Freud - Complete Works (504 page)

  
¹
Cf. a later passage on the distinction
between testing with regard to reality and testing with regard to
immediacy. [‘
Relitätsprüfung
’ and
‘
Aktualitätsprüfung
’.]

  
²
I may venture to suggest in this connection
that the toxic hallucinoses, too, e.g. alcoholic delirium, are to
be understood in an analogous fashion. Here the unbearable loss
imposed by reality would be precisely the loss of alcohol. When the
latter is supplied, the hallucinations cease.

A Metapsychological Supplement To The Theory Of Dreams

3038

   What is performed in amentia by
this ‘repression’ is performed in dreams by voluntary
renunciation. The state of sleep does not wish to know anything of
the external world; it takes no interest in reality, or only so far
as abandoning the state of sleep - waking up - is concerned. Hence
it withdraws cathexis from the system
Cs.
as well as from
the other systems, the
Pcs.
and the
Ucs.
, in so far
as the cathexes in them obey the wish to sleep. With the system
Cs.
thus uncathected, the possibility of reality-testing is
abandoned; and the excitations which, independently of the state of
sleep, have entered on the path of regression will find that path
clear as far as the system
Cs.
where they will count as
undisputed reality.¹

   As regards the hallucinatory
psychosis of dementia praecox, we shall infer from our discussion
that that psychosis cannot be among the initial symptoms of the
affection. It becomes possible only when the patient’s ego is
so far disintegrated that reality-testing no longer stands in the
way of hallucination.

   In what concerns the psychology
of dream-processes we arrive at the result that all the essential
characteristics of dreams are determined by the conditioning factor
of sleep. Aristotle was entirely right, long ago, in his modest
pronouncement that dreams are the mental activity of the sleeper.
We might expand this and say: they are a residue of mental
activity, made possible by the fact that the narcissistic state of
sleep has not been able to be completely established. This does not
sound very different from what psychologists and philosophers have
said all along, but it is based on quite different views about the
structure and function of the mental apparatus. These views have
this advantage over the earlier ones, that they have given us an
understanding, too, of all the detailed characteristics of
dreams.

   Finally, let us once more glance
at the significant light which the
topography
of the process
of repression throws for us on the mechanism of mental
disturbances. In dreams the withdrawal of cathexis (libido or
interest) affects all systems equally; in the transference
neuroses, the
Pcs.
cathexis is withdrawn; in schizophrenia,
the cathexis of the
Ucs.
; in amentia, that of the
Cs.

  
¹
Here the principle of the insusceptibility
to excitation of uncathected systems appears to be invalidated in
the case of the system
Cs.
(
Pcpt.
). But it may be a
question of only the
partial
removal of cathexis; and for
the perceptual system in especial we must assume many conditions
for excitation which are widely divergent from those of other
systems. - We are not, of course, intending to disguise or gloss
over the uncertain and tentative character of these
metapsychological discussions. Only deeper investigation can lead
to the achievement of a certain degree of probability.

3039

MOURNING AND MELANCHOLIA

(1917 [1915])

3040

Intentionally left blank

3041

MOURNING AND MELANCHOLIA

Dreams having served us as the prototype in
normal life of narcissistic mental disorders, we will now try to
throw some light on the nature of melancholia by comparing it with
the normal affect of mourning. This time, however, we must begin by
making an admission, as a warning against any over-estimation of
the value of our conclusions. Melancholia, whose definition
fluctuates even in descriptive psychiatry, takes on various
clinical forms the grouping together of which into a single unity
does not seem to be established with certainty; and some of these
forms suggest somatic rather than psychogenic affections. Our
material, apart from such impressions as are open to every
observer, is limited to a small number of cases whose psychogenic
nature was indisputable. We shall, therefore, from the outset drop
all claim to general validity for our conclusions, and we shall
console ourselves by reflecting that, with the means of
investigation at our disposal to-day, we could hardly discover
anything that was not typical, if not of a whole class of
disorders, at least of a small group of them.

   The correlation of melancholia
and mourning seems justified by the general picture of the two
conditions.¹ Moreover, the exciting causes due to
environmental influences are, so far as we can discern them at all,
the same for both conditions. Mourning is regularly the reaction to
the loss of a loved person, or to the loss of some abstraction
which has taken the place of one, such as one’s country,
liberty, an ideal, and so on. In some people the same influences
produce melancholia instead of mourning and we consequently suspect
them of a pathological disposition. It is also well worth notice
that, although mourning involves grave departures from the normal
attitude to life, it never occurs to us to regard it as a
pathological condition and to refer it to medical treatment. We
rely on its being overcome after a certain lapse of time, and we
look upon any interference with it as useless or even harmful.

  
¹
  Abraham (1912), to whom we owe the
most important of the few analytic studies on this subject, also
took this comparison as his starting point.

