Manic Games

Game 1. Manipulation of the Self-Esteem of Others

• Sensitivity to issues of self-esteem in others

• Increasing or lowering of another's' self-esteem as a way of exerting leverage

Management of Manipulation:

• Avoid excessive praising for ingratiating behavior

• Avoid using such phrases as, "I want....." and "I need....."

• Ask the patient to define their understanding of the problem

• Reward self-help with such phrases as, "My sense is that you are learning the differences between doing just as you please from learning how to please your own inner self"

• Don't argue nor explain

• Point out to the patient how the arguing effects you; such as, "When someone argues like this, I get distracted from wanting to be with them"

• Ask the patient what choices they see for themselves

Game 2. Perceptiveness to a Group's Vulnerability and Conflict

• The ability to sense, reveal, and exploit a group's covert sensitivities

• Playing one faction against another faction

Management of This Splitting

• Refer the person back to the person complained of

• Stress their past success in working with the person complained of

• Cut off lengthy discussion before it becomes a struggle by saying, "I feel uncomfortable. If I don't listen to your complaint, you will feel frustrated. If I do listen, I will be agreeing with you that you are lacking the strength to deal directly with....." and name the person complained about

Game 3. Projection of Responsibility

• The ability to shift responsibility 

• Others become responsible for the manic's actions

Management of Projecting Responsibility

• "Your description suggests that you are convinced that you made no significant contribution to any of these problems"

• Do not take over

• Ignore protests of helplessness

• Do not give advice

• Reward any movement towards independence or tentative decision making by saying, "Many adults do experiment this way"

• "In what other ways are you disappointed in me in what I have not been able to do for you?"

• "I do have significant limitations of understanding, significant limitations of skill, significant limitations of compassion, and significant limitations of time. Regardless of all my limitations, you do deserve from me quality care"

Game 4. Progressive Limit Testing

• The manic extends the limits imposed on him

• "Uping the ante" 

Management of Progressive Limit Testing

• "The choice is yours to make"

• "Are you requesting controls?"

• Show interest at other times when the behavior is not demanding attention

• Give it a chance to pass

• Make clear your willingness to talk later when the patient is ready

Game 5. Alienating Family Members:

• Process by which the manic distances himself from the family

Management of Family Alienation:

• Avoid being a go-between

• Offer to meet with the family as a whole

• Don't argue nor explain

For further related articles see Answers for Families and Patients:

• Bipolar Disorder (Manic-depressive Illness) In Teens  [In Preparation]
• Comprehensive Psychiatric Evaluation  (Open New Window)
• Normality   (Open New Window)
• Recognizing Recurrence of a Manic Episode  (Open New Window)

See also:

• Your Child (1998 Harper Collins)
• Your Adolescent (1999 Harper Collins)

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