What Do I Talk About in Bipolar Therapy?

Recently, someone visited my website asking the question, “What do I talk about in bipolar therapy?” I suspect this person hadn’t started therapy yet and was trying to psyche himself/herself up to do so by gathering background information. I understand this. It’s something I might do myself. But it is a good question, what are you supposed to talk about in front of a degree-laden stranger? This question actually comes down to two answers and it depends on what type of bipolar therapy you’re getting as to what you’re likely to talk about during a therapy appointment.

Interpersonal/Psychodynamic/Talk Bipolar Therapy

The traditional therapy people usually think about when the envision therapy is “talk” therapy. It’s where people explore all aspects of themselves, including their history, feelings, thoughts, relationships, actions and current state. It’s been around for decades and used to be pretty standard.

In this type of bipolar disorder therapy there’s a fairly extensive “getting to know you” phase as the therapist wants to know about you and your history in an in-depth way. This means knowing about your family and your childhood all the way up to the present.

After this is done, the therapist will help the patient work on his or her issues by dealing with past problems and traumas and putting a mirror up to the patient so he or she can create his or her own solutions to the problems he or she are facing.

This type of therapy tends to be long and drawn out due to the method and what the therapist is trying to cover. That being said, this type of therapy is absolutely appropriate for people who need to work through experiences from their past such as abuse, neglect or trauma.

Action-Focused Bipolar Therapies

I call this group of therapies “action-focused” because, normally, they are focused around a short-term goal and on your immediate situation. Evidence-based examples of this type of therapy used in bipolar disorder include cognitive behavioral therapy (CBT), prodromal detection therapy, psychoeducation therapy, interpersonal and social rhythm therapy and family-focused therapy.

Each therapy is different but they all focus on what is happening now. What are your relationships like with your family and friends? What are your bipolar symptoms? What are your thoughts and feelings when a certain event happens? What do you know about your illness? And so on.

For these types of therapies you tend to talk about what is going on around you right now and how you think and feel about it. If, for example, you are having trouble getting your spouse to understand your illness, that might be something you would talk about so you could find new ways of communicating with him or her about it. If, for example, you expressed unwarranted anger at your boss, you would talk about that so you could figure out why and how to avoid it in the future. While you past may come up in these therapies, it is not the focus.

These types of therapies tend to be short and leave you with some sort of action plan and there’s often homework and assignments involved.

What to Talk about During Therapy?

Ultimately, what you talk about during any therapy is up to you but I will say, the more you are willing to put into the therapy the more you will get out of it; so, if you’re having multiple affairs because of your hypersexuality but don’t mention it, then the therapist can’t possibly help you in that area; and if you hide the fact that you use alcohol six times a week then you’re leaving out a vital part of the puzzle that can keep therapy from working.

My advice is to talk in bipolar therapy about what is comfortable for you, at first, and then work into the less comfortable areas as you move on. This is how therapists generally try to structure things. But the important thing is to be honest and if you really feel like you can’t talk about something then just say so. That’s much better than lying about it. Remember, your therapist is there to help you, not judge you, and you openness and honesty is what is going to make the treatment work.

You can find Natasha Tracy on Facebook or Google+ or @Natasha_Tracy on Twitter or at Bipolar Burble, her blog.