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Upon learning that I was writing this review, my eldest son, who is unfailingly in touch with the ever-changing Zeitgeist, informed me that bipolar disorder is the disease du jour. It has, in fact, become one of those fashionable terms that get used as shorthand descriptions in conversation: “He's bipolar” is like “You're being paranoid” or “neurotic.” I told him that I regret hearing this, because this kind of
inclusion into the larger culture trivializes a condition that is serious, and when accurately diagnosed, may be treated by appropriate intervention. For a similar instance of the dangers of popularization, one need only think of “recovered memory” in regard to childhood sexual abuse issues.
My own interest in manic-depressive or bipolar disorder arises primarily from its occurrence in my own family and, of course, from its occurrence in my practice. My own experience has made me wonder whether or not we, as psychoanalysts, are enough attuned to bipolar disorders. Certainly, most of us, during hospital internships and residencies, have come in contact with patients in florid manic states, or in the major depressions that often follow. Yet those people in our clinical practices who describe episodes of rage and irritability, who exhibit a sense of entitlement bordering on the grandiose, who are easily narcissistically wounded, and who swing between idealization and disillusionment in their relationships, are more often diagnosed as narcissistic or borderline personalities. When prolonged analytic treatment is effective in the patient's gaining insight into his or her behavior and its origins while the behavior remains unchanged, we may be more likely to search for reasons in the analytic interaction rather than in the biological etiology of the disorder.
It is in this connection that I review these two recent books. One deals directly, the other indirectly, with bipolar disorder. An Unquiet Mind by Kay Jamison, Ph.D., is an autobiographical account by