As stated earlier, man is in a continuous process of splitting between life and death, trying to get as far away from the idea of death, always considering that it is the other who is going to die and not him. It configures then, a situation in which the man defends himself by segregation.
This fact is confirmed by Mannoni (1995): "Our societies today, defend themselves from disease and death through segregation. There is something important there: the segregation of the dead and the dying goes hand in hand with that of the elderly, indocile children (or others), deviants, immigrants, delinquents, etc."
According to Torres (1983): "Western society does not know what to do with the dead. An intense or intimate terror presides over the relationships she intervenes with these 'strangers' - bodies that suddenly stopped producing, stopped consuming - masks that do not respond to any appeal and resist all seductions."
The author goes on to speak of this segregation at another time, when she says that it takes place through the rejection of the dying person. Some mechanisms that try to deny or cover up the reality of death are triggered in this process.
The medical team in charge of terminally ill patients, most of the time, cannot work out the possible death or concrete death of their patients. In general, physicians and support staff are quite unprepared to deal with death, failing to accommodate the patient and his family.
According to Mannoni (1995) two processes can occur with the attendant in relation to the patient. One of these processes would be idealization, in which there would be a sacralization of the patient, as if he were protected from the forces of destruction. Another process would be denial, in which there would be a refusal of the death situation, an avoidance on the part of the attendant. This behavior prevents the reception of bereaved family members.
The medical team experiences the death of a patient as a failure, putting medical omnipotence to the test. Also according to Mannoni (1995): "it is because death is experienced as a failure by medicine that medical services come to forget the family (or to hide from it)."
According to Kübler-Ross (1997): "When a patient is seriously ill, he is usually treated as someone without the right to an opinion."
The author questions whether the fact that doctors assume the will of the patient in a serious condition would not be a defense against "... the embittered face of another human being reminding us, once again, of our lack of omnipotence, our limitations, our failures and, last but not least, our own mortality?"
For the author, the concern of science and technology has been to prolong life and not to make it more human. And she goes on talking about her will as a doctor: "if we could teach our students the value of science and technology, teaching for a while, the art the science of human interrelationship, of human and total patient care, we would feel a progress real."
Within this humanity in caring for the terminally ill, Kübler-Ross (1997) tells us about the importance of the doctor's care for the sick, the importance of truth. The author questions not to tell the truth or not, but how to tell this truth, approaching the patient's pain, putting yourself in his or her shoes to understand his suffering. That would be the true human availability to help the other on their way towards death.
Despite the importance of the truth, the patient is not always able to hear it, precisely because he stumbles on the idea that death also happens to him, and not just to others.
In his research with terminal patients, Kübler-Ross (1997) identified five stages when the patient becomes aware of his terminal stage. The first stage is denial and isolation, a phase in which the patient defends himself from the idea of death, refusing to accept it as reality. The second stage is anger, when the patient puts all his anger at the news that his end is near. At this stage, the patient often becomes aggressive with the people around him. The third stage, bargaining, is a time when the patient tries to behave well, in the hope that this will bring him a cure. It's as if this good behavior or any other philanthropic attitude brought extra hours of life. The fourth stage is depression, a phase in which the patient withdraws, experiencing an enormous sense of loss. When the patient has an elaboration time and the acceptance described above, he will reach the last stage, which is acceptance.
But it is not only terminal patients who cause discomfort by referring us directly to the issue of death. The elderly also bring us the idea of death and it is not without reason that this happens. With the progress of science in combating mortality, the association between death and old age has become ever greater. According to Kastembaum and Aisenberg (1983), this event relegates death to the background, something that only happens to the other (old person). According to Mannoni (1995), the elderly refer us to a degraded and degraded image of ourselves, and it is from this unbearable image that segregation comes, as discussed above.
Considering the association between old age and death, what is created, according to Torres (1983), is a narcissistic society completely focused on youth. There is no place for old age. A consequence of this is that "... elderly people in general do not want to become aware that they are old, nor do they want to seek guidance to That would be like giving yourself a death sentence in a society whose space of death is in White.
The existing segregation in relation to the elderly makes them at the mercy of the social sphere. In many of the cases, there is a concrete separation of the elderly, who are placed in nursing homes and nursing homes. Mannoni (1995) criticizes these places quite intensely, saying that institutions for the elderly often reveal abysses of inhumanity and loneliness.
For man, a creature unable to accept his own finitude, it is not easy to deal with a prognosis of death. Deep down, the great fear of death is the fear of the unknown.
Freud (1914) tells us that the death of a loved one revolts us because this being takes with him a part of our own beloved self. And he goes on to say that, on the other hand, this death also pleases us because, in each of these loved ones, there is also something strange.
There arises ambivalence, which are simultaneous feelings of love and hate, and are present in all human relationships. In these relationships, the desire to hurt the other is frequent and that person's death may be consciously desired. That's why, often, when the other dies, the person who wished to do so can keep one feeling of guilt difficult to bear and, to alleviate this guilt, remains in an intense mourning and prolonged.
