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Case ReportFull Access

Schizoid Anxiety: A Reappraisal of the Manic Defense and the Depressive Position

The author views the manic defense as a combined attempt to control persecutory objects and to save them from the aggressive forces within the ego. Rather than strictly a manifestation of depressive guilt, it is also a defense against the fear of destroying the object and subsequently the self. Therefore, Melanie Klein’s depressive position is a hierarchical outgrowth of more primitive schizoid anxieties about killing off the ideal part object. This is contrasted with the depressive guilt of harming the whole and reliable object. The depressive position is a psychic state of worry about loss of the object’s love resulting from temporary harm done to the object that can be fixed. The paranoid-schizoid position is a much more hopeless internal situation involving a complete loss of the object and, by extension, the self. A case study is used for illustration.