Motivation and emotion/Book/2022/Death drive

Overview


"One thing that is certain from the time that we are born, is that the goal of life is death" (Freud, 1920). However, why is it that some people are more drawn to behaviours and activities that can promote death quicker? Why are some people are more interested in death defying stunts or why there is true crime so popular? This could be due to a person's death drive. Death drive is a Psychoanalytical theory that was coined by Sigmund Freud in his 1920 essay 'Beyond the Pleasure Principal' (Freud, 1920). Freud (1920) thought that there were two competing drives; death (Thanatos) and life (Eros). While the life drive is more interested in love, creativity and sexual reproducing, the death drive involves aggression, sadism, destruction, violence, and death (Karbelnig, 2020).

This chapter covers the motivational factors that relate to the death drive. It also discusses its history, the most important people, psychopathology and how the death drive can be negotiated.

"DEATH DRIVE: The bodily instinct to return to the state of quiescence that preceded our birth. The death drive, according to Freud's later writings (Beyond the Pleasure Principle, "The Uncanny"), explains why humans are drawn to repeat painful or traumatic events (even though such repetition appears to contradict our instinct to seek pleasure). Through such a compulsion to repeat, the human subject attempts to "bind" the trauma, thus allowing the subject to return to a state of quiescence." (Felluga, 2015)
 * Definition


 * Focus questions
 * What is the death drive and how was it created?
 * How is the death drive observed socially?
 * How can we negotiate the death drive?

Sigmund Freud
Sigmund Freud was an Austrian Neurologist and the founder of psychoanalysis (Jay, 2020). The death drive was first recognised by Freud in his 1920 essay 'Beyond the Pleasure Principal' (Frank, 2015). The pleasure principal describes that when a person is younger or immature there is an immediate want to fulfil our needs, to feel pleasure and to avoid suffering at all costs (Moccia et al., 2018). Freud was trying to understand destructive personality disorders (Kernberg, 2009), negative-therapeutic reactions, masochism and repetition compulsion (Black, 2006). When in the 1920s he wrote his essay 'Beyond the Pleasure Principal' and first describing the death drive. Freud said in that essay that "The goal of life is death" (Freud, 1920). Freud thought that there were two competing drives; death (Thanatos) and life (Eros). While the life drive is more interested in love, creativity and sexual reproducing, the death drive is aggression, sadism, destruction, violence, and death (Karbelnig, 2020). And thus, the dual drive theory was created - life and death. Life consists in a negotiation between the life and death drives, which must form arrangements with one another in order to coexist in the one organism (Faulkner, 2005)

Freud realised that veterans repeat traumatic events in dreams and that children have an insatiable need to repeat certain games or behaviours in order to process difficult experiences. He thought that this behaviour seemed to give people a kind of satisfaction that could not be derived from the need of the unconscious to maximize pleasure and minimize pain. In order to explain this repetition, he introduced the concept of the death instinct, which strives to undo connections, to destroy, and to lead life back into an inorganic state. He suggested that all living creatures have this impulse to return to the inorganic state from which they have emerged.

The conscious
Before 1920, Freud developed a theory of the human mind which differentiated between three core 'conscious' components (Thwaites, 2007).

Pre-conscious: can be called into consciousness if needed, however it is the part of the mind which is not the current focus of attention (Thwaites, 2007). This includes memories for things we’ve either implicitly or explicitly learned (Westen, 1999)

Conscious: the manipulable thoughts and images currently in our short-term memory (Westen, 1999)

Unconscious: those mental processes and influences which are out of conscious reach (Thwaites, 2007).

The id, superego and the ego
From this Freud came up with three structures which he hypothesised controlled human thought and behaviour (Segrist, 2009):

The Id: the aspect representing unconscious drives and urges of the mind (Doige, 2002)

The Superego: the part representing the influence of morality (Doige, 2002). Includes moral imperatives and social constraints and operates at both the conscious and unconscious level (Segrist, 2009).

The Ego: the moderator between the forces of the Id and the Superego, and the most conscious (Segrist, 2009).

Freud's beliefs
Kernberg, (2009) outlined that the phenomena that has lead Freud to the establishment of the death drive included:

i. The phenomenon of repetition compulsion

ii. Sadism and masochism

iii. Negative therapeutic reaction

iv. Suicide in severe depression (and in non-depressive characterological structures)

v. Destructive and self-destructive developments in group processes and their social implications.

