Wednesday, March 19, 2008

Cognitive Therapy (Part 2) and rant...

I would like to thank everyone who responded to yesterday's post Cognitive Therapy (Part 1): ariadnek, ph.d., Roanne, Danielle, and Gianna. Today, I was going to suggest that the one thing I liked about the idea of cognitive therapy is that it would seem to help identify patterns of behavior, and help people try to change them. What I also said was that I've never tried this form of therapy and have only read one book about it--years ago. At the time I was offended because it seemed so judgmental.

I had intended to do more research on cognitive therapy, but then I read Gianna's comment and decided not to. (Again, I'm providing a link to the Beck Institute for Cognitive Therapy and Research, so please feel free to make your own decision on this. A last minute comment by Jane Doe suggests that this was the best therapy she's ever done.)

What Gianna from Bipolar Blast said truly resonated with me so here goes...
"I've attempted to give various forms of CBT/DBT a chance and find it invariably insulting. I find the practitioners condescending and the books patronizing.

As ariadnek said---judgmental hogwash.

Personally I like the idea of taking responsibility for my psyche, but I do that by accepting myself, not forcing myself to think differently.

You know Susan, the mental health system strips us of our self-esteem because most of the people practicing don't believe we can be whole, functioning individuals who can recover. I say bulls%^& to that. It's taken years and I'm still trying to shake the self stigmatization but it is bull. If we were approached with the good faith that we are not hopeless and that we can recover we would be much better off.

I'm blessed to have everyone in my life believing that about me now, but much damage has been done."
I couldn't agree more. I spent years trying to find someone--anyone--specializing in bipolar disorder who truly is a healer. But, no one believes we can get well. And when I did find a doctor who provided hope (she specialized in Integrative Medicine) once a depression hit, I found her to be as ineffective as everyone else.

As I've said before, if you go to a heart doctor and have a heart attack, they treat you. If you go to a diabetes specialist and your blood sugar spirals out of control, they help you lower it. But when you go to a psychiatrist and have a severe depressive episode, they're willing to hospitalize you (in a lock down psychiatric ward, which anyone with normal intelligence might agree isn't the most uplifting atmosphere), but other than that, they throw some medicine at you and you're supposed to go home and try to survive.

The lack of support is truly chilling. The lack of insight into this illness is inexcusable. And the treatment protocols are so ineffective that 50 percent of the bipolar population tries to commit suicide and 20 percent is effective in doing so.

While I try to write this blog about wellness because there is so little hope anywhere, deep down I'm outraged and believe that everyone who's bipolar should be as well! I only wish there was one consumer organization who didn't wave the mental illness banner, didn't accept funding from pharmaceutical companies, and spoke out loud and clear about a Bipolar Wellness Program. I'm only sorry I can't be the one to lead it. (Having survived more than 120 depressive episodes has taken its toll.)

P.S. I'd like to acknowledge that today would have been my mother's 86th birthday. Mama, while you may no longer be here physically, I love you dearly!


my life with bipolar disorder said...

Susan, it is not easy to find a good therapist for Cognitive Therapy. Thank God, I was helped by a lady counselor / therapist earlier last year through 9 sessions of Cognitive Behavioural Therapy which changed my life! My counselor helped me to identify certain unhelpful thinking patterns and unhelpful ways I was viewing things in life. These sessions with her are changing my life in many wonderful ways. I shared a little about it on my blog. Thanks for these 2 posts! Take care. Regards, Nancie

Gianna said...

There are consumer organizations that don't waive the "mental illness banner." I find them all problematic in various ways but I do support them to some degree in different ways as well. I'm very much involved with a couple of them. I think that unless I started my own organization I would find just about any organization problematic when in comes to mental health. I have very strong personal opinions. But these groups are doing important work and are important parts of a puzzle that has yet to be completed.

Some of them off the top of my head are:
Icarus Project
Alternative Mental Health/Safe Harbor
National Empowerment Center
The Freedom Center
Law Project for Psychiatric Rights

A simple google search will locate the websites of these orgs.

Most, if not all, of these organizations do not take money from pharmaceutical companies.

Aimee said...

I was treated with CBT for a year, and agree that it seems to foster self-judgment and blame. Also, I’m not sure about the underlying assumption that the thoughts cause the behavior, instead of the condition of bipolar causing the thoughts. Chicken or egg.

That said, my personal experience is that some form of CBT can be helpful for mild depression, or when I’m on the way down, before it gets worse. (I understand there's new research into CBT for hypo/mania, but I haven't seen it yet.) It’s the kind of learned positive thinking that you write a lot about in this blog – what are the things you can do or think about to counteract the negativity? If gardening works, then that would seem to be a form of CBT, to be able to recognize that fact. Or if yoga works, then you learn to concentrate on breathing. That changes your thoughts, too. It seems to be a path to increased self-awareness, if one can view the overall process with less judgment, and the bad therapists out there, as well.

