The Linking Objects

of Pathological Mourners
Vamik D. Volkan, MD, Charlottesville, Va

A study of adults involved in pathological response to the death of a griefing. The long-term observation possible in the case of
loved/hated person discloses the use of controllable symbolic ob- these eight patients permitted extended assessment of
jects to perpetuate the link with the dead individual. Although resem- their reactions to death and the part grief played in their
bling in some respects fetishes, transitional objects, and inherited psychiatric difficulties. The rest of the group of 55 were,
items that are simply valued and put to appropriate use by a mourn-
with few exceptions, inpatients averaging between 30 and
er, they are sufficiently specific in their function of maintaining psy-
40 days of hospitalization during which they were treated
chophysical balance in the face of loss to be differentiated as unique
entities. An externalization process is suggested by which linking ob- by psychiatric residents under the supervision of the in¬
jects provide a focal point in which the self-representation of the vestigators. The age range of the patients, who were of
mourner merges with that of the dead person, and in which the pain- both sexes, was from 17 to 45.
ful work of mourning and ambivalent object relationship can be ac- Reactions to loss can be seen as distributed along a
commodated. spectrum. Engel6 suggested that uncomplicated grief ap¬
pearing at one end of the scale might be classified as an
illness since it has a discrete syndrome with relatively pre¬

STUDIESdepartment
1 atric
disclosed the
conducted since 1966 in the psychi-

adoption
of the University of Virginia have
and use of inanimate objects by
dictable symptomatology. Bowlby7 described three phases
of mourning. Parkes8 amplified the scale to include four
phases—numbness, yearning (to recover the lost object),
pathological mourners. These studies defined the phenom¬ despairing disorganization, and, finally, behavioral reor¬
enology of pathological grief in adults, recorded the im¬ ganization.
pact of "known" loss and the attempted restitution that On the other end of the scale from uncomplicated grief
followed it, and assessed the effectiveness of a brief psy¬ appears that reaction to loss which has turned into a de¬
chotherapy of "re-grief work" for pathological mourners.1-5 pression or other identifiable neurotic, psychosomatic, or
psychotic clinical entity so that the clinical diagnosis of
The Recognition and Description of Linking Objects pathological grief reaction is inappropriate. I have at¬
tempted3·4 to show that between these two extremes lies
The data for this report come from a study of 55 pa¬ the clinical entity of pathological grief, with predictable
tients whose diverse symptoms had appeared on the clini¬ symptomatology, a psychodynamic constellation, and
cal level at the time of the loss of a loved/hated person, characteristic findings. Among these findings was the typ¬
immediately following the loss, or on the anniversary of ical use of certain objects by pathological mourners, most
its occurrence. Sixteen of the 55 patients were treated in of whom were aware that they had invested the objects
re-grief therapy of four or five weekly sessions for three with symbolism but unaware of just what was being
or four months, with follow-up according to the patients' symbolized.
availability. Seven of the 55 went into psychoanalytic psy¬ These objects can be placed in four categories, with
chotherapy on the basis of two or three visits a week, and some overlapping in classification: (1) objects which had
one went into a successful psychoanalysis after his re- been worn by the deceased, like a dress, a watch, a ring, or
forpublication Sept 20,1971.
eyeglasses; (2) objects which had not been worn (in the
Accepted usual sense) by the dead but which could be viewed in the
From the Department of Psychiatry, University of Virginia Medical
School, Charlottesville. psychoanalytic sense as an extension of their bodies, like a
A preliminary version of this paper was read before the fall meeting of camera—an extension of visual intake; (3) objects with
the American Psychoanalytic Association, New York, December 1970.
realistic or symbolic resemblance to the deceased, often a
Reprint requests to Department of Psychiatry, University of Virginia
Medical School, Charlottesville, Va 22901 (Dr.Volkan).n photograph; and (4) objects at hand when the news of the

