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One hundred fifty patients with leukemia or lymphoma manifested a characteristic adaptation to object loss. The nature of the mechanism rather than its connection with leukemia is the subject of this report. The adaptation to object loss takes place in two phases. In the first phase the person maintains his own personality relatively intact, but also assumes the role of the lost object: for example, he becomes 'both father and mother'. In the second phase, another person who has suffered the same loss becomes the vicarious object. The grief is then displaced to the vicarious object, toward whom the person is protective and comforting, profiting through identification with the vicarious object. If this process breaks down, through loss of the vicarious object, some persons develop leukemia. These proxy mechanisms have not been properly appreciated for several reasons. These patients are seldom seen as psychiatric problems, and their ministrations to the vicarious objects are frequently medically useful. Also there has been a preoccupation with the resemblance to mourning and melancholia. Moreover the adaptive quality of the mechanism may afford valuable sublimations.
Proxy mechanisms may be used in successful resolution of grief and so not be considered pathological. As operative within a family these mechanisms may have a synergistic relation to other processes of mourning and so help to maintain the family.