The Confrontation with Death*

It is significant that in spite of the quantity of psychoanalytical literature dedicated to life, so little has been written about death as a psycho-physiological fact, and so little psychotherapeutic help is given to patients who are gravely ill or dying. In my opinion this is due to the prevalent denial of the inevitable fact of our mortality. Even writing about it confronts one with the evidence of one's own death and forces one to confront one's mortality, more so than even the scientific explanation of the second law of thermodynamics, that is, entropy or the reduction of tension to zero.

This denial of death has caused many far-reaching reactions: establishment of religion as a means in the search for transcendence, of art as an answer to the need for immortality, and of many philosophical systems whose last aim would seem to be the search for something more valid than passing reality.

For Freud, death was not represented in the unconscious since we are full of death wishes toward others. We are only convinced of our mortality through identification with someone whose death we either fear or desire. Freud distinguished between fear of death and fear of an object, as well as between libidinal and neurotic anxiety. The fear of death would occur when the Ego withdraws a large amount of its narcissistic cathexis, that is, the Ego surrenders itself in the same way that it abandons an external object when feeling deeply anxious.

Thus it seems to me that fear of death occurs when the three following psychodynamic conditions are present: when the Ego is weakened, the Ego Ideal is very pronounced and the Superego is very punitive. The fear of death can then express itself either as a reaction to an external danger or as an internal process (such as we find in the melancholic). In the latter case, the explanation could be that the Ego, instead of feeling loved, feels hated and persecuted by the Superego. Living requires being loved by the Superego, which fulfills the prote