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 death came, or present at the funeral—things that could This process of searching for the deceased is unconsciously
be considered "last minute objects" related to the last mo¬ intensified, and it is habitual and specific enough to be
ment in which the deceased was seen as alive. called a mechanism of defense-defense mainly against
The objects to which the pathological mourners clung the tension of ambivalence and the eruption of derivatives
had no common physical characteristics such as softness, of those aggressive and libidinal drives originally directed
color, or odor. They were not put to use in the way for toward the deceased.
which they had been designed. A watch previously belong¬ The introject of the deceased is kept as his represen¬
ing to a dead person, for example, was never worn, but tation like a foreign body within the mourner, who contin¬
kept in a drawer. One patient did shave at times with his ues to have a conflictual relationship with it. Three of our
dead father's electric shaver, which had become a linking patients actually referred to a foreign body in the chest;
object, but he did so only with great anxiety. He did not during re-griefing they exhorted it to leave them, shout¬
regard it as a serviceable tool, and was unable to clean it ing, "Get out! Get out!" A detailed account of this appears
after use, fantasizing the merging of hairs from his face elsewhere.5 If the boundaries of this foreign body dis¬
with those from his father's.5 appear, and it melts into the rest of the patient's person¬
Linking objects are jealously protected. One patient ality, we speak of identification with the deceased. Some
kept his murdered sister's identification bracelet hanging identification may be adaptive, some may be symptomat¬
from the sun visor of his car, and when the car was demol¬ ic. Total identification does not occur in the typical patho¬
ished in an accident this was the only thing he saved, go¬ logical mourner, as Pollock13 also demonstrated. As Abra¬
ing to great lengths to retrieve it from the wreck. The ham14 said long ago, the purpose of identification is "to
linking object must be available to be looked at or to be preserve the person's relation to the lost object." The pa¬
touched whenever the unconscious need arises, but physi¬ tient may be so convinced of the persistence of the dead
cal distancing from it is always possible. In some cases it person within himself that he engages in continual inner
must be avoided, although the patient requires reassur¬ conversations with him. One patient, whose brother had
ance of its availability. The man who kept the watch in a drowned, not only reviewed conflictual issues in these in¬
drawer, for example, had arranged for it to be out of sight ner conversations, but even sought from the introject (his
but within reach. One patient used his father's broken brother's) advice about his daily affairs.
cameras as linking objects. They hung for 14 years after Temporary identification with the deceased also occurs
the death in a clothes closet where the patient could in pathological grief through merging, as Schäfer15 de¬
glimpse them each morning as he dressed. The linking ob¬ scribed it. His view showed merging with another to be
ject characteristically exerts an eerie fascination for the essentially a phenomenon of the primary process which,
mourner. One of our patients demonstrated this by lock¬ like other primary process phenomena, may be repre¬
ing himself in a room and gazing at his dead father's pic¬ sented consciously in spite of its being more customarily
ture until he sensed his reincarnation. an unconscious experience.
In these ways linking objects are clearly differentiated
Approaches to complete merging of subjective self and object
from inherited items simply put to appropriate use. One are evidenced by a high degree of fluidity or ambiguity in local¬
who has completed his mourning successfully may, for ex¬ izing attributes and experiences in the subjective self or the ob¬
ample, wear a ring previously worn by the deceased, and ject, as if self and object freely substitute for each other, as if in¬
be able to do so without anxiety, feeling no undue com¬ terest in individuation has been pretty much suspended, and as if,
pulsion to protect it, and no conflict between a desire to ultimately, it is undifferentiated unity that is experienced or
see it and a wish to keep it out of sight. In this case, the sought rather than the relation of one person to another.
ring would not be a linking object but a keepsake, the dif¬ The clinical difference between relating to an introject
ference lying in that indefinite area between the patho- · and actually merging with the deceased is clear. The in¬
logical and the normal. The more ambivalent the relation¬ troject is regarded as if it had existence of its own. In
ship with the one who died had been, the more likely it is merging, however, the mourner loses awareness of his dif¬
for something inherited to become a linking object. ferentiation from the one he mourns, in a total but tempo¬
Theoretical Considerations rary identification with him. This transient experience is
usually abrupt, and many patients have spontaneously
An extensive review of the literature on the psy- used the word "merging" in speaking of it. An example
chodynamics of mourning is not required here, nor is it can be seen in the patient who, throughout a therapy hour,
necessary to point out the similarities and dissimilarities feels that the tone of his voice and the gestures of his
of mourning and depression, which have been studied as hands are not only his but those of the one he mourns. It is
twin subjects since the publication of Freud's Mourning usual for such an experience to be "shaken off," only to
and Melancholia." Siggins'10 critical survey of the liter¬ reappear suddenly on occasion.
ature on mourning, and Gaylin's" collection of relevant In pathological grief the psychodynamic process of the
papers show changing theoretical formulations. To under¬ work of mourning is frozen. Indeed, the pathological
stand linking objects, however, it is important to recog¬ mourner frequently uses the word "frozen" in describing
nize that the state of the ego in true pathological mourn¬ his "typical" dream2-4 in which the struggle of keeping the
ing is different from that in depression. In the latter there dead person alive appears. The lost one is both killed and
is a state of helplessness,12 but in pathological grief there not killed, is both buried within the mourner, and not
is a chronic hope and a continuing effort to regain the lost buried within the mourner. Excessive use of the splitting
one.3·4 Bowlby7 defined a "persistent seeking of reunion." mechanism, as Freud showed,1'1·17 creates a fence-sitting

