Failure to mourn and melancholia
Psychoanalytic ideas are often criticized as speculative, though it is worth noting that a non-analyst like Sir Aubrey Lewis (1967), in his important historical review of melancholia, wrote of psychoanalytic views, “It is idle to gainsay their importance”. This paper reviews ideas about depression and mourning from various quarters, particularly from psychoanalytic writings, then from a sociological perspective, and, finally, from some of the work in behavioural psychotherapy on guided mourning. Among the psychoanalytic views considered here are, first, Freud’s classic paper “Mourning and melancholia” (1917b). Klein’s concept of the “depressive position” is then reviewed in light of Winnicott’s modification and his argument that the term should be re-framed as “the stage of concern”. In turning to the work of Brown and Harris (1978a), particular attention is given to their finding that the loss of mother through separation or abandonment before the age of eleven predisposes a woman to neurotic depression, and their more remarkable finding that the loss of mother through death, again before the child is age eleven, predisposes the 40child to psychotic depression. My central theme, close to Winnicott’s, will be that where there has been good-enough mothering in childhood, a good-enough internal object will be established which, though threatened by later loss, will enable healthy mourning to take place and a satisfactory internalization of the lost object over time. When there has been some degree of incomplete secure internal object attainment in childhood, later loss will bring difficulties in mourning, possibly leading to depression. The title of the essay, “Failure to mourn and melancholia”, is borrowed both from Freud and an idea in a paper on Eugene O’Neill where an important theme in The Iceman Cometh is the “failure to mourn leading to chronic depression” (Hamilton, 1976).