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The International Journal of

Int J Psychoanal (2010) 91:583600 doi: 10.1111/j.1745-8315.2010.00261.x

Two modalities of manic defences: Their function in


adolescent breakdown

Catalina Bronstein
Brent Adolescent Centre, 51 Winchester Avenue, London NW6 7TT, UK
c.bronstein@btinternet.com

(Final version accepted 13 October 2009)

The aim of this paper is to explore two different modalities of manic defences and
their specific underlying anxieties. I will describe the relation between these
defences and the role of the superego and their specific function in adolescent
breakdown. While one type of manic defence operates by the egos identification
with a sadistic superego the other one operates via evacuation of a guilt-inducing
superego. I will illustrate the proposed ideas with clinical examples from the
analysis of two adolescents. This paper stresses the specific differences between
these two modalities and the clinical importance of both identifying and addressing
the enactment in the transference of the unconscious phantasies and anxieties
(paranoid and depressive) that give rise to these two types of defences.

Keywords: acting-out, adolescence, adolescent breakdown, body, loss, mania, manic


defences, paranoid anxieties, depressive anxieties, self-harm, superego

in the manic patient life begins anew


(Abraham, 1911, p. 149)

Introduction
Whilst for many years the psychoanalytic understanding of mania attracted
quite a lot of attention from psychoanalytic writers, the concept of manic
defences has been widely used but the different types of manic defences and the
mechanisms involved in their formation have been less thoroughly delineated.
Manic defences involve a sense of omnipotence. They are constituted by a
number of different defensive components (such as denial, idealization, dis-
paragement, evacuation and omnipotent control of the object) (Klein, 1935,
1940). An important characteristic is the omnipotent denial of psychic real-
ity which leads to a distorted sense of external reality (Riviere, 1936). Manic
defences can assume different forms and they do not necessarily always
operate in the same way (Klein, 1935).
In this paper I will explore two different modalities of manic defences and
their relation to the superego.1 This does not necessarily imply that these
are the only ways in which manic defences operate but I think that they are
sufficiently distinctive and different from each other not only in their func-
tion but also in the type of anxieties that lie behind them.
1
I will be focusing on the superego as a critical agency and will not be addressing the role of the ideal-
ego which also plays a very important role in adolescence.

2010 Institute of Psychoanalysis


Published by Blackwell Publishing, 9600 Garsington Road, Oxford, OX4 2DQ, UK and
350 Main Street, Malden, MA 02148, USA on behalf of the Institute of Psychoanalysis
584 C. Bronstein

The first modality of manic defence is employed against paranoid anxi-


eties and persecutory guilt. It manifests itself as a sense of triumph and con-
tempt and has a strong sadomasochistic component. It operates through the
subjects identification with a sadistic superego. The main anxiety it is
attempting to exorcize is the possibility of annihilation of the self. I will
exemplify this modality by describing an adolescent whom I called Martin.
The second modality, which operates mainly against depressive anxieties,
involves a sense of omnipotence and relief obtained by the ejection (evacua-
tion and projective identification) of all indications of the existence of a
guilt-inducing superego. The main anxiety in this case is a depressive anxiety
concerning the survival of the object. I will exemplify this by discussing the
case of Daniel.
However different, these two modalities of manic defences have a common
aim which is to evade psychic conflict and deny psychic pain, allowing the
subject to achieve a state of omnipotence. In a similar way to the fluctuation
between paranoid and depressive anxieties, in most cases patients can resort
to both types of defence mechanisms at different times in the analysis.
When considering the relationship between the ego and superego in rela-
tion to manic defences, I am taking into account the essential role that
internal object relationships have in the constitution of both ego and super-
ego. I will be addressing this issue predominantly from a phenomenological
perspective, that is, by taking into account the phantasmatic qualities that
internal objects can acquire and their influence on the relationship between
the ego and the superego (Baranger, 1980; Bronstein, 2001; Segal, 2001).

Mania, manic defences: The role of the super-ego


While mania has been clearly defined, the concept of manic defences bor-
rows some of the characteristics of mania but, as we will see later, it is used
in different ways by different analysts. Neither Freud nor Abraham wrote
about manic defences and it was mainly Melanie Klein and her followers
who developed this concept which is now quite broadly used.
In Mourning and melancholia, Freud (1915) touches upon the subject of
mania. Whereas in melancholia the ego is powerless in relation to the super-
ego, in mania the ego has regained its omnipotence, either by triumphing
over the superego or by being united with the superego and participating in
its power (Fenichel, 1966, p. 407).
Freud stresses that while in melancholia the ego has succumbed to the
complex in mania it has mastered it or pushed it aside (Freud, 1915,
p. 254). He adds: the manic subject plainly demonstrates his liberation
from the object which was the cause of his suffering, by seeking like a raven-
ously hungry man for new object-cathexis (Freud, 1915, p. 255).
These concepts were further extended and elaborated by Abraham in
1924. He describes the manic state as one in which there is a state of
intoxication and all existing inhibitions are swept away. The traits he
describes can be seen in many patients and, as I will discuss later, particu-
larly in adolescents, without this necessarily being part of a manic
depressive syndrome.

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Two modalities of manic defences: Their function in adolescent breakdown 585

According to Abraham, mania and melancholia differ from one another


in the relation of the individual to the superego. While in melancholia the
superego exercises its critical function with excessive severity, Abraham
states that the manic patient has thrown off the yoke of the superego,
which no longer takes up a critical attitude towards the ego, but has become
merged in it (Abraham, 1924, p. 471) so that the difference between ego
and superego has disappeared.
This results in an increase in the persons oral desires, like a gobbling
mania (Abraham, 1924, p. 472). Abraham adds something important:
But it is characteristic that this pleasurable act of taking in new impressions is cor-
related to an equally pleasurable act of ejecting them almost as soon as they have
been received.
(Abraham, 1924, p. 472)

Melanie Klein continued to develop Freuds and Abrahams ideas further.


