Death as rupture, mourning as repair: A relational rendering of grief.

This paper honors Jeremy Safran's legacy of scholarship and pedagogy through the lens of his emphasis on rupture and repair. Challenging a Freudian rendering of mourning as ultimately giving up a lost object, the author draws on Nicholas Abraham and Maria Torok's application of Sandor Ferenczi's concept of introjection to offer a relational rendering of the grieving process.

Impacts of the COVID-19 Pandemic on the Bereaved.

The COVID-19 pandemic has killed millions across the world in only two years. Government health restrictions aimed at preventing transmission have impacted typical mourning practices such as funeral gatherings and in-person grief support services. This research examines the potential impacts that the pandemic may have had on people's ability to grieve. We employed a mixed methods study design to ask those who have lost a loved one during this time to reflect on their mourning practices with an anonymous survey. Our results present themes of complicated grief, the uncertainty of who to blame for frustrations, and common needs requested by the bereaved to help them mourn during these unprecedented times. These findings may help inform grief support and bereavement services during current and future mass death and pandemic health concerns.

War, terror and mourning. Cultural memory in the inner dialogue.

This text compares four essays dealing with war, state terror in dictatorships, social violence such as racism, mourning and the avoidance of mourning. It shows that dictatorships share similarities in their techniques of manipulation, linguistic style and reference to history. They seek to exploit national myths through manipulative alienation. Myths are a central element of cultural memory, and their effect can be understood through a model of internal dialogue. This dialogue determines whether the regime's attempts at manipulation are successful.

Direct Losses and Media Exposure to Death: The Long-Term Effect of Mourning during the COVID-19 Pandemic.

Background: The social distancing policies adopted during the COVID-19 pandemic forced many individuals to confront their mortality and worry about losing loved ones, making it impossible to say goodbye to them properly. Those not directly experiencing loss were inundated with information about COVID-19-related deaths throughout social media, leading to vicarious grief. This study delved into the long-term effects of direct and vicarious mourning on people's mental health during the COVID-19 pandemic. Method: A sample of 171 adults (65% female) aged 19-66 years (Mage = 25.8, SD = 8.57) voluntarily participated in an online survey assessing self-reported psychological measures of complicated grief, stress, depression, dispositional neuroticism, trait anxiety, and situational anxiety. Results: MANOVAs revealed that direct mourning experiences had an extremely severe impact on anxiety, stress, and fear of COVID-19, and a moderate effect on those without personal losses. Indeed, participants reporting high media exposure showed higher scores of depression and stress. Conclusions: Findings from the current study displayed that during the COVID-19 pandemic, people engaged more in proximal defenses than distal ones, taking health-protective measures, experiencing increased anxiety levels toward virus infection, and feeling distressed. Additionally, vicarious mourning was more strongly associated with depression due to emotional empathy with others.

The inability to mourn: Past and current challenges for psychoanalysis.

Although the capacity to mourn is ubiquitously acknowledged as critical for individual psychic functioning, the impact of this capacity on a collective social level has been examined to a very limited extent in the psychoanalytic literature to date. The two papers that take up this this topic thus bring various critical and complex issues to our attention. After reviewing and commenting on these papers, I discuss how these issues are particularly relevant today to society in general and psychoanalysis in particular. I believe that the ability to mourn is under siege in the Western world at present, with respect to both "macro" mourning that is, mourning for significant losses such as a beloved person, ideal, or country, and "micro" mourning or mourning for losses inherently and unavoidably implicated in choices we make in everyday life. These mourning processes are undermined by the impact of complex socioeconomic parameters on psychic functioning, as evidenced by various internal problems and symptomatology characteristic of our times. In turn, difficulties in mourning contribute to social problems including social injustice, wars and the climate crisis. As psychoanalysts we are called upon to address these issues in our clinical work as well as in our global community.

Is it True That "There are no Right or Wrong Ways to Grieve"?

This article explores some of the implications of the often-heard saying that, "There are no right or wrong ways to grieve." In order to do so, this article offers some reflections on the key phrases that are involved implicitly or explicitly in this advice: loss, bereavement, grief, grieving, and mourning. On that basis, this article examines a series of claims: Are there actually no right ways to grieve?; Is there no single right way to grieve?; Are there no wrong ways to grieve? These analyses are enriched by incorporating some of the new understandings of loss, grief, and mourning that have emerged in the professional literature in recent years from research and scholarship. The conclusion offers lessons that should be learned and that should not be learned from the advice that, "There are no right or wrong ways to grieve".