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 man who is ready to jump to either side—to acceptance of griefing and subsequent psychoanalysis has been reported else¬
the reality of the loss or to the other possibility of keeping where5 was the oldest son of a surgeon and a manic-depressive
the deceased alive. mother whose hospitalization on several occasions during his
The meaning of the linking object as a tie with the de¬ childhood left her son sensitized to separation. Her instability led
him to depend on his own resources. He developed into a child who
ceased is clarified by this understanding of the psy-
masked his basic dependence by an air of great self-reliance and a
chodynamics of the pathological mourner. The linking ob¬ fiercely protective interest in his rights.
ject belongs both to the deceased and to the patient He was frightened during his childhood and puberty by the se¬
himself, as if the representations of the two meet and ductive behavior his mother exhibited toward him during her man¬
merge in an externalized way. The ambivalence which had ic phases. In a dream reported during his later analysis, the Gulf
characterized the relationship with the dead one is in¬ of Mexico represented the mother who could engulf him. He felt
vested in the process of distancing the object in a repre¬ that she had engulfed his father during the act of intercourse. The
sentation of psychic distancing, but at the same time father seemed bewildered by his wife's behavior, and was domi¬
nated by an older brother and his own father, a veritable clan
keeping it available. The mechanism used here resembles leader. At the death of the clan leader the patient's father as¬
the one used by the so-called satellite patients Corney and
serted himself, gained prestige in his profession, and followed his
I described,18 in whom ego development arrested at the
successful brother to the fashionable part of town. He took an in¬
separation-individuation phase of childhood found a ma¬ terest in his son, prepared him for medical school, and was the
lignant compromise in the adoption of the role of satellite only one to favor his projected marriage.
to the mother-or, in later life, to her substitutes. The son responded with constructive attempts to identify with
The satellite is suspended, as it were, between engulfment by him. The father had made a point of checking the boy's testicles
regression to symbiosis with the mother and annihilation through during his puberty to assess his sexual potency, and this interest
separation from the mother. For the satellite to move in either di¬ had given the child misgivings, leaving him with the feeling that
rection (regression or progression) would precipitate a clinical his only proof of being a man would be to impregnate a woman.
psychotic state. When his father died suddenly in his sleep at a vacation resort,
In these individuals the experience of physical separa¬ the patient was 22 years old, and unable to go through an un¬
tion from the mother usually becomes symbolized, repre¬ complicated course of mourning. In an obvious effort to prove his
senting the experience of psychic separation. Like the sat¬ manhood, he made his fiancee pregnant. On the first anniversary
ellite doomed to orbit around the mother but able to of his father's death, the patient was hospitalized with a severe
case of anniversary reaction, showing symptoms of pathological
control the distance from her, the pathological mourner,
doomed to keep his linking object, can control its distance. grief.
One of his linking objects was a photograph of his father which
All of the psychoanalytic literature on identity forma¬ his mother had sent him after the death. Except for an occasional
tion is relevant to the problem of object loss and the mech¬ glimpse he was unable to open the folder enclosing the picture.
anisms of introjection, identification, projection, and His father's corpse was flown back from the resort where he had
projective identification. However, in earlier times in¬ died, and the son experienced conflict about looking at it, deciding
trojection and identification were emphasized. I have al¬ finally not to do so. The covered photograph can be seen as a rep¬
ready referred to the pathological mourner's attempts at resentation of the father in his coffin. The patient tried to resolve
reunion with the lost one by means of introjection. The the work of grief in an externalized way by placing the photo¬
presence of the linking object indicates a special emphasis graph where it was dampened by slowly leaking water in a repre¬
in pathological mourning on projection and externali- sentation of (1) his tears over the dead father, and (2) an attempt
to repeat the death scene, which had followed a day of snorkeling
zation, in the broadest sense of these terms.19 The linking during which, his son felt, the father had probably taken enough
object itself is evidence of the externalization of what is sea water into his lungs to account for his subsequent heart con¬
painful—the work of mourning and the persistence of ex¬ gestion. During his treatment the patient gave clinical evidence
ternal object relationship. Jaffe20 has reemphasized the that he was afraid of weeping lest he be drowned in his tears.
dualistic and conflictual nature of the mechanism of pro¬ Identification of the linking object that appeared during his re-
jection which griefing was validated by the fact that in the re-griefing process it
involves the psychic apparatus in a continuously ambivalent mode lost its magic. The patient then voluntarily framed it and made a
of dealing with object relationship. On one end of the continuum, place for it on his study desk. No other linking object replaced it
the annihilation of the object is predominant; while on the other, during his three years of psychoanalysis.
the identification with and preservation of the object is para¬ Case 2.—A 27-year-old Jewish patient went through re-griefing
mount. and is now in the second year of three-times-a-week psy¬
The dual role of the linking object, which evokes both chotherapy. He was born in Nazi-occupied Belgium, and his first
the impulse to destroy it and the impulse to preserve it, 17 months were spent in hiding. He had internalized the anxiety
can be understood in this light. The two opposing impulses
and helplessness felt by his parents during his childhood, and his
can be maintained externally in a dynamic conflict which
capacity to express emotion had necessarily been stifled. At the
is not a dominant feature of depression and which thus age of 7 he accompanied his parents to the United States, and in
later life somatized some of his affective expressions as his father
further differentiates it from pathological grief. had done. The father had hoped for success in the new world, but
In the cases illustrating these theoretical consid¬ developed a survivor's syndrome21 and died in an iron lung after a
erations, only material relevant to the genesis of patho¬ year of suffering from multiple sclerosis. His son was 13 when the
logical grief and to the significance of linking objects will death took place.
be reported. The patient had taken care of his father, and at his death could
not discharge the anger which would have been an indication of
Case Abstracts
the separation. He identified his aggression with the Nazis; it did
Case 1.—A 23-year-old married man, whose course through re- not surface at all except when it overflowed in an occasional tem-