The concept of manic defences became meaningful through her work. In
her 1935 paper A contribution to the psychogenesis of manic-depressive states,
Klein explored the nature of mania and of manic defences. The mobiliza-
tion of manic defences is seen here to operate in order to annihilate
persecutors and to deal with newly experienced feelings of guilt and despair
in connection with having attacked a loved object. She stressed the need that
the manic person has to master his objects in order to prevent them not
only from injuring himself but from being a danger to one another (Klein,
1935, p. 278). Here, mastery and control of the internal and external
world seem to be paramount.
The manic defence assumes so many forms that it is, of course, not easy to postu-
late a general mechanism. But I believe that we really have such a mechanism
(though its varieties are infinite) in this mastery of the internalized parents, while at
the same time the existence of this internal world is being depreciated and denied.
(Klein, 1935, p. 278)

Klein highlights different characteristics of what is going to be seen to be


part of the egos manic defence: idealization, a sense of omnipotence, the
denial of psychic reality, the denial of the importance of the good objects,
that is, the disparagement of the objects importance and the contempt for
it, and the utilization of the sense of omnipotence for the purpose of control-
ling and mastering objects (Klein,1935, p. 277, italics in original).
Omnipotence is used both to deny the fear of the objects that are perse-
cuting as well as to make manic reparation. She stresses that: In mania
the ego seeks refuge not only from melancholia but also from a paranoiac
condition which it is unable to master (Klein,1935, p. 277).
While some analysts focused more on the role of manic defences against
depressive anxieties and guilt (Riviere, 1936; Segal, 1973; Winnicott, 1935),
other analysts placed the emphasis on the role they play in psychosis and
against anxieties of disintegration (Garma, 1968; Heimann, 1955; Rey,
1994). Amongst many others, Rosenfeld (1960) stressed that manic defences
are related both to paranoid and depressive anxieties. Winnicott underlined
the role that omnipotent phantasies have as a defence against the acceptance

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586 C. Bronstein

of inner reality, trying to cover anxiety that belongs to the capacity of the
individual to feel guilt, and also to acknowledge responsibility for instinc-
tual experiences (Winnicott, 1935, p. 144).

Manic defences in adolescence


While manic defences can be operative throughout life and play a part in
ordinary development, they are often heightened in adolescence when there
is a search for a state of omnipotence to ease the increased anxiety aroused
by the upsurge in both sexual and aggressive drives. This is a process that
every adolescent has to go through and manic defences are, up to a certain
point, part of ordinary adolescent development and they are also supported
by an adolescents culture (Pick, 1988). But in certain situations, mostly
when there have already been childhood disturbances, the irruption of pub-
erty can lead to a mental break with the world and an intensification of
these types of defences (Barrett, 2008; Baruch, 1997; De Filc, 2006).
After the relative calm of latency, the period of adolescence constitutes
by definition an interruption of peaceful growth (Freud A, 1958, p. 267).
This is the time when the up-rush of instincts, both sexual and aggressive,
confront the adolescent with irreversible sexual development and with physi-
cal changes, jointly with a changing image of themselves and of their par-
ents (Bronstein, 2000). The reworking of the oedipal conflict and of early
phantasies and anxieties is set up against the background of a changing
body that contributes to making the adolescent feel both powerful and pow-
erless and at risk of being carried away by his impulses. Early infantile anxi-
eties and unconscious phantasies and the defence mechanisms that were
used by the child to deal with them are now relived within the context of a
changing body and the feasibility that incestuous and aggressive phantasies
could be now realized. The intensification of these conflicts allows for a cer-
tain psychic fluidity that leaves open the question as to whether certain ways
of reacting herald a move to a new resolution and psychic growth or to a
regression to a pathological organization (Britton, 2001).
One of the main tasks of adolescence is that the adolescent should no
longer see himself as a child in the care of parents, but that he should feel
that his sexually mature body belongs to him and that he alone is responsi-
ble for it (Laufer, 1975, 1984). Moses Laufer defined adolescent breakdown
as the breakdown of this developmental process. It is a breakdown in the
process of integrating the physically mature body into the mental picture of
oneself (Laufer, 1982, 1997). In these cases there is often a rejection
of development and a wish to deny and cancel out any manifestations of
change and growth. But there can equally be self-hatred and condemnation
of any aspects of the self felt to belong to infancy. Experiences of need and
dependence on the parental objects and the need to renegotiate depressive
anxieties can then become highly conflictive.
In states of adolescent breakdown there is often an intensification of the
use of manic defences. In a way that is not dissimilar to the tendency to
externalize conflict in manic states (Freeman, 1971), adolescents resort
to action when they feel at the mercy of uncontrollable impulses that are felt

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Two modalities of manic defences: Their function in adolescent breakdown 587

to take over their minds and bodies, impulses that might not be able to be
contained and thought about. This action restores a sense of omnipotence
and triumph and translates into modes of behaviour that are often compul-
sive and that can become repetitive and sometimes addictive (such as
shoplifting, binging and vomiting, self-harming, alcohol binging, drug
intake, etc.). One of the aims of compulsive acting-out behaviour is to
evacuate the mind so as not to feel the anxiety that results from psychic
conflict, in particular, anxiety that is originated by the workings of the
superego and that confronts the adolescent with feelings of guilt, blame and
shame.
I have chosen to exemplify the two different modalities of manic defences
with two analytic cases of adolescents. They both came five times a week. In
both cases manic defences became enacted in the transference, within the
session and in between sessions. Their manifestation as well as the counter-
transference that they produced were quite different.

