Chris L. Minnick, M.D.

An Overview of Manic Defenses in Clinical Practice

General Overview:
1 – Dr. Albert Mason says that perhaps as much as 75% of the work of analysis involves the effort to
diminish manic defenses. These maneuvers are in almost constant operation in any form of
psychotherapeutic situation even if the therapist is not primarily trying to work on them.

– Because they aim to preserve the patient’s unconscious sense of self-sufficiency and limit the
vulnerability to loss or guilt about how the therapist is treated, virtually any successful form of
therapeutic relationship is a potential threat to these unconscious states of mind:

e.g. any state of acknowledging dependence, feeling of need, or feeling of helplessness

e.g. every separation, especially including the 6 days between sessions in once per week therapy

e.g. contact with loving, caring feelings for anyone, but especially the therapist (because love makes
one aware of dependence on and need for the other to reciprocate)

e.g. successful interventions by the therapist that make the patient aware of his or her psychic reality
(i.e. having an unconscious inner world that he cannot control and therefore hates)

e.g. interventions that give the patient relief from distress but make the patient aware of being
dependent on the therapist for getting that relief

e.g. any situation or interpretation that makes the patient aware of their mistreatment or harm done
to another person (often friend, family member, or therapist) leading to guilt for hurting
someone whom they love (which is may be the most painful feeling of all emotions that humans
can have)

e.g. it useful to think of these as specific maneuvers to defend against smallness, need and
dependency and their consequences for the pains of the depressive position, analogous to the
way narcissism is a global character defense against the same smallness, dependency but
additionally and most importantly in the case of narcissism, the potential for feeling envy

2 – Most therapeutic relationships that interrupt prematurely do so as a result to manic defenses

3 – Much of what makes patients difficult or unpleasant to work with is a result of manic defenses
– these are usually patients with severe character disorders whose attacks and devaluations as a result
of manic defenses combined with unconscious envy make them so unbearable to work with

4 – Manic defensive maneuvers often manifest themselves in much more silent fashion
– e.g. living inside the object

– e.g. consciously valuing the therapy but splitting off the hostile part of self into someone else,
commonly a spouse, parent or friend who does the undermining or attacking of the therapy

– e.g. respond to interpretations with open agreement but with an unconscious or private feeling that
they knew it all along (and therefore don’t need you for anything they don’t already have)

Definitions of Klein’s Developmental Positions:
1 – Paranoid-Schizoid Position: A set of primitive psychic maneuvers that are necessary in earliest
infancy for the baby to bring order to its world so that it can internalize a core, good relationship to its mother. This is stored in the form of a good part-object representation of her, the good breast, that will
be the foundation of a lifelong sense of emotional stability and sense of being loved and safe.

To achieve this ordering of its world the infant must divide itself and mother (or caregiver) into good and
bad (the processes of “splitting-and-idealization”) and then hold onto the good and get rid of the bad
into the outside world (achieved by the process of “splitting-and-projective identification”). It now
feels that both it and its object are all good (actually purified to the point of being “ideal”) and that the
outside world contains the really bad elements. The “paranoid anxieties” are about the bad stuff
returning to attack and ruin the idealized self and object.

This is a value system of self interest with little concern for the other except to the degree it benefits and affects the self.

[Note: If this splitting into good and bad goes too far initially because of difficulties in the mother
infant relationship, then the bringing the two versions of mother back together in the depressive
position is made much more difficult. The result is potentially significantly problematic for later life.]

2 – Depressive Position: As development continues into the middle of the first year of life, the infant’s
increasing psychic capacities and organization bring about an ever increasing awareness of its
separateness from its mother. As it introjects her as a loved, good figure, it feels itself to contain more
goodness and is even more able to tolerate separateness. This creates a positive cycle for development.

It is in contrast to all of the pains of infancy where mother has been felt to have so much and the infant so little and her relationships with others compound the distress. These combine to create very painful states of envy and jealousy, which when combined with grievances about separation, frustration, etc. lead to hateful attacks on mother.

If the splitting-and-idealization of self and mother is not excessive, the increasing awareness of separateness, as positive development proceeds, leads to a painful realization that the ideal mother that
the baby loves and the all bad mother that it hates are one and the same person. It then realizes that it
is injuring its “good” mom when it attacks the “bad” mom during states of hateful rage. This makes
it painfully aware that is has mixed, i.e. ambivalent feelings, for one and the same person. In turn, it
wishes to repair and restore the mother that it loves after damaging her in states of rage, etc. This wish
to repair is the product of feeling both loss of the good mom and potentially unbearable guilt for
hurting and/or damaging her.