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 per tantrum. For 14 years he exhibited symptoms of pathological and died at one minute after midnight. In the mind of this pa¬
grief and attempted reunion with his father. His collection of link¬ tient, Father Time, his own father, and the surgeon who had put a
ing objects included his father's two cameras, a pair of sunglasses, "vagina" in his chest were all condensed.
and a watch. All were broken, representing the father broken with Besides these symptoms, the patient exhibited the typical char¬
multiple sclerosis. At times the son thought of having them re¬ acteristics of pathological mourning. He could not allow his father
paired, but did not do so. This response was consistent with his un¬ to die, and kept attempting reunion with him. Among his symp¬
conscious fantasy of his father's being both alive and dead. toms of pathological grief was his use of his father's old car as a
One of the cameras, which hung like a skeleton in his closet, had linking object. Although he was poor he spent as much as $1,000
a syringe-like "time-delayer." This represented the delayed work yearly to keep the car and its motor in good condition in spite of
of mourning as well as the syringe which the patient had used in the fact that he nevertook it out on the road. The fate of his link¬
giving injections to his sick father. The injections evoked ambiva¬ ing object subsequent to his discharge from the psychiatric ser¬
lence. They were given as a life-saving measure, but after com¬ vice is unknown, as we had no further communication with him
pleting them the son had to carry the shrunken body to a toilet, after he left the hospital.
and there he fantasized flushing it away. The syringe-like object Case 4.—An unmarried black woman in her early 30s exhibited a
also represented a snake with which the patient had tried to re¬ pathological grief reaction after the death of her mother. While
solve his work of mourning in an externalized and symbolic way. she realized intellectually that her mother had died, her behavior
He caught the snake six months after his father's death, put it in denied this. She spent her days fantasizing her mother as being
a bottle of acid, and watched it decompse like the dead man's body still able to observe her actions and, perhaps, being able to "come
in its grave. Through the mechanism of internalization he simul¬ back."
taneously developed boils-his own skin started to "rot." The patient was the youngest of six children. The mother-child
His other linking object was the watch with his father's initials, unit had been disturbed because the mother had been severely
S.M., engraved on it in the reverse of M.S. (multiple sclerosis). The burned when the child was six months old. Bedfast for a year, she
broken watch represented the broken father, and the patient felt had been unable to function adequately as mother or wife. The
compelled to keep it in a drawer as a link with him. When we dis¬ continued symbiotic relatedness turned into a sadomasochistic re¬
cussed this in therapy he volunteered that he could see why it had lationship between mother and daughter, the closeness of which
been so hard for him to win his M.S. degree. Because of the ten¬ was reflected in the patient's need to keep her mother alive after
sion generated by ambivalence, a distancing from the father with death. Although the other siblings moved away, the patient had
his M.S. (multiple sclerosis) was a necessity. This patient is in his remained at home with her mother, who became a widow and, dur¬
second year of psychoanalytic psychotherapy on a three-times-a- ing the last ten years of her life, an amputee because of diabetes.
week basis after his initial re-griefing. His linking objects have To care for her mother the patient had given up college scholar¬
lost most of their magic, but he still clings to them and from time ships, opportunities for a good marriage, and any independent so¬
to time asks his therapist about disposing of them. The therapist cial life. Although she sometimes wished her mother would die,
has refrained from giving advice or suggestions about them. she was in the habit of telephoning her on a regular schedule three
Case 3.—A 38-year-old man had a successful hiatus hernia oper¬ times a day "to see if she was OK." She slept at night at the foot
ation a year before the death of his 79-year-old father. Soon after of her mother's bed and awakened periodically "to make sure she
the death, the patient's surgical scar began to give him pain, and was still alive."
he became impotent. It was necessary to hospitalize him on the After her death the mother often appeared in her daughter's
first anniversary of his father's death because of these symptoms. fantasies and dreams, wearing the red robe in which she had died.
The patient was obsessed with fear that physical activity would The patient had purchased this luxurious robe for herself during
reopen the scar on his chest. It became evident that, appearing as one of her infrequent holidays, but had ended up by presenting it
it did on a hairy skin surface, it represented a vagina to him. He to her mother, who asked for it. It became a linking object, be¬
was regressed to dependency, and needed care from his wife and longing to both women, and an ambivalence-strained link which
mother, toward both of whom he felt unexpressed rage. As a child had to be externalized and put aside. The daughter became ac¬
he had noticed his mother's preference for his younger brother, tually afraid of it, but kept it carefully. When asked to show it to
and had reached up to his father in an effort to pair with him. us she instructed her sister to bring it to the hospital in a paper
However, pre-oedipal sibling rivalry and a sense of being rejected bag. When the bag was in the room, she fantasized that the dead
by his mother interfered with the development of normal oedipal woman would come out of it, and gave a lively display of appro¬
conflicts, renunciations, and identifications. Accordingly, moti¬ priate fearful affect. After going through enough re-griefing ther¬
vated by an unconscious attempt to avoid the unpleasant aspects apy she spontaneously burned the robe, the genetic aspect of this
of the pregenital phase by reaching up the ladder of psychosexual act referring to her mother's burns suffered so many years earlier.
development, he became preoccupied with being in his father's Follow-up two years after the completion of her re-griefing in¬
company and being an athlete. Similar psychodynamics in another dicated no return of symptoms of pathological grief.
case are described elsewhere.22 Case 5.—A patient in his mid-30s was diagnosed as a paranoid
This attempt did not lead to a real solution of the oedipal con¬ schizophrenic when he had a delusion that his wife was trying to
flict nor to the establishment of an adaptively useful identi¬ poison him. He was convinced that a yellow spot at the bottom of
fication with the father. The original oedipal father of the ex¬ his coffee cup was poison. Because his symptoms had started nine
ternal world survived in the acutal father during the post-oedipal months before at the time when his 19-year-old half-brother
phase of the son's conflict. Although in the course of time he mar¬ drowned, he was accepted by the study group because of the possi¬
ried and engaged in his own profession, the patient remained ge¬ bility that he was suffering from pathological grief. This proved to
ographically close to his father. The hiatus hernia operation was a be the case, and his psychotic symptoms cleared in therapy when
symbolic castration and also an obstruction to the satisfaction of he was helped to grieve effectively.
his oral needs, since it involved his stomach. The operation was His mother had died of melanoma, and he and his sister had
performed a year before the death of the father, who still predomi¬ both had operations for the same disease. The half-brother who
nantly represented the original external oedipal father. It was drowned was the child of the patient's father's second marriage.
then that the patient reported that "Father Time caught up with" The delusion about the spot of poison could be understood against
him. It was clear that Father Time was his father who, like the the background of a horror of death from melanoma and death by
symbolic representation of Time, had a beard, lived a long time, drowning in muddy waters. Therapy disclosed that the spot repre-

