Mania and Mourning1

Centuries ago, when mania, melancholia, and dementia were the simple divisions of madness, Plato thought of mania not only as madness, but as the mad, emotional, creative state of the poet. I would agree that the poet, and with him the orator, the prophet, the artist, the actor, the philosopher, and the theologian have each something to add to the psycho-analyst's understanding of mania. One theologian, for example, Mgr Ronald Knox (1950), has written on Enthusiasm as seen in the lives of religious leaders. Preachers, in their language, whether it be the result of true inspiration or false enthusiasm, take us to the heart of the problem, since each of us has, in his own way, to talk to patients about their relationship to themselves their society, their God or their 'all'.

Analysts see great metapsychological variety as between different excitements, and their approach is very different from the traditional trend towards naming and making descriptive classifications on which to base treatment. Lewin said recently in Boston that the extension of the psycho-analyzation of psychiatry is doing much to substitute an outworn faculty psychology for a more useful dynamic model. In a short paper such as this, however, it is only possible to summarize the most generally accepted views and to say little about the more controversial opinions. First I shall speak briefly about the mechanisms involved, secondly about developmental problems, and, thirdly, I shall discuss three patients.

Half a century ago, soon after the first attempts of Abraham and Freud to use psychoanalytic hypotheses to understand depression, Freud (1917) described the fusion of the ego and the ego-ideal in mania, and Abraham (1911), (1916), (1924) described an altered balance of libido and aggression—a balance altered in favour of libido.

Freud, in Mourning and Melancholia, wrote that melancholia differs from mourning only inasmuch as the mourner shows no disturbance of self-regard. The other extreme of