I read a book about combining CBT and mindfulness; it’s helped me to see my symptoms and trends more clearly. Mindfulness can be useful to see what your personal triggers are, and at what point you start reacting emotionally to them, without judgment, and then CBT will ask you to think through alternative thought patters. Mindfulness is also useful to balance out the excessive self-analysis that CBT seems to encourage, which can easily lead to ruminations… not always good if you’re already a little unstable. Meditation is a great way to practice mindfulness, but it’s not the only way.

Finally – I wanted to thank you for your “thanking people” post, and how great it is that you have such optimism yourself, even when it seems hard. You provide hope to a lot of people, even mostly passive readers like me! Even though it seems like there’s not much progress in this field, I find it amazing that there are blogs like this that probably wouldn’t have existed 10 years ago, so we can share information. Thanks!

Bipolar Wellness Writer said...

Dear Nanci,
Thanks for your comments. I'll look at your blog later today to see what she recommended. I'm so glad that this woman helped you!


Bipolar Wellness Writer said...

Actually, I'm familiar with all those organizations. Unfortunately, I have problems with them for different reasons. But I appreciate the list!


Bipolar Wellness Writer said...

Dear Aimee,
Thanks for your comment. I really appreciate it. It's good to hear a completely different perspective on CBT. You, Nanci, and Jane Doe have said good things about it. Usually, I try not to be critical about a treatment unless I've undergone it myself. And then I try to report my own experience rather than giving a blanket condemnation. We all know that different treatments and medications work for different people.

And you're certainly right, a good therapist may make all the difference with any form of treatment.

What you wrote about the combination of mindfulness and CBT is certainly something to think about. Three of the co-authors of the book on Mindfulness Meditation and Depression wrote a book about Cognitive Therapy and Mindfulness Meditation, which I haven't read.

And thank you for thanking me. I know you don't comment often, but when you do, you bring genuine insight to this subject.

I'm afraid I've been sick for so long that a part of me has lost hope (for myself). If I were younger and could start over, I'd certainly do things differently.

But I'm experiencing a lot of sadness, loss, and grief these days. So, it's always nice to hear that I may be helping others even when I can't seem to help myself.

But, I'm still experiencing a depression so perhaps this, too, will change.


Gianna said...

I wouldn't be surprised if our reasons for having problems with the groups are at least in some instances similar...

I do feel frustrated as you do with the lack of support within our ranks so to speak.

I do hope to start something someday. I have yet to give up on having a second career. And hope that my life, first being a professional social worker in mental health all the while being patient and now as disabled, recovering patient will bear some fruit.

Oh! And I should say, I'm glad what I said originally resonated with you and inspired a good post.

Bipolar Wellness Writer said...

Dear Gianna,
Thanks for letting me know how you feel about the list you provided. I think it's great that you're going to get involved in the field, and might form your own organization. And you're welcome for focusing on your comment.


~beth ♥ said...

I stumbled upon your blog today. Wow! What a great resource for those of us with bipolar disorder.

Mariposa said...

Susan, this is the reason why I opted to have a Spiritual Director instead. He also, like other theraphist has enough background in psychology and psychiatry as he studied. He is also helping me with my medication...but only when we both agree it is really necessary.

Reading about BP thing is consistent...most people agree on not being healed/ cured. Scientifically maybe that is more or less accurate. Yet, I chose not to yield to that. You see, I have been free from BP meds for years now...and I never had any manic depression episodes since my last treatment. I was diagnosed when I was turning 18...I'm 28 now.

I'm not sure how my spiritual director is leading me...but looks like, he had helped become aware of my whole being...that I can watch my own patterns and whether you believe it or not, I'm able to mange them. There...maybe it can't be removed from our system...but we can manage it...and if we are able to manage it...then there is none. That is how I think about it. I have resolved long ago never to limit myself from reaching my potentials bec of that 6-letter word. :)

I wrote an article about it. And from that, I quote my last lines...

I remember now so clearly what my Spiritual Director used to tell me, to never allow negative thoughts to go beyond two sentences. He said...

"Do not allow them to become a story because that can overwhelm you, the Lord doesn’t want us to be shaken.”

Christian or not...let's hold on that thing which we believe and gives us a reason to live each day in rejoice, that despite all, we made it a step at a time.

Sorry for the long comment... ;)

Sending happy thoughts to all!

Bipolar Wellness Writer said...

Dear Beth,
Thanks for much. I appreciate your kind words!


Bipolar Wellness Writer said...

Dear Mariposa,
Actually, I appreciate the long story. It's quite inspirational and I plan on mentioning in my post tonight. I think that's great news. I, too, believe I could have controlled this illness if I had started earlier and hadn't taken so much medication.

But I think what you're doing is great. Maybe, things will turn around for me. I'm still in a bit of a depression so I may feel more hopeful tomorrow!

Thanks for writing!