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

The American Journal of Psychoanalysis, Vol. 66, No. 3, September 2006 ( 2006) DOI: 10.1007/s11231-006-9020-8

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.

KEY WORDS: existential guilt; bulimia; compassion; mourning; agency; aggression; neurosis; grief.

THEORETICAL BACKGROUND FOR CASE PRESENTATION

Freud

Sigmund Freud initiated psychoanalytic interest in the psychological meaning of the mourning process in his paper, Mourning and Melancholia, in 1915. Yet his view of mourning at this time did not include the processing of aggression. In fact aggression is seen in this paper only in its defensive form, in a melancholic individual who is so dominated by her aggression in its unconscious form that she remains paralyzed in a state of blocked or pathological mourning. She remains addicted to a hatred toward a lost other, which is turned defensively into a self blaming attack on the self.

By contrast, Freuds supposedly healthy mourner is seen in a pure state of loss, without mention of aggressive dynamics. Freud speaks of the slow and

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.

Address correspondence to Susan Kavaler-Adler, Ph.D., Object Relations Institute for Psychotherapy and Psychoanalysis, 115 East 9th Street, 12P, New York, NY 10003, USA; e-mail: [email protected].

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0002-9548/06/0900-0239 2006 Association for the Advancement of Psychoanalysis

FROM NEUROTIC GUILT TO EXISTENTIAL GUILT AS GRIEF: THE ROAD TO INTERIORITY, AGENCY, AND COMPASSION THROUGH MOURNING. PART I

Susan Kavaler-Adler

240 KAVALER-ADLER

painful detachment of the ego from the lost love object, as if a visceral adhesion needed to be relinquished bit by bit, resulting in an excruciating pain related to object loss. This painful journey would be necessary to free any of us from dead and/or lost other so that new relationships with...