The final challenge: ageing, dying, individuation

Abstract

This paper1 is about the psychotherapy of a woman who passed from what Waddell (1998) would term 'older age' to 'later life', by which latter I mean the inevitable decline into dying and death. However unwelcome these developments may be to the individual, they are none the less activities of the soma, and therefore activities of the self-deintegrates. Much of the work of the psychotherapy centred around the task of enabling the patient to relate to and accept the bodily and emotional correlates of this process, which she tended to want to disown and deny by means of a split between mind and body along the lines of a long-standing internal depressive relationship. Permitting her contact with herself allowed her a much greater sense of internal company and peace, and arguably facilitated an easier process of dying, involving a self reconciled with itself rather than one at odds. Technically, the approach involved a greater concentration on the intrapsychic relationship rather than on the relationship between patient and analyst, and this is briefly discussed in terms of the work of Armando Ferrari who had himself died, shortly before the paper was first presented, and to whom therefore it is in part a homage.

II. A Brief Introduction to the thought of Armando B. Ferrari

“…These were deeply informed by his experiences of mortality, of the mortal body and of its relationship with the ineluctable nature of the ‘arrow of time’ (Ferrari, ). Ferrari linked the fear of mortality and the body's relationship with mortality to a rejection of the awareness of the body (Carvalho, ; Ferrari & Stella, ). Two of Ferrari's earliest papers are in Portuguese on the death instinct, and were influenced by his experiences as an anthropologist (Ferrari, , ).…”

“…But the eclipse, even where it is successful, is not absolute, and the body with its sensations and emotions – its ‘marasma’ – can and needs to reassert itself in times of crisis, disturbance or illness where new accommodations and adjustments need to be made to and by the ego configuration (see below). Prototypically such bodily reassertion happens in adolescence where the bewildering rate of dramatic and unexpected bodily change over an extraordinarily short time‐span can be overwhelming to the adolescent mind and ego (see Romano, ); and similar crises may be presented to mind by body in childbirth, with the menopause, with the onset of old age, or when the body becomes ill, and with the advent of death (Carvalho, ).…”

“…Mind is required to expand and change accordingly but often baulks at the challenge (see Romano, ). Each life event, crisis, illness or life stage will require the ego to reconfigure: illness, parenthood, the empty nest, menopause, middle age, old age, dying (Carvalho, ).…”

“…The effectiveness of Ferrari's approach in cases of severe pathology such as anorexia and in other ‘psychosomatic’ conditions, or psychosis, has been recorded in the Anglophone literature particularly by Lombardi in recent years (Lombardi, , , , , ). Otherwise, Ferrari's thought has found very little expression in English other than in Carvalho (, , ), although a translation by Isabella Ghigi of those parts written by Ferrari himself in three books edited by Ferrari appeared as From the Eclipse of the Body to the Dawn of Thought in 2004.…”

On deaths and endings; Psychoanalysts' reflections on finality, transformations and new beginnings

“…This failure in being able to mourn, or indeed being allowed to mourn, was very much the theme of a paper Richard Carvalho (2008) wrote for a conference on Mourning and melancholia in Florence in 2006, which was later published elsewhere but has relevance to the context for this review. Of relevance too is that the conference had been convened by the elderly Armando Ferrari, who shortly before the conference took place, died of a prolonged illness (2008, p. 2).…”