Martin
In this first case I hope to show the use of manic defences to ward the ado-
lescent from an intense feeling of persecution that could have led him to kill
himself. This persecution stemmed from a harsh, shaming and blaming
superego with which he was identified.
Martin had a breakdown at university at the age of 18. He was suffering
from the delusion that he was under attack, that he was being followed. He
felt that there was a man (whom he called Brutus) behind his neck. By the
time Martin asked for help he had made a severe suicidal attempt by taking
58 tablets of paracetamol plus Prozac. After taking the tablets Martin got
into the bath and cut himself on his wrists, arms and legs. The analysis with
me started after one year of hospitalization in a specialized Adolescent Unit.
The transition from the Unit to the analytic situation was quite difficult as
he was, on the one hand, looking forward to getting analytic help but, on
the other hand, he was terrified of becoming too dependent on the analysis
as he was hoping to lead a more independent life.
I will say very little about his background except that he was the younger
of two children and that his parents separated after his father had an affair
when Martin was 15. According to Martin, his mother was perfect. He
rejected his father, especially after his parents separation. He described a
rather isolated childhood and being very dependent on his mother. At the
age of 18 he started university and had a girlfriend. At the same time he
started to entertain homosexual phantasies. He had a homosexual relation-
ship and thereafter oscillated between going out with girls and with boys
but he was unable to form a relationship with anybody. He then started to
self-harm, cutting himself on his arms and legs. He often described the
feeling of exhilaration and relief brought by cutting himself. Martin was
bordering on anorexia, though he sometimes described himself as bulimic.
He was heavily involved in taking drugs (cannabis, cocaine, and smoking
heroin). He was also addicted to shoplifting which he self-righteously justi-
fied as an anti-capitalist political act. He often became quite triumphant

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588 C. Bronstein

when telling me about his destructiveness and self-destructiveness, all of


which he felt were necessary for his survival though condemned by society.
My first encounter with Martin left me feeling very anxious. He presented
himself in a calm, superior and controlled way. He smiled with contempt at
my attempts to reach him. He looked superior and at the same time I felt
that he was at great risk of killing himself. During the analysis he often
stayed in his long silences holding a sort of smile and ridiculing me when-
ever I tried to understand what was going on. He fiercely protected his need
for starvation, his shoplifting and his drug intake. Sometimes this defensive
faade gave way to reveal some torturing psychic pain and fear as he
appeared to be at the receiving end of an extremely harsh, mocking, sadistic
superego that relentlessly attacked him for any need he could feel towards
me. These times, though they were sadly quite infrequent, he was more
available and he could share with me his anxiety about being driven mad by
his own mind, in particular by voices telling him that he should kill himself.
Martin could not lie on the couch because he felt that there was another
man in the room, a man carrying an axe. He felt that this man was going to
attack him and that I would not be able to stop this and protect him from
being murdered (he was not consciously aware that he might be anxious
about me not being able to protect myself from his murderousness). This
other man was the one whom he felt was following him at all times so that
he needed to sit on the couch with his back, and particularly his neck,
against the wall in order to feel safe. The other man carried the murderous
part of him. (It is relevant to add here that before his admission to the Ado-
lescent Unit he had tried to hang himself.) But more often the persecution
was experienced as coming from inside, from his own body. When the perse-
cution was projected into the other man, Martin became very frightened
but it seemed as if he felt less tortured than when he felt it came from his
own body. He was obsessed with his tummy rumbles. On the one hand he
tried not to eat in order to stop any possible noises coming from his guts.
On the other hand he felt that his hunger also produced noises in his guts.
He felt that he had to get the absolutely right amount of food to stop the
noises. But if he ate too much and his guts made a noise, he had to punish
himself very severely as this was for him the proof of his giving way to his
need for food. This would lead to a sense of satisfaction at the feeling that
he could actually punish himself his guts and control his appetite.
Sometimes he felt that he or what was lodged in his guts deserved
greater punishment and he went for days without eating, living with a mix-
ture of great physical pain and masochistic triumph. But then he was again
overcome by hunger, often by a wish to binge on sweets. After the binge he
mercilessly attacked himself again. This ruthless system was re-enacted in
his analysis.
In his sessions he was often silent for long periods of time holding a
rather mockingly painful smile. If I tried to get through and inquire what
was going on in his mind, or if I made an interpretation, he would not
respond. Then I would get some communication about what he was doing
to himself, or about what he had done to himself the day before, something
that would usually make me feel very concerned, as it was always about

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Two modalities of manic defences: Their function in adolescent breakdown 589

