Mourning and Melancholia Notes

Transitions and Revisions

• Transitions and revisions are points where no conclusion can be deduced from our description.
• They require independent investigation.
• In human beings, pathological conditions can alter or exchange the content and characteristics of the two systems.

Mourning and Melancholia

• Freud noted self-reproaches felt upon the death of loved ones as early as the mid-1890s.
• He said these reproaches could lead to hysteria, obsessions, or depressions (melancholia).
• He used the ego ideal to understand self-punishment methods.
• Comparison of similar but distinct mental states helps clarify understanding.
• The paper was written in 1915 and published in 1917.

Differences Between Mourning and Melancholia

• Mourning: Inhibition and loss of interest are due to the work of mourning.
• Melancholia:
  • Involves similar internal work due to an unknown loss, causing inhibition.
  • The inhibition is puzzling because the cause is not visible.
  • Displays a significant decrease in self-regard and ego impoverishment.
  • Patients consider themselves worthless, incapable, and morally despicable.
  • They reproach, vilify, and expect punishment.
  • They abase themselves and pity their relatives for being associated with them.
  • They believe they were never better in the past.
  • Symptoms include delusions of moral inferiority, sleeplessness, refusal to eat, and overcoming the instinct to cling to life.

Contradicting the Patient

• Contradicting the patient is not scientifically or therapeutically useful.
• The patient's statements reflect their perception.
• There is often a mismatch between self-abasement and justification.
• Feelings of shame are not prominent in melancholics.
• Melancholics may exhibit insistent communicativeness and self-exposure.

The Essence of Melancholia

• The key is not the accuracy of self-denigration but the correct description of the psychological situation.
• The patient has lost self-respect for a reason.
• Analogy to mourning suggests a loss related to an object, while the patient describes a loss related to their ego.

The Human Ego in Melancholia

• One part of the ego opposes, judges, and objectifies another part.
• The critical agency may show independence in other situations.
• This agency is commonly called 'conscience'.
• It is considered a major institution of the ego, along with censorship of consciousness and reality-testing.
• It can become diseased on its own.
• Dissatisfaction with the ego on moral grounds is prominent in melancholia.
• Self-evaluation focuses less on physical or social inferiority, except for fears of poverty.

Explanation of Contradiction

• Self-accusations often apply more to someone the patient loves or has loved.
• The facts confirm this conjecture.
• Self-reproaches are reproaches against a loved object shifted onto the patient's ego.
• Genuine self-reproaches mask the transposed reproaches.
• Complaints are "plaints" about someone else.
• Patients do not show humility or submissiveness.
• They are a nuisance and feel slighted, indicating a revolt.

Reconstructing the Process

• An object-choice existed, but a real slight or disappointment shattered the object-relationship.
• Instead of displacing libido to a new object, the libido was withdrawn into the ego.
• It established an identification of the ego with the abandoned object.
• The shadow of the object fell upon the ego.
• The ego was judged by a special agency as if it were the forsaken object.
• Object-loss transformed into ego-loss.
• Conflict shifted from the ego and loved person to a split between the ego's critical activity and the altered ego.

Pre-Conditions and Effects

• A strong fixation to the loved object must be present.
• The object-cathexis must have little power of resistance.
• Narcissistic identification substitutes for erotic cathexis.
• Love-relation need not be given up.
• This substitution is important in narcissistic affections and schizophrenia recovery.
• Identification is a preliminary stage of object-choice.
• The ego wants to incorporate the object, especially in the oral phase.
• Abraham attributes the refusal of nourishment in melancholia to this connection.

Disposition to Melancholia

• The disposition to melancholia lies in the predominance of narcissistic object-choice.
• Empirical material is insufficient to confirm this.
• Regression from object-cathexis to the narcissistic oral phase characterizes melancholia.
• Identifications with the object are common in transference neuroses, especially in hysteria, as symptom-formation.

Narcissistic vs. Hysterical Identification

• Narcissistic: Object-cathexis is abandoned.
• Hysterical: Object-cathexis persists, influencing isolated actions.
• In transference neuroses, identification expresses commonality and love.
• Narcissistic identification is older and leads to an understanding of hysterical identification.

Melancholia's Features

• Melancholia borrows features from mourning and regression from narcissistic object-choice to narcissism.
• It reacts to the real loss of a loved object.
• The loss presents an opportunity for ambivalence to emerge.
• Obsessional neurosis results in self-reproaches for causing the loss.

Occasions for Melancholia

• Occasions extend beyond loss by death to situations of being slighted, neglected, or disappointed.
• Ambivalence can arise from real experiences or constitutional factors.
• Love takes refuge in narcissistic identification and hate operates on this substitute object.
• Self-tormenting satisfies sadistic trends.
• Patients take revenge on the original object through their illness.
• The person causing the emotional disorder is usually in the patient's immediate environment.
• Erotic cathexis undergoes a double vicissitude: regression to identification and sadism due to ambivalence.

Sadism and Suicide

• Sadism explains the tendency to suicide in melancholia.
• The ego's self-love is immense.
• Neurotics turn murderous impulses against themselves.
• The ego can kill itself by treating itself as an object and directing hostility at itself.
• In regression from narcissistic object-choice, the object is more powerful than the ego.
• In love and suicide, the ego is overwhelmed by the object in different ways.

Other Problems in Melancholia

• The fear of becoming poor may be derived from anal erotism.
• Melancholia passes without leaving traces.
• In mourning, time is needed for reality-testing.
• The ego frees its libido from the lost object.
• Sleeplessness in melancholia indicates rigidity.
• The complex of melancholia acts like an open wound, drawing energies and impoverishing the ego.

Somatic Factors

• Evening amelioration may be a somatic factor.
• A loss in ego or toxins may cause melancholia.

Some Character-Types Met with in Psycho-Analytic Work: [The Exceptions]

• Freud grouped cases under diagnostic rubrics such as hysteria or paranoia but also valued individual differences.
• He published three papers in 1916 on interesting patients, the first on "exceptions."
• The second deals with "Those Wrecked by Success," drawing on Shakespeare's Macbeth.