Rethinking pathological mourning: multiple types and therapeutic approaches

Different types of pathological mourning are discussed, with the idea that refining psychoanalytic nosology in this sector can contribute to the enhancement of interventions more suitable for each. Primary fixation to the object--extant before the loss--is differentiated from secondary fixation, which occurs when suffering in the present leads to idealization of an object that is only then felt to be actually lost. The role of narcissism, guilt feelings, and paranoid anxieties in the process of pathological mourning is considered. Clinical material illustrates some of these conditions.