3 – Manic Defenses: An organized set of mental maneuvers that are aimed at diminishing the pains of the
“depressive position”. As awareness of separateness increases in the middle of the first year, anxiety about losing one’s good mother and/or guilt about damaging her in moments of hostility becomes greater than the infant can bear. Instead of returning to the primitive earlier mechanisms of the paranoid-schizoid position, the infant uses a new, more organized set of mental postures.

These defenses have, as their primary aim, the diminution of these pains by avoiding any experience of the
psychic reality of them. First and foremost, this means evading the essential realities of being a baby
who cannot live without its mother. To evade these realities it must do something about (1) its needy
dependence on its mother as it increasingly recognizes its separateness from her and (2) its loving
concern for her welfare when it mistreats her (i.e. depressive anxieties and guilt).

The infant may also hope to eliminate those situations that generate its envious or jealous hostility, resulting from its increasing awareness of its separateness (due to the progressive diminution of massive states of fusion attendant to projective and introjective processes).

The evasion of these psychic realities is achieved by use of the “manic triad” of “control, contempt,
and triumph”. These three states of mind eliminate the experience of need for and dependence upon a
unique person who is separate. The also make the person no longer worthy of guilty concern for how
it is treated.

In many individuals, these attitudes are augmented by a very powerful tendency to replace the need for a separate, living, uncontrollable other with something which is not separate, not alive, and is very
controllable. In the infant this means turning to its own body and bodily products for comfort and
sustenance (i.e. erogenous zones and excreta). In later life, these maneuvers are unconsciously
transformed into more socially acceptable activities but they retain the same infantile significance.

4 – Mania: The state of mind that results from an acute, massive domination of the personality by manic
defenses as a result of an extreme depressive situation that is felt to be unbearable. It is more linked to
a state of psychotic functioning than neurotic functioning and can easily lead to a more openly psychotic state. When the underlying depressive anxieties break through without being dealt with constructively, an overt clinical depression often results.

5 – Manic Reparation (to evade experience of guilt): An omnipotent maneuver in which reparation is done quickly without any acknowledgement of guilt about damage done or possible loss of a loved figure. The guilt is therefore completely denied and thus does not register in psychic reality. No real loving feelings for the person are allowed as this would risk true depressive concern for the object.

To avoid concern the repair must be done with special conditions: (1) it is done in relation to objects other than the primary object, (2) the object is not experienced as having been damaged by oneself, (3) the object must spoiled so that it is seen as contemptible, inferior, dependent, etc.

Because proper concern and repair in relation to the originally damaged loved object is avoided, manic reparation is never successful and complete. If it were successful, the restoration would lead to a loved object being re-established toward whom love and depressive concern would be reignited and guilt would result.

Baby Origins of Manic Defenses:
1 – As the infant recognizes mother as a separate, unique individual, it begins to see that mother is her
own agent and can leave the infant whenever she wishes, be with someone else, etc.

2 – While recognizing mother as separate, the infant also increasingly recognizes its utter dependence on
her for its very survival to meet all the needs it cannot provide for itself. If the infant is of a
particularly envious predisposition, it also feels intense resentment and even hatred that mother is the
source of what it needs. In effect, it envies her for “having everything, knowing everything, and
being able to do anything”.

3 – When the infant feels enraged and destructive, it realizes increasingly that it is damaging a good
mom who it needs and loves. It thus wishes to repair her and restore its good, loving relationship
with her. This requires the (1) acknowledgement of the damage, (2) toleration of the feeling of guilt
about having hurt her, and a (3) willingness to feel sorry and try to make amends. In effect, its
tolerance of the feeling of love for the good mother has to outweigh the pain of its guilty feeling of
responsibility for damage imagined to have been done.

4 – Repair of the damage and restoration of the good mother is likely to fail:
– where the infant does not feel the damage can be repaired (often because of excessive violence in
the reaction of the infant)
– where the infant is excessively intolerant of need and dependence
– where the infant has an excessive tendency toward hurt and grievance that it cannot get past
– where the infant is excessively envious of the mother for being the source of everything good

5 – When the infant feels it cannot bear the psychic realities of dependence, loss, guilt, etc. it will resort
to defensive postures to prevent their occurrence or evade their consequences. The goal will be to
evade feelings of smallness and need, dependence on a separate person, guilt about damage
imagined to have been done, and to deny all psychic realities that relate to these issues. Where the
infant has a predisposition to turn to its own body and bodily products to generate a phantasy of self
sufficiency, then premature sexualization of the erogenous zones and anal omnipotence may become
prominent aspects of the manic denial of needing mother.