Firstly, Freud established that the patient engages in an endless repetition of destructive behaviour (Kernberg, 2009). Severe manifestations of sexual sadism and masochism are a second type of a fundamental drive to self-destruct (Kernberg, 2009). Cases of sexual perversion - a significant restriction of sexual behaviour to a specific interaction that becomes an indispensable condition for sexual excitement and orgasm, may be linked to a dangerously sadistic or masochistic behaviour, reflected in severe self-injurious or self-mutilating behaviour as a precondition for sexual enjoyment (Kernberg, 2009). Patients with borderline psychopathology often show severe self-mutilation, cutting, burning and, in the most severe cases, self-mutilation leading to the loss of limbs as a relentless drive which, at times, causes all therapeutic efforts to fail - negative therapeutic reaction (Kernberg, 2009).

The third type of manifestation is that of negative therapeutic reaction. Freud described one type of negative therapeutic reaction in his clinical observation of patients who appeared to get worse under conditions when they experienced a helpful intervention by the analyst, as an expression of unconscious guilt over being helped. There is an even more severe form of negative therapeutic reaction, and one which has the unmistakable signs of a highly motivated self-destructiveness, namely, an unconscious identification with an extremely sadistic object, so that it is as if the patient felt that the only real relationship he may have is with somebody who destroys him (Kernberg, 2009).

 Emma is a patient and is presenting with a severe self-mutilating behaviour. She has successively cut off segments of fingers off her hands and severed major nerves in one arm. She presented the syndrome of malignant narcissism, and her psychoanalytic psychotherapy was carried out, in part, during extended hospitalisations. She was not psychotic at any point. In the transference, the identification with an extreme aggressive and incestuous paternal image was a dominant element. (Kernberg, 2009)

A fourth type of severe self-destructive impulse is reflected in suicidal urges and behaviour. Freud considered suicidal tendencies in melancholia as another expression of the death drive (Kernberg, 2009).

Around the world roughly 800,000 people die by suicide a year and is the foremost cause of death worldwide among those that are 15 to 24 years of age (Seena & Bo 2020).

Lastly, Freud also described severe self-destructiveness as a social phenomenon in the behaviour of large social group processes, in human masses as ideologically united conglomerates, in mutual identification with a grandiose and aggressive leader (Kernberg, 2009). In this process, the group projects their individual superego functions onto the group leader, with the consequence of groups anctioned expression of primitive, ordinarily suppressed impulses, particularly of an aggressive type (Kernberg, 2009).

Borderline personality disorder
Borderline personality disorder (BPD) is a chronic psychiatric disorder (Kulacaoglu & Kose 2018). BPD can be characterized by pervasive affective instability, self-image disturbances, impulsivity, marked suicidality, and unstable interpersonal relationships (Kulacaoglu & Kose 2018). Due to abnormalities in neurobiological systems sub-serving emotional regulation and stress responsibility, individuals with BPD have an underlying vulnerability to emotional hyperarousal (Kulacaoglu & Kose 2018). They also have an underlying vulnerability to social and interpersonal stressors due to abnormalities in neurobiological systems mediating social cognition, attachment, and social reward. Under stressful conditions, BPD patients are unable to regulate their emotions and quickly return to their baseline emotional states (Kulacaoglu & Kose 2018).

Cotard's syndrome
Cotar d's syndrome is a rare neuropsychiatric condition characterized by anxious melancholia, delusions of non-existence concerning one's own body to the extent of delusions of immortality (Grover et al. 2014). Grover et al. (2014), has stated the Cotard's syndrome is most commonly seen in patients with severe depression and that the symptoms develop over the period. Taking this into account there are three stages of development of Cotard's syndrome:


 * 1) germination stage - characterized by hypochondriasis and cenesthopathy.
 * 2) blooming stage - development of full symptoms of nihilistic delusions.
 * 3) chronic stage - chronic changes in mood and systematisation of delusions. (Grover et al. 2014).

 Lucy has started believing that their body parts did not exist and thus reduced food intake which was evident as nutritional deficiencies. This can be partly due to severe depressive illness they suffered from and can also be attributed to the psychopathology of denial of their existence. Connor a second patient went on to develop catatonia in due process of progression of illness. Both patients suffer with Cotard's Syndrome.

