Did You Say Bipolar Disorders ?

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ARCE ROSS, German, « Did You Say Bipolar Disorders ? About Strictly Bipolar, the book of Darian Leader, Penguin Books, London, 2013 », Huit Intérieur Publications, huitinterieur.com, Paris, June 2015.

I met Darian Leader in Paris, many years ago through an ex-girlfriend of mine. He is now psychoanalyst in London and wrote in 2013 a pocket book about bipolar disorders: Strictly Bipolar (Penguin Books, London, 2013).

When he makes a list of melancholic problems involved in the experience of the death of the other, Darian Leader refers to some authors, like Thompson MacCurdy, Terri Cheney, and others as well as including my work (pp. 52-56). Hereby, even if we agree in some points, for example that we both are contrary to theories of the American Psychiatric Association about Manic-Depressive Psychosis (MDP), in my opinion, bipolar disorders are only a part of the MDP and these cannot replace the aforementioned ones.

As I’ve showed in some previous texts (some of them joined in Manie, mélancolie et facteurs blancs. Beauchesne, Paris, 2009), the manic-depressive subject does not value the loss in an affective and emotional sense. And, Darian Leader frequently quotes that the manic-depressive subject does not seem being aware of any sense of death, or of any sense of debt. Also, in addition, he quotes as me that, certainly, the mania crisis triggers often after a loss…

Most pages of his book, that I really appreciated, is devoted to the manic states, insofar as he seems to follow my idea on the prevalence of the mania on melancholy in the manic-depressive bipolarity. In this respect, this author endorses the base of my thesis in 1999 when he wrote that « depression itself can be manic » (p. 75). Concerning this point, it should be said that indeed in 1999, 2003 and 2009, I had raised this insight : « if melancholic delirious has generally as contents the idea of died or suicide, it is only in the mania that one can find his realization. Because, in the mania, the delirious construction has as perspective an act of solution, in such way that we could say that it is the latter which dominates and marks out the first » (cf. Arce Ross, G., « La Fuite des idées dans le diagnostic de Psychose maniaco-dépressive », Bulletin de psychologie, T. 56, 3, 465, Paris, mai-juin 2003, pp. 367-381).

In despite of, he notes today most of the items which I used a decade or more to rank mania, Darian Leader evidently does not refer identifying my work in many concepts. We only find a slight reference when he talks about the sense of death that remains unresolved for the older generations of the patient. Leader discusses throughout my concepts like delirium of death, manic foreclosure and white factor’s themes, i.e. altruistic anxiety, death altruism in mania, loss of the sense of death, delirious about death, foreclosure of the sense of guilt, foreclosure of the affective and emotional value of loss…, without expliciting all implications concerner about and value of these concepts.

Maybe trying to follow the furrow traced by the white factors, but without saying clearly the source they come from, Darian Leader focuses the problem of manic-depressive states in the responsability and in the charge of culpability concerning the death of somebody loved. Leader says : « In case after case, we find a dilemma about responsability at the level of preceding generations. It is often the parent of the manic-depressive person who will have experienced the tragic loss of a child, a sibling or a parent, and the responsability for this death remains unresolved » (p. 53). At this point, to prove the importance for the clinic of manic states of the responsibility of some death, instead of the foreclosure of the emotional value of the loss, Darian Leader refers to a case studied by Abraham Brill in 1929.

For example, concerning Brill’s patient we can say that he doesn’t really suffer from the responsibility of the accidental death of his brother, although this seems to be the opposite. But he suffered from the fact that his mother, confronted to this tragic accident, puts unconsciously the patient in the place of a white factor. As D. Leader stresses « mania perhaps involves a foreclosure of the conscious feelinf of guilt and debt » (p. 55). Of course ! Needless to say « perhaps ». Obviously, manic patients have both foreclosure of the sense of guilt and foreclosure of the sense of debt. And this fact this is not « a temporary abolition of the barriers of guilt ». Even during the melancholic phases the barriers of guilt is not operating because, in these cases, this relates to a delirious culpability.

Also, Leader uses the same theories that I defend, which noted a hierarchy between depressive phase and the manic phase. These theories consider mania like the pivot of the system. According to myself, as Leader says, « the manic component, much more than a simple polarity towards which the sick person can tip over, seems to be an essential, explicit trend or not, of the elaboration of the delirium and the melancholic act » (cf. Arce Ross, G., Manie, mélancolie et facteurs blancs. Beauchesne, Paris, 2009, p. 130).

In the Brill’s case, we can imagine the following possibilities. By trying feel responsible to her son about the brother’s death, the mother has created conditions for a white factor in her relationships with the surviving son. But we can suppose that the brother’s death was still for the patient a dark cloud of emotions by preventing the affective value of loss. We have thus two kinds of white factors. Firstly, a white factor located in the accident that has provoked the brother’s death. Why a such accident, implying him in the death of the brother, could happen? No sense. No sense of affects and emotions regarding the brother’s loss. Secondly, after this event, but also perhaps even before, there was another white factor between relationships with the mother. How can mother accuse, explicitly or not, her son about the brother’s death ? No sense either. And this second white factor would mobilize the first one.

Obviously, in some way, even if this could seem superficial and accessory, the body could be involved, as a psychic part, in the manic-depressive process.

We wish only that Darian Leader focuses more widely, i. e. more explicitly, in our theory of the white factors to make progress together in the psychoanalysis of those manic-depressive cases.

German Arce Ross. Paris, June 2015.