Disordered Variants and Some Conditions Contributing

When young lips have drunk deep of the bitter waters of Hate, Suspicion and Despair, all the Love in the world will not take away that knowledge.

RUDYARD KIPLING, Baa Baa Black Sheep

The four long accounts of children whose mourning failed, presented in Chapter 19, are intended to give an impression of some of the diverse patterns of pathological mourning seen in children and also of the ways that certain conditions can influence the form the responses take. The aim of this chapter is to examine these and other variants in more detail and the conditions that tend to promote each, and to give further illustrative examples. Once again the latter are drawn from the reports of clinicians working on both sides of the Atlantic: between them they represent almost every theoretical approach current within psychoanalysis. The fact that their empirical findings, when freed from divergent and often obscuring theory, are mutually compatible gives confidence in their validity.

It seems clear that some of the variants to be described, especially those in which self-reproach is prominent, are closely related to the chronic mourning of adults. Many others are characterized by a prolonged absence of conscious grieving. In some of the latter no psychiatric problem may be evident until many years later. In others problems of one kind or another appear fairly soon, during childhood or adolescence, and it is with these that this chapter is mainly concerned.

For purposes of exposition we consider the problems presented under a number of headings. They are chosen to reflect the great variety of symptoms and behavioural disorders that bereaved children show. The order in which they are discussed starts with those that are readily seen as responses to loss and moves on to those that, because combined with prolonged absence of mourning, may seem until examined to bear no relation whatever to loss.