Freud's Jaw and Other Lost Objects: Fractured Subjectivity in the Face of Cancer by Lana Lin
Freud's Jaw, which adapts Melanie Klein's theory of early childhood development to the experience of cancer, offers a new and compelling way to view cancer's impact on survivors. Psychoanalytic readers will be familiar with Klein's formulation of the paranoid-schizoid and depressive positions, which she posits as necessary stages in the infant's creation of an inner world. What they may be surprised to discover is how useful Klein's theory is in thinking about the challenges of later life, including those of illness and loss. Lin grasps the larger implications of Klein's theory and extends it into a profound meditation on mourning.
Klein assumed that infants perceive the world initially in terms of "good" and "bad" objects, the mother's breast representing both, based on whether it is perceived as satisfying or frustrating. Unable to tolerate their destructive feelings towards the "bad" breast, infants split this awareness off into the fantasy of an external persecuting force. In other words: "I do not hate my mother's breast; it hates me." At a later stage of development, the infant becomes aware of its capacity for greed, envy, destructiveness, and rage. This leads to the so-called "depressive" position, in which the infant feels guilt and regret about these impulses, along with a desire to make amends. Klein understood the capacity to tolerate inner conflict and ambivalence (hence the achievement of the depressive position) as essential to human development.
Once highly controversial, Klein's ideas have gained increasing acceptance over time, due in part, I would say, to a growing awareness of the power of hatred and rage on the global stage. Much of humanity now seems immersed in a paranoid-schizoid type of mentality, rather than one of ambivalence, tolerance, or recognition of the need for reparation. In this [End Page 649] sense, Klein intuited the implications of Freud's formulation of the "death instinct." Freud's emphasis on the life-giving pleasure principle in his early writings gave way in later life to a more sober realization of the forces within us that lead to death and dissolution.
We know much about the losses of Freud's later years but little about how he may have felt about them. His best beloved daughter Sophie died of influenza in 1920, and his favorite grandson Heinele in 1923, the same year that Freud was diagnosed with cancer of the jaw. This sixteen-year ordeal involved numerous surgical interventions and the use of an unwieldy prosthesis, which caused difficulties in speaking and eating. Ill and in constant pain, he consented in 1938 to leave Vienna for London, where he died on September 23, 1939, less than a month after Hitler's invasion of Poland. One cannot help but wonder how Freud withstood the succession of losses of his final years.
Lin's first chapter focuses on Freud's experience of cancer of the jaw, the devastations it wreaked on him, and the adjustments he made to it as a means of repairing its assault on his life and sense of personal integrity. Central to her argument is Klein's understanding that major loss can reanimate the conflicts we experience in the very first months and years of our existence. In "Mourning and its Relation to Manic-Depressive States" (1940/1986), Klein wrote movingly about the impact of grief and the work of mourning in later life.
The pain experienced in the slow process of testing reality in the work of mourning thus seems to be partly due to the necessity, not only to renew the links to the external world and thus continuously to re-experience the loss, but at the same time and by means of this to rebuild with anguish the inner world, which is felt to be in danger of deteriorating and collapsing. Just as the young child passing through the depressive position is struggling, in his unconscious mind, with the task of establishing and integrating his inner world, so the mourner goes through the pain of re-establishing and re-integrating it.(p. 156) [End Page 650]
Experiences of loss and mourning work to undo the difficult process of integration we labor to achieve in the earliest phases of our development, requiring a re-negotiation of them in order to arrive at a new sense of internal coherence and well-being. While this insight might apply to any experience of major loss, Lin relates it specifically to the trauma of cancer.
Cancer, she tells us, undoes the precarious sense of wholeness we achieve in the process of growing up. She states:
Cancer could be said to be ego-dystonic in the sense that it works against the ideally integrated, totalizing ego, opposing Ernest Jones' definition of ego-syntonic tendencies as those that are "consonant, compatible, and consistent with the standards of the self." Trauma, such as cancer, can unmoor the ego and self-object, producing the disconcerting feeling that a foreign object has intruded upon the ego.(p. 5)
The diagnosis of cancer (or any other life-threatening illness) challenges our hard-won sense of who we are. More than other diseases, cancer feels like an alien invasion, re-animating perhaps our earliest childhood fears of persecution. "Physical calamity," Lin states eloquently, "shatters the sensation of unity with oneself, resulting in the experience of an alien version of oneself intruding upon oneself" (p. 5). But this is not the end of the story. We are not doomed to repeat the paranoid schizoid position without release, as if trapped in one of Dante's circles of Hell. In returning to this earlier stage of development, we may also find new ways of integrating ourselves and our experiences that are reparative for ourselves and for others who are important to us. Cancer, Lin maintains:
not only complicates the ideal of wholeness in which people are physically and psychically invested, but it also unveils the unwanted knowledge that from the outset we have never been entirely whole, a knowledge that most of us repress in order to function from day to day. In short, cancer shows the hole in the whole. It lays bare the illusory aspects of our feelings of bodily stability [End Page 651] and the unconscious assumption that our bodies and psyches are and will remain invulnerable to disrepair. The subjects I investigate are in the process of devolving into fragmented partial objects and must devise means to reinstate, at least temporarily, their physical and psychic unity. This, I propose, is accomplished through creative reparative projects such as love or writing.(p. 2)
Lin sees Freud's lifelong project of collecting antiquities as one major aspect of his effort to connect himself with the past, hence stabilizing himself in the present, while assuring himself of his place in the history of Western culture. These "part objects," along with his writing, offset and helped to repair the damage incurred by his oral cancer and the pain he suffered as a result.
