Waska R T
Institute for Psychoanalytic Studies, San Francisco, CA, USA.
Am J Psychother. 2001;55(1):105-21. doi: 10.1176/appi.psychotherapy.2001.55.1.105.
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.
作者认为，躁狂防御是一种综合尝试，旨在控制迫害性客体，并将它们从自我内部的攻击性力量中拯救出来。它并非严格意义上抑郁性内疚的表现，也是对摧毁客体进而摧毁自我的恐惧的一种防御。因此，梅兰妮·克莱因的抑郁位态是对杀死理想部分客体的更原始分裂样焦虑的分层演变。这与伤害整体且可靠客体所产生的抑郁性内疚形成对比。抑郁位态是一种心理状态，担心因对客体造成可修复的暂时伤害而导致客体失去爱。偏执-分裂位态则是一种更为绝望的内在情境，涉及客体的完全丧失，进而自我的完全丧失。文中通过一个案例研究进行说明。
