The bitterness of honey.
Reflections on Miele *
This article was originally published in Rivista di Psicoanalisi, LXI (2): 515-525, 2015.
The protagonist of Leoš Janáček’s opera The Makropulos Case (1926), Emilia, is a woman who, some three hundred years after having drunk a magic potion of eternal life, considers her existence as a terrible curse. But it is death, and not life, that we tend to think of as a curse! Death, a sooner-or-later inevitable fact for us all (even if unconsciously we believe otherwise), is something that most of us dread and try to postpone with all means at our disposal in the hopeless, and rather naïve, attempt to deny its reality. However, as demonstrated by the large number of suicide cases in all societies and throughout history, there are plenty of circumstances when death can be longed for rather than dreaded, and anticipated as the ultimate liberation from one’s suf- ferings (be these physical, mental or both), or even just from the limitations imposed by old age.
Our culture, through its technological advances in medicine, surgery and even cosmetics, all supported by enormous commercial interests, inexorably seduces us into paying almost any price in order to prolong life (and productivity and potency and beauty), while any effort to shorten it, even when such circum- stances as a painful and undignified terminal illness seem almost to demand it, are often met with legal restrictions and moral outrage. As a result, any initiatives in that counter-flow direction are left to brave (or sometimes greedy) individuals prepared to take the risks upon themselves, and to well-meaning (or sometimes unscrupulous) institutions such as the famous one in Switzerland called Dignitas.
Under certain special circumstances suicide is described as «euthanasia» (the word derives from the Greek eu – good, and thanatos – death). A «good death» then, whether procured in solitude (Stoic philosophers such as Seneca considered slashing one’s wrists in a hot bath as the best way to die) or, as more commonly understood, in someone else’s presence and with their sympathetic assistance.1
If the latter also involves, as it often does, an active intervention to procure the death of others, then what occurs is located in the uncomfortable border-zone between suicide and homicide.2
1 The word euthanasia is also used in relation to the Nazi programme of extermination of psychiatric and other patients.
2 This observation is quite different from, though not unrelated to, the view that all suicides also involve homicidal fantasies. Those who commit suicide often displace and enact against themselves a murderous hatred of others, who are then left full of resentment and sometimes guilt. These feelings are mostly doomed to remain unconscious.
While the psychoanalytic literature on suicide is vast, little has been written on euthanasia. Of some interest here is a clinical essay by Felix Deutsch (1936) where he states that euthanasia, as the art of dying easily and painlessly, «would not be so difficult to achieve if the pain of dying were physical only. But painful above all is the mental anguish, the fear of death» (350), that is a fear of what we assume there is (or of what there is not) «beyond» life. The fear of death must be differentiated from the fear of dying, that is, to the process of deterioration that will eventually culminate in death. Deutsch notes that «the dying seek in various ways to achieve reconciliation with what the Greeks call ananké, the inexorable necessity of departure from life. These various ways are: by gratification of the reactive aggressive impulses; by a last uplifting of narcissistic self-satisfaction; by liberation from anxiety through disburdenment from the sense of guilt by way of masochistic self-punishment; by a last clinging to or conversely by an aban- donment of object relationships; and by seeking consolation in the anticipation of new, non-ambivalent relationships in another world» (363). Although Deutsch does not discuss assisted suicide as such, it is clear that those individuals asking for it have achieved, or are at least searching for, the kind of reconciliation with ananké which he makes reference to.
We find a literary instance, as wonderful as it is absurd, of a (mock) assisted suicide in Shakespeare’s King Lear (Act 4, Scene 6). Betrayed by his bastard son Edmund, blinded by his enemies, exiled from his home and profoundly depressed, the old Earl of Gloucester wants to jump off a cliff to his death: «This world I do renounce, and in your sights shake patiently my great affliction off», he tells Edgar, his loyal son incognito to him. Edgar pretends to help him in this suicidal plan, convinces him that if he steps forward he will precipitate into an abyss («Give me your hand. You are now within a foot of the extreme verge...»), but in fact only makes his father trip over himself on an even beach.
