The Paradox Of Loss: Toward A Relational Theory Of Grief (Book Review)

Title:  The Paradox Of Loss: Toward A Relational Theory Of Grief
Author: McCabe, Marilyn
Publisher: New York: Praeger, 2003
Reviewed By: Henry Seiden, Fall 2004, pp. 56-57

One morning last week a 68-year-old woman patient of mine came to session needing to talk about an experience that Marilyn McCabe would understand. The patient is a widow who started therapy a year or so ago because she was having a hard time in the aftermath of the death of her husband. She had by now been feeling better. She had achieved some perspective on herself and on her loss. She had retired from a job she never liked and gotten her financial life in order (significantly for her, without the help of her husband who, throughout their life together, had handled the money). She’s found some interesting and useful social activities; she is happy at the birth of a first grandchild—a boy named for her husband.

But over the previous weekend she was cleaning out closets and opened the one that held her husband’s suits and his favorite, worn, baseball cap. She was hit by a wave of grief! She had thought she was over all that; she thinks (again) that maybe there is something wrong with her. I found myself reassuring her (yet again): no, there is nothing wrong with her; yes, this is the way loss is, it is never over. Marilyn McCabe would agree—more than agree. She would insist on it. The “relationship” with the lost love object endures; the pain of loss never goes away entirely.

Here are some of McCabe’s own words: ”It is clear that the tacitly accepted assumptions of prevailing grief theory detract from forming a more accurate and less rigid conception of actual grief experience. While the theories help organize a holding place with which to view grief, it is necessary to see that the construction of universal-type stages or phases and continuums of normality/abnormality is based on certain presumptions, and does not represent truth itself. Because the linear, take it or leave it (i.e., “holding on” versus “letting go”) models do not provide adequate explanation for the temporal or relational aspect of grief, they need to be revised (p. 74).”

The major burden of McCabe’s book is to argue with stage theories of grief, which medicalize grief as a temporary emotional disorder and which imply that in healthy grieving an end can be expected to come. No, says McCabe, not so. In the service of the promised “revision” of such theories, she offers herself as an example. And here is where the trouble with The Paradox of Loss lies. At the center of McCabe’s book—and one suspects, its entire raison d’etre—is a long central chapter devoted to an explication of her experience of losing her mother. She needs, she says, to tell her story. And tell it she does. She documents the terms of her loss, quotes extensively and in great detail from her journals and poems, (written over a five year period following her mother’s death) and she presents a phenomenological “analysis” of her own experience. The bottom line is the “paradox” of the title—despite the inconsolable loss, her mother has not gone away, they still have a “relationship.” Her mother is still there.

Ones heart goes out to McCabe! But the problem with the book is that it is framed as scholarly—studded as it is with references, quotes from, and citations of, anyone and everyone who has anything to say about the subject. While it is presented as social science, what it serves is the author’s wish and longing. It represents McCabe’s struggle to square the circle—to make her own deep emotional insistence reasonable and scientific. She is sometimes more, and sometimes rather less, successful.

In an early chapter McCabe takes on and does an exhaustive comparative analysis of stage and phase theories of grief and mourning, only to end up dismissing all of them as not adequate to addressing the ongoing and untidy way grief reactions, especially her own, tumble one on another and go on and on. This is actually the books strongest contribution: In my clinical experience with people in mourning, this is what grief looks like and feels like. Mourning is messy and, pace Kubler-Ross et al, it follows no good order. (Although it must be pointed out that this is so in all of our psychiatric rubrics—be it grief and mourning, or phobia, or schizophrenia, or learning disability or whatever. What is individual is idiosyncratic and matches only a little what one finds in the textbooks.)

But because the conclusion precedes the argument, much of what looks like scholarship in The Paradox of Loss isn’t really. The pile upon pile of citations adds up to an obsessive (and sometimes querulous) argument against anything which suggests we have to “let go” of those we mourn. Everything, says McCabe, which argues for a letting go is a “bias.” Indeed she devotes a chapter to such “biases,” listing among the villains those who, she says, see as “failures” those individuals “who are unwilling to give up their attachments to the dead” (p. 58). In this group she includes Bowlby, Freud, Kubler-Ross, and others.