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 sented melanoma, and the coffee represented muddy waters. never totally not-me. It links not-me with mother-me. It
This patient's linking object is an example of the fourth cate- fades away ultimately, and its memory is not subjected to
gory-an object recalling the last moment during which the dead active repression.
person was thought of as being alive. Word of his brother's acci¬ Childhood Fetish.—Differing from Winnicott, Sperling
dent had reached the patient as he was putting records on the
record player. The first word was that the boy had not surfaced
suggests that the transitional objects he describes are
after a dive and the search was still in progress. Another call a pathological manifestations of a specific disturbance in
few hours later reported the discovery of the body. The records on object relationship. Before the age of 2 the child becomes
the record-player became highly symbolized for the patient, who attached to an inanimate object, something concrete and
insisted that they remain where they were, as if the act of playing real; when it is a part of the child's own body it is a re¬
them had been frozen. Unable to listen to them, he was equally placeable feature like fingernails. The child does not ac¬
unable to remove them and put them away. At last he played the cept weaning, but replaces the mother's breast with the
records and went into an abreaction. Even after they were put fetish, the symbolic function of which concerns separation
away, the records contained a heavy investment of his unfinished anxiety (1) during weaning; (2) at the height of the anal
work of mourning, and were not used until the patient was well
into his treatment. An exercise of his re-griefing was the playing
phase (in reference to clinging to or letting go of feces—
the mother equivalent); and (3) during the oedipal phase,
of the records and weeping over his dead brother while listening
when the mother is renounced as the sexually gratifying
to them. A two-year follow-up of this patient indicated that no
pathological grief symptoms persisted, nor were the records any object. In summary, the childhood fetish represents a
longer symbolized. pathological defense against separation from the mother
on the pre-oedipal levels, and may or may not lead to adult

The Linking Object, Fetishes, fetishism.

