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In his usual lucid, erudite, and gently witty manner, Nathan Roth has written an important, concise, and, above all, readable book, “The Psychiatry of Writing
a Will.” In doing so, he ventures into an area generally ignored (or feared?) by psychoanalysts.
Psychoanalysis, the study of human motivation and control, evolved, in major part, out of the libido matrix. The study of the “libido,” the origin and flowering of sexuality, holds fascination and curiosity for it reaches levels of the mind full of early instinctual pleasure yet not fully expressed because of societally induced repression. To be sure, later developments have stressed the importance of “object relations” and of object loss as fundamental in human anxiety. This is separation anxiety, the fear and despair induced by the loss of the mother or other nurturing figure.
Psychoanalysts rarely take the next step, to encourage associations, to hear about what is generally considered the ultimate separation: death. Particularly in younger therapists, ideas of death and of its compatriot, loneliness, create personal forebodings, threaten personal mechanisms of suppression and repression, create, as Roth indicates, an avoidant countertransference. There is hidden pleasure in uncovering repressions centered about the libido, the life force, but dysphoric twinges when uncovering those centering about the ending, not the propagation of human life.
It is here that Roth makes a significant contribution. He acquaints us with the magical thinking surrounding death. As this magical thinking is deflated, fear of death subsides. In terms of the reality principle, burial does not mean suffocation or awareness of decomposition, nor cremation awareness of dissolution. How reassuring it is to accept death, like birth, as characteristic of organismal life! Decline and end come to all and, with cessation of the body processes, so there is cessation of sentience. After loss of sentience, there is no separation dread; there is no