Stress-induced hypomania in healthy participants : the allostatic “manic-defence hypothesis”.

Abstract

This thesis analyses the structure, conditions, promises, and results of Large Group Awareness Trainings (LGATs)3, demonstrating that established environmental triggers for hypomania/mania are core features of the LGAT process, and that the majority of (ostensibly healthy) LGAT participants display symptoms that closely resemble hypomania/mania. Through an understanding of the biology of stress (the common element in identified environmental triggers for hypomania/mania), and with reference to the dopamine hypothesis of bipolar disorder, the 1911 manic-defence hypothesis is revisited, and an allostatic4, rather than solely psychoanalytic, mechanism by which the structured application of psychological stress leads to hypomania/mania is hypothesised. Disclaimer It is crucial when considering LGATs as a category to apply the label cautiously - while there are likenesses between trainings, there are also noticeable differences. It is evident that these groups have a similar source, and that they have multiplied through copies of the original trainings, and copies of those copies. While highly scripted (and thereby easy to emulate) there would, however, have been natural evolution, individual preferences of leaders, and deliberate revision of their processes over time. It is important to bear this in mind when contemplating a “typical” LGAT: “Although psychologists have often classified LGATs as a generic group (cf. Finkelstein, Wenegrat, & Yalom, 1982) and although this classification does have considerable heuristic value, it must be kept in mind that each of these interventions is unique” (Fisher, et al., 1989, p. 747). Having acknowledged these limitations, there are conspicuous similarities between many of these trainings, and there is utility in aggregating findings from organisations which have a similar origin, make similar promises, employ similar techniques, create similarly stressful environments, involve similar confrontational interactions, are structured in similar ways, utilise similar sales models, advocate similar philosophies, and – perhaps most significantly – elicit similar results. While the term “LGAT” is frequently used, and many organisations’ trainings are commonly described as such, some resist the categorisation, and a universally accepted definition of the term has not yet been established. Although a concise and comprehensive definition remains elusive, the similarities in origin, processes, and results between identified LGATs will be highlighted so that, at least for the purposes of this thesis, these trainings may reasonably be grouped and collectively assessed.