and the Transitional Object The observation of psychotic children brought to the at¬
tention of Speers and Lansing26 a similar phenomenon re¬
When the term fetish is seen in its etymological refer¬ sembling Sperling's childhood fetishism in its dynamic
ence it may seem a suitable term to apply to the linking meaning. These children created "instant mothers"
object. However, since the linking object is unique and through the use of movable inanimate objects. Mahler27
specific in its institution, its usefulness in maintaining gave clinical examples of the "psychotic preoccupations"
psychophysical balance in the face of a loss, and in the re¬ of children with an inanimate object (the "psychotic fet¬
lated psychodynamics, a special descriptive term to distin¬ ish") such as a fan, a record player, a jar—even a thread to
guish it from the fetish in the psychoanalytical sense and wind around the finger. These she described as a form of
from the transitional object as well, seems warranted. transitional object.
It is outside the scope of this report to review the liter¬ The Fetish.—In the classical sense, the fetish represents
ature on the fetish or the transitional object, but it will be the illusory penis of the mother, and it may represent the
profitable to refer to articles by Greenacre23'24 in which the last moment in which the woman could be regarded as
clinical forms and functions of each are compared. In phallic;16 thus it is a special solution of the castration
these papers Greenacre uses the term fetish in the limited threat. The roles of pregenital sexual experience, of ag¬
sense of adult fetishistic perversion. After summarizing gression, and of other aspects of fetishism have been
her information about the fetish and the transitional ob¬ studied extensively since Freud. Bak,29 summarizing
ject I will compare them to the linking object. I will also points in the development of fetishism, included: weak¬
refer to fetishism in children as Sperling25 describes it, ness of ego structure; fixation in pregenital phases; the
and the "instant mothers" used by the psychotic children representation by the fetish of breasts, skin, buttocks,
studied by Speers and Lansing,26 who applied the insights feces, nipples, and the female phallus, separately or in
of Mahler.27 All these kinds of uniquely significant objects combination. He emphasized the importance of identi¬
overlap in function and description, but they are recogniz¬ fication with the penisless mother, in which the wish to
ably different from one another. give up the penis creates marked intrastructural conflict.
Transitional Object.—The "transitional object" was de¬ The classical fetish used by the adult pervert, usually a
scribed by Winnicott28 as "an object that becomes vitally male, can be described according to Greenacre's summary.
important to the child . .more important than the
. It is an inanimate object the presence of which is neces¬
mother, an almost inseparable part of the child." He con¬ sary if the pervert is to sustain potency for the completion
sidered this a universal phenomenon in normal emotional of sexual intercourse. It is often an article of clothing,
development. Agreeing, Greenacre emphasized that the such as a shoe. The color black (representing pubic-hair) is
transitional object is a temporary construction to help the important, as are odor and visibility. It symbolically com¬
infant toward a sense of reality and the establishment of bines male and female attributes; the fetishist's mother-
his own identity. Usually chosen, from whatever is avail¬ me combination is concerned with genitals. In adult per¬
able to the infant in the first year of his life, on the basis version the fetish is a link between the denial of sexual
of texture, odor, visibility, and movability, it is a con¬ differences and their affirmation, and must be indestruc¬
solation for the separation of going to sleep. It may be an tible. There is no spontaneous recovery from fetishism.
old blanket, for example; or the mother herself can be The Linking Object.—Like the others, the linking object
treated as a transitional object. It absorbs neglect and appears in relation to loss understood in the broadest
even abuse, as well as the most loving closeness. If it is sense to include psychical separation. The transitional ob¬
lost, the baby usually finds as a replacement a new object ject, a normal and transitory manifestation (in spite of
like it. It represents symbolically the first not-me, but it is Sperling's suggestion to the contrary), provides restitu-

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 tion for the loss of total oceanic symbiosis and identity ". the nonhuman surroundings possess psychological signifi¬
formation. In the adoption of the childhood fetish the cances
. .
not confined to their serving as such a
for us which are
shock-absorbing background; to the degree that some differ¬
separation anxiety due to the loss of the pre-oedipally sat¬
entiation between ego and surrounding nonhuman environment
isfying mother is more important than castration anxiety.
. . .

has been achieved, various specific elements of the nonhuman

"The childhood fetish represents a pathological defense
realm (such as machines) can be reacted to by the developing ego
against separations from the mother on the pre-oedipal which is engaged in a defensive struggle, as symbols of the
(oral and anal) levels."25 warded-off drives and affects."
I cite Bak's paper29 from the extensive literature on fet¬
ishism in adults to illuminate the separation aspect of this Productions in the psychic field like delusions and hallu¬
phenomenon. Bak saw the fetish as a compromise between cinations used to link the mourner with the dead should
separation and castration, reflecting (1) the wish to give have consideration. The Schreber case clarifies this point.
up the penis in order to identify with the penisless mother Niederland,31-33 whose investigations have done so much to
and avoid the danger of separation from her, and (2) the shed light on Schreber's childhood, demonstrates how
alternative danger of castration. As indicated in one of some of the patient's childhood experience emerged in the
his reported cases, the anxiety of being abandoned may form of "miracled-up" delusions during the psychotic pro¬
mobilize fetishistic ceremonies. In this instance the re¬ cess. These are projected in the Memoirs "as if the pages

