What does a person experience when they lose someone close? Why does one individual, despite profound pain, gradually return to life, while another experiences the loss as a total psychic catastrophe?
Within the paradigm of Transference-Focused Psychotherapy (TFP), loss is understood not simply as an emotional event, but as a challenge to the stability of the internal structure of object relations. What becomes decisive is the extent to which the psyche is capable of integrating love and aggression, and whether it possesses sufficient ego strength to maintain an internal connection with the lost object.
Under normal conditions, a person is capable of tolerating ambivalence. They may grieve while still preserving a whole representation of the object. This means that the “good” image of the deceased is not destroyed by pain or by occasional surges of anger.
A patient with an integrated identity may say:
- “It hurts terribly without her, but I still feel as though I continue speaking with her internally.”
- “I miss him every day, but I feel that part of him remains with me.”
In TFP terms, this reflects the stability of libidinally invested dyads (Self—Object—Love). Even in the physical absence of the other, the internal representation of the object remains “alive” and sustaining. This makes it possible to preserve narcissistic investment in the self — the capacity to feel alive and capable of forming new relationships.
However, in borderline personality organization (BPO) or pathological narcissism, this process collapses through the mechanism of splitting. Loss is experienced not as separation, but as the disintegration of the internal world.
When identity diffusion predominates, the patient lacks a stable sense of self independent of the other. The loss of the object leads to the loss of part of the self-representation.
Patients describe this as an inner emptiness.
If patients with borderline and narcissistic disorders were able to symbolically represent their inner world and communicate it to us directly, they might tell us that:
- “After his death, it feels as though everything inside me died.”
- “I no longer feel anyone.”
- “It is as if I no longer exist.”
Usually, they are unable to express this in words, and we, as therapists, are left to construct a “map” of their inner world by relying on other channels of communication — nonverbal signals, countertransference, and the ways in which the patient enacts feelings they cannot tolerate or contain.
In cases of loss experienced by borderline and narcissistic patients, we often observe the activation of aggressive dyads. Unconscious aggression — guilt, anger that the object has “abandoned” them, or longstanding conflicts — cannot be integrated. Through splitting, this aggression becomes directed either toward the self (depression) or toward others (devaluation).
In TFP, the therapist’s task is not limited to “mourning work,” but involves helping the patient integrate the split-off parts of their experience. Only when the patient becomes capable of tolerating their own aggression toward the lost object without destroying its “good” representation does it become possible to move from pathological emptiness toward healthy grief.
(c) Yuliia Holopiorova,
Ukrainian Association of Transference-Focused Psychotherapy