Mourning And Melancholia

3042

   The distinguishing mental
features of melancholia are a profoundly painful dejection,
cessation of interest in the outside world, loss of the capacity to
love, inhibition of all activity, and a lowering of the
self-regarding feelings to a degree that finds utterance in
self-reproaches and self-revilings, and culminates in a delusional
expectation of punishment. This picture becomes a little more
intelligible when we consider that, with one exception, the same
traits are met with in mourning. The disturbance of self-regard is
absent in mourning; but otherwise the features are the same.
Profound mourning, the reaction to the loss of someone who is
loved, contains the same painful frame of mind, the same loss of
interest in the outside world - in so far as it does not recall him
- the same loss of capacity to adopt any new object of love (which
would mean replacing him) and the same turning away from any
activity that is not connected with thoughts of him. It is easy to
see that this inhibition and circumscription of the ego is the
expression of an exclusive devotion to mourning which leaves
nothing over for other purposes or other interests. It is really
only because we know so well how to explain it that this attitude
does not seem to us pathological.

   We should regard it as an
appropriate comparison, too, to call the mood of mourning a
‘painful’ one. We shall probably see the justification
for this when we are in a position to give a characterization of
the economics of pain.

   In what, now, does the work which
mourning performs consist? I do not think there is anything
far-fetched in presenting it in the following way. Reality-testing
has shown that the loved object no longer exists, and it proceeds
to demand that all libido shall be withdrawn from its attachments
to that object. This demand arouses understandable opposition - it
is a matter of general observation that people never willingly
abandon a libidinal position, not even, indeed, when a substitute
is already beckoning to them. This opposition can be so intense
that a turning away from reality takes place and a clinging to the
object through the medium of a hallucinatory wishful
psychosis.¹ Normally, respect for reality gains the day.
Nevertheless its orders cannot be obeyed at once. They are carried
out bit by bit, at great expense of time and cathectic energy, and
in the meantime the existence of the lost object is psychically
prolonged. Each single one of the memories and expectations in
which the libido is bound to the object is brought up and
hypercathected, and detachment of the libido is accomplished in
respect of it. Why this compromise by which the command of reality
is carried out piecemeal should be so extraordinarily painful is
not at all easy to explain in terms of economics. It is remarkable
that this painful unpleasure is taken as a matter of course by us.
The fact is, however, that when the work of mourning is completed
the ego becomes free and uninhibited again.

  
¹
Cf. the preceding paper.

Mourning And Melancholia

3043

   Let us now apply to melancholia
what we have learnt about mourning. In one set of cases it is
evident that melancholia too may be the reaction to the loss of a
loved object. Where the exciting causes are different one can
recognize that there is a loss of a more ideal kind. The object has
not perhaps actually died, but has been lost as an object of love
(e.g. in the case of a betrothed girl who has been jilted). In yet
other cases one feels justified in maintaining the belief that a
loss of this kind has occurred, but one cannot see clearly what it
is that has been lost, and it is all the more reasonable to suppose
that the patient cannot consciously perceive what he has lost
either. This, indeed, might be so even if the patient is aware of
the loss which has given rise to his melancholia, but only in the
sense that he knows
whom
he has lost but not
what
he
has lost in him. This would suggest that melancholia is in some way
related to an object-loss which is withdrawn from consciousness, in
contradistinction to mourning, in which there is nothing about the
loss that is unconscious.

   In mourning we found that the
inhibition and loss of interest are fully accounted for by the work
of mourning in which the ego is absorbed. In melancholia, the
unknown loss will result in a similar internal work and will
therefore be responsible for the melancholic inhibition. The
difference is that the inhibition of the melancholic seems puzzling
to us because we cannot see what it is that is absorbing him so
entirely. The melancholic displays something else besides which is
lacking in mourning - an extraordinary diminution in his
self-regard, an impoverishment of his ego on a grand scale. In
mourning it is the world which has become poor and empty; in
melancholia it is the ego itself. The patient represents his ego to
us as worthless, incapable of any achievement and morally
despicable; he reproaches himself, vilifies himself and expects to
be cast out and punished. He abases himself before everyone and
commiserates with his own relatives for being connected with anyone
so unworthy. He is not of the opinion that a change has taken place
in him, but extends his self-criticism back over the past; he
declares that he was never any better. This picture of a delusion
of (mainly moral) inferiority is completed by sleeplessness and
refusal to take nourishment, and - what is psychologically very
remarkable - by an overcoming of the instinct which compels every
living thing to cling to life.

