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Lewin, B.D. (1949). Mania and Sleep. Psychoanal Q., 18:419-433.

(1949). Psychoanalytic Quarterly, 18:419-433

Mania and Sleep

Bertram D. Lewin, M.D.

In mania, to cite Rado (1928), the ego fuses with its superego in an intrapsychic reproduction of that fusion with the breast which takes place at nursing. In going to sleep, many have remarked (since M. J. Eisler's original exposition in 1921), the ego repeats a process like the first infantile falling asleep: a fusion with the breast at nursing. Except for the topography and the two mental end states, these remarks are identical: an intrapsychic fusion repeats the baby's psychic experience at the breast and leads in one case to mania, in the other to sleep. Freud, in Group Psychology and the Ego, compared sleep and mania because of the disappearance in both of a part of the personality. In sleep the ego disappears, rejoining the id, and comparably in mania the superego disappears, rejoining the ego. Referring to the Saturnalia, carnivals and other feasts, Freud thinks of a possible periodic biological necessity for both types of psychological dedifferentiation.

Superficially, certainly, it is hard to see what this common feature of the two states could mean, for the manic patient appears supremely awake. The phenomenologists, who try through Einfühlung and Nacherleben to grasp the subjective Erlebnis of a mental state, would hardly find themselves intuiting or re-experiencing in mania anything that suggests the subjective experience of sleep. The introspective method (and common sense too) would say at this point: Go no further! Indeed, we cannot go further—with introspection and common sense. Another path we may take, however, away from the introspective surface, was blazed by Freud whom Blüher called der Stoffdenker. We are permitted to regard visible manifest form—even so apparently all-embracing a form as the quality of a total state of consciousness—as a manifest element for which there is a latent content.

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