sponse to the threat of loss can be clearly seen. of the manuscript which Schreber filled with his delusional
Like fetishes in the classical sense, linking objects are descriptions had served him as a welcome screen for the
seen in adult men and women. In our study, the physical externalization and concretization of his fantasies."33 Nie¬
loss through death occasioned the adoption of a linking ob¬ derland called my attention to Schreber's hallucination of
ject. The loss involved in the use of a fetish is usually "divine miracles" as constituting linking references to
symbolic and diffuse. To adult males, the classical fetish manipulations which Schreber's father had practiced on
represents the mother's penis, and this remains its highest his son's body and which the sick son later "miracled-up"
significance in spite of the interweaving of pregenital as¬ in order to revive the infantile tie between himself and his
pects with the genital. The chief function of the linking father. I suggest that this may be called a linking phe¬
object for the adult, however, is the response to an obvious nomenon in an extension of the concept of the linking ob¬
loss (with its condensed aspects from different levels of ject.
psychosexual development). Paraphrasing Freud, I4 have In adult life, linking objects mark a blurring of psychic
suggested that the linking object is a "token of triumph" boundaries between the patient and the one he mourns, as
over loss. Although the loss involved in the establishment if representations of the two persons, or parts of them,
of childhood fetishism concerns the pre-oedipally grat¬ merge externally through their use. Winnicott28 believed
ifying mother, the loss by death may represent to the that the transitional object is held in memory without
pathological mourner separation from representations of repression, gradually becoming decathected, and that it
a greater diversity of important objects from every level may reappear in later life when deprivation threatens. It
of psychosexual development. For example, I noted in one would be enlightening to know whether pathological adult
of my case histories that the dead father—or Father mourners using linking objects had used a transitional ob¬
Time—represented the original oedipal father needed for ject excessively in childhood or had the type of childhood
the resolution of the oedipal conflict and the completion of fetish described by Sperling. Among the patients in our
the superego. In this instance the patient wanted to avoid study and seen in treatment over the years we failed to
separation at the oedipal level. The inherited car parked in establish the earlier use of a childhood fetish. The rela¬
the front yard with its motor in working order probably tionship must remain speculative for the present. How¬
represented both his father's penis and his own, and the ever, problems of psychic separation from the mother
patient defended himself against both separation and cas¬ seem evident in three cases cited-that of the first patient
tration anxiety by using his linking object. In such a case who was later analyzed, that of the man born in hiding,
it is difficult to distinguish between a true linking object and that of the woman whose mother had been burned.
and a fetish, but since the symbolization of the car defi¬ Further research into the genetic aspect of the linking ob¬
nitely corresponded in time with the death I considered it ject is required. It is hoped that the recognition of the phe¬
to be the former. nomenon of the linking object will direct the attention of
Other inanimate objects not descriptively identical with other analysts and psychotherapists to its appearance dur¬
either the classical fetish or the linking object are used to ing the treatment of suitable patients.
handle separation anxiety. Elsewhere22 we have reviewed The distancing used with linking objects also distin¬
accounts of man's psychological connection with his ma¬ guishes them from the fetish and the transitional object.
chines and reported the case of a 16-year-old boy who, dur¬ The child holds, sees, and smells the transitional object.
ing treatment, employed a series of machines, some of The adult pervert needs at least the sight of the fetish in
which he made himself. In considering the many possible order to feel sexually potent. With the linking object in
meanings of his inanimate objects (machines), we were pathological mourning, knowledge of its whereabouts is
struck by his attempt to reconstruct the equilibrium of ob¬ highly important, but it is as usual for the patient to dis¬
ject relationships at the time of a critical separation. Fur¬ tance himself from it as to embrace it. In the example of
ther generalizations arise from the work of Searles,30 who the red robe, it was avoided in spite of the fact that its
completed an extensive study of man's kinship with his existence was important. In another case, the dead fa¬
nonhuman environment. He wrote, ther's picture was placed under a leaking pipe, where it

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 served to resolve externally some of the patient's conflicts the object of the "last moment" in which the mother can
without directly involving his sensory perceptions. One be considered to have a penis.
might even consider the linking object a higher-level sym¬ The linking object provides a means whereby object re¬
bol, since it does not have characteristics easily associated lationships with the deceased can be maintained ex¬
with body parts, but takes its importance instead from the ternally. The ambivalence of the wish to annihilate the de¬
individual's ideation. ceased and the wish to keep him alive is condensed in it, so
As Greenacre23 indicated, the fetish contains congealed that the painful work of mourning has an external refer¬
anger, born of castration panic. The linking object also ence and thus is not resolved. Recognition of linking ob¬
contains anger, and is similarly an instrument for the con¬ jects and formulations regarding them may provide tech¬
trol of expressions of anger arising from separation panic. nical suggestions for dealing with pathological mourners
I suggest further that the linking object is more signifi¬ as we deal with the phobic patient who, after sufficient
cantly invested with the aggressive drive than is the fet¬ analysis of its symbolic meaning, needs to confront the
ish; this characteristic accounts for the phenomenon of dreaded object. The pathological mourner needs to stop
distancing and avoidance. using the linking object to bring it with all its implica¬
The linking object may represent the "last moment" in tions fully into the field of therapeutic working through.
which the dead individual was felt to be alive; the fetish is

