Abstract
This paper is about chronic illness and its impact on the chronically ill and their loved ones who live through the illness and the eventual death. A new concept is introduced, the concept of “passing”: physically ill people may pass as healthy even though they are physically ill. In addition to a discussion about why people choose to pass, two major paradoxes are considered. One concerns the paradox that results from “passing.” The paradox is that while the falseness of “passing” keeps the self alive, it also deadens it before death. Specifically, “passing” enables the person with a physical illness to keep his well self alive with others, but results in one feeling dead, disconnected, detached, and inauthentic, before death. The second paradox involves the pressure on the chronically ill person to be heroically agentic in fighting the illness and overcoming it and, also, the pressure for this same person to be totally submissive and compliant with treatment. While in analytic treatment, the ill person can be helped to access authentic emotions and aliveness and to feel the power of authenticity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alpert, J.L. (2007). Passing is an option while dissociation is a given. Presidential Address, Division 56, presented at the Convention of the American Psychological Association, August, San Francisco, California.
Altman, N. (2005). The analyst in the city: Race, class, and culture through a psychoanalytic lens. New York: Relational Perspectives Book Series.
Bauby, J.D. (1997). The diving bell and the butterfly. New York: A. A. Knopf.
Becker, E. (1973). The denial of death. New York: Simon & Schuster.
Boulanger, G. (2007). Wounded by reality: Understanding and treating adult onset trauma. Hillsdale, NJ: The Analytic Press.
Brody, J. (2004). A doctor's duty, when death is inevitable. The New York Times (Health section), August 10.
Bromberg, P. (1993). Standing in the spaces: Essays on clinical trauma and dissociation. New Jersey: Analytic Press.
Dreiser, T. (1925). An American tragedy. New York: Boni & Liveright.
Fitzgerald, S.F. (1925). The great Gatsby. New York: Charles Scribner's Sons.
Freud, S. (1912). Recommendations to physicians practising psychoanalysis. Standard Edition (Vol. 12, pp. 109–120 ). London: Hogarth.
Goldman, D. (2007). Faking it. Contemporary Psychoanalysis, 43 (1), 17–36.
Grand, S. (2000). The reproduction of evil: A clinical and cultural perspective. Hillsdale, NJ: The Analytic Press.
Grand, S. (2007). Reflections on intentionality, powers, and the mask: Discussion of papers by Margaret Crastnopol and Dodi Goldman. Contemporary Psychoanalysis, 43 (1), 37–46.
Groch, J. (2004). The person who was inside the patient, but the doctors never met him. The New York Times, July 6, p. F5.
Hellman, B. (2007). Seizing perfume, propped by paradox. Psychoanalytic Dialogues, 17 (4), 39–45.
Herman, J. (1992). Trauma and recovery. New York: Basic Books.
Hurvich, M. (1991). Annihilation anxiety: An introduction. In H. Siegel, L. Barbanel, I. Hirsch, E. Lasky, H. Silverman & S. Warshaw (Eds.), Psychoanalytic reflections on current issues (pp. 135–154). New York: New York University Press.
James, H. (1881). Portrait of a lady. London, UK: Macmillan and Co.
Kohut, H. (1984). How does analysis cure? Chicago, IL: University of Chicago Press.
Krystal, H. (1985). Trauma and the stimulus barrier. Psychoanalytic Inquiry, 5 (1), 131–161.
Kübler-Ross, E. (1969). On death and dying. New York: Simon & Schuster.
Lacan, J. (1977). Ecrits. A. Sheridan (Trans.). London: Routledge.
Lang, J.M. (2004). Learning sickness. Virginia: Capital Books.
Laub, D. & Auerhahn, N.C. (1993). Knowing and not knowing massive psychic trauma: Forms of traumatic memory. International Journal of Psycho-Analysis, 74 (2), 287–302.
Murphy, R. (1990). The body silent. New York: Henry Holt.
Ogden, T.H. (1983). Reverie and interpretation: Sensing something human. Northvale, NJ: Jason Aronson.
Parsons, T. (1958). The social system. London: Routledge.
Rimmon-Kenan, S. (2002). Narrative fiction: Contemporary poetics. London: Routledge.
Roth, P. (2001). The human stain: A novel American trilogy. New York: Houghton Mifflin.
Rothenberg, L. (2003). Breathing for a living: A memoir. New York: Hyperion.
Schmitt, E.E. (2003). Oscar and the lady in pink. New York: Other Press.
Shengold, L. (1989). Soul murder: The effects of childhood abuse and deprivation. New Haven, CT: Yale University Press.
Slochower, J. (2006). Psychoanalytic collisions. Hillsdale, NJ: The Analytic Press.
Stolorow, R. (2008). The contextuality and existentiality of emotional trauma. Psychoanalytic Dialogues, 18 (1), 113–123.
Author information
Authors and Affiliations
Corresponding author
Additional information
A version of this paper was presented at the Institute of Contemporary Psychoanalysis, Los Angeles, on July 11, 2009.
1Ph.D., Professor, Department of Applied Psychology, New York University (NYU); Co-Director, Trauma & Violence Transdisciplinary Studies Program, New York University; Faculty & Supervisor, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis.
Rights and permissions
About this article
Cite this article
Alpert, J. Loss of Humanness: The Ultimate Trauma. Am J Psychoanal 72, 118–138 (2012). https://doi.org/10.1057/ajp.2012.8
Published:
Issue Date:
DOI: https://doi.org/10.1057/ajp.2012.8