Pathological organizations as obstacles to mourning: the role of unbearable guilt

A patient is described who made moves to face his internal and external reality only to find that this put him in touch with an internal world in a horrific state. The horror resulted from his view of damaged and imprisoned objects which arose from the way his defences were organized into a pathological organization of the personality which controlled his objects with ruthlessness and cruelty. As he began to loosen his dependence on the organization and to face his internal situation, depressive anxieties became prominent and of these he found guilt particularly unbearable. In order to escape from guilt he retreated once more to the protection of the organization and it is this which prevented him mourning his lost objects. It is argued that it is in the process of mourning that lost parts of the self are regained and it is specifically this process which was interfered with by the pathological organization.