On Finding Out How We Don't Know Ourselves in Therapy and Counselling. (On Defences, Part Six.)

Continuing this series of posts on defence mechanisms in counselling and psychotherapy, today we'll look at the manic defence. For more information on defence mechanisms, check out the first post in this series.

Very broadly, the manic defence is an attempt to do things or think things quickly, to create a sense of busyness that shuts out unpleasant feelings. More specifically, often the feelings that are being shut out are feelings of powerlessness or hoplessness, which are often being shut out with the contradictory feelings of euphoria, goal oriented activity, and control or mastery. Like other defence mechanisms, there really is an intelligence to this, it is very hard to feel hopeless whilst energetically pursuing a meaningful goal. It works. In my opinion the manic defence is also one of the most widespread defences, at least in Western culture where being busy and constantly doing are a virtue. 

For many people powerlessness and hopelessness in the extreme can manifest as depression, including lack of energy and pervasive sadness or numbness. The manic defence is often thought of as a defence against depression, though many consider the manic defence to be different from bipolar - or what was once called manic-depression.

In the psychotherapy or counselling process I most often notice the manic defence when a client talks a lot. In particular, when the client's talk is tangential, and is a response to us beginning to talk about painful feelings. When appropriate, I might notice this with a client, by saying something like: "Do you notice that just now as painful feelings began to rise up, you began to get anxious, and you distanced yourself from these feelings by talking fast and changing the topic?" In such a situation, with a client who is ready and willing to work on their defence mechanisms, it may be an act of kindness for the psychotherapist to actually interrupt their client's torrent of words and to help them see their manic defence in action. Thought it may be painful in the short term, experiencing painful feelings rather than shutting them down through mania may at times be a better long term choice. The cost of overusing the manic defence can be exhaustion, spiralling anxiety (because the problems are not dealt with), and difficulty connecting emotionally with others.

For those who are actively working with their own defences of mania and busyness, mindfulness can be an effective practice. Usually this will start with moments of mindfulness in the psychotherapy room, such as the above example when the psychotherapist helps the client to be mindful of their reaction to painful emotions in the moment. Some may take up mindfulness practice in their daily life. By just noticing and not amplifying the flow of thoughts, over time the thoughts slow down, and the usual experience is relief at the lifting of a burden that couldn't even be fully recognised until it lifted. Mindfulness practices that involve being still (rather than for instance walking mindfulness practice) have the advantage of creating physical as well as mental stillness, which further helps with the manic defence.

An interesting Australian article here discusses use of the manic defence by mental health professionals. An example given in the article is the use of antidepressants by GPs and psychiatrists to treat depression. Here the response is to do something, to prescribe something that stimulates rather than to deal with the painful feeling directly. Though I cannot personally comment on prescribing, and don't discourage use of antidepressants, this article is thought provoking. Amongst psychologists, psychotherapists, and counsellors, I see the manic defence at work at times, when the clinician out of a sense of helplessness or anxiety throws behavioural tasks or exercise at a client. Once again, though behavioural interventions aren't bad (I use lots of them myself), when they are being given to clients as a reaction to the clinicians own anxiety, I believe that the client on some level can feel the emotional disconnect, and is affected by it.