Meetings of the New York Psychoanalytic Society

March 29, 1966. FEAR OF DEATH AND ANALYTICAL TECHNIQUE. Max M. Stern, M.D.

Fear of death and its relationship to psychoanalytic technique has been neglected in the literature. Dr. Stern's thesis is that 'fear of death is essentially fear of repetition of mortal anxiety experienced in early traumatic states, with the difference that while these have been overcome, the ultimate trauma will be final'. Mastery of this fear is developmentally essential and must be worked through for successful termination of an analysis.

Material pertaining to fear of death emerges early in certain analyses and may lead anamnestically back as far as age three years. 'Symbiotistic' fantasies (fantasies of re-establishing the infantile symbiotic relationship with the mother) arise as specific defensive structures. In these cases, working through the fear of death has a dramatic catalytic influence when a stalemate has occurred after years of analysis. In the transference the analyst represents the protective mother, fusion with whom serves as defense against fear of death. Interpretation of such transference wishes is followed by depression and regression to 'symbiotistic' fantasies. Working through leads to exploration of the original conflictual phase of separation-individuation and ego maturation ensues. Stern presents two cases in which fear of death was an important focus.

Inquiry into the nature of fear of death led the author to suggest a revision of the translation of Freud's term Todesangst as 'mortal anxiety' rather than as 'castration anxiety'. Freud defines mortal anxiety as the affect emerging when the ego 'lets itself die' in a situation of real danger that appears overwhelming. The situation of overwhelming danger enlivens wishes for maternal symbiosis for at that phase of development gratification by the mother protects against trauma and death. Stern points out that death would not be feared were it not regarded as a 'repetition of a previous situation in which t