Melancholia from the perspective of the self
pp. 189-219
in: Giovanni Stanghellini, Massimiliano Aragona (eds), An experiential approach to psychopathology, Berlin, Springer, 2016Abstract
Referring mainly to the experiences of the patient, phenomenological anthropological diagnostics is shown as a supplement to a symptomatologicalcriteriological one. Since Greek Antiquity up to modern diagnostic glossaries there is the question of the structure of melancholia and mania and their interrelation. Recent issues of personality research, particularly under the aspect of "typus melancholicus" and "typus manicus" allow us to put these questions in a new way. We introduced two polar concepts, that of intolerance versus tolerance of ambiguity (of FrenkelBrunswik) and of "I" and "me" building up the self (G.H Mead). Deviant from obsessivecompulsive personality disorder we see the behavior of typus melancholicus mainly as hypernomic, compensating a primary lack of egoachievements. The preand intermorbid behavior of melancholics and of bipolars and manics, relate to each other in an inversive way of intolerance of ambiguity. Also the self in the melancholic episode, mainly oriented to the "me" (ObjectI) and that of mania to the "I" (SubjectI) shows the same inversive structure. This allows for a new understanding of the symptoms and phenomena in these states as the expression of a particular kind of depersonalisation in melancholia and of hyperpersonalisation in mania. Remarks on the psychotherapeutic guidance and rehabilitation are given.