The Oedipal Virtual Citadel: Varieties of Isolation, Oedipal Conflict, and Cover-Up.

The author elaborates some of the fantasies and defenses that protect some patients in their oedipal fixations, particularly those related to forms of personal isolation. To some extent, cover-up is intrinsic to oedipal conflict and fantasy, but what is covered up is quite variable. In this paper, the author highlights elements of personal isolation that the patient cultivates in order to protect love for a desired oedipal parent and the conscious and unconscious fantasies associated with this love. The patients described here use forms of personal isolation to cover up and secure the gratification of oedipal fantasies. Their isolation also serves to protect them from fantasies of unique forms of destructiveness in relation to self and the desired other. The citadel, a concept from Guntrip's description of defenses protecting the schizoid patient's fear of destructive love, is characterized here for the neurotic patient as virtual because in some ways, each of the participants in oedipal conflict turn a "blind eye" to a staged cover-up. Clinical illustrations examine the transference-countertransference process of shifts from turning a blind eye to sustaining a process of seeing what is being covered up but has already been seen.

"Mourning and Melancholia" Meets The Babadook: Emptiness and its Relation to Absence.

This paper explores how the film The Babadook illuminates psychoanalytic understandings of melancholia and mourning. The author attempts to unwind the complicated character of melancholia, using Freud as an initial point of orientation, then relying on a few ideas from Klein and later writers. The paper attempts to refine our understanding of the difference between absence and emptiness, especially the difference between being captured in the nothing or deadness of melancholic emptiness, on the one hand, and being alive enough to suffer the absence of a lost object, which bears a potential for mourning, on the other. The possibility of psychic tension between these states is explored. Some implications of the relationship between absence and emptiness for the mourning process are considered. The author uses the film as a resource throughout.

Mourning, melancholia and machines: An applied psychoanalytic investigation of mourning in the age of griefbots.

Death and mourning are being shaped by posthumous opportunities for the dead to affect current life in ways not possible in pre-digital generations. The psychological and sociological impact of the dead 'online' and of 'grief tech' is only beginning to be understood. It has not yet been explored psychoanalytically until this paper that examines one type of grief tech, namely the griefbot. This development is critically explored through a psychoanalytic reading of an episode of Black Mirror. I suggest that a psychoanalytic model of mourning provides an invaluable perspective to help us to think about this technology's potential as well as the psychological and ethical risks it poses. I argue that the immortalisation of the dead through digital permanence works against facing the painful reality of loss and the recognition of otherness, which is fundamental to psychic growth and to the integrity of our relationships with others. Drawing on Derrida's conceptualization of 'originary mourning', I suggest that mourning is an interminable process that challenges us to preserve within the self the otherness of the lost object. The tools we use for mourning need to be assessed first and foremost against this psychological and fundamentally ethical process.

Entrenched grievance as a harbour for the unmourned.

This paper hopes to enhance understanding about entrenched grievance in a couple of ways: (a) Initially, the paper reviews how entrenched grievance reflects melancholic states of mind in terms of its avoidance of the pain of loss and change. But the main contribution of the paper is likely to be found in (b), that is, via detailed clinical material, the paper illustrates how earnest efforts on the part of the analyst to bring understanding may lead to cognitive entrapments such as the convictions incumbent in the "knowing" analyst. Further, that this knowing analyst may need to become aggrieved, that is, narrow, impatient and concrete towards her patient's entrenchment, and then to recogize this plight in herself before she can genuinely hear her patient's grievance about her from a wider view, that is as a complaint from the "lively self", deserving recognition. The clinical detail demonstrates that such recognition softened the patient's grievance, allowing both members of the dyad to become more collaborative and open to the pains and growth available from mourning states of mind.

[The subjective experience of contact with the deceased or necrophany: a widespread and little-known phenomenon]. / Le vécu subjectif de contact avec un défunt ou nécrophanie : un phénomène répandu et peu connu.

The subjective experience of contact with the deceased (VSCD), spontaneous and direct, by people most often in mourning, is neither rare nor new. It's even considered a universal and timeless phenomenon. Yet this psychological and sensory manifestation, which can manifest itself through sight, hearing, smell or touch, remains little known to the general public and health professionals alike. This article is an opportunity for many to discover this phenomenon, also known as necrophany.

The Sorrow of an Analysand.

