The Role of Grief in Psycho-Analysis

The purpose of this paper is to re-emphasize the importance of psycho-analysis as a process, placing special emphasis on the importance of the grief work and the peculiar characteristics which differentiate it from all previous experience. The grief-work which occurs in the unique environs of the psycho-analytic situation and 'seals' the cure will be referred to as effective grief, since it seems to me to differ from the daily recurring grief work described by Freud (1917).

It is my hypothesis that the child cannot grieve effectively, and therefore cannot relinquish the earliest essential object-relationships. This means that the repetition compulsion must continue in full command of the personality until the time when the ego discovers that it can tolerate the postponed separation anxiety and, so strengthened, can face the work of grieving. This mastery of original grief is essentially different from the working through of ordinary day-to-day grief, as described by Freud and others.

With experience, first as a patient and increasingly as a therapist, I have been intrigued with the role that grief and effective grief-work play in recovery during treatment. It has become clearer, as I hope the elaboration which follows will show, that one of the most important goals during the psycho-analytic process is the patient's attainment of the ability to grieve effectively, since it is my feeling that without a prolonged period of effective grief there can be little permanent change or lasting personality reorganization. Since I am talking not only of sadness, mourning, or the reaction to present loss which reawakens reaction to past loss, but of a unique emotional response experienced, perhaps, only in the psycho-analytic process, I have chosen, for the time being, the term 'effective grief' to describe and differentiate it. The patient reaches a point in therapy when the particular response is available to him after a great deal has been made conscious and after the ego