LEVELS OF MENTALIZATION OF SUFFERING IN CLINICAL PRACTICE: AGONY, DISTRESS, AND ADAPTIVE SADNESS
This paper identifies three levels of mentalization of suffering : agony, distress, and adaptive sadness. Agony is an unrepresented experience of suffering; distress is a represented experience of suffering which is too concretely felt to be dealt with subjectively; adaptive sadness is a type of suffering which is represented and tolerated, and facilitates the elaboration of loss. Clinical interventions with these qualities of suffering are often limited to either amplifying of relieving suffering. The paper proposes that unmentalized suffering should be transformed in order to help clients “suffer better”.