seduction,date rape,and aborted surrender

Abstract

This paper clarifies the dual-layered nature of the “demon lover complex,” with its background of both pre-Oedipal trauma and Oedipal-level desire. It draws on an object relations understanding of the unconscious and dissociated addiction to an internal demon object that has derivations in the personalities of the actual parents, and in the internalization of these parents. The dramatic case of early trauma compounded by adult date rape trauma serves to illustrate how a “developmental mourning process” in treatment can resolve such trauma. It also illustrates how reparation with the mother that partially heals pre-Oedipal trauma cannot immunize anyone against Oedipal-level attractions to a “demon lover” father, as represented in a displacement, resulting in victimized behavior, and in an aborted surrender to heterosexual desire. However, this victimization can be resolved, as seen in the clinical illustration, when the psychoanalyst has an understanding of the mourning process in developmental terms, working with a natural interaction between mourning and transference evolutions in treatment. The case also demonstrates the transitional object role of the psychoanalyst who is involved with the healing of pre-Oedipal trauma through mourning.     

Trauma Accommodation and Anniversary Reactions in Children

Anniversary reactions in traumatized children have been well recognized in the literature. Examined herein are temporal issues in the mourning process often realized by traumatized children. The case study of Laura is presented as a clinical illustration of problems in trauma accommodation that include anniversary reactions in children. Anniversary reactions in children are more common than is generally recognized in clinical practice. Such reactions are more likely to be found among children who exhibit persistent, repetitive, but insufficient efforts of trauma mastery through their incomplete grief and inadequate mourning process. Clinical issues are discussed.     

THE ENCHANTED BEDSIDE

This paper is based on the authors' work offering psychological therapies to patients and their families in a specialist palliative care unit, pre‐ and post‐death. In addressing issues of family interaction around the bedside of the dying patient, the authors have noted a pattern of events that arise from strongly ambivalent relationships.

In particular, family adjustment to the declining health of the patient is acted out in a physical and emotional move around the bedside, with a ‘hierarchy of bereavement’ indicating the status of the relationship to the patient. Previously conflicted feelings towards the dying patient are replaced by an impermeable idealization, lasting throughout bereavement.

In trying to understand this process of idealization the authors have used an analytical frame, referring to Freud and Klein and their work on mourning. This leads on to an exploration of the implications for clinical practice within palliative care. An unshifting idealization can be problematic for many reasons. The reader is left with a discussion about how to work best with families whose initial protective defence can easily crystallize into a long‐term grief reaction.     

The Divine,The Deviant and the Diabolical: A Journey Through An Artist's Paintings During Her Participation in a Creative Process Group: An Evolution of "Developmental Mourning"

Participation in writing and creative process offers a unique window to view the evolution of the mourning process. This study traces how a painter's work as shown to such a group reveals and interacts with her developmental progress as she goes through the mourning process in individual therapy with the author, who is also the leader of the writing and creative process group to which the artist belongs. Through these mutually beneficial exchanges, the patient is able to relinquish her constructed false self-identity for an authentic female identity, as seen in the evolution of her painting over her two-year participation in the writing and creative process group.     

Children of victims of terrorist activities: A family approach to dealing with tragedy

Abstract

The present report deals with the treatment of families of victims of terrorist activities. Such families are subject to an initial crisis situation involving severe stress as well as disruption in family role structure and homeo-stasis. Much of the trauma precipitated by such events is a result of their suddenness, their salience in the public consciousness and the consequent stigma they produce towards survivors and/or relatives of victims. A number of specific issues were common in the two case studies presented in this report as well as in other families affected by terrorism. These included dealing with the need to be a superparent and correcting unrealistic expectations, teaching effective limit setting including giving permission to be a parent, giving permission to be an adult, dealing with guilt and phobic reactions as well as family and network reorganization. Therapy concentrated on promoting family strengths and coping and deemphasized individual pathology. Common to most families treated was the strong desire of the victim's children to be treated as normal and not as psychological casualties. Thus, family therapy proved to be an ideal treatment modality for dealing with the tragic loss. By focusing on the problems of day-to-day living, the mourning work evolved naturally in the course of therapy. Specific therapeutic modalities such as cotherapy and network intervention facilitated family adjustment considerably.