Facing Mortality: Surfacing Themes Among Four Cases

Working with people who have been confronted with mortality – their own or that of an essential other – is a constituent part of everyday psychoanalytic practice. But how analysts work with people who are facing mortality has been less systematically examined. A group of 7 psychoanalysts, the Existential Maturation Group, used the Three-Level Model (3-LM) to systematically analyze 4 cases, including a retiree with a good prognosis cancer, a young person who developed cancer during the analysis, a young child with parent loss, and a middle-aged person with multiple traumatic losses. Striking emergent themes included the crucial role of formative object relations; reliance on object functions from a supportive other, especially in the case of the child; and that developing a way to think about death is essential and entails being able to perceive, realize, and process the realities. Furthermore, it seemed that being able to think about death in the context of good enough object relatedness resulted in vitalization. Having accompaniment in the process of confronting mortality seemed to be part of what worked well, as did working on a sense of personal legacy. Inability to process mortality seemed to be psychologically traumatic. Finally, we observed powerful parallel processes, and noticed that groups may provide additional containment when the difficulties are great. We explore some implications of the themes we found.