Classic Triad of Manic Defenses:
1 – Control: The central problem for the infant is that to survive, it is in need of things that it cannot
itself provide. It must therefore depend on mother to provide such needed things as sustenance,
care-taking, and love. If one mistreats this needed figure, and it is felt to be separate, then
it can go away and the infant will die. The most constructive approach to this problem is to accept
these realities and preserve a good, loving relationship to mother, making repairs to the relationship
whenever damage to it occurs (in reality or unconscious phantasy).

The main alternative, if one cannot tolerate these realities for whatever reason, requires eliminating
the psychic experience of dependence on someone who is separate. One must get these needs
met while simultaneously denying the reality of dependence on a source that is separate and can go
away. This is in effect making mother an extension of oneself so that all needs are met without any
acknowledgement that they are coming from a separate source. This can be done with the use of
several different phantasies and maneuvers, the central distinguishing characteristic being whether
they are (1) done from the “inside” of mother or (2) from the “outside” mother. Generally speaking,
control from the outside is less extreme than control from the inside because the person is allowed to
be separate (just not allowed a real life of their own).

– If one stays, in unconscious phantasy, on the “outside” of mother, then an illusion of complete control
over her must be maintained while her other relationships are be ignored or hallucinated out of
existence. Very disturbed children and borderline adults will often use overt coercion and intrusion
which represent the most extreme and violent versions of attempts at control of the needed figure.

A simpler and less dramatic approach is to imagine that mother is in need of or dependent upon the
child, in effect a role reversal achieved by projection of ones own baby neediness into the mother
while simultaneously taking possession of her desirable traits and capacities through unconscious
introjection of them. Varying degrees of actual intrusive and controlling behavior of mother and her
activities are used as needed to augment these phantasies.

– Where the infant found separateness from mother particularly difficult to accept in early infancy,
and opted to remain an “unborn, inside baby”, then it is more likely to resort to this phantasy as a
maneuver when it is trying to cope with the depressive anxieties of loss and guilt later in infancy.

In effect, it is resorting to a phantasy that is a normal part of early infancy, but whose use in later
infancy and childhood becomes increasingly problematic as its ongoing use undermines the normal
procession of development in childhood.

2 – Contempt: Remember that these defenses are usually occurring at a time when the infant or child is
angry at mother and imagines she has been damaged and may go away. If one denies that one loves
her, cares about her, or needs her, then guilt and loss can be denied and avoided. Since one is already
angry at her, it is easiest to just stay angry while devaluing mother so that she is neither needed or
worthy of guilt for how she is treated. Since one no longer cares how she is treated, continued
attacks are justified.

This contempt for mother and denial of any need for her is commonly augmented in the infant by
turning to is own body (especially erogenous zones) and bodily products (especially the anal ones) in
order to generate a phantasy of being self-sufficient.

3 – Triumph: This is really an extension of the omnipotent phantasies seen in the contempt, especially
when unconscious envy leads to a wish to cruelly reverse roles with the parent. The contempt used to
avoid dependence and vulnerability to loss is extended to a triumphant defeat of the parent so that
the parent becomes the worthless, helpless, needy baby and the baby becomes the big, fancy parent.

The risk of unconscious guilt for these attacks and a return of even worse depressive anxieties of loss
make for a serious potential of a vicious cycle requiring increased omnipotent self sufficiency and
ongoing devaluing attacks.

Manic Defenses, Anal Omnipotence, and Masturbation: While control, contempt, and triumph represent the primary components of manic defensive maneuvers, they are all aided, abetted, and augmented by various masturbatory activities that can be used at any moment, in any combination, to increase the sense of self-sufficiency. Whenever a therapist sees either one, i.e. manic states or masturbatory activities, then the therapist should be on the lookout for the other.

1 – Omnipotence: A state of mind generated for the moment to deal with a task at hand. It amounts to an
unconscious phantasy that “I can do this”. At its deepest underpinnings, it is most commonly a baby
wish for magic to deal with a mental pain in relationship to mother. Sexual excitation and
obsessional maneuvers are the most common generators of this phantasy as they combine a feeling
of self-sufficiency with a sense of control over the object.

2 – Masturbation: The use of any erogenous zone to generate pleasurable or distracting sensations that
give one a “magical” sense of control and/or self-sufficiency. The activities are often used to
generate or augment a baby level phantasy of getting inside mother to be safe and/or emptying
out an unwanted state of mind e.g. getting away from the unvbearable pain of anxiety and frustration.

