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Pao, P. (1971). Elation, Hypomania, and Mania. J. Amer. Psychoanal. Assn., 19:787-798.

(1971). Journal of the American Psychoanalytic Association, 19:787-798

Elation, Hypomania, and Mania

Ping-Nie Pao, M.D.

SUMMARY

In the psychoanalytic, as well as the psychiatric literature, there is a tendency to use elation, hypomania, and mania synonymously. This tendency is incompatible with the findings of developmental studies, such as Mahler's, which establish the concept that elation is a basic mood. Clearly, an ego state or a mood that is basic must be nonpathological; and pathological conditions such as hypomania or mania, though obviously related, can hardly be conceived as being "basic" in the same sense.

I have attempted to examine the developmental sequence described by Mahler in the child's practicing period par excellence, and the basic mood of elation which is characteristic of this period. Mahler's assertion that the elation of the practicing period is a basic mood is a view I believe useful in the genetic and dynamic understanding of the more complex normal states of later elevated moods.

I have distinguished the pleasurable experience of joy as a response to the infant's reunion with the mother, from the nonerotic work pleasure caused by self-accomplishment and associated with a sense of omnipotence. There is no doubt that while one obtains pleasure from the exercise of ego functioning one gains pleasure from affirmation by internalized objects as well. Therefore, the basic mood of elation as it is being crystallized during the practicing period comprises both joy from reunion and work pleasure.

The surface appearance of a toddler during the practicing period and a manic patient is similar. But the similarity is spurious, because the toddler's behavior is not compulsive, whereas the behavior of a manic patient is. The mania is a defense, represents a conflict, and is not a normal unfolding of developmental phase. Having thus compared the dynamics of the normal state of an elevated mood with the dynamics of the pathological states of mania and hypomania, I would suggest that we should not use elation, hypomania, and mania as synonymous but should rather

limit our use of elation to "normal" states of elevated mood and use hypomania and mania for obviously pathological clinical entities.

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