Adolescent mourning: A paradigmatic case report

Adolescent Psychiatry, 2000 by Garber, Benjamin

The mourning process in the adult and the child has been studied extensively, but that in the adolescent has been neglected. This paradigmatic case report illustrates the many ways in which an adolescent girl mourned the loss of her father. She dealt with the loss by escaping, trying to appear overly normal, overinvesting in siblings and peers, acting hypermature, acting out, identifying with the dead parent's ambitions, hopes, and aspirations, and searching restlessly. Mourning in adolescence is unpredictable and does not conform to any consistent clinical pattern.

Although the mourning process in the adult has been studied extensively, and the episodic mourning work in the child has been delineated, the mourning process in the adolescent has been relatively neglected (Furman, 1974). This has been a puzzling omission in the psychiatric and psychoanalytic literature. As the parents of adolescents are at least middle-aged, adolescents experience parent loss (Ewalt and Perkins, 1979). Whether one sees adolescence as a period of turmoil (A. Freud, 1958; Blos, 1962) or as a developmental period of normative dimensions (Offer, 1969), the adolescent's reactions to losing a parent have been alluded to but not thoroughly explored. Ever since Anna Freud (1958) described a type of mourning process as part and parcel of normal adolescent development, psychoanalytic researchers have felt that the study of mourning in adolescence as a result of parent loss would be a complex and daunting task. The clinician would be compelled to examine two intertwined mourning experiences-one an aspect of normal development, the other a product of a traumatic event. To separate the two might prove exceptionally difficult.

The purpose of this chapter is to explore and demonstrate the various facets of a delayed mourning process in an adolescent girl who was in analysis for four years. Although the adolescent's mourning may contain elements of latency and adulthood, there are manifestations unique to adolescent development.

Review of Pertinent Literature

Root (1957) spoke of the work of mourning as an important psychological task of adolescence. This accounts in part for the seemingly larger number of depressive states occurring during this developmental period. Adolescents have a normal and healthy need to remove themselves from both parents to stop being dependent and to become more self-sufficient as they proceed on the pathway to mature adulthood. This "object removal" continues ambivalently into adulthood and ushers in a mourning process described by Sugar (1968) and is modeled along the sequential phases of mourning delineated by Bowlby (1960). Blos (1962) indicated that the object loss that adolescents experience in relation to the parent of their childhood, a loss in relation to the parent image, contains prominent features of mourning and that this adolescent loss is more final and irrevocable than the one that occurs at the end of the oedipal phase. Jacobson (1964) felt that, in the process of decathecting the infantile image of the parents, the adolescent experiences an intensity of grief unknown in previous developmental phases.

Laufer (1966) thought that parent loss in adolescence could become a prominent obstacle to normal development. Although the parental death itself is not necessarily pathogenic, object loss can become the nucleus around which earlier conflicts and latent pathogenic elements are organized. Laufer concluded, "The extent to which the work of mourning will interfere with normal adolescent tasks is determined by the kind of defenses that are available to deal with the oedipal ambivalence and by the quality of the relationship to the object" (p. 269). Wolfenstein (1966, 1969) arrived at a series of far-reaching conclusions about adolescent mourning based on her work with 42 cases of parent loss. She felt that, in those instances in which depressed moods emerged in adolescence, they were isolated from thoughts of the parent's death, thoughts to which reality testing has not yet been applied. She felt that the representation of the lost object was not decathected, that indeed it had become invested with an intensified cathexis. The adolescent idealizes the dead parent, and the rage is diverted toward the surviving parent. In time, reproachful feelings toward the abandoning parent emerge, and this ambivalence may represent the initial step in reality testing.

Nagera (1970) suggested that adolescents shy away from the type of mourning that one sees in adults. Their overt behavior and response to the loss are significantly different from that of the adult. Yet, they are greatly affected by the loss and react in strong and specific ways of their own.

Most psychoanalytic researchers conceptualize adolescence as a period of significant turmoil, and so they see bereavement as an interference with normal development. However, nonclinical descriptive studies of adolescents (Offer and Sabshin, 1984) conclude that, by and large, good coping and smooth transition into adulthood are much more typical than the opposite. In a parallel manner, there is an extensive descriptive literature that concludes that coping with bereavement during adolescence leads to greater maturity. Rather than producing insurmountable obstacles to development, the trauma of bereavement more often promotes growth (Hogan and Greenfield, 1991; Oltjenbruns, 1991). Although bereaved children and adolescents are expected to grow up more quickly, these discrepancies in the literature stem from observations from differing vantage points.