The heart of the book—her account of her own story—is the biggest failure. Here the circle will not square. Because McCabe can’t or won’t see the forest (grief generally) for the trees (her own grief), her self-revelations are excessive, maudlin, and ultimately embarrassing. The chapter is painful to read because there is no enlightenment in it sufficient to justify the endless dwelling on the details of the agony. The “analysis” of her experience is just another kind of holding on. It’s as if one hears a child crying bitterly in these pages and there is no soothing to be offered. This is a bright child who should be amenable to reason: old people do have to die. But there’s no reason, no reasonableness she will listen to. There’s some reference to progress, after a year or two she is “feeling more hopeful,” but it’s hard to find much hopefulness in all this. Let me be clear: I do not deny McCabe her right to her feelings. Only why make a reader go through all this? What is being offered to make it worth it?

To be fair to her, McCabe struggles mightily, and leaves no reference behind, in her further attempts to square the circle. In the long chapter that follows her examination of her own diaries, she considers the co-constructedness of self and the impact of grief on the “dialogical” self. But because McCabe so badly wants to keep her mother alive in some symbolic form she keeps calling her process—and therefore the grieving process generally—a “relationship.” In doing this she risks doing a disservice to language and to clear thinking. Relationship with the dead as a metaphor makes sense; relationship in the literal way McCabe seems to want to mean it doesn’t—it’s a sentimentality. The closest to what she could mean (and, in her penultimate chapter, she does give some lip service to this) is a complex, necessary, internal representation that changes over time; but the changes are, all too obviously, coming from only one side of the exchange, from the self who imagines the selfobject. Regardless of the fact that we “talk” to the dead, and alas for us, they are only there in that, selfobject, sense. This is not a relationship in the way we usually mean the word—even though in the process of this “talking” the self may change too.

McCabe insists that all grieving is “relational.” There is the promise that this formulation will extend a concept that has much useful currency in psychoanalytic theorizing, i.e., that self is co-constructed, that we are who we are always in relation to an other, or to many others. That our grieving should be informed by and inform this condition makes perfect sense. When an important other is radically transformed or lost, we should be transformed as well. But how? This is an interesting question to which McCabe after much, much, wandering in the literature of psychology, psychoanalysis, anthropology and even selected contemporary literature, does suggest the beginning of an answer. Here’s what she comes up with:

“When someone dies, particularly someone we love, who has become a very real part of our selves, the ultimate paradoxical experience occurs. We cannot negate the reality of physical death. Nor can we deny the reality of the emotional loss caused by this physical annihilation. Yet paradoxically, not only in the first moment or the first months of the loss, but perhaps on and on for years to come, there is a presence of the person who has died. A remembrance of what was, in varying possible levels of concreteness and salience. And there is the reality of that person inside ourselves that contradicts the fact that he or she is no longer physically alive. There is both a presence and an absence, each seeming to illuminate the other (p. 154).”

So there it is: loss makes presence stronger; presence makes the loss harder to bear. Well, maybe yes. And certainly worth contemplating. But is this always so? And for everyone? I’m not so sure. I’m inclined to think that (as we say on the consulting room) it all depends. I lost my own mother recently and I loved her. But my mourning process has been nothing like McCabe’s.

Ultimately, because The Paradox of Loss is essentially an explication of her own experience, McCabe falls into the trap of thinking her experience is universal. There is an important lesson here for psychoanalysts. (Even though McCabe’s book is not psychoanalytic: not psychoanalytic because in all the discussion of her essential case material, her own experience, there is nothing about antecedent conditions. What were things like before her mother died? What was her childhood like? Was there no father? What were the terms of her “friendship” with her mother? Was there no ambivalence? No strain? No separation struggle? On all these questions, she is silent.)

The lesson for analysts is this. One of the great contributions of psychoanalysis, clinically, and to intellectual life generally, is to legitimize enlightened introspection as a source of understanding. As analysts we feel some confidence that we know what our patients are experiencing because we know such feelings in ourselves. But the other side of the coin is that we can never know for sure. We’ve learned to check and keep checking. Is your grief like my grief? Is your mother like my mother? Is your relationship with yours like mine with mine? McCabe fails to check—or doesn’t want to know.

Karen Zelan has written extensively on the psychology of children’s learning. She is the author of Between Their World and Ours:Breakthroughs with Autistic Children.

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