Family Loss and Hospital Suicide

In 19 consecutive cases of inpatient suicide occurring over many years, 18 out of the 19 cases (95 percent) were judged to have a significant “family” loss issue affecting the suicide. In five cases (26 percent), there seemed to be a powerful institutional attachment and loss threatened that attachment. In 13 cases (68 percent), a major family issue was involved which included events that estranged the patient from the family (real or imagined); divorce or separation issues; death or illness of a significant other; a family that insisted on continued treatment (and/or growth). In 13 cases (68 percent), significant communication from or about the “family” occurred which seemed to have an impact on the suicidal behavior often within days of the final event. In 10 cases (53 percent), an actual family visit had occurred within two weeks of the death. These issues are discussed and case examples presented.     

Mourning the Religious Self: An Experience of Multiplicity,Loss, and Religious Melancholia

The loss of religion is not one thing to all people, nor even one thing to one person. This article asks the question, “when we are talking about the loss of religion, who is mourning what?” The author considers what the loss of religion looks like if we view the self as abiding in both multiplicity and melancholia, and claims that the loss of religion requires a reconfiguration of the inner landscape of centrality and marginality. A clinical example illustrates how one patient’s “loss of faith” calls her to a complex mourning process that includes confronting many personal losses and their relation to her transgendered self.     

Symbolic Loss in American Adolescents: Mourning in Teenage Cinema

I argue that the changing economic conditions in the contemporary world have caused a shift in religious and cultural values among American youth. This shift in cultural and religious values and practices is interpreted in this essay as an experience of symbolic loss, or a loss of socially shared historic ideals and symbols (Homans in Childhood and selfhood: essays on tradition, religion, and modernity in the psychology of Erik H. Erikson. Bucknell University Press, Lewisburg, pp 189–228, 2008). I argue that the symbolic loss among American youth can most clearly be seen in the contemporary horror film genre in America. I assess the popularity of this genre, its value structure and the psychosocial consequences of the symbolic losses experienced by American youth as witnessed in this film genre. I suggest two ways in which adolescents and adults can work to re-create cultural and religious meanings that both foster courage and serenity in the face of the profound despair that accompanies the rage and paranoia in the contemporary horror film genre.     

Mourning the Loss of the Idealized Self: A Transsexual Passage

Abstract

The few published psychoanalytic writings that exist regarding transsexual men and women tend to focus on the etiology of their gender identities and almost invariably define these patients as inherently pathological. Such myopic viewpoints leave no room for analysis and discussion of the transsexual patient's normal developmental process. In this paper, I use a Kleinian framework to depathologize the coping strategies employed by transsexual patients and to illustrate the importance of mourning in the development of a positive transsexual identity. A clinician who is able to sit comfortably with contradiction may facilitate the transsexual patient's mourning process—saying goodbye to the persecutory object of the past and letting go of the idealized image of the future.     

Parental Loss and Family Violence as Correlates of Suicide and Violence Risk

Seventy-nine psychiatric inpatients were administered a battery of psychometric instruments that obtained information about early parental loss, exposure to family violence, and behavioral problems in themselves and in their first-degree relatives. These variables were correlated with suicide and violence risk measures. Suicide risk significantly correlated with all family variables whereas violence risk correlated with behavioral problems both in oneself and in one's first-degree relatives. Moreover, suicidal and/or violent patients had experienced maternal loss significantly more frequently than the nonsuicidal/nonviolent patients. In the suicidal/violent group, age of patient at death of parents was significantly lower than in the nonsuicidal/nonviolent group. Finally, family violence was significantly correlated with behavioral problems in self and in first-degree relatives. Findings are interpreted according to the authors' theoretical model of aggression regulation.     

The Phenomenology of Bereavement, Grief, and Mourning

Loss, understood as a process of bereavement, grief, and mourning, most immediately affects our bodily experience in our world, known in the phenomenological tradition as our lived world. Unlike Cartesian conceptions of the body as a self-contained entity, encapsulated within the skin, our bodying forth, as articulated in the discourse of Merleau-Ponty, and more recently Drew Leder, entails various manifestations of lived experience. These reflections on miscarriage loss, understood through the notions of Merleau-Ponty's chiasmic structure of flesh, and Drew Leder's recessive, ecstatic, and dys-appearing body, provides the possibility for a phenomenology of lived loss.     