The death of an analyst does not imply a socially sanctioned role for their analysand as a mourner. Through an account of experiences following her first analyst's death, the author reflects on the role of writing as a mode of grieving, on the impact of her subsequent analysis, and on the holding function of analytic community.

Was It Just a Dream? Aging and Dreaming the Psychoanalytic Process.

By revisiting the last years of a long psychoanalytic treatment of a female patient, a psychoanalyst reflects on her own development as a clinician and on the changes in her experience of psychoanalytic generativity. An increasing ability to understand patient's shifts between creativity and destructiveness brings about a different understanding of the process of mourning, while the shared aging of the analytic dyad highlights the difficulty of ending an analysis that has become a way of life.

Proposing a new history of grief's medicalisation: A critical discourse analysis.

Conceptualisations of grief have transformed significantly in recent decades, from an experience accepted and expressed in community spaces to a diagnosable clinical phenomenon. Narratives of this transformation tend to focus on grief's relationship to major depression, or on recent nosological changes. This paper examines the possibility of a new narrative for medicalisation by grounding in the networks of language and power created around 'grief' through a critical discourse analysis of psy-discipline articles (n = 70) published between 1975 and 1995. Focusing on shifts in definitions of, methods used to approach, and rationales motivating study of the experience, it posits that the psy-disciplines exerted exclusive expertise over grief decades before its creation as a diagnosis. By reconceptualising grief in the terms of psy-specific symptoms and functional performance and by approaching it with the decontextualising and interventionist methods of an increasingly scientific psy-discipline, the psy-community medicalised grief between 1975 and 1995. Identifying neoliberal and other cultural influences shaping this process of medical construction and reconsidering narratives of grief's history mindful of the powers exerted in medicalisation, this paper establishes that these moments played a critical role in the development of the present's grief.

Grief and loss in people living with dementia: a review and metasynthesis of qualitative studies.

OBJECTIVES: This review seeks to synthesise qualitative studies that focus on the experience of grief and loss in people living with dementia. METHODS: Included studies were quality appraised, synthesised and analysed using inductive thematic analysis. RESULTS: 19 studies were selected for inclusion in the final review and metasynthesis, including 486 participants (115 participants living with dementia, 152 family carers, 219 professionals). Five key dimensions of grief in people living with dementia were identified during the analysis process: grieving for the person I used to be, grieving for how others see me, grieving for the person I will become, grieving for those who have died and what helps me with my grief. CONCLUSION: It is evident that people living with dementia can experience grief related to a range of previous, current and anticipated losses. Many of the studies included in this review did not directly include people living with dementia in their research and did not ask participants directly about their experience of grief and loss. As grief is a highly personal and individual experience, further research addressing the experience of grief that directly includes participants living with dementia is required, in order to improve awareness of grief-related needs and to develop and deliver support to meet these needs.

Claiming ecological grief: Why are we not mourning (more and more publicly) for ecological destruction?

Eco-anxiety, grief and despair are increasing, yet these emotions tend to remain private, rarely expressed in public. Why is it important and necessary to grieve for ecological loss? Why are we not-as individuals and societies-coming together to express and share our grief for ecological destruction? I address these questions from three angles. Firstly, I draw on recent literature on ecological grief and prior work on grief for human lives, to argue for the importance and urgency of grieving publicly for ecological loss. Building on this, I identify perceptual, cognitive, affective, ritual and political obstacles to ecological mourning; these obstacles point at critical intersections between emotions, practices, disciplines, public and private realms, which can turn into fruitful venues for further research, debate and action on ecological grief (and its absence). In closing, I propose a set of 'ecological skills' that might help us overcome these obstacles, and lead us to embrace ecological grief and mourning as acts of ethical responsibility and care for the planet.

From love to pain: is oxytocin the key to grief complications?

While most adults confronted with the death of a loved one manage to grieve, about 10-20% of individuals develop complicated grief, characterized by persistent distress and impaired social skills, or pathological grief, defined by the onset or decompensation of a psychiatric disorder. Little is known about the biological causes of these grief complications. Recent work suggests that oxytocin, a major neuroendocrine hormone regulating many neurocognitive mechanisms, may be involved in this process. Oxytocin is widely studied and well known for its impact on the mother-child bond and hormonal and brain systems related to attachment and social interactions. In this article, we propose a neurocognitive model of grief complications based on existing data on the role of oxytocin in interpersonal attachment and its impact on brain activity. We suggest that complicated grief is associated with dysfunctional cerebral oxytocinergic signaling and persistent hyperactivation of the nucleus accumbens. This mechanism is involved in limiting the reduction of interpersonal attachment to the deceased during acute phases and in searching for new interpersonal relationships during the recovery phase. We show how the exploration of cerebral oxytocinergic signaling would improve the understanding of physiological grief mechanisms in the general population and could allow the development of new therapeutic perspectives against the complications of grief.

