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Although we know that after such a loss the acute state of mourning will subside, we also know we shall remain inconsolable and will never find a substitute. No matter what may fill the gap, even if it be filled completely, it nevertheless remains something else. And actually this is how it should be. It is the only way of perpetuating that love which we do not want to relinquish.
SIGMUND FREUD1
It is eighty years since Freud first adumbrated the idea that both hysteria and melancholia are manifestations of pathological mourning following more or less recent bereavement,2 and sixty since in ‘Mourning and Melancholia’ he advanced the hypothesis more explicitly (1917). Since then there have been a host of other studies all of which in different ways support it. Clinical experience and a reading of the evidence leaves little doubt of the truth of the main proposition—that much psychiatric illness is an expression of pathological mourning—or that such illness includes many cases of anxiety state, depressive illness and hysteria, and also more than one kind of character disorder. Plainly Freud had discovered a large and promising field of enquiry. Yet it is one that only in recent years has been receiving the attention it deserves.
Controversy, never absent, still abounds. To understand it we turn to history. In doing so it is necessary to trace how ideas have developed in regard to two distinct types of problem:
ideas regarding the nature of mourning processes themselves and in what ways healthy and pathological processes differ
ideas regarding why some individuals and not others should respond to loss in a pathological way.
In regard to the first set of problems the early literature is concerned almost exclusively with the mourning of adults. In regard to