Mourning And Melancholia

3044

   It would be equally fruitless
from a scientific and a therapeutic point of view to contradict a
patient who brings these accusations against his ego. He must
surely be right in some way and be describing something that is as
it seems to him to be. Indeed, we must at once confirm some of his
statements without reservation. He really is as lacking in interest
and as incapable of love and achievement as he says. But that, as
we know, is secondary; it is the effect of the internal work which
is consuming his ego work which is unknown to us but which is
comparable to the work of mourning. He also seems to us justified
in certain other self-accusations; it is merely that he has a
keener eye for the truth than other people who are not melancholic.
When in his heightened self-criticism he describes himself as
petty, egoistic, dishonest, lacking in independence, one whose sole
aim has been to hide the weaknesses of his own nature, it may be,
so far as we know, that he has come pretty near to understanding
himself; we only wonder why a man has to be ill before he can be
accessible to a truth of this kind. For there can be no doubt that
if anyone holds and expresses to others an opinion of himself such
as this (an opinion which Hamlet held both of himself and of
everyone else ¹), he is ill, whether he is speaking the
truth or whether he is being more or less unfair to himself. Nor is
it difficult to see that there is no correspondence, so far as we
can judge, between the degree of self-abasement and its real
justification. A good, capable, conscientious woman will speak no
better of herself after she develops melancholia than one who is in
fact worthless; indeed, the former is perhaps more likely to fall
ill of the disease than the latter, of whom we too should have
nothing good to say. Finally, it must strike us that after all the
melancholic does not behave in quite the same way as a person who
is crushed by remorse and self-reproach in a normal fashion.
Feelings of shame in front of other people, which would more than
anything characterize this latter condition, are lacking in the
melancholic, or at least they are not prominent in him. One might
emphasize the presence in him of an almost opposite trait of
insistent communicativeness which finds satisfaction in
self-exposure.

  
¹
‘Use every man after his desert, and
who shall scape whipping?’ (Act II, Scene 2).

Mourning And Melancholia

3045

   The essential thing, therefore,
is not whether the melancholic’s distressing self-denigration
is correct, in the sense that his self-criticism agrees with the
opinion of other people. The point must rather be that he is giving
a correct description of his psychological situation. He has lost
his self-respect and he must have good reason for this. It is true
that we are then faced with a contradiction that presents a problem
which is hard to solve. The analogy with mourning led us to
conclude that he had suffered a loss in regard to an object; what
he tells us points to a loss in regard to his ego.

   Before going into this
contradiction, let us dwell for a moment on the view which the
melancholic’s disorder affords of the constitution of the
human ego. We see how in him one part of the ego sets itself over
against the other, judges it critically, and, as it were, takes it
as its object. Our suspicion that the critical agency which is here
split off from the ego might also show its independence in other
circumstances will be confirmed by every further observation. We
shall really find grounds for distinguishing this agency from the
rest of the ego. What we are here becoming acquainted with is the
agency commonly called ‘conscience’; we shall count it,
along with the censorship of consciousness and reality-testing,
among the major institutions of the ego, and we shall come upon
evidence to show that it can become diseased on its own account. In
the clinical picture of melancholia, dissatisfaction with the ego
on moral grounds is the most outstanding feature. The
patient’s self-evaluation concerns itself much less
frequently with bodily infirmity, ugliness or weakness, or with
social inferiority; of this category, it is only his fears and
asseverations of becoming poor that occupy a prominent
position.

Mourning And Melancholia

3046

   There is one observation, not at
all difficult to make, which leads to the explanation of the
contradiction mentioned above. If one listens patiently to a
melancholic’s many and various self-accusations, one cannot
in the end avoid the impression that often the most violent of them
are hardly at all applicable to the patient himself, but that with
insignificant modifications they do fit someone else, someone whom
the patient loves or has loved or should love. Every time one
examines the facts this conjecture is confirmed. So we find the key
to the clinical picture: we perceive that the self-reproaches are
reproaches against a loved object which have been shifted away from
it on to the patient’s own ego.

   The woman who loudly pities her
husband for being tied to such an incapable wife as herself is
really accusing her
husband
of being incapable, in whatever
sense she may mean this. There is no need to be greatly surprised
that a few genuine self-reproaches are scattered among those that
have been transposed back. These are allowed to obtrude themselves,
since they help to mask the others and make recognition of the true
state of affairs impossible. Moreover, they derive from the
pros
and
cons
of the conflict of love that has led to
the loss of love. The behaviour of the patients, too, now becomes
much more intelligible. Their complaints are really
‘plaints’ in the old sense of the word. They are not
ashamed and do not hide themselves, since everything derogatory
that they say about themselves is at bottom said about someone
else. Moreover, they are far from evincing towards those around
them the attitude of humility and submissiveness that would alone
befit such worthless people. On the contrary, they make the
greatest nuisance of themselves, and always seem as though they
felt slighted and had been treated with great injustice. All this
is possible only because the reactions expressed in their behaviour
still proceed from a mental constellation of revolt, which has
then, by a certain process, passed over into the crushed state of
melancholia.