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This is a thoughtful article in an area that has been rather neglected by psychoanalysts. The author questions Freud's position on awareness of death and death anxiety. How can the unconscious be convinced of its own immortality when it is oblivious to time? How can we not believe in our own death
when we in fact avoid facing it because of the narcissistic injury involved? Hoffman suggests that there is instead a conscious belief in immortality which is defensive against an unconscious fear of death. Hoffman agrees with Kohut that the fear of death represents the destruction of the nuclear self, but he also reproves him for not integrating this anxiety within Freud's genetic hierarchy of anxiety experiences. The author postulates a more advanced ego level that is achievable, in which tolerance of ambivalent feelings about death can exist. Here existential "dread" and anticipatory mourning, as well as self-affirmation, occur. Hoffman reached his views through work with parents who have had to deal with a fatal illness (leukemia) in their child. The author was impressed by the ability of parents to live with simultaneous contradictions and ambiguity. These parents could affirm faith in the self and yet experience profound skepticism, doubt, and anger. The work of mourning became increasingly focused on the quality of the child's life and of the time spent with her or him, in lieu of the amount of time lost, and thus a change in the quality of investment in both the lost object and in potential new objects appeared to be an important outcome of this process. Hoffman points out that the course of adaptation to mortality should be further investigated clinically through analytic work with older patients, since the heightened sense of "time running out" is likely to resonate with previous kinds of threats to the integrity of the self and is likely to stir up early developmental conflicts. The author concludes by stating his belief that this entire subject c