some activity that could lead to him endangering himself, via abusing drugs
and alcohol, shoplifting, often getting very close to killing himself, or not
eating, as he sometimes starved himself for two or three days. Like with his
suicidal attempt, he communicated that it was now too late, that I could not
do anything for him because I was not around when he actually needed me.
Even though this seemed to convey a reproach that I should have been
available when he most needed me, I felt this was said more in order to
prove that I was failing him and to make me feel anxious and guilty rather
than to ask for help. And still, this was also a cry for help as he was com-
municating the terrifying internal world in which he lived and that he could
not escape from.
In my countertransference I felt that we should both be very careful
because if we got it wrong, if he had feelings feelings which were often
felt to be connected to his body in order to kill those feelings, he would
have to kill himself. When he managed to feel either in control of his need
for me and or in control of me and of what I could stir up, he felt good,
triumphant, at times even exhilarated. This feeling of exhilaration was also
experienced when he tried to master his need for food and it was achieved
mainly after some days of not eating. The more the control and cancellation
of anything alive within himself and in the session the greater his
gratification and, I think, his relief. There was a search for a sense of
chastisement that, when he felt he had achieved it, made him feel high and
triumphant. But then his tummy would rumble and remind him of some-
thing still alive and desiring in him, of some liveliness he had not yet
managed to destroy. Equally, after starving us from contact and when
I would be closer to giving up hope, he would bring some material for us
to think together.
About a year into his analysis Martin spent some sessions sitting with his
head against the wall, smiling in a mocking way. At one point he murmured
something and, when I asked him what he had said, he smiled with even
more contempt. In my countertransference I felt quite tortured by his tanta-
lizing smile as well as by his dismissive attitude towards me and his mocking
of my attempts at trying to find some way to speak to him. He then asked
me if I knew Comandante Pedro. He said that he assumed that I did not
know him. He mocked me for my supposed ignorance. How could I know
him if I was part of the same rotten capitalistic society he was trying to
fight against? [Sub-comandante Pedro is said to have been a Zapatista who
was apparently tortured and killed by the Mexican armed forces in 1994.]
I took up his anxiety about the vicious fight and torture that was going on
inside him. This seemed to help a little and he slowly started to tell me
about his eating problems, his wish to binge, and his self-punishment
through starvation.
The next session he managed to lie down on the couch. He said he had
this nightmare:it was a very frightening dream that woke him up at 4 in the
mourning. He could see his body full of creepy-crawlies, like bugs, that were
in his arms and neck and chest, and he tried to remove them and got rid of
them, but he then realized that his T-shirt was also full of green stick-insects.
His T-shirt was like a spiders web, well not really like a spiders web, more

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590 C. Bronstein

like made out of candy-floss. He got very frightened at this feeling of these
insects stuck on his T-shirt and woke up terrified.
He said that yesterday he had been feeling good after the session because
he felt he had never been able to talk about his eating problems. He said
that he always felt hungry but that he did not want to eat, because he felt
that if he ate he would just go on eating forever and eat more and more
and would never stop and he would become fat and hate himself. He felt
that his fight trying not to eat was the same as him trying not to cut him-
self. Cutting became irresistible. It made him feel good about himself. He
has to resort to taking drugs because it makes his craving for food less pain-
ful. It was the same as with drinking, and, actually, after yesterdays session
he got a bit drunk. Later on in the session he described a feeling of having
a monster in his stomach.
I interpreted his wish to kill this greedy, infantile, sticky and devouring
monster that he felt he became yesterday when he needed me and when he
felt pleased to have been here and to have told me about his problems
around eating. A bit later I said that his phantasy was that if he stopped
eating, not only he would be punishing the monster, making it suffer, but
also that the monster will disappear, it would be killed and he will be free
from it. As he felt that this monster was lodged in his body, if his body dis-
appeared, the monster will also disappear.
He said: Yes, it would be such a relief just to have a head, like a head in
a bottle, stuck in a bottle of jelly. Later on he said that he wants to feel
that he has no feelings coming from his body. Because of that he loves tak-
ing pain-killers. He later linked the creepy-crawlies with insects he liked as a
child but he was now feeling frightened of the ones stuck on to his T-shirt.
He remembered that, after a family session at the in-patient unit, he wanted
to shake everything off.
I took up that he might be experiencing my interpretations as something
initially good but they would then stick to him and he starts to feel threa-
tened as it might mean we are now stuck together.
He mentioned that his mother said that she felt that her children were
demanding too much attention from her.
We were reaching the end of the session and he then became quite distant
again. I was aware of this being his last session before the weekend.
I wanted to make contact with him, feeling the risk that I might become the
creepy-crawly chasing him now that he had brought me a dream.
I said that I was now perhaps going to get stuck to this candy-floss while
he was now shaking me off his T-shirt. By the end of the session he was
again detached and unavailable having recovered his smile.
From the point of view of manic defences, this session enabled me to
understand what happened when he mocked me and triumphed over me.
I could see his struggle with a extremely harsh, sadistic superego to which
he submitted and with which he then became identified in his contempt for
his own needs and cravings. His anxiety was that the analysis was actually
making him want more and, if he was going to want and need, he would
then have to attack himself even more. His wants were experienced to be
concretely stemming from his stomach and he felt persecuted by a hungry

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Two modalities of manic defences: Their function in adolescent breakdown 591

stomach that he could no longer control, i.e. his desire to incorporate me,
stick to me like the insect, to take possession of me. In phantasy, the mon-
ster part of himself was fragmented into many insects but this increased his
anxiety as he would be even more unable to control them. He hated both
himself and me for stirring up these feelings that made him feel weak and
passive. His manic defences, his contempt, his sadistic attacks on himself
and on me made him feel again omnipotent and in control. In this session
which followed a session where his attack on me gave way to allowing me to
help him, he brought a dream depicting this dangerous and creepy web. But
this carried the risk of us getting together in the session, getting closer to
what he feels and wants, to his horror that we would see him wanting to get
stuck to what he feels I am seducing him with. At the same time his dream
is also like candy-floss. I went for it and, once I got caught up in it, he just
shook me off in order to return to his rather safe omnipotent position, his
only way to survive the onslaught from his superego, the death penalty for
his desires.