Post traumatic stress disorder
Post traumatic stress disorder (PTSD) is a mental disorder that may develop after exposure to exceptionally threatening or horrifying events (Bisson et al., 2015). PTSD can occur after a single traumatic event such as a car accident or fire or from prolonged exposure to trauma, such as sexual abuse in childhood (Bisson et al., 2015). It is also associated with substantial psychiatric comorbidity, increased risk of suicide, and considerable economic burden (Bisson et al., 2015). Those with PTSD are likely to replay and revisit these traumatic events in dreams, which goes against the pleasure principal and towards the death drive (reference).

Psychological interventions
Each of the psychological disorders listed above has an intervention - or it could also be seen as a way to negotiate the death drive.

PTSD
Psychological interventions have been evaluated after traumas concerning a single incident, such as a road traffic crash and physical or sexual assaults (Bisson et al., 2015). Meta-analyses show that brief, trauma focused, cognitive behavioural interventions can reduce the severity of symptoms when the intervention is targeted at those with early symptoms (Bisson et al., 2015).

Cotards
In terms of treatment of Cotard's syndrome Electroconvulsive therapy (ECT) has been reported to be useful although there are case reports of beneficial effect of antidepressant alone, antipsychotic alone or a combination of both (Grover et al. 2014)

Suicide
There is a few treatment options to prevent suicide including pharmacologic and psychological treatments. There have been studies that show the use of antipsychotic medications have had a reduction in suicide rates in those with schizophrenia and Lithium trials in patients with bipolar and depression have also reduced their rates of suicide (Seena & Bo, 2020)

BPD
The psychotherapies that have been adapted to treat patients with BPD are; Dialectical behavior therapy (DBT), Mentalization-based therapy, Transference-focused therapy, Cognitive-behavioral therapy (CBT), and Schema-focused therapy (Kulacaoglu & Kose 2018). Psychoeducation is also an important part of BPD treatment. It includes informing patients and families about the disorder, signs and the symptoms of the disorder, and also possible causes and treatment options (Kulacaoglu & Kose 2018).

Social reactions to the death drive
At 8:46 am on September 11, 2001, a Boeing 767 jet flew into the North Tower of the World Trade Center. Eighteen minutes later, another plane crashed into the South Tower. Within 2 hours, both towers had collapsed. The crash and the resulting fires and building collapses killed 2801 people, 147 of whom were passengers on the 2 jets (Klitzman & Freudenberg, 2003). "Freud's conceptual opposition of death and eros drives in the human psyche was applied by Walter A. Davis in Deracination: Historicity, Hiroshima, and the Tragic Imperative and Death's Dream Kingdom: The American Psyche since 9/11. Davis described social reactions to both Hiroshima and 9/11 from the Freudian viewpoint of the death force. Unless they consciously take responsibility for the damage of those reactions, Davis claims that Americans will repeat them" (Davis, 2001).

"Steven Miller examines the drive that pushes the legendary high-wire walker Philippe Petit to dedicate years of his life to the seemingly impossible quest of traversing a wire suspended between the twin towers of the World Trade Center, which he ultimately accomplished in 1974. While Petit’s quest might seem to be death driven in the most conventional sense of the term—an inane risking of life without purpose or utility—Miller argues that Petit’s act is no mere stunt but a work of art whose beauty makes the audience forget the proximity of death by offering an “aesthetic presentation of limitless freedom. He reminds us that the death drive is not merely a drive to mortality and inanimacy but is intimately bound up in what is most alive and free in human experience" (McNulty, 2017)

Conclusion
The death drive was a construct created in 1920 by Freud. Today we see that there are quite a few medical disorders that can cause people to go towards their death drive. PTSD can cause the repetitive behaviours of the death drive. BPD can cause people to be more likely to complete suicide and those with Cotards syndrome already think that they are there with their death drive. There is also a social fascination with traumatic world events that cause people to be interested in death, and destruction - Hiroshima and 9/11 were used as examples here. However, it has been shown that with treatment and prevention the death drive can be negotiated and it is possible to have both Eros and Thanatos equally.

The death drive was created in 1920 by Sigmund Freud and it is the bodily instinct to return to the state of quiescence that preceded our birth We can observe the death drive in global events that are repeated, in watching stunts and by participating in extreme sports such as tight rope walking. yes!
 * Focus Answers
 * What is the death drive and how was it created?
 * How is the death drive observed socially?
 * Can we negotiate the death drive?