Bipolar ThoughtsTherapy


So I have had a few posts before about the different therapy methods used to treat common mental illness. And if you would like to see more articles about CBT, ACT and other things like that, please look below this article to find links.

But today I want to talk about these things in terms of thoughts.

So here is a really brief (and not because it is boring but because I know so little about it) rundown of how we tend to think about thoughts as they relate to therapy.

Ok, so starting with psycho-analytical therapy, think Freud, people believed that thoughts are sort of intrinsic to us and always are rooted in our psychology. The method of dealing with harmful thoughts was often to trace their lineage and then work through the root and all the way back out. It tended to work. It took forever, often years, and only really dealt with major rooted issues. So if my thinking is that I’ll never have a meaningful relationship, then maybe that gets followed back to some security of abandonment issues. You find the root, talk about it until you feel better, and then follow the train of thought out to today.

Then, in like the 80’s they developed Cognitive Behavioral Therapy (CBT) and one of the major tenets of this therapy was that not all of your thoughts matter, or are valid. In fact, a ton of them are useless and only cause problems. So the way that CBT often works is to focus on a thought, usually negative, and then actively debunk it. So if the thought is that I’ll never have a meaningful relationship, then maybe we would focus on all of the meaningful relationships I already have, and have had in the past until I realize that not only am I capable of such a thing, but that I have been in them all along.

And then very recently, they have developed mindfulness therapy. And in the various forms of this therapy they teach you that almost none of your thoughts are important almost ever. They train you to focus only on what you want to focus on and on what helps you. They teach you to acknowledge but then just let the thoughts float around, don’t worry about it. So that no matter what I’m thinking it will pass and it isn’t a big deal.

Pretty much the psychoanalytical philosophy is gone in modern psychology. It works, but it isn’t very fast, and it is difficult to conclude what is actually the root of something, and it doesn’t really train you at all to deal with your current thoughts.

CBT is still the most popular form out there, but I have mentioned in previous posts that while this is great for obsessive thinking or anxiety, it isn’t really great for bipolar. It just isn’t a proven method. The biggest problem I have experienced with it is that you can reason your way around it. If I’m thinking I’ll never be in a meaningful relationship, often times I can redirect those instances where we try to disprove that thought. ‘Yeah I’m close with Frank but he doesn’t really know me, if he knew the real me he would be close to me, and if he doesn’t really know me then is it meaningful anyway?’ Sure, you have to make those stretches, but unless you are willing to accept that your thinking could be wrong, this therapy won’t go anywhere. And it can still take months to fully debunk deep seated thoughts. It doesn’t necessarily help you out right now.

Mindfulness therapy is the only form that really attempts to give you tools to deal with every thought you have as you have it. And I can imagine that is why it is quickly becoming a preferred method. It is difficult to find though. When I was most recently looking for new therapists I couldn’t find a single mindfulness practitioner. And reading the books often feels more like talking to a guru then a doctor. There is a lot of meditation and sometimes a very, uh, granola feel to it all.

However, there is a ton of money flowing into this research right now. Especially with regards to bipolar. Most every reputable mental health journal has written an article about meditation and bipolar. It appears that maybe this is the next direction.

Of course, this is still the new thing. And the new thing often gets primacy without reason. Will it phase out CBT? Maybe. But maybe a better question is why did CBT phase out psycho-analysis? That method did work. And CBT does work. And mindfulness does work. But maybe this should be more of a case by case basis, right?

This is a problem I have with the mental health industry as a whole. There is not a long history of success in almost every area, so things tend to change quickly. Most people you meet with mental illness are taking a medication still being advertised on TV. But why? Is that true of anything else? Sure the newest is likely to be the best, but is it always?

And of course, therapy is great to deal with thoughts, but not great at dealing with physiology.