Daniel
I am going to introduce another adolescent boy, whom I will call Daniel.
I hope to show how his manic defences were used mainly though not
exclusively to ward off depressive anxieties about the harm he felt he did
to his loved objects. He predominantly resorted to manic defences of an
evacuative type, that is, in phantasy, he evacuated and projected his guilt
into the analyst so that he triumphed over a guilt-inducing superego and
denied its existence.
Daniel started analysis at the age of 19. At the time of starting his
analysis he was engaged in drinking, promiscuity, and he spent thousands
of pounds on his fathers credit card without knowing where they went,
mostly inviting friends to expensive nightclubs and buying drinks for them.
He had failed at two college courses and his parents, who lived in Scotland,
demanded that he should go back home though they agreed to let him try
again just once more. They suggested that he seek help and he came to see
me in a panic at the idea that he might have to go back home to live with
his parents. At the first consultation he spoke non-stop, quite cut off from
any feelings but conveying a sense of urgency. Something had to be done
now! He had to change! He did not know why he did not manage to com-
plete anything. In a rather grandiose way he said that he felt that he was
highly capable; he could just study at the last minute and could learn it all
very fast and pass his exams though he could not explain why this was not
working at the moment. He moved from expressing great worry to saying
that he did not care about his studies. He showed quite an aversion to adult-
hood and to taking responsibility for himself. He liked spending money and
going out with lots of girls and dreaded a more permanent relationship.
The more ostensible source of anxiety that Daniel brought to the initial
consultations was the possibility that his father might suddenly die. Daniel
was very dismissive of his mother. He somehow felt more sympathetic
towards his father. Even though his father was quite old-fashioned and very

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592 C. Bronstein

strict, he felt loved and supported by him. However, Daniel showed no


apparent remorse or guilt about having taken money from his father without
his permission and no concern about his parents worries about him.

Early history
After giving birth to Daniel, his mother rejected him. According to Daniel,
she blamed him for the pain she had gone through and she refused to look
at him and after him for the first 10 days of his life. Apparently, mothers
breakdown lasted for around three months. During this time, Daniel was
looked after by his father and by an aunt. Daniel never experienced any
sense of missing his mother. He was often sent away on exchange trips and
he never felt homesick.
Daniel was a difficult boy; he was hyperactive and he never quite settled
at school. From his description of his childhood it seemed to me that he
oscillated between depressive and manic states. Puberty was a major uphea-
val. At the age of 13 he still looked like a small child. I think that one
major contributor to his anxiety about growing up, perhaps his paralysis at
this point, had to do with his father needing an operation for a potentially
life-threatening condition when Daniel was 12. This operation came as a
great shock to him and seemed to signal his fathers vulnerability. It also
threatened Daniel with the loss of the only good object whom he felt he
could love and be loved by. I think it was also felt to be the proof of the
power of his unconscious murderous wishes towards his father. His terror of
his fathers death pervaded and he had frequent nightmares about it. Daniel
felt that if his father died he would have to replace him as head of his fam-
ily. He felt totally unprepared for this task though he was less aware of a
possible wish to occupy the fathers place. Oedipal anxieties about both his
wish and his dread to take his fathers place paralysed him. The fear of
death percolated his manic defences and he felt persecuted by death. He
fainted at museums and at churches when he saw graves. He had repeated
nightmares about death. At the same time he evacuated and defied his fears
in a counter-phobic way. He constantly endangered himself, by putting him-
self at risk of accidents (he drove very carelessly and had some car accidents,
skiing accidents, etc.).

The analysis
Daniel communicated a pattern of having to be on the move, to leave girl-
friends, friends, colleges and countries. Daniel appeared to me to be a quite
disturbed boy, often very dissociated, moving from omnipotent, manic states
of mind to feeling helpless and lost. He frequently came at times that were
not his times, confused and baffled when he was confronted by reality.
Daniels absences became one of the predominant aspects of his analysis,
one that weighed heavily on my countertransference. For long stretches of
time he mostly came two or three times a week. He often missed two or
three weeks of sessions before and after breaks. It seemed terribly important
for him to know that I was waiting for him, never knowing when he would
come, neither pushing him out nor forcing him to come. I then became the

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Two modalities of manic defences: Their function in adolescent breakdown 593

abandoned (and dismissed) child always waiting for a disengaged mother to


turn up. But I also became the container for his guilt as he missed many
appointments which his parents were paying for while at the same time tell-
ing them that he was coming to his sessions. This made me have to collude
with his lies and therefore participate in his abuse of his parents help. Any
initial attempt to interpret this was met with denial and more running
away. I often wondered about what to do technically. I decided not to com-
municate his absences to his parents as I thought that in order to under-
stand their meaning it was important to maintain the setting and to
contain both Daniels attacks on it as well as his projected guilt. I also felt
that to let his parents know about this would be an enactment in the coun-
tertransference as I would be playing either the role of the superego or of
the helpless victim in need for a more powerful paternal figure, a role that
repeated his perception of his mother who was frequently felt to be helpless
and relying on the father to impose rules and sanctions on their son. In
the transference, I thought that the guilt I had to carry was the result of
the evacuation and projective identification of his guilt into me. This evacu-
ation and projective identification did not leave him free from anxiety. The
damage he felt he did to his internal and external objects was permanently
present. I think that this probably contributed to his difficulty to come
back to his sessions.
His anxiety, his evacuation of guilt, of psychic pain and of awareness of
reality became clear in the following dream: His father has died. He saw
himself at every stage of his fathers funeral and burial and at each stage he
left. He sort of forgot that he was attending his fathers funeral and left but
then he got into a panic and ran back to get back there. He saw himself doing
this several times. He said that then, a part of himself, another Daniel woke
him up knowing that he was suffering and that he was feeling unbearable
anxiety.
I think that it is important that the panic lies in both places: if he
acknowledges his death wishes against his father, it brings unbearable pain,
sadness, depressive guilt. But if he runs away he is also persecuted by guilt
(the panic that follows him). He feels there is no resolution to this conflict
though he is still able to symbolize it in a dream to bring it to his session.
A week prior to the session I am going to discuss, Daniel had a terrifying
dream: It was not a dream, he felt it happening, his hair was going white! He
knew it and he didnt have to look at the mirror.
After having this dream he flew back home and got very drunk on both
Friday and Saturday nights. He missed his Monday session, came to the
Tuesday session when he reported this dream but then missed the next three
sessions.
The next Monday he was 20 minutes late. He came rushing in, out of
breath. He sat down and started talking straight away.
He said he had not come last week, which day he came? Monday, Tues-
day?, well, he knows he had not come for a while but he could not come.
For the first time in the analysis, since he was coming here, he was fright-
ened, not of you he quickly clarified, of this He felt that he could not
cope any more because he was not sleeping. He was going mad and he

