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This is an electronic version of excerpts of an article published in the journal Psychoanalytic Dialogues, 15 (4): 499-527, 2005.

Psychoanalytic Dialogues is available online at:



Mary V. Sussillo, LCSW, BCD



The author considers a relational perspective of mourning and suggests an elaboration and extension of Freud’s theory of mourning with a sharper focus on the dialectic of holding on and letting go of the formative lost object relationship. Sussillo argues that Freud’s early (1917) theoretical tilt toward the relinquishment of affective ties with the dead, later expanded and culminated in a deeper relational sensibility, was shaped by his developing theories and personal losses. Her position is that the analyst can help facilitate the adult patient’s affective experience of felt continuity with the absent object, lost in adolescence, that ultimately allows the separation and the transformation of the primitive bond. Sussillo’s perspective represents a synthesis of relational theories in a broad sense—also informed by attachment theory, contemporary bereavement research, infant research, and developmental theory. This thesis is illustrated by a clinical example that highlights the therapeutic action.


The Trauma of Parental Loss in Adolescence

“Death is an anathema” to adolescents (Raphael, 1983, p. 139). In adolescence, the focus is on life, limitless potential, and passionate vitality. The adolescent’s subjective experience is a cauldron of conflicting forces of change and growth. The body’s development and sexual urgency are exhilarating and alarming; the rapidly expanding cognitive competencies are exciting; the anticipated landscape of adult power and privilege is tantalizing and so near. The untimely death of a parent is experienced as an incomprehensible and overwhelming assault that strikes at the core of the adolescent’s intrapsychic and external world.

It is important to understand how the adolescent psyche is profoundly affected in a multiplicity of ways by the loss of a parent. I believe it is a severe life trauma1 that is experienced as a crisis on two critical fronts (Shapiro, 1994), affecting both the sense of the self and the attachment-individuation process (Lyons-Ruth, 1991, p. 10).2 Beginning with the self-crisis, the youthful mourner experiences a severe injury to the self in the wake of the rupture of the self-object bond with the formative attachment figure (Hagman, 1995). In order to understand the impact of the loss on the adolescent’s sense of self, the question that first needs to be addressed was raised by Mitchell (1998): “What makes a parent meaningful?” In his words, “Parents provide a safe base to explore inner and outer experience.” Parental figures continue to be counted on to sustain, to regulate affect, and to repair aspects of the self. When the parent dies, it might be precisely this parent that the adolescent would have leaned on for help in assimilating the unbearable sea-storm of crashing affect. Having experienced her mother’s death as a loss of part of herself (Kohut, 1971), a patient of mine described her self-experience at age 17 following her mother’s death: “We were so close; she loved me unconditionally. I felt like I lost half of myself when my mother died.” Adolescents experience a sense of never being the same again, a changed self, no longer dealing with everyday concerns and a new sense of vulnerability (Lattanzi-Licht,1996). The bereaved teenager is vividly aware of the discontinuous experience of the psychological Great Divide, internal and external, between life-before-death and life- after-death (Harris, 1995, p.10-13). The normal order has been ruthlessly revoked. From that point on, her life is shadowed by the parental death (Furman, 1974).

Many aspects of the self and of one's interpersonal surround are experienced as violently altered and irrevocably different, even though some external realities—school, friends—may look the same. That sense of difference is often experienced as a profound change in the atmosphere (p.8). Virginia Woolf (1985) whose mother died in her early adolescence when she was 13, described her affective experience the day of her mother's death: "Her death was the greatest disaster that could happen; it was as though on some brilliant day of spring, the racing clouds all of a sudden stood still, grew dark and masked themselves; the wind flagged, and all creatures on the earth moaned or wandered seeking aimlessly" (p.4). As Woolf's imagery so vividly conveys, the magnitude of the untimely loss of the still-needed parent often unleashes intense panic, disorientation, feelings of helplessness, outrage and profound separation anxiety (Bowlby, 1958, 1969, 1973, 1980). Further, the adolescent is exposed to ongoing feelings of shame, deprivation, anger and envy in everyday situations in which they compare their trauma to the average expectable experience of peers (Furman, 1974). The adolescent tends to dissociate the unbearable affect, detach emotionally and act as if the self has not experienced the impact of the loss (Bromberg, 1998).

