The inability to mourn is a common but not sufficiently recognized theme underlying various forms of psychopathology. The paper will demonstrate how a patient has defended against the pain of loss by turning away from the external object in reality and creating a maternal object in fantasy over which she has omnipotent control. Focus is on a contemporary understanding of the inability to mourn as a ''disease of narcissism.'' Aspects of transference distortion, annihilation fantasies, and merger with the maternal object will be highlighted. Through treatment the patient has begun to relinquish the fantasied object, have moments of experiencing real loss of others, and connect more realistically with others.
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