Psychoanalytic Approaches to Loss: Mourning, Melancholia and Couples PDF
Preview Psychoanalytic Approaches to Loss: Mourning, Melancholia and Couples
‘This book focuses on the impact of loss in couples and families where persis- tent grief leads to a chronic form of melancholic depression and sense of hopelessness, referred to diagnostically as complicated grief. Drawing on clin- icaland theoreticaldevelopments incouple and family psychoanalysisoverthe last several decades, this text, the first of its kind, provides the reader with a range of contemporary and innovative contributions concerning this clinical presentation, one hundred years after Freud’s original text Mourning and Melancholia (1917). The extensive clinical experience of the internationally known authors has allowed them to develop and illustrate an integrated object relations and link theory framework, which opens new perspectives in the understandingofcomplicatedgriefasit,manifestsincouplesand families.The editors propose an original approach to the assessment of this problem and a short-term intervention model for its treatment, underpinned by this frame- work. Their clinical approach allows a questioning of the method, the metap- sychology and the epistemological pedestal of contemporary psychoanalysis and indoing so, opens upa new field of research. This new wayof listening to psychic suffering, which focuses on the inter-subjectivity of the couple rela- tionship,alsohighlightsthepotentialpreventivementalhealthvalueofsuchan approach to diagnosis and treatment. From this vertex the book also examines the effects of the intergenerational transmission of un-mourned loss, which not only affects the couple (family) as a whole, but also has consequences for the broader social and cultural contexts in which they live. Moreover, the book addresses a clinical issue of immense contemporary relevance considering the suffering and adverse implication un-mourned loss can cause in individuals, couples and families and thus our world. The book, whose authors are recog- nisedbytheIPAand theIACFP,therefore representsasignificantcontribution to the field of couple and family psychoanalysis.’ Rosa Jaitin President, International Association of Couple and Family Psychoanalysis ‘Loss, grief and mourning are universal human experiences. Over the cen- turies, tradition, culture, religion, philosophy, direct interpersonal sensitivity, generosity and intergenerational wisdom have provided human beings help and support in facing these painful experiences. This book demonstrates, however, that when complicated grief occurs, such supports are often not enough and darkness and despair can dominate the internal psychic land- scape. In these circumstances medication is often seen as the solution. The authors show how psychoanalysis can go deeper. In particular, they demon- strate how couple and family psychoanalytic interventions can help in facing and working through the immense loss of a family member and avoid the temptation of denial, disavowal, withdrawal or fixation to an impossible, omnipotent recovery, as in the myth of Orpheus and Euridices. I highly recommend this seminal text on complicated grief, not only becauseit isscientificallyvaluable,butalsobecauseit isfull ofhumanity.The book is both fascinating and touching, wide and deep and profoundly rooted in psychoanalytic theory and culture. It contains the best psychoanalysis can offer today about this crucial subject, thanks to the contributions of some of the most experienced and qualified clinicians from around the world, who represent cutting-edge thinking about couple and family psychoanalysis.’ Stefano Bolognini, Immediate Past-President, International Psychoanalytical Association ‘Howtimely,followingthepublicationjustover100yearsagoofFreud’sseminal paper, Mourning & Melancholia, that such a rich collection of perspectives on loss are explored in relation to the important field of couple and family rela- tionships.TimothyKeoghandCynthiaGregoryRobertshavebroughttogether theirowncreative thinking onworking withlossincouples and familieswitha collection of astute clinical papers from highly acclaimed couple and family psychoanalytic therapists from around the world. All affirm that it is the unconscious meaningof lossthat determinesthe capacity tomournor fallinto seriousdepression. Theeditorsare,bothexperiencedcliniciansinthisarea,havealsoproduced abookthatinterweavesObjectRelationstheorywiththeconceptofthelink(el vinculo)creatinganenrichedunderstandingoftheimpactofunmournedlosson relationships, including intergenerationally on those in the present. The other contributorstothebook highlight throughcloselyobservedclinicalmaterialor film,boththeshockinglytangiblelossesthatarenonethelessavoidedandtheless tangiblelossessuchasthelossofanidealisedrelationship,thatarehardertoget hold off. They show that without being addressed, these have a destructive influence on relationships. We know that loss is an intrinsic part of human experience and the failure to mourn is detrimental to mental health. What this impressivebookachieves,istoshowhowunrecognisedandunmournedlossgets deeply embedded in the couple and family psyche, how, without being addres- sed,thisimpedescreativedevelopment.Thisexcellentbookwillbeofenormous valuetoallthoseworkingwithcouplesandfamilies,whethercoupletherapists, analystsormentalhealthpractitioners,particularlyforthosewishingtoexpand their understanding of the more deeply unconscious aspects of loss and the impactonrelationships.’ Mary Morgan, Reader in Couple Psychoanalysis, Tavistock Relationships Psychoanalytic Approaches to Loss PsychoanalyticApproachestoLoss:Mourning,MelancholiaandCouplesapplies psychoanalyticideastotheclinicallycomplexissueoflossincouplesandfamilies and outlines a new model for the assessment and treatment of associated unresolvedgrief.Inlinewithcontemporaryapproachestocoupleandfamily psychoanalysis, this integrated object relations and link theory model pro- vides a clear framework and approach for assessing and treating this clinical presentation. The book brings together contributions from internationally known and respected clinicians and authors who focus on loss, including repeated preg- nancy loss, the loss of a child or parent and the loss of a relationship itself. These psychoanalytic couple therapists take the reader inside their consulting rooms, enabling observation of their approaches to the treatment of couples experiencing loss and associated unresolved grief. Psychoanalytic Approaches to Loss: Mourning, Melancholia and Couples will make an important contribution to the literature on grief and mourning and the application of psychoanalytic thinking to couples presenting with difficulties linked to unresolved grief, following loss. It represents an essential resource to psychotherapists, counsellors, family therapists, mental health professionals and manyothers supporting those experiencing loss. Timothy Keogh is a training and supervising analyst and full member of the Australian Psychoanalytical Society. He is Honorary Senior Lecturer, Medi- cal School, University of Sydney and a research fellow of the International Psychoanalytical Society. Cynthia Gregory-Roberts is an individual, couple and family psychoanalytic psychotherapist in private practice in Sydney, Australia. She is a member of theAustralianAssociation ofSocial Workers andCollegeofSocialWork and an accredited Mental Health Social Worker. This page intentionally left blank Psychoanalytic Approaches to Loss Mourning, Melancholia and Couples Edited by Timothy Keogh and Cynthia Gregory- Roberts Firstpublished2019 byRoutledge 2ParkSquare,MiltonPark,Abingdon,OxonOX144RN andbyRoutledge 711ThirdAvenue,NewYork,NY10017 RoutledgeisanimprintoftheTaylor&FrancisGroup,aninformabusiness ©2019selectionandeditorialmatter,TimothyKeoghandCynthia Gregory-Roberts;individualchapters,thecontributors TherightofTimothyKeoghandCynthiaGregory-Robertstobeidentifiedas theauthorsoftheeditorialmaterial,andoftheauthorsfortheirindividual chapters,hasbeenassertedinaccordancewithsections77and78ofthe Copyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthisbookmaybereprintedorreproducedor utilisedinanyformorbyanyelectronic,mechanical,orothermeans,now knownorhereafterinvented,includingphotocopyingandrecording,orinany informationstorageorretrievalsystem,withoutpermissioninwritingfromthe publishers. Trademarknotice:Productorcorporatenamesmaybetrademarksorregistered trademarks,andareusedonlyforidentificationandexplanationwithoutintent toinfringe. BritishLibraryCataloguinginPublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloginginPublicationData Acatalogrecordhasbeenrequestedforthisbook ISBN:978-1-138-31243-2(hbk) ISBN:978-1-78220-548-7(pbk) ISBN:978-0-429-45823-1(ebk) TypesetinTimesNewRoman byTaylor&FrancisBooks Contents List of illustrations ix Acknowledgements x Editors xii List of contributors xiii Series Co-Editor’s Foreword xv Preface xviii Introduction 1 TIMOTHYKEOGH PARTI Theoretical understandings and clinical approaches to loss 13 1 Psychoanalytic understandings of loss and their relevance to couples and families 15 TIMOTHYKEOGH 2 Link theory and object relations theory: an enriched approach to working with melancholic couples 34 ELIZABETHPALACIOS 3 Assessing and formulating issues of unresolved loss in couple functioning 45 CYNTHIAGREGORY-ROBERTSANDTIMOTHYKEOGH 4 A proposed theoretical framework and model for intervention 60 TIMOTHYKEOGHANDCYNTHIAGREGORY-ROBERTS viii Contents PARTII Loss in couples and families: theory and practice 75 5 The family’s use of regressive defences as an avoidance of mourning 77 ANNAMARIANICOLÒANDSTEFANIATAMBONE 6 The lamp of tragedy past: traumatic intergenerational loss and the couple 87 JUDITHPICKERING 7 Some considerations regarding the impact of early parental loss on adult couple functioning 102 CATRIONAWROTTESLEY 8 Mourning and melancholia and the couple experience of a miscarriage 118 CARLBAGNINI 9 Loss in the everyday life of couples 129 MONICAVORCHHEIMER Epilogue 140 TIMOTHYKEOGHANDCYNTHIAGREGORY-ROBERTS Author Index 143 Subject Index 145 Illustrations Figures 4.1 Dynamic developmental anxieties/link theory model of couple functioning 65 4.2 The Unresolved Grief Triad (UGT) 67 Table 4.1 A grid depicting developmental anxiety, link and therapeutic focus 70
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