IX. Intimations of Mortality: Bereavement, Sickness, Hypochondria

From a psycho-analytic point of view, hypochondria, a sign of depression, originates in identification with a dead or dying internal object — a member of the internal family who has been attacked, in phantasy, by a hostile part of the self. It thus connects with the anxiety from the first two sources as a state of mind in which internal objects have deteriorated in health, and has features reminiscent both of mourning and of suffering from a disease. It is the life support services of bodily organs and the great systems of the body, for example the gastro intestinal, the cardio-respiratory, the genito-urinary, which link their meaning at phantasy levels with internal parents who feed, toilet and preside over the development of the organism.

The sense of one life being dependent on another is vivid between a baby and its mother. When the infantile bond continues into adult life, a danger to the self persists when the parent dies.

One striking example occurred in an African woman who lived with her husband in London. She was only forty-five years old, but suffered from angina and diabetes. In retrospect, perhaps both illnesses were related to her incapacity to live apart from her parents. One evening she received news of her father's death abroad. She immediately felt faint, broke out in a sweat and thereafter remained restless and ill. On the tenth day she suddenly clutched her chest, cried out, “Lord have mercy! It's no good! Lay me out!” — and died. Her husband, who was present, was horrified by the connection between the two deaths.

A man of fifty-eight, married and the father of seven adult children, was devoted to his mother who lived nearby and whom he frequently visited. One morning at the surgery he complained of chest pain. He mentioned that three weeks ago his old mother had died. He was admitted to hospital where the diagnosis of coronary thrombosis was confirmed. He recovered a little at first, but died suddenly on the day planned