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594 C. Bronstein

thought about the sessions, he had not forgotten but he could not come. It
was too painful, too painful. [He repeated this a number of times in various
orders.] He felt he could not cope. On Friday he went out with a friend, his
flat-mate, who was going away on holidays and after he left he went back
home and slept. He woke up the next day at 3 in the afternoon. Then on
Saturday he went to sleep at 8 at night and he slept again for many hours.
[He sounded very relieved as if he was immensely relieved that he had recov-
ered his mind.]
I said that he sounded very relieved that he had recovered his mind, when
last week he felt driven mad. It sounded as if he felt I was driving him mad
so he had to stay away.
Daniel: No, it was more to do with the pain. The enormous pain
Analyst: I think that what you call pain is perhaps guilt, that you felt dri-
ven mad by the feeling that time was rushing, that you had wasted all this
time, that you are not coming to your sessions, that your hair has gone
white, old and white and unable to make things better, that it was too late
to make things better.
D: I had a dream: I woke up and thought I have to remember to tell you
about it. It was very strange. You know that I always dream with death, my
fathers death, my death This was like that but different. I was like in a
restaurant, no, like in my boarding-school. [He was sent to boarding-school at
17 to study for some exams he had previously failed. His mother wanted
him to go and his father didnt.]
D: You know, the boarding-school I went to when I was 17. Well, there
they had one week per year a trip to a place where we did not have to wear
uniform, where the teachers were quite nice and I liked it there. There we
had to get our food from a trolley: you first took the trays and then went
through this other place where the cook gave you the food and after eating
you put the tray back into another trolley. But in the dream: instead of a
tray, there were coffins. Small coffins, but not like a childs coffin, though
small. I dont know what was inside. Perhaps they were empty, dont know.
But we had to throw them into the fire though there was no fire. Like when
you . [He lost the word here for cremation and tried to explain.] like
burning. The strange thing is that I felt nothing, absolutely nothing.
He then told me a bit more about going to boarding-school: it was the
first time he had left home for a year but it was good because there were so
many fights about him and with him at home and he felt that it was too
difficult and his parents suffered a lot because of him.
I interpreted that he seemed very relieved that he had made the pain dis-
appear and that this was the only way that he could come back to see me,
as if he felt that I had the power to drive him mad by making him feel bad
and guilty. He is then unable to come to his sessions, he kills them off like
the small coffins and this makes him feel powerful and relieved because
there is no pain, but then more anxious and frightened of me as he fears
I am going to feed him again with guilt.
D: There is one thing that I dont like about the analysis. I want to com-
plain, well, its not quite a complaint But before I was much better
socially. Now I care too much. I used not to care. Now I have become too

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Two modalities of manic defences: Their function in adolescent breakdown 595

intense, you know like with the tennis, or the yacht race or with my girl-
friend. On Thursday the same thing happened at work. I dont like the
intensity. [Then he told me that on Thursday he had desperately tried to
trace a client using the Internet. He found a place in US where he thought
this client could be, isolated hundreds of possible phone numbers and after
dialling many of them he finally got through to this man. He felt that was
too much. People at work said it was as if he had lost a girlfriend in Alaska
and he had to find her.]
A: Perhaps what you reproach me for is your intense longing to be here,
as if you were desperately looking for a mother whom you have lost, or who
has left you. But then you fear feeling unbearably guilty for rejecting the
sessions.
His eyes filled with tears and in a moving way he said that his father had
asked him about his exam results and he told him. [They were pretty bad.]
His father then said that it did not matter what his results were like, that he
could see that Daniel was working really hard and trying very hard. Daniel
was very moved.

Discussion
Freuds contribution towards the understanding of the role played by identi-
fication with an object in Mourning and melancholia was followed by his
revelatory exploration of the role of the super-ego and unconscious sense of
guilt in The Ego and the Id (Freud, 1923). Kleins idea of an early sadistic
superego and the notion that the punitive and cruel aspects of the superego
derive from early terrifying introjects is of relevance when we consider
how Martin and Daniel dealt with their development (Riesenberg-Malcolm,
1999, p. 59). I think that in both adolescents these harsh internalized objects
were not sufficiently modified in early childhood. When confronted with the
emotional roller-coaster brought about by pubertal changes they both felt
helpless and unable to deal with the harshness of their superegos. In their
own different ways they struggled to keep a state of omnipotent control to
overcome this.
In manic states where the adolescent is identified with a sadistic superego
there is gratification from inflicting damage to the self and or others. In
these conditions the adolescent masochistically submits to the superego, a
superego that owns the patient like an omnipotent god requiring total sur-
render, obedience and worship (Brenman, 1982, p. 24). This might be akin
to a melancholic state of mind although the predominant anxiety is perse-
cutory in that there is a threat to ego-integration, to the survival of the ego.
In these adolescents, the sadomasochistic conflict is frequently lived out in
the relationship to the body in that, in phantasy, the now sexually developed
body can be felt to contain and represent hated aspects of parental objects
and of the self that are projected into it. Adolescents might then feel that it
is the body that is persecuting them with unbearable and forbidden needs
and wants. In these cases, adolescents can feel driven to attack themselves
physically. There can be a sense of elation stemming from self-punishment.
The aim in these cases, like in self-mutilation, is to control and evade a

