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Reporting on 15 years of clinical research with over 150 patients, 16 to 58 in age, who were “treated or otherwise seen professionally” by himself, Dr. Volkan states that all complications in the mourning process other than protracted normal grieving eventually result in either reactive depression or another neurotic syndrome, “established pathological mourning.” All other recognizable chronic problems of mourning, he states, arise from one or the other of these conditions and/or can be reduced to them.
Reactive depression and established pathological mourning differ according to the mourner's handling of the representation of the lost one. In reactive depression this ambivalently charged representation is kept within the mourner, who “identifies totally and disruptively” with it. In established pathological mourning, identification with the deceased has not yet occurred and the introject of the deceased is maintained ambivalently in the hope of resolving that ambivalence. The mourner also externalizes (projects) the representation onto the outside world and struggles between killing it or not, leading to a fixation, which typically involves the selection of a “linking object.” This is a magically used inanimate object that contains elements of the mourner and the mourned, providing the illusion of absolute control over the final acceptance of death (“killing”) or return to life of the dead person. The introject also serves the function of absolute control.
A major part of this work is the description of “Re-grief therapy,” a short-term psychotherapy Dr. Volkan developed to deal with established pathological mourning by stimulating resumption of the work of mourning through special attention to the study and use of the linking object. Beginning with techniques taken from behavior therapy, this has evolved into a treatment he claims is consonant with psychoanalysis, a “mini-focal analysis.” “Demarcation,” a major re-grieving technique, seeks to place a boundary between