Redes sociais significativas de familiares no processo de luto antecipatório no contexto dos cuidados paliativos / Significant family social networks in the anticipatory mourning process within palliative care / Les réseaux sociaux familiaux significatifs dans le processus de deuil anticipé en soins palliatifs / Redes sociales significativas en el proceso de duelo anticipatorio de los cuidadores familiares, en el contexto de los cuidados paliativos

Resumo: O objetivo deste estudo qualitativo foi caracterizar a estrutura e as funções das redes sociais significativas no processo de luto antecipatório de familiares cuidadores no contexto dos cuidados paliativos. Utilizou-se a entrevista semiestruturada e o Mapa de Redes com 14 familiares cuidadores que estavam acompanhando pacientes em um hospital oncológico do Sul do Brasil. Os dados foram organizados e analisados com base na Grounded Theory e com auxílio do software ATLAS.ti 7.5. Os resultados indicaram a prevalência de redes de tamanho médio e grande, além do predomínio dos membros da rede familiar. As principais funções desempenhadas pelos membros das redes foram de ajuda material e de serviços e apoio emocional. Este estudo evidencia a importância da visibilização das redes sociais significativas como recursos de intervenção em saúde, que promovem apoio material, cognitivo e emocional durante o processo dos cuidados paliativos, principalmente quanto à elaboração do luto antecipatório.

Abstract: This qualitative study characterizes the structure and functions of significant social networks in the anticipatory mourning process of family caregivers within palliative care. Data were collected by means of semi-structured interviews and the Map of Networks conducted with 14 family caregivers at an Oncology Hospital in southern Brazil, and then organized and analyzed by Grounded Theory using the ATLAS.ti 7.5 software. Results showed a prevalence of medium and large-sized networks, as well as the predominance of family network members. Material help and services and emotional support were the main functions performed by network members. This study highlights the importance of making meaningful social networks visible as health intervention resources that provide material, cognitive and emotional support during palliative care, especially in regards to anticipatory grief.

Résumé : Cette étude qualitative caractérise la structure et les fonctions des réseaux sociaux significatifs dans le processus de deuil anticipé des aidants familiaux dans le cadre des soins palliatifs. Les données ont été recueillies par des entretiens semi-structurés et de la carte des réseaux réalisées avec 14 aidants familiaux de patients dans un hôpital d'oncologie du sud du Brésil, puis organisées et analysées selon la théorie ancrée. Les résultats montrent une prévalence des réseaux moyens et grands, ainsi que la prédominance des membres du réseau familial. L'aide et les services matériels et le soutien émotionnel sont les principales fonctions remplies par les membres du réseau. Cette étude souligne l'importance de faire apparaître les réseaux sociaux significatifs comme des ressources d'intervention en santé qui apportent un soutien matériel, cognitif et émotionnel au cours de soins palliatifs, notamment en ce qui concerne le deuil anticipé.

Resumen: El objetivo de este estudio cualitativo fue caracterizar la estructura y las funciones de las redes sociales significativas en el proceso de duelo anticipatorio de los cuidadores familiares, en el contexto de los cuidados paliativos. Se utilizaron entrevista semiestructurada y Mapa de Redes con 14 cuidadores familiares de pacientes en un Hospital de Oncología del sur de Brasil. Los datos se organizaron y para su análisis se aplicó la Grounded Theory, con el uso del software ATLAS.ti 7.5. Se observó la prevalencia de redes medianas y grandes, y predominio de miembros de la red familiar. Las principales funciones desempeñadas por los integrantes de las redes fueron la ayuda material y los servicios y el apoyo emocional. Este estudio destaca la importancia de visibilizar redes sociales significativas como recursos de intervención en salud, que brindan apoyo material, cognitivo y emocional durante el proceso de cuidados paliativos, especialmente en la preparación del duelo anticipatorio.

Mourning in Hamlet: Turning ancestral ghosts into ancestors.

Extracts from Shakespeare's Hamlet are used to show how obstacles to mourning may arise from the persistent demands of melancholic internal objects demanding repair and revenge. It is only with the development of symbolic function as a result of separateness between self and object that reparation becomes possible and ghosts are turned into ancestors.