Moving forward in time, Lin considers the work of poet Audre Lorde, whose groundbreaking Cancer Journals (1980) opened the subject of women's experiences of their bodies to emotional and theoretical discourse. Lorde, she maintains, made use of her personal experience not only to address the subject of women's physical reality but also to challenge received notions of female sexuality and femininity. A pioneer of the Women's Movement of the 1970s and 1980s, Lorde altered the landscape of Queer, Black, and Feminist discourse. She lived with her breast cancer diagnosis (and treatment for metastases) for fourteen years, demonstrating by her survival that cancer is less of an ending than a beginning.
In her essays and poetry, Lorde wrote fiercely about her body, countering the euphemizing medical rhetoric of the time and exhorting other women to follow her example. Eve Kosofsky Sedgwick, a leader of the Queer Studies movement, followed Lorde's example in confronting the fact of her illness directly and sharing her insights with her readers in a series of "advice" columns titled "Off My Chest," and her last book A Dialogue on Love (1999). Sedgwick speaks to the reader in a blend of essay, poetry, and memoir about the transformations she experienced as a result of her protracted illness. Both women treat their suffering as a stimulus to mourning and reparation, involving a recreation of themselves, their relationships to cherished others, and to their readers. Summarizing [End Page 652] her conclusions, Lin states that "mourning can be a creative form of care, and the work of mourning a labor of care" (p. 153).
Lin's argument is theoretically sophisticated and occasionally hard to follow, but her emphasis is clear. Like Klein, she regards mourning as an essential element in psychic development. Deepening Klein's insights, she applies her radical theory to the trauma of cancer. Like Lorde and Sedgwick, Lin was prompted by a personal cancer diagnosis to explore the particular kind of devastation it wreaks and to extend her meditation to other kinds of loss we endure throughout our lives. She concludes:
our narratives, our bodies, and our lives consist of discontinuous parts that are loosely held together and that may not add up to a coherent, self-contained whole. We are held together by something that is not quite ourselves, or not only ourselves. We are held together by our desires to connect to and be connected with others, perhaps by the love we feel for and from objects.(p. 147)
Cancer, once a taboo subject, is now out in the open and available for scrutiny by its most intimate observers—those who have experienced it. By current statistics, one in three people in the developed world will receive a cancer diagnosis during their lifetime, while one in eight women in the United States will be diagnosed with some form of breast cancer. What this means is that most of us know someone who has undergone or will undergo this experience—if not ourselves then a member of our family or within our network of friends. I, myself, have had two non-breast related experiences with cancer—each independent of the other. None of us knows what the future may hold.
Lin has provided an important insight into the ways that we strive to feel coherent and whole and how our efforts keep coming undone. Instead of reading this prospect as tragedy, she sees it as a means of expanding our awareness of ourselves and reaching out to others through the work of love and reparation. Klein's discourse, she affirms: [End Page 653]
is rooted in mourning. By her account, mourning is a creative process that enables survival [. . .] The depressive position is achieved through the mourning of loss, which is bound up with the attempt to make reparations. Creativity coincides with the desire to repair the damaged objects and make good the injuries inflicted.(p. 77)
Lin's final chapter considers the ways that the two extant Freud museums: Bergasse 19 in Vienna and Maresfield Gardens in London, constitute a cultural attempt to cope with the loss of Freud himself as the founder of psychoanalysis. Neither can represent him adequately, but by their very incompleteness (full of randomly ordered antiquities or empty of them) they remind us of our struggles to maintain a sense of provisional integrity in the face of loss and hence our own lifelong labors of mourning. [End Page 654]
Madelon Sprengnether is a poet, memoirist, and literary scholar. She is Regents Professor Emerita of the University of Minnesota. Her publications include The (M)other Tongue: Essays in Feminist Psychoanalytic Interpretation (Cornell University Press, 1985), Shakespearean Tragedy and Gender (Indiana University Press, 1996), and The Spectral Mother: Freud, Feminism and Psychoanalysis (Cornell University Press, 1990). In addition, she has published three memoirs and three collections of poetry. Her most recent books are Great River Road: Memoir and Memory (New Rivers Press, 2015), Near Solstice: Prose Poems (Holy Cow! Press, 2015), and Mourning Freud (Bloomsbury Academic, 2018). She is also a regular blogger for Psychology Today.