Further, it is my view that the traumatic impact of the death of a parent is often compounded, as multiple losses are usually sustained. There is a profound adjustment to the loss of the significant object and the functions that object provided, the loss of the primary relationship including the numerous, daily interactions with the formative attachment figure. At times, there may be the loss of the emotional attunement of the surviving parent who is understandably destabilized from the shock of losing one's life mate and is now also facing the demands of single parenthood. In effect, some adolescents may experience the loss of being psychically held by both parents when one parent dies. When grief intrudes in bursts, the adolescent's experience in the absense of emotionally attuned others, may be alarming, profoundly isolating and despairing.

Bereavement Research: "Constructing the Dead"

In the past decade, there has been a significant clinical and research effort to understand the specific experience of adolescents during mourning. Several clinical researchers have focused on child and adolescent parental loss (Balk, (1991), Silverman, Nickman and Worden (1992), Tyson-Rawson (1993,1996,1996b), Corr and Balk (1996), Klass, Silverman & Nickman [eds.], (1996), Lattanzi-Licht, (1996) and Christ (2000). This relevant new data is enhancing our theory and technique on bereavement and the mourning process. The cumulative research indicates that the bereaved maintained some form of vital affective bond with their lost loved one which facilitated coping with grief and aided rather than hindered, continued development and growth. These connections were concrete or more abstract. For example, children and early adolescents often saved personal keepsakes of the lost parent, such as a piece of well-worn clothing, as this "transitional object" provided an evocative, sensory pathway to the beloved (Silverman et al., 1992; Christ, 2000).

Many of our concepts on normal mourning are based on retrospective studies of pathological mourning or from clinical studies of individuals in treatment prior to the loss with little followup subsequent to the loss (Furman, E., 1974; Klass et al., 1996). A significant continuing study, the Harvard Medical School Child Bereavement Study (Silverman and Worden, 1992), substantiates the need for an ongoing sense of the lost parent and some form of continued relationship. In my view, the value of this large prospective study of children and adolescents from a non-clinical community sample, is that it filled a considerable knowledge gap for clinicians about how the average young person actively adapts over real time to parental loss. In effect, it described, in the children's own voices how this age group maintained conscious and unconscious connections to their dead parent. I found it compelling that the young person actively engaged in an ongoing process of "constructing" the longed-for lost parent which involved creating the meaning of this now dead parent in the child/adolescent's life and finding a way to carry the lost parent forward with her as needed (p.71, 85).

Moreover, the striking statistics documented an interactive relationship with the deceased (Normand, Silverman and Nickman, 1996) in which the lost parent was still watching over the surviving child. The young person's inner representation of their deceased parents was not static but evolved in an ongoing way and was connected to the individual's developmental level (Silverman, Nickman and Worden, 1992). I use an example taken from another study to illustrate this concept. A late adolescent female, college student spoke about how her relationship with her dead father had progressed: "Well, I'm older now and I think he probably really appreciates what I've become. We had some fights...I said I hate you". But I'm more mature and it makes me feel good to realize that he's proud of me and understands that the arguing and talking back weren't how I felt about him" (Tyson-Rawson, 1996b, p.137). This interactive relationship seemed to be modified as the intensity of the grief diminished over time (Silverman et al., 1992). The relationship with the parent became more internalized and integrated into a "sense of a new self" (Klass, 1988).

As I see it, Gaines' (1997) analytic concept of "creating or maintaining continuity" with lost love relationships compliments the Harvard researchers findings of "constructing the dead". Gaines, from an interpersonal perspective, referred to "internalizing actions" occurring after object loss which repair, modify or expand preexisting internalizations and enable an inner connection and meaningful relation to the absent other (p.550). I find the emphasis on "constructing the dead" and "creating continuity", clinically invaluable. In our analytic work, we are experienced in reconstructing the past. With patients who have lost parents prematurely, my position is that, an awareness of the need for self-continuity enables the analyst to help the patient also "construct the future" (post-loss)—by preserving and extending the lost dyad and by also mourning what was never fully realized in the truncated relationship. Not only children, but also the bereaved adult patient needs to renegotiate and redefine, as needed, their relationship with the dead parent (Gaines, 1997). Of course, the necessity for continuity is most obvious for children. As analysts, we generally recognize that children need their parents to foster their development and to build and maintain inner structure. At the same time, it is also present for adults whose relationships with parents continue to be needed and to evolve over the lifespan whether parents are dead or alive (p. 555).


1 It is beyond the scope of this paper to explore the range of opinion in the trauma literature on loss.

2 Lyons-Ruth posited that “attachment-individuation” describes more fully than “separation-individuation” the infant’s paradoxical needs for intense connection to caregivers as well as for individual agency and mastery.

I use the female pronoun throughout this paper to refer to both genders.