3 – Anal Omnipotence: A probably inherited tendency that is definitely augmented by deprivation and
disturbance in infancy, in which self-sufficiency, intrusion, and at times violent attacks on the object
are all augmented by a turning to one’s own anus and stools. Odors are commonly used after
early infancy to secretly maintain these phantasies because social mores restrict overt turning to
ones stools. Manifestations later in life often include an excessive valuation of things one can
produce oneself, e.g. speech, writing, painting, money, drug usage, smoking, etc., in preference to
people and relationships.

Manic Defenses as Seen in Dreams: Less ill patients usually attempt to consciously treat their therapist decently, so most of the manic maneuvers and attacks on the therapist occur unconsciously and are represented in dreams, often long before they are consciously recognized.
1 – Dreams denying separation

2 – Dreams denying the proper feeding relationship to the therapist/breast
– communist/socialist defense of making everyone the same, i.e. no difference between parents and
children

– sexualizing the relationship to the therapist = *erotic transference*

– role reversals with the therapist

– seeing the therapeutic relationship as a commercial exchange

3 – Dreams that overtly devalue the therapist

4 – Dreams of omnipotent self sufficiency and turning to one’s own body and bodily products

Manifestations Relevant to the Working Therapist in the Clinical Situation:
1 – Mistreatment of internal and external parents
– spoiling the parent as an individual, often profound with alcoholic, violent, or crazy parents

– splitting the parent’s relationship apart

2 – As seen in the transference toward the therapist (often leading to a negative transference)
– living inside the therapist

– denying the therapist as a living being with needs and feelings e.g. a machine just doing its job

– using the therapist exclusively as a “toilet breast” (patient is continually evacuating, not
communicating, or feeding)

– being self sufficient and denying need for the therapist as a feeding breast

– reversing roles so that the therapist needs the patient or is seen as the destructive figure

– overtly denigrating and spoiling the therapist’s work

– erotic transference to make equal and evade feeding dependency and/or envy

3 – Manic defenses and acting out(side) the therapy:
– financially

– sexually (especially infidelity)

– addictions

4 – Manic defenses often go unrecognized because they are projected into family member, friend, boss,
etc.
– often see manic activity aided and abetted in someone else

Consequences of Failure to Address Manic Defenses:
1 – Manic defenses undermine psychic change because these defenses always do harm to the therapist,
the patient, and their relationship. Therefore, they are continually generating guilt and paranoid
anxieties of retaliation, no matter how unconsciously held or split off. Simultaneously they
undermine any capacity for appreciation and gratitude and ultimately the love that would allow the
patient to see the value and benefit in the relationship to the therapy and therapist.

– the patient’s personality is not developing improved internal figures to give a sense of stability

2 – The therapy is inherently being undermined, progress is thus being undermined, with a result that the
therapy stagnates even if the patient stays committed to being “inside” the therapy relationship. With
more disturbed, envious, or paranoid patients, there is a chronic risk of interruption of the therapy.

– patients that resist change even though their manic defenses are being analyzed can be thought of
as remaining “inside” the “eye of the hurricane” (i.e. the womb) where it is calm, fearing getting
separate and into the storm

3 – The manic defenses are self-perpetuating as a vicious cycle, so therapy must stalemate until they are
addressed. There is always a danger that this vicious cycle will escalate, resulting in much more
serious consequences including destructive mania, depression, and suicide.

Key Treatment Postures for the Therapist:
1 – It is crucial to mobilize guilt in order to stop destructive, negative, spoiling activities

2 – All manic maneuvers used by the patient must be addressed as they are being used. Children will
escalate before your eyes until something breaks down, commonly in the form of an accident or
a minor injury. Adults will commonly escalate until they break off therapy.

3 – Manic maneuvers should be addressed as they first present themselves This lessens the likelihood of
their becoming problematic in the therapy as it allows the patient to begin to develop a concept of
the patient’s own activities bearing a relationship to baby feelings. Later analysis of them in detail in
the transference is then much easier for the patient to recognize and hopefully accept, and there is
less damage, paranoia, and guilt that has to be dealt with and repaired.

– anticipation of negative transference and its early analysis greatly diminishes the ultimate
destructiveness of negative transferences

4 – With “thin skinned” patients, who are easily persecuted by the feeling that the therapist is “sitting-
in-moral-judgment” of them, the infantile anxieties underlying the manic maneuvers need to be
spelled out so that the behaviors have a human side to them.

5 – With “thick skinned” patients, who easily deflect any feeling of guilt, it is important to “hold their
feet to the fire”, examining in great detail the destructiveness, etc. of their maneuvers to mobilize
guilt and not allow intellectualization.

– Meltzer: If patient says they kicked somebody, ask the shoe type, power of kick, where it landed,
what it did to the recipient, etc., etc.