Because of its profound moral, psychological and legal implications, the issue of euthanasia is a difficult one to treat – in real life as well as in any artistic representation of it, such as a novel, a play or a film. It is therefore sensible to remain sceptical about inflexible and ideological attitudes towards its practice, be these favourable or hostile. For instance, the humane, «humanistic» view that society should offer all individuals the right to decide how, where and when to die in a dignified manner needs to be balanced with the awareness of the need to pro- tect all potentially vulnerable people from the risk of exploitation by members of their own family (or indeed by anybody else, clinicians included) who may have a vested interest in their «premature» death. A common suspicion in this respect, especially from people with religious beliefs, is that those in charge of assisting others to commit suicide, also compared to those procuring abortions, may just be indulging in the omnipotent fantasy of «playing God». That same argument, however, would only be justified if one were prepared to apply it also to medical practitioners keeping us alive with their treatments...
The feature film to have dealt most directly with the theme of assisted suicide in many of its complex ramifications is Alejandro Amenabar’s Mar adentro [The Sea Inside] (2004). In that movie Javier Bardem plays the real-life character Ramón Sampedro, a man made quadriplegic by a diving accident that had occur- red some thirty years before. After a long struggle with the authorities and despite a law preventing him from choosing when and how to die, he is finally helped by a group of euthanasia sympathizers in his wish to end his unhappy life.3
3 Many other fictional films have included euthanasia in their plots: An Act of Murder (Gordon 1948), Whose Life Is It Anyway? (Badham 1971), The Last Supper (Roberts 1994), Igby Goes Down (Steers 2002), Million Dollar Baby (Eastwood 2004) and more recently Amour (Hanecke 2012) – to mention just a few.
The recent Italian movie Miele (2013), Valeria Golino’s debut as writer and director, also deals with the theme of euthanasia with much sensitivity. By por- traying ambivalent, three-dimensional characters involved in dynamically complex relationships – to their internal objects no less that to their external ones - Golino succeeds in avoiding most of the traps of facile moralizing, sentimentality and political correctness. It is left to us, the viewers, to reach our own conclusions as to the significance of what happens on the screen.
Played by Jasmine Trinca, Miele’s central character is thirty-year old Irene (the Greek for «peace»). Although we are also shown glimpses of her private life - including her energetic practice of such sports as swimming and cycling, and her conflictual relationship with a married man with whom she seems to engage almost exclusively at a sexual level – Irene’s professional activity is to engage with terminally ill patients. Referred by her medical friend Rocco, these are desperately sick individuals (we meet three of them – Carla, Filippo and Lorenzo – presented in realistic, distressing vignettes) who want to die in a dignified way, that is: how, when, where and with whom they choose.
We watch Irene travel to Mexico to buy over-the-counter bottles of Lampu- tal, a potent barbiturate used «to put dogs to sleep» (the veterinary euphemism for euthanasia), and then smuggle the lethal drug back to Italy. Within this illegal practice – a job? a mission? – Irene, known to her clients under the sweet nickna- me of the film’s title «Miele» (Italian for honey), behaves in a professional man- ner, efficient to the point of appearing somewhat detached. Her routine involves assisting and offering comfort to the patients’ relatives, the careful preparation and ministration of the drug, providing all the useful information about its likely effects, helping her dying clients to select their favourite music to accompany the last moments of their life, asking several times for confirmation that they have not changed their minds, and finally getting them to sign the appropriate documents to exonerate all those involved, herself ex primis, from any responsibility.
In the course of a panel discussing this film with me,4 my colleague Maria Vittoria Costantini described Irene as «a traumatized character, lonesome, distant and emotionally frigid, a dummy performing ritual gestures with no thought sup- porting them, in a repetitive circular time, within a body having no sense of time or identity» (Costantini, 2014). In my view, however, Irene’s attitude is mostly compassionate, as we would expect from a serious professional dealing with such painful situations which she clearly experiences as upsetting to herself.5
4 At the 27th Congress of the European Psychoanalytic Federation in Turin, on 11 April 2014.
5 I also disagree with Costantini’s description of Irene as an Angel of Death – an image associated with Nazi doctor Josef Mengele's sadistic experiments in the Auschwitz extermination camp.