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596 C. Bronstein

superego that demands suicide a even greater punishment while also


getting gratification from attacking their hated bodies (Garma, 1968;
Jacobson, 1957; Lewin, 1932). Identification with the superego and the
masochistic omnipotent gratification stemming from self-harming can thus
become a compromise in order to stay alive, often a protection from suicide
(Rosenberg, 1991). The sadomasochistic gratification and subsequent perse-
cutory guilt can lead to a compulsively acting out behaviour. In the analysis,
these patients might try to entangle the analyst in a sadomasochistic
relationship and the analyst can then feel either provoked into becoming
sadistic or feel helpless, incompetent and useless. This is frequently enacted
in a non-verbal way (Cycon, 1994; Feldman, 1994).
Martins fragmented and persecuting internal world threatened him with
annihilation. His infantile needs, his longing for an object of love were con-
demned by him and experienced to be shaming and humiliating as they were
unconsciously linked to the wish to regress to an idealized prepubertal state
and to the rejection of his new sexual development. The necessity to rework
the Oedipus complex in the light of his bodily changes was also met with
hatred and self-hatred as it implied an identification with a father who had
been denigrated and attacked. One can speculate that Martins internal
world had always been split and that the idealization and denigration of his
objects were accompanied by a ruthless primitive superego. The delusional
creation of Brutus was quite complex in that it was partly the result of the
externalization of this primitive, murderous superego (Blum, 1980). But it
also carried the projection of the aspects of the self that he hated most
about himself as Brutus was felt to be envious, greedy and disloyal. At this
point Martin was terrified of Brutus and in great fear of death. Martins
body became the site for the projection of his infantile longings and of his
hatred of both them and of his adult sexual development. His body was
thus felt to be the source of his persecutory anxieties as well as the arena on
which his anxieties were played out (Bronstein, 2007). Martins delusional
belief was that if he tortured his body, which was seen to be the container
and producer of his longings and need for his objects, he would appease his
superegos demands to kill himself. His ultimate wish was to get rid of his
body and of all the feelings he attached to it including his sense of need,
desire, dependence, greed, envy and competition (Laufer and Laufer, 1984).
When he felt he managed to get closer to this state of mind he felt trium-
phant and elated. His masochism protected him from a possible defusion of
the life and death drives that could have carried him to his own death (and
the death of his internal objects). In this way he could torture his body but
stay alive. This was enacted in the transference as I was often meant to
carry the projected helpless hopeless aspects of himself as well as the anxi-
ety about his self-destructiveness while he mocked me and triumphed over
me.
In the second modality of manic defences I underlined that they operate
against depressive anxieties and that the predominant mechanism is that of
triumph over the superego. Their aim is to get rid of a superego that brings
guilt and psychic pain by reminding the adolescent of his attachment to his
objects. There is not only an evacuation of the anxiety stirred up by the

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Two modalities of manic defences: Their function in adolescent breakdown 597

superego but also an evacuation of part of the mental apparatus, with the
subsequent denial of reality and of any perceptions that could stir up psy-
chic conflict. Awareness of time, vulnerability, mortality are all cancelled
out. Equally, awareness of internal reality, such as of feelings of need, miss-
ing and dependence, seem to evaporate. These are actions that are used by
the adolescent to evade conflict rather than work through it (Williams,
1978). Such a conflict frequently arises from aggressive and triumphant feel-
ings towards the oedipal object and is linked to an unconscious phantasy
that their sexual development can actually kill the object. Even though there
might still be some sadomasochistic component, the gratification has more
to do with the evacuation of any experience of psychic pain and guilt
towards the object that is both loved and hated. There is also an evacuation
of feelings of need, love and pain provoked by it, feelings that, jointly with
the rivalry, competition and envy of the object, could provoke guilt. Adoles-
cents who function in this manic way search for a state of omnipotent,
blissful mindlessness. This can also eventually provoke actual harm to the
adolescent and to those surrounding him.
Like Martin, Daniel also felt tortured by his superego. In his hallucina-
tory dream he felt persecuted by his white hair, proof that, in his
omnipotence, he had become his father and thus killed his father with the
subsequent punishment via his own imminent death. The unbearable guilt
was not just provoked by his attack on his father but was also based on his
hatred of his mother and his refusal to take anything good from her. He
resorted to manic denial, to an evacuation of the superego (and of a guilt-
inducing me) via not coming to his sessions thus turning potential good
food into dead objects. As highlighted by Rosenfeld (1952) this evacuation
was accompanied in phantasy by projection of his superego into me. In my
countertransference I felt anxious and guilty about what he was doing with
his life and with the analysis while he seemed oblivious to this and rejected
taking any responsibility for his actions.
I think that in the session I reported Daniel could regain contact with his
projections and, therefore, with the damage he did to his objects and to the
love he got from them. The dream alludes to the maternal object and his
transformation of food into deadness, though it also brings up part of
his own experience of actual deprivation and of his mothers own deadness.
Even though he attacks himself, and there is some masochistic gratification,
I think that the main aim is to evacuate psychic pain and guilt.
Both Martin and Daniel enacted their struggle with anxieties stirred up by
the superego in the analytic relationship. Martin oscillated between seeing
me as somebody who contained this murderous, mocking, vengeful superego
and a me who became the container of the projected infantile needy, disgust-
ing creepy-crawly aspects of himself that he had to get rid off. But in as
much as he needed to maintain his ruthless internal constellation he was
frightened that I would force back into him what he had projected into me
as well as that the analysis would actually take away his defensive organiza-
tion and drive him to kill himself. When Martin managed to develop a
number of friendships that made him feel more normal and less dependent
on me, he decided, against my recommendation, to end his analysis.