Physiological Reactions to a Suicide Film: Suicide Attempters,Suicide Ideators,and Nonsuicidal Patients

A film about two teenagers who commit suicide was shown to three groups of psychiatric inpatients: 17 who had attempted suicide, 20 who had expressed suicidal thoughts, and 10 who were not suicidal. Anxiety before and after the film was evaluated with psychometric (anxiety rating scale) and physiological tools (heart and respiration rate, blood pressure, electromyogram). Values noted before and after screening, and the degree of change in these values, were compared. In addition, psychomotor agitation was rated at several points during the film. Most results were negative. The suicide attempters had significantly lower postscreening heart rates and a significantly lesser change in heart and respiration rates than the other two groups. The suicide attempters revealed an increase in psychomotor agitation until the discovery of the suicide and a decrease thereafter, whereas the agitation of the nonsuicidal patients continued to increase from the start to the end of the film. The study suggests that on some parameters, suicide attempters reveal less anxiety than nonsuicidal psychiatric patients following exposure to a simulated suicide. The reaction of suicide ideators falls somewhere between the two groups.     

Mourning the Dead,Following the Living

In this paper I take up the ambivalence we rightly feel toward leaders by examining the relationship between charismatic authority and moral exemplarity. Drawing on the social theory of Max Weber, and in dialogue with a case study of an anti‐militarism movement called the SOA (School of Americas) Watch, I demonstrate that through a “politics of sacrifice” leaders synchronize their own stories with those of communally recognized exemplars and act in ways that evidence a solidarity in the suffering of those exemplars thereby generating their charismatic authority. While performing crucial strategic, motivational, and pedagogical roles, this charisma also introduces problematic temptations to authoritarianism that short‐circuit the practical reasoning that exemplars supposedly help to form. In the end this leaves our sense of ambivalence intact. What is needed, I argue, are practices of critique that reopen the distance between leader and follower and thus allow the possibility of practical reason.     

Parental Mourning and Children's Behavior

This article alerts professionals to sibling death as a possible reason for behaviors exhibited by young clients. Aside from their own grief, children are affected by parental mourning over a child's death and accompanying changes in the family environment. Children show their distress in a variety of behaviors, some of which appear to be unrelated to the loss. Four areas of concern are presented with case illustrations: cognitive distortions, reactions to parents' distress and preoccupation with the loss, being a replacement child, and effects of parents' failure to work through their grief. Suggestions for helping children and parents include using a genogram for identifying loss, helping the family talk about the death, and providing a support group for children.     

School Violence, Depression, and Suicide

The spread of endemic school violence in the United States from urban black, Hispanic, and other minority areas to white suburbia and smaller communities has alarmed the nation. Contrary to common belief, the incidence of school violence has been fairly stable except in the areas of violence against females and gang membership. The culture of violence and easy availability of guns is a major contributing factor. The relationship between school violence, suicidality and psychiatric disorders, specifically depressive disorders, conduct disorder, and alcohol and drug abuse are discussed within the framework of the psychological autopsy of suicide in children and adolescents. There are striking similarities between acts of school violence and suicidality. Specific guidelines are provided regarding clinical assessment of potentially violent youth with emphasis on exploration of attachment behavior in various developmental stages.     

Mourning and the symbolic process

Abstract: This paper describes the analysis of a patient whose difficulty symbolizing absence had prevented her from being able to mourn the loss of her father in her adolescence. Through a series of symbolic enactments and synchronistic events, she was eventually able to carry out a mourning ritual that enabled her to lay her father to rest. Some implications for symbolization are discussed, developing Segal's view of symbol formation as reparation: symbols are embedded in a context of communication and can only develop in the context of a relationship; they represent relationships as well as objects; and they are emergent in the sense that they exist within a complex web of interactive, multiple meaning and cannot be reduced back to any one object that they represent.     

Social Trauma,Nostalgia and Mourning in the Immigration Experience

Immigration and exile can qualify as social traumas. The individual is deprived of a holding, secure environment in which to continue their life. The process of mourning is a necessary step to connect with “going on being.” Another psychic experience in migration is nostalgia; it helps the immigrant defend against the aggression resulting from current frustrations. The feeling of nostalgia can also be used to protect the ego from inadequacy. The complex components of nostalgia come from positive ones such as joy and gratitude connected with sadness about the associated loss of security, familiarity, and historical continuity. At other times, nostalgia cannot evolve, particularly in forced migration or exile. In this case, the individual enters a depressed state with accompanying feelings of self-pity, resentment, envy, and guilt, which prevents the mourning process from developing. To deal with these painful experiences, the person resorts to linking objects or linking phenomena that help them continue having contact with the past, while adjusting to their new environment.