Mourning and Melancholia

Mourning and Melancholia

Failures in the process of mourning take many forms. In a famous paper called “Mourning and Melancholia,” Freud contrasted the normal process of mourning with the pathology of melancholia (i.e. clinical depression). He argued that, in mourning, a person gradually comes to terms with loss by giving up (separating from) the lost love object, whereas in depression this cannot happen because the patient denies the loss. You cannot come to terms with a loss if you do not acknowledge that it has happened. Freud said that this was particularly apt to occur if the original attachment to the lost object had been a narcissistic one. In a narcissistic attachment, the separateness of the love object is not recognized, and it is treated as if it were part of the self.  Narcissism is contrasted with object love, which is a more mature form of attachment, where the independence of the love object is acknowledged. Freud showed that in melancholia, the patient denies the loss of the love object by identifying himself with it (by literally becoming that object in fantasy. The depression itself then results from the internalization of the feelings of resentment toward the object that has abandoned him. The narcissist attacks the internalized object with all the ruthless vengefulness of a lover scorned. 

This explanation seems to hold good for the third case of right-hemisphere syndrome that was investigated psychoanalytically. This case – Mrs, A (Kaplan-Solms & Solms, 2000, pp.173-179) – suffered severe spatial deficits, neglect, and anosognosia, but at the same time she was profoundly depressed. This is unusual for right-hemisphere patients, producing a paradoxical situation in which the patient was unaware of a loss (anosognosia) and yet simultaneously displaying severe depressive reactions to it. She was constantly in tears, lamenting the fact that she was such a burden to the medical and nursing staff, whose generous attention she did not deserve since she was not fit to live, and so on. The psychoanalytic investigation revealed that Mrs. A was, in fact, unconsciously very much aware of her loss, but she was denying it by means of the introjective process described by Freud. Unconsciously, Mrs. A did have an internalized image of her damaged, crippled self, and she attacked that image to the point of twice attempting to kill herself.

In this case, the patient was overwhelmed by feeling of the same type that the previous two patients managed (for the most part) successfully to suppress. In two final cases, the situation was more complicated still.

Mourning and Melancholia. Photo by Elena.