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Lord, R. Ritvo, S. Solnit, A.J. (1978). Patients' Reactions to the Death of the Psychoanalyst. Int. J. Psycho-Anal., 59:189-197.

(1978). International Journal of Psycho-Analysis, 59:189-197

Patients' Reactions to the Death of the Psychoanalyst

Ruth Lord, Samuel Ritvo and Albert J. Solnit

SUMMARY

There have been to date no empirical studies of the impact on a patient of the death of the analyst during the period of treatment. As a first step, we have collected information both from

analysands who themselves experienced such a loss, and from subsequent therapists whose observations were complementary and more objective. The help of colleagues has been indispensable in the questionnaire construction, data analysis and the sharing of clinical experience. We are aware that the nature of our undertaking does not permit in-depth observations or conclusions.

Our patient sample is well distributed between men and women, and between training candidates and other analysands. There was also an even distribution between those who reported autobiographically and those who were described by a subsequent therapist. Of 27 patients whose analysts died before the ending of treatment, slightly more than one-third had what we viewed as expected mourning reactions, and almost two-thirds either pathological (complicated and prolonged) or no mourning reactions. Almost twice as many non-candidates as training candidates experienced pathological mourning.

Early loss and deprivation appeared to be the most important factors associated with pathological mourning reactions. The analysands with expected or normal mourning had sustained far less early loss. A surprising number of patients, almost one-fourth of the total, evidenced minimal or no discernible mourning after their analysts died. These patients were notable for the absence of significant loss or deprivation in childhood or adolescence. Another factor of possible influence on mourning reactions may be the age of the patient. A larger sample might confirm a trend which appears in our data, that older patients experienced the most difficult and prolonged mourning. One could speculate that their anguish was heightened in part from a realistic fear that an opportunity to resolve their difficulties had been irrevocably lost. That the patients in our sample who evidenced no mourning were also the youngest group supports this inference. Their lack of profound distress at the loss suggests an awareness that life would allow them other chances, including a subsequent analysis.

Factors which had no apparent influence on the mourning reaction included the sex and relative ages of patient and analyst, and, surprisingly, the phase of treatment. We were not able to determine definitively the significance of the nature of the analyst's death, nor of the state of the transference, on the mourning reaction.

An issue we would raise is the way in which the loss of the analyst differs from that of a parent, parent figure or other person much depended upon or needed. The role of the analyst is one through which intensely felt relationships may be relived. The death of the analyst poses a powerful paradox: the 'omnipotent rescuer' (Bernstein et al., 1973), perhaps uniquely equipped to assist with a crisis of such magnitude, not only can never do so again, but is indeed its cause.

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