For psychoanalysis, the intensity of pain in the face of a loss is narcissically configured as the death of part of oneself.
the mourning
The mourning is no longer experienced as in the past and, most of the times, the mourners experience the pain of loss in loneliness, as the people around them prefer to keep the fear of death away from them. What is currently required is the repression of the pain of loss, instead of the once-usual manifestations. Mannoni (1995) tells us about this process: "Today it is no longer so much about honoring the dead, but about protecting the living who are confronted with the death of their own."
The rites, so essential, have become inconvenient in our sanitized society, as has death itself. Today, funerals are quick and simple. Symbols are eliminated, as if it were possible to eliminate the reality of death or trivialize it. But there is no way to erase the presence of the absent being, nor the necessary mourning process. So that the death of a loved one does not take obsessive forms in the unconscious, it is necessary to ritualize this passage.
According to Freud (1916), "Grief, in general, is the reaction to the loss of a loved one, to the loss of some abstraction that took the place of a loved one, such as the country, freedom or the ideal of someone, and so on. "And he goes on to say that normal grief is a long and painful process, which eventually resolves itself when the bereaved finds replacement objects for what has been lost.
For Mannoni (1995), following Freud's interpretation, "the work of mourning thus consists of a divestment of an object, which is more difficult to renounce as a part of oneself sees itself lost in it."
According to Parkes (1998), mourning the loss of a loved one “involves a succession of clinical conditions that mix and replace each other... numbness, which is the first phase, gives way to longing, and this gives way to disorganization and despair, and it is only after the disorganization phase that recovery takes place.”
The author goes on to say that "the most characteristic feature of grief is not deep depression, but acute episodes of pain, with a lot of anxiety and psychic pain."
In the face of death, the conscious knows who has lost, but it still does not measure what it has lost. Why does unfulfilled grief lead to melancholy, a pathological state that can last for years and years?
For Freud, (1916) some people, when going through the same situation of loss, instead of mourning, produce melancholy, which provoked in Freud the suspicion that these people have a disposition pathological. To justify this premise, the author made a series of comparisons between grief and melancholy, trying to show what psychically occurs with the subject in both cases
In grief there is a conscious loss; in melancholy, one knows who has lost, but not what has been lost in that someone. "Melancholy is somehow related to an object loss withdrawn from consciousness, as opposed to mourning, in which there is nothing unconscious about the loss."
The author also talks about the melancholic, who experiences the loss, not of the object as in mourning, but as a loss related to the ego. "In mourning, it is the world that becomes poor and empty; in melancholy it is the ego itself. The patient represents his ego to us as if he were devoid of value, incapable of any achievement and morally despicable..."
The key to the melancholic clinical picture is the perception that "... self-recriminations are recriminations made of a loved object, which have been shifted from that object to the patient's own ego."
In this regard, Mannoni (1995) also tells us: "Somewhere there is, there, an identification with the lost object, to the point of making itself, as an object (of desire), an abandoned object."
Still quoting Freud, (1916) the melancholic can present characteristics of mania. "...the maniac clearly demonstrates his release from the object that caused his suffering, seeking, like a man voraciously hungry, new object cathexes." That is, there is an indiscriminate search for other objects in which the individual can invest.
What could be said after all is that the melancholy person puts himself to blame for the loss of the loved object.
There is a period considered necessary for the bereaved person to go through the experience of loss. This period cannot be artificially prolonged or reduced, as mourning takes time and energy to be worked through. It is usually considered - without taking this as a fixed rule - that the first year is very important for that the bereaved person can go through, for the first time, significant experiences and dates, without the person who he died.
In Jewish burial rituals, excessive expenses with funerals are prevented so that, with this, no family feelings are compensated or hidden. Kriyah (the act of tearing clothes) is like a catharsis. Right after the funeral, family members have a meal together, which symbolizes the continuity of life. Mourning is established in stages: the first stage (Shiva) lasts seven days and is considered the most intense stage, in which the person has the right to gather with his family and pray for the dead. The second stage (Shloshim), which lasts thirty days, is intended to establish a longer period for the elaboration of mourning. The third stage, on the other hand, lasts a year and is designed mainly for children who have lost their parents. Finally, Jewish mourning is characterized by phases that favor the expression of pain, the elaboration of death and, finally, the return of the mourner to the life of the community.
For each bereaved, their loss is the worst, the most difficult, because each person is the one who knows how to scale their pain and their resources to face it. However, there are many factors that come into play when it comes to assessing the bereaved person's condition, their resources to cope with the loss, and the needs that may present themselves.
Grief for the loss of a loved one is the most universal and, at the same time, the most disorganizing and frightening experience that human beings experience. The meaning given to life is rethought, relationships are remade based on an assessment of its meaning, personal identity is transformed. Nothing is like it used to be. And yet there is life in mourning, there is hope for transformation, for a new beginning. Because there is a time to arrive and a time to leave, life is made up of small and large mournings, through which the human being becomes aware of his condition of being mortal.
BIBLIOGRAPHY
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FREUD, Sigmund. "Dreams of the Dead". Brazilian Standard Edition of the Works
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KATENBAUM, Rua and AISENBERG, R. “Psychology of death”. Publisher of
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