Wednesday, May 22, 2013

Cognitive Behavioral Therapy Techniques and Bipolar Disorder

Cognitive Behavioral Therapy is talk therapy that examines the client's thought process and relevant emotions to those thoughts. Both the client and therapist examine those thoughts in hopes to find a viable intervention that either promotes more positive thinking or eliminates negative thought.

Cognitive Behavioral Therapy is great for addressing current problems as it doesn't dig too deep into past issues. It is also relatively short-term when compared to other therapy methods. Measurable progress could be seen as soon as the fourth session, should the client and therapist find an intervention method that clicks.

An example intervention technique is addressing automatic negative thoughts. Imagine your boss walks up to your desk in a neutral manner and says "in 10 minutes, I need to see you in my office for a private discussion." What's the first thought that comes to mind? If it's "oh, I must be in trouble", then that would be an automatic negative thought. The problem happens when these thoughts exist without real rationale and they cause overwhelming stress and anxiety to the point where you have visible problems coping. In this example, it would be a rational thought if your boss frequently spoke to people privately when they were in trouble and used a similar approach.

However, it may not be rational if the thought extends to "he's going to fire me today. I know it. And I'm sure he hates me anyway", especially if you've never been in trouble and no other evidence shows that your boss has a dislike for you. For bipolar disorder patients experiencing paranoia or depression, this line of thinking wouldn't be uncommon. These thoughts could interfere with sleep and work in general. And interrupted sleep for bipolar disorder patients can promote negative actions and may even trigger a manic or depressive episode.

A therapist using cognitive behavioral therapy may ask the client to write down the thought and analyze it with the following questions:

1. Is it true?

2. How can I validate that this thought is true?

3. How do I react with this thought?

4. Where would I be without this thought?

The patient would bring those answers to the therapist and they would discuss to see the effects and what could be done if it turns out the automatic negative thought wasn't validated.

The additional value of cognitive behavioral therapy interventions like this is that they can help patients see the manic episode coming and learn how to react better to it. If more automatic negative thoughts are happening, the patient can start looking for the other symptoms and triggers. He can give this information to loved ones and the therapist to see if lifestyle adjustments or other treatments need to be made.

This is just one example of cognitive behavioral therapy. There are many other interventions and methods that use a similar style and require the patient to do these types of self-examination and bring the results back for analysis. As long as the bipolar patient is willing to do the work, cognitive behavioral therapy can help them manage moods more effectively.

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