Irene’s activities and indeed her very raison d’être are unexpectedly chal- lenged by the discovery that one of her clients, the middle-aged engineer Carlo Grimaldi (played by Carlo Cecchi), is in fact not ill at all, but affected instead by what seems to be a sort of extreme ennui or existential boredom: «I have lost interest in everything», he claims, «all is meaningless to me». Before becoming aware of his condition (or lack thereof) Irene had already delivered the bottle of Lamputal to him. Colluding with Carlo’s wish to die would go against her prin- ciples and so, in the hope to recover the «weapon» she had naively sold him and to convince him to renounce his insane suicidal project, Irene finds herself almost forced to engage at a deeper level with him and, in the process, with her own self.
The focus of the film now turns towards their complex relationship. The mee- ting with Carlo – a successful professional, as clever as he is cynical and bitter – and the rapport that gradually develops between them destabilize what was pre- sented in the early part of the film as Irene’s firm belief in the moral value of her activity. In the end Carlo will still kill himself: not with Irene’s «poison» (which he eventually returns to her), but by jumping out of a window – thus protecting her from the guilt of having directly caused his death, though not from the distress of a painful loss.
Can death ever be «good», as the word euthanasia suggests? Irene tells us that, in her experience, nobody ever wants to die, though some individuals, such as those who approach her for her services, may no longer want to live because their existences have become intolerably bitter to them due to their hopeless and painful physical condition.
But what is intriguing in Golino’s film are not so much the reasons why some people may be determined to put an end to their lives, but Irene’s own motivations for engaging in the illegal, and therefore dangerous, job of procuring suicide assi- stance to them. That such an activity should also be financially rewarding to her- self may of course be relevant here; that many people may find euthanasia to be morally justified, if indeed also controversial, is an important component too. And we cannot perhaps rule out a certain amount of voyeuristic curiosity on the part of Irene, and of Golino, and of ourselves - all spectators of the dramatic last moments of someone’s lives (will our own be much different, we may be wonde- ring...). But we are left with the impression that there must be deeper reasons for Irene’s involvement with her clients.
In this respect I would suggest that unconscious rescue fantasies may play an important part and provide a key for the understanding of Irene’s character and behaviour. Rescue fantasies often include among their overdetermined sources a component of unresolved narcissistic infantile omnipotence (as a defensive con- version into its opposite: the dependence of children upon caring adults), with its related primitive delusional ideas of immortality (as a defensive conversion into its opposite: the reality of our biological condition as mortals). Freud (1910) him- self referred to the «rescue motif» and speculated on its psychogenetic signifi- cance as «an independent derivative of the [...] parental complex». He explained: «When a child hears that he owes his life to his parents, or that his mother gave him life, his feelings of tenderness unite with impulses which strive at power and independence, and they generate the wish to return this gift to the parents and to repay them with one of equal value» (172). Children will then form the fantasy of rescuing their parents from danger, or indeed anyone else representing them in their unconscious minds, and of saving their lives.6
6 It is probably no more than a curious coincidence that Jasmine Trinca, who plays Irene in Miele, started her acting career in Nanni Moretti’s La stanza del figlio [The Son’s Room] (2001), where she was the daughter (also named Irene!) of a psychoanalyst and the sister of a boy who dies in a diving accident, leaving the whole family in a state of despair and unconscious guilt.
Rescue fantasies, which seem to motivate many of our activities and relation- ships, could also originate in attempts to repair some damage we unconsciously believe we may have caused – in our fantasy, if not also in reality. Usually, howe- ver, we associate «rescuing» with saving someone’s life, not with ending it: rescuers are those paramedics rushing to the scene of an accident to fly the vic- tims by helicopter to a hospital for emergency surgery, or those volunteers who dig in the rubble looking for survivors of an earthquake; in less dramatic scena- rios, rescuers are the restorers of damaged works of art; even the psychoanalysts who help patients to emerge from their emotional predicaments with well-consi- dered interventions within a safe therapeutic setting. What Irene does, on the con- trary, is to poison others to death – an activity which even Filippo’s sister, who had hired Miele to help her sick brother to die, describes as «a shitty job». So, we may ask, whom – or what – is Irene really rescuing? Herself, perhaps?
