Compassion Focused Therapy for People with Bipolar Disorder

Abstract

Bipolar affective disorder arises from major dysregulations in various affect and drive systems and constitutes a major mental health problem. Compassion Focused Therapy (CFT) was developed from a neuroscience and evolutionary approach and pays particular attention to affect regulation. It therefore lends itself to both the analysis of bipolar disorders and offers potentially important interventions. This article will explore the applications of CFT to the understanding of bipolar disorder and development of compassion-focused interventions. Clients with Bipolar Disorder (BD) face a range of complex recovery challenges, including the need to work with mood instability, the fear of relapse, and the experience of potentially complex states of ambivalence associated with engaging with manic states and medication use. Recovery efforts of people with BD are frequently hampered by a tendency to strive for high standards, which can lead to difficulties with the pacing of recovery, and the presence of an attacking self-to-self relational style, which can have a powerful negative impact on the ability to cope with setbacks. Within this article, processes associated with BD, as understood by the modified Behavioral Activation System dysregulation theory (Urosevic, Abramson, Harmon-Jones, & Alloy, 2008) and social rank theory (Gilbert, McEwan, Hay, Irons, & Cheung, 2007) are described, along with details of how Compassion Focused Therapy (CFT) can be used to help clients to strengthen their soothing systems, which is viewed as a key step in rebalancing mood states. Bipolar disorder is a serious illness, with a lifetime prevalence of approximately 0.8% (Johnson, 2004). As BD is recognized on the basis of historical information, unless revised in light of further information, a diagnosis tends to be lifelong (Mansell, Powell, Pedley, Thomas, & Jones, 2010). BD is understood to exist in two forms, type I in which a person has experienced a clear episode of mania, or a mixed episode involving aspects of depression and mania, and type II, which is identified if a person has experienced an episode of hypomania, and one or more episodes of depression (Johnson, 2004). It is generally, although not totally, accepted that BD exists on a continuum of severity.