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598 C. Bronstein

Daniel also saw me as the one containing a guilt-inducing superego that


was confronting him with guilt and psychic pain. He was compelled to deal
with this through evacuation and magically got rid of his pain by not com-
ing to his sessions, only to be confronted with the fact that he could not
make his pain disappear. But he was also more able than Martin to keep
alive his love for his external and internal objects. Daniels capacity to toler-
ate guilt and pain improved considerably. By the time we reached an agreed
termination, after several years of analysis, he was working full-time and
paying for the analysis himself.
In their own way, both Martin and Daniel struggled to maintain a precar-
ious balance threatened by their unresolved internal conflicts. Their manic
defences were felt to be indispensable to protect them and their internal
good objects from themselves.

Translations of summary
Zwei Modi der manischen Abwehr: ihre Funktion beim adoleszenten Zusammenbruch. Das Ziel
dieses Beitrags besteht darin, zwei unterschiedliche Modi der manischen Abwehr und ihrer je spezifischen
grundlegenden ngste zu untersuchen. Ich beschreibe die Beziehung zwischen diesen Abwehrmechanis-
men und der Rolle des ber-Ichs sowie ihre spezifische Funktion beim adoleszenten Zusammenbruch.
Whrend ein Typus der manischen Abwehr durch die Identifizierung des Ichs mit einem sadistischen
ber-Ich operiert, kommt der zweite durch die Auslagerung eines schuldgefhlinduzierenden ber-Ichs
zustande. Diese berlegungen werden anhand klinischer Beispiele aus den Analysen zweier adoleszenter
Patienten illustriert. Der Beitrag betont die spezifischen Unterschiede zwischen diesen beiden Modi und
die klinische Bedeutung sowohl der Identifizierung als auch der Bearbeitung des bertragungsagierens
der unbewussten (paranoiden und depressiven) Phantasien und ngste, die diesen beiden Abwehrtypen
jeweils zugrunde liegen.

Dos modalidades de defensas manacas: Su funcion en la crisis adolescente. El presente artcu-


lo se propone explorar dos modalidades de defensas manacas y las angustias especficas subyacentes. Se
describe la relacin entre estas defensas y el papel del supery y la funcin especfica que tienen en la
crisis adolescente. Mientras un tipo de defensa manaca opera mediante la identificacin del yo con un
supery sdico, el otro tipo opera va la evacuacin de un supery inducidor de culpa. La autora ilustra
las ideas propuestas con ejemplos clnicos provenientes del anlisis de dos adolescentes. Se hace hincapi
en las diferencias especficas entre estas dos modalidades y en la importancia clnica de ambas, y se iden-
tifica y aborda el enactment en la transferencia de las fantasas y angustas inconscientes (paranoide y de-
presiva) que originan estos dos tipos de defensas.

Deux types de defenses maniaques: leur fonction dans leffondrement depressif a


ladolescence. Lauteur de cet article vise
explorer deux types de d fenses maniaques ainsi que les
angoisses sp cifiques qui les sous-tendent, en tudiant la relation entre ces d fenses et le r le du surmoi
ainsi que la fonction de ces d fenses dans leffondrement d pressif chez ladolescent. Tandis que le
premier type de d fenses maniaques est activ par lidentification du moi
un surmoi sadique, le second
est mis en uvre via l vacuation dun sentiment de culpabilit induisant le surmoi. Lauteur illustre ses
hypoth ses
laide dexemples cliniques extraits de lanalyse de deux adolescents. Elle souligne les diff -
rences sp cifiques entre ces deux types de d fenses ainsi que la n cessit didentifier et de traiter lactuali-
sation dans le transfert des fantasmes et angoisses inconscients (parano des et d pressifs) qui mettent en
uvre ces deux types de d fenses.

Due Modalita di Difese Maniacali: La loro funzione nel crollo psicotico adolescenziale. Questo
lavoro si propone di esplorare due diverse modalit
di difese maniacali e le ansie specifiche che le
sottendono. Descrivo dapprima la relazione fra queste difese e il ruolo del super-io, e la loro specifica
funzione nel crollo psicotico adolescenziale. Mentre un tipo di difesa maniacale si realizza mediante
lidentificazione dellio con un super-io sadico, laltro si manifesta attraverso levacuazione di un super-io
che induce sensi di colpa. Passo poi ad illustrare le idee da me proposte con esempi clinici tratti

Int J Psychoanal (2010) 91 2010 Institute of Psychoanalysis


Two modalities of manic defences: Their function in adolescent breakdown 599
dallanalisi di due adolescenti. Il lavoro vuole porre laccento sulle differenze specifiche fra queste due
modalit
e la rilevanza clinica di entrambe individuando e analizzando i fenomeni dellenactment nel
transfert di fantasie inconsce e ansie (paranoidi e depressive) che causano linsorgenza di questi due tipi
di difese.

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