From Irene’s answer to one of Carlo’s searching questions, we learn that her mother had died of an illness ten years earlier. Among Irene’s overdetermined rea- sons for her activities, and consistently with Freud’s above-mentioned «parental complex», we can speculate that she may have tried to be supportive to her dying mother but was ultimately powerless to save her life. Young Irene was presumably much distressed by this loss, even traumatized, but perhaps unable to come to terms with it, having failed to go through the normative stages of the grieving pro- cess. Irene’s well-intentioned engagement with her present activities, those we witness in the course of Golino’s film, could then be construed as her belated attempt to save her mother – and her traumatized self in the process: not by preven- ting others from dying, but quite the opposite, by allowing them to end their lives. Here I agree with Costantini’s interpretation that for Irene «death and trauma seem to be inexorably intertwined within her and to have found as their only solution the procuring of death, as honey sweet, to all those invoking it because of their pain, lack of dignity, humiliation and despair» (Costantini, 2014).
Irene reminds me of the character of another brilliant film: the protagonist of Mike Leigh’s Vera Drake (2004). The differences between them are huge even leaving aside their contrasting personalities: Leigh’s character is a working-class Londoner in her sixties whose story takes place in 1950; Golino’s is a young middle-class woman operating in Rome and other Italian cities in the 2010s. Besides, while Irene expects to get paid by her clients, Vera wouldn’t dream of it. What they have in common, on the other hand, is that they are both well-intentio- ned women trying to be helpful to desperate people: Irene by assisting in the sui- cide of terminally ill patients, Vera by procuring back-street abortions to unfortu- nate girls who have got themselves pregnant.
If indulging in the fantasy of being the rescuer of unhappy people wishing to end their lives can at one level help Irene to deal with her underlying depression, on the other hand putting herself in the emotionally demanding role of assisting her dying subjects is itself likely to make her feel high levels of anxiety and unconscious guilt, buried under a veneer of morally or politically coloured ratio- nalizations. Engaging as Irene does in sporting and sexual exploits not only has a cathartic, liberating effect, but may also function as a kind of hypomanic defence to ward off at least some of her own psychological pain.
We learn that Irene had dropped out of her medical studies after two years of university. This suggests that she must have acquired some knowledge of patho- logical conditions, but it also indicates a reversal in her attitude towards diseases: not, as we expect from physicians, to cure them but, on the contrary, to accelerate their deadly effects on the bodies of those individuals affected by them, in patent breach of the Hippocratic Oath, one of whose precepts reads: «I will give no deadly medicine to any one if asked, nor suggest any such counsel».
However, under her display of professionalism and efficiency, doubts of all kinds must have festered in Irene’s mind, and many of her (and our own) assumptions are brought to the surface by Carlo’s challenges, in particular the notion that only terminal, physical, painful illnesses suffered by individuals who are still in full control of their mental faculties could justify this extreme sort of humane assistance. But, we may ask, how is anyone to decide, and on which moral or even rational grounds, where to place the dividing line between physical and mental suffering? How is anyone truly to know whether a cancer patient is funda- mentally unhappier, and therefore more justifiably entitled to be helped to die, than someone con una salute di ferro («fit as a fiddle») like Carlo, nor ostensibly affected by any serious physical or even psychiatric condition, but still desperate to put an end to what he experiences as a meaningless existence?
Their encounter opens up a crisis in Irene’s life. When working psychothera- peutically in the mid-1970s with people undergoing a first psychotic breakdown,7 I came to conceive of it as a turning point in people’s own view of themselves, and indeed in the course that their future life could take. For the psychotic individuals this is a crucial time, a crisis, which could either become the starting point of a career as mental patients or be an opportunity to reconsider basic assumptions and earlier choices, to come to terms with past traumatic experien- ces, and to bring about fundamental changes in their lives. Under the pressure of the crisis situation, and provided that sufficient time and suitable therapeutic sup- port are available, such radical changes are indeed possible.
