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Meissner addresses the enigma of suicide through a detailed study of van Gogh's life and letters, and through the observations of other authors, such as Gedo, Heiman, Menninger, Nagera, and Poznanski, which are relevant to van Gogh's experience. While acknowledging the basic Freudian mechanism of murderous impulses turned against the self, he greatly enhances our understanding of the various yet interactive forces which tend to make the suicidal act compelling. And he describes three suicidal elements, "heightened inimicality, increased emotional perturbation and hopeless constriction," which in conjunction embody the suicidal state. He notes that the organization of pathogenic introjects is central to understanding the dynamics of suicide. He quotes Buie: "Suicide is a phenomenon of disturbed internalization, an effort to cope with hostile introjects and to cope with the absence of those comforting inner presences necessary for stability and mental quiet."
The historical life data he presents are clearly illustrative of these disturbed internalizations. Meissner explores van Gogh's symbiosis with his brother Theo and his inability to enlist anyone but Theo as a secret sharer. In his one close artistic relation with Gauguin, he contrived to have himself rejected and despised. We learn that van Gogh was "a replacement child" born a year to the day after the first Vincent. The influence of his mourning mother, the austerity of the parsonage, and the ever-haunting presence of the grave of his brother (the primary object of his mother's affection) gave him the sense that it was better to be dead than alive. Being a replacement child, an inevitable disappointment to his parents, was the central pathogenic introject van Gogh repeatedly attempted to overcome. Another unconscious introject was his identification with Christ. In his Pietà we can discern multiple interwoven dynamic factors: the suffering, persecuted son (with Vincent's features), the mourning moth