References
1. Volkan VD: Normal and pathological grief reactions: A guide 17. Freud S: Splitting of the ego in the defensive process, in
for the family physician. Virginia Med Monthly 93:651-656,1966. Collected Papers. London, Hogarth Press Ltd and the Institute of
2. Volkan VD, Showalter CR: Known object loss, disturbance in Psychoanalysis, 1956, vol 5.
reality testing, and "re-grief" work as a method of brief psy- 18. Volkan VD, Corney RT: Some considerations of satellite
chotherapy. Psychiat Quart 42:358-374, 1968. states and satellite dreams. Brit J Med Psychol 41:283-290,1968.
3. Volkan VD: The University of Virginia study in pathological 19. Rapaport D: Projective techniques and the theory of think-
mourning. Tip D\l=u"\nyasi42:544-551, 1969. ing. J Projective Tech 16:269-275, 1952.
4. Volkan VD: Typical findings in pathological grief. Psychiat 20. Jaffe DS: The mechanism of projection: Its dual role in ob-
Quart 44:231-250, 1970. ject relations. Int J Psychoanal 49:662-677, 1968.
5. Volkan VD: A study of a patient's "re-grief" work through 21. Niederland W: Psychiatric disorders among persecution vic-
dreams, psychological tests and psychoanalysis. Psychiat Quart tims. J Nerv Ment Dis 139:458-474, 1964.
45:255-273, 1971. 22. Volkan VD, Luttrell A: Aspects of the object relationships
6. Engel GL: Is grief a disease? A challenge for medical re- and developing skills of a "mechanical boy." Brit J Med Psychol
search. Psychosom Med 23:18-22, 1961. 44:101-116, 1971.
7. Bowlby J: Process of mourning. Int J Psychoanal 42:317-340, 23. Greenacre P: The fetish and the transitional object. Psy-
1961. choanal Study Child 24:144-164, 1969.
8. parkes CM: "Seeking" and "finding" a lost object: Evidence 24. Greecacre P: The transitional object and the fetish with
from recent studies of the reaction to bereavement. Soc Sci Med special reference to the role of illusion. Int J Psychoanal 51:447-
4:187-201, 1970. 456, 1970.
9. Freud S: Mourning and melancholia, in Collected Papers. 25. Sperling M: Fetishism in children. Psychoanal Quart 32:374-
London, Hogarth Press Ltd, and the Institute of Psychoanalysis, 392, 1963.
1956, vol 4. 26. Speers RW, Lansing C: Group Therapy in Childhood Psy-
10. Siggins LD: Mourning: A critical survey of the literature. chosis. Chapel Hill, NC, University of North Carolina Press, 1965.
Int J Psychoanal 47:14-25, 1966. 27. Mahler MS: On Human Symbiosis and the Vicissitudes of
11. Gaylin W: The Meaning of Despair. New York, Science Individuation. New York, International Universities Press, 1968,
House, 1968. vol 1.
12. Bibring E: The mechanism of depression, in Greenacre P 28. Winnicott DW: Transitional object and transitional phe-
(ed): Affective Disorders. New York, International Universities nomena. Int J Psychoanal 34:89-97, 1953.
Press, 1953. 29. Bak RC: Fetishism. J Amer Psychoanal Assoc 1:285-298,
13. Pollock GH: Mourning and adaptation. Int J Psychoanal 1953.
42:341-361, 1961. 30. Searles HF: The Nonhuman Environment. New York, In-
14. Abraham K: A short study of the development of the libido ternational Universities Press, 1960.
in the light of mental disorders, In Selected Papers. London, 31. Niederland W: Schreber: Father and son. Psychoanal Quart
Hogarth Press Ltd, 1949. 28:151-169, 1959.
15. Schafer R: Aspects of Internalization. New York, Inter- 32. Niederland W: The "miracled-up" world of Schreber's child-
national Universities Press, 1968. hood. Psychoanal Study Child 14:383-413, 1959.
16. Freud S: Fetishism, in Collected Papers. London, Hogarth 33. Niederland W: Further data and memorabilia pertaining to
Press Ltd and the Institute of Psychoanalysis, 1956, vol 5. the Schreber case. Int J Psychoanal 44:201-207, 1963.

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