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Suffering is the result of a feeling of alienation and insurmountable ambivalence; being a defensive attitude, its aim is the reduction of anxiety. When Sigmund Freud asserts in Civilization and Its Discontents (1930a) that "the three sources from which our suffering comes" are "our own body. . . the external world. . . and our relations to other men" (pp. 86, 87), he could not make it clearer that human suffering opens up the entire field of psychopathology. The classical medical tradition has always sought to name the condition that causes the patient to suffer, thus to satisfy the patient's wish for their suffering to be less mysterious. Psychoanalysis escapes this preoccupation with diagnosis in that it demonstrates the ubiquity of a suffering that is at once undergone and created by the subject. If suffering marks the entry into the treatment, the orientation of the treatment itself is towards a demonstration of how this suffering is provoked by the individual subject, in the name of a particular search for pleasure "in a different place" (Laplanche, Jean, 1976 [1970], p. 104). Suffering is thus not only the source of the complaint, but also the necessary lever of its own mobilization and even its own transcendence by the treatment. In the tradition of Freud's work on "Mourning and Melancholia" (1916-17g [1915]), Melanie Klein (1935) treated accession to the depressive position as a fecund moment in the development of the child's object-relationships and the harbinger of the processes of symbolization. The same intimate connection between suffering and thought-processes informs Christian David's notion that man is in a sense "destined to suffer": "We cannot avoid being permanently confronted by separation and loss, by absence, by intersubjective and intrapsychic splits whether fantasied or actual.. . . If the psyche drew no strength from its own division, it would no doubt be unable to tolerate this state of affairs for long and would be liable to disintegrate at the first jolt" (1983). Interpretation during the treatment depends largely on the effectiveness of a process of working-through, toward the relief of suffering. As arduous as this work may be for those who embark on it, they feel motivated to do so by a wish to live better, even to be "cured." It is by no means certain that insight leads to cure. Analysts are only too well aware of the effects of the repetition compulsion and of primary masochism, only too familiar with clinical pictures that lie beyond the reach of the regulatory mechanism of the pleasure-unpleasure principle. The "work of the negative" may even become indistinguishable from what is irreducible or radically unthinkable due to the opacity of suffering—merging, in effect, with what Jean-Bertrand Pontalis (1981) calls the principle of pain, jouissance, or agony (in the sense of Donald Winnicott's "primitive agonies" [1974]): "The logic of unpleasure/pleasure seems to give way to, or even to be completely overwhelmed by a logic of despair that reduces our logic, that of the primary as much as that of the secondary processes, to despair."

See Also


  1. Freud, Sigmund. (1916-17g [1915]). Mourning and melancholia. SE, 14: 237-258.
  2. ——. (1930a). Civilization and its discontents. SE, 21: 57-145.
  3. Klein, Melanie. (1975). Contribution to the psychogenesis of manic-depressive states. In Love, guilt and reparation and other works, 1921-1945 (The writings of Melanie Klein, vol. 1), London: Hogarth/Institute of Psycho-Analysis]]
  • [[New York: Delacorte/Seymour Lawrence. (Original work published 1935)
  1. Laplanche, Jean. (1976 [1970]). Life and death in psychoanalysis. (Jeffrey Mehlman, Trans.) Baltimore: Johns Hopkins University Press.
  2. Winnicott, Donald W. (1974). Fear of breakdown. International Review of Psycho-Analysis, 1, 103-7.