7 As a resident psychotherapist, and later as a consultant, at the Arbours Crisis Centre in London.
While not in the grips of a psychotic crisis, Irene’s whole internal world, set of values and lifestyle are shaken by the realization, through her encounter with Carlo, that she had to reconsider what procuring lethal drugs to her clients actual- ly meant to her. Irene’s special relationship with Carlo (a man who by age could be her father), their well-balanced combination of intimacy and respectful distan- ce, their violent arguments alternating with moments of sincere affection for each other and understanding of their respective fundamental dilemmas, as well as their understated and never enacted Oedipally-coloured sexuality, constitute the most rewarding scenes in the whole film.
Carlo’s manifest reason to get in touch with Irene was to obtain from her the means to kill himself in the privacy of his luxurious home. However we could suggest that he unconsciously hoped for the opposite: that she could rescue him from his deadly plan. If Irene’s relationship with him fails in this respect, it allows her to see from a new perspective at least some of the meanings and implications of her actions, and to reconsider their relative value. A consequence of Irene’s encounter with Carlo is that she tells Rocco that she no longer intends to continue with her career, though we cannot know whether she will actually act upon her intentions; nor should we assume that an interruption of it would necessarily be a positive development for her. But Irene – and we, the viewers of Miele, with her – have now become aware that, once such questions are asked, they can no longer be ignored.
As Carlo eventually returns the bottle of Lamputal still full of the poisonous liquid, Irene and most spectators of the film would believe that their friendship had succeeded in saving his life. But Miele is not a Hollywood film, and a happy ending is not its inevitable conclusion. Carlo kills himself by what he had earlier described as the «messy» method of jumping off from his fifth-floor flat. In the beautiful and almost surreal last sequence of the film we watch his caricatural self-portrait as an anthropomorphic dog (a reference to the image of a Labrador on the bottle of Lamputal, but maybe also to Carlo’s own «dog’s life») float up towards the cupola of the Süleimaniye Mosque in Istanbul: up, that is, in the opposite direction of Carlo’s heavy body pulled down to his death by the combi- ned forces of gravity and despair.
Much as Carlo had doggedly, yet for reasons that remain to a large extent mysterious to the viewers, sought his own death, his killing of himself – and that of the other characters of Golino’s film seeking euthanasia – is still a tragedy. We, the spectators of Miele, are left with the existential question whether his suicide, indeed any suicide, could or should have somehow been prevented. But even the most experienced of psychoanalysts must know this question to be ultimately unanswerable.
L’AMERTUME DU MIEL. RÉFLEXIONS SUR MIEL. Cet article est une réflexion à partir d’un point de vue psychanalytique sur certaines des questions soulevées par le film de Valeria Golino Miele (2013). Irene, la jeune protagoniste, gagne sa vie convaincue d’être utile aux autres en se procu- rant un médicament mortel pour les patients souffrant de maladies terminales qui veulent décider eux-mêmes quand, où et comment mourir, en les aidant dans les dernières heures de vie.
L’article explore quelques-unes des complexes implications morales et psychologiques concer- nantes le phénomène de l’euthanasie, et plus précisément quelles sont pour Irene les raisons surdé- terminées de son activité. Celles-ci comprennent des importants «fantasmes de sauvetage», en partie découlants de ses expériences personnelles. La relation d’Irene avec Carlo, un client poten- tiel, et le suicide tragique de lui, obligent à la fois la protagoniste et nous, les spectateurs de Miele, à nous poser des questions difficiles, auxquelles il n’y a probablement pas de réponses, sur le sens même de l’existence.
MOTS-CLÉS: Euthanasie, Fantasmes de sauvetage, Miel (Golino), Suicide.
COSTANTINI M.V. (2014). Rotture catastrofiche e rotture generative. Unpublished paper. DEUTSCH F. (1936). Euthanasia: A Clinical Study. Psychoanal. Quart., 5, 347-368. FREUD S. (1910). A special type of choice of object made by men. SE, X1. SHAKESPEARE W. (c. 1605). King Lear. In P. Alexander (Ed.), William Shakespeare: Complete Works.
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