Bipolar Thoughts


I’ve mentioned multiple times before the bipolar is treated with CBT, cognitive behavioral therapy (although I do have a posting about the use of other types of therapy including ACT, but this is very new and virtually unproven). And what my therapy consists of is basically CBT.

There is a little model that you can use to imagine how CBT works, and this model is based on the notion that all feelings are associated with thoughts and vice-versa. For example, the feeling of needing to urinate is followed by the thought of having to find a bathroom. Likewise, the thought that you might fall off the edge of a building brings with it the feeling of anxiety or fear. They are joined at the hip, according to CBT.

I am not a doctor, so I am not really here to talk about the validity of that theory (I kinda think it is crap), but I am here to tell you about the method. This method seems easy to do, but I have been trying to master it for at least four years now, to practically no avail.

So here is the model:

Thoughts – Feelings = Behavior – Consequence

So basically, thoughts and feelings are associated with each other and either can lead to the either. And behavior and consequences are obviously tied together, either begetting the other. And the red arrows in between the two pairings symbolizes a choice.

The process of CBT is to identify the behaviors/ consequences, and analyze the choice. Or to identify the feeling/ thought and analyze the choice. The goal is not to eradicate the feelings/ thoughts, but to make better choices that lead to desirable behaviors and consequences.

The famous way to do this is with feel/ because statements. “I feel _______ because ________”. So when you feel depressed you say to yourself: I feel depressed because… and identify the trigger. This part is not always easy, for a number of reasons. Sometimes it isn’t easy just because a lot is going on. More often it is difficult because you lie to yourself. This is especially true when you know you are being irrational, so you put up a wall of logic around the truth of your emotion. Driving over the Zilwaukee bridge scares the shit out of me. I know I won’t blow off, or it won’t crumble. And those rationalizations disguise the truth that is I am scared my car will blow off.

A lot of the essays I write for this website happen right after therapy, and in a lot of way you get to peer into what we talked about that night. As you might have realized, I have worked out a lot of my depression becauses. I know about my body issues, my strange definitions of success, my inability to let go of the past, and my big ego.

But my anxiety stuff is mostly a mystery to me. It is an area to continue work on. And of course, just because I have recognized some causes of my depression, I haven’t worked out how to make them go away.

Today in therapy we talked about FLASH. These are the five emotions I need to focus on for my feel/ because statements. FLASH stands for Fear, Love, Anger, Sadness, Hurt (she told me to sub in anxiety, happiness, frustration, depression, an disrespect, she also told me to widen those words however I saw fit, but just remember FLASH and what it means).

Apparently these are the core five emotions to work out in CBT. Unlike the core emotions in ACT, which you can see in the Disney Pixar movie Inside Out.

I’m not too good at doing this type of thing, so we will see how it goes and what I can gain from it. Hopefully I can flashforward to a happier tomorrow!

Hahahahhaha, that was terrible!