The first step toward mastery of any topic is education. Benefiting from knowledge gained by experts in the field has been a tried and true formula since time immemorial. In this regard, putting bipolar "in order" begins with education.
With the advent of the internet, educational opportunities abound. With them comes a new problem: which ones can be trusted to deliver useful information? While many sources are accurate from a factual standpoint, they more often advocate avoidance rather than developing an understanding of the actual condition.
When I first started going to support groups, I met many people who had encyclopedic knowledge of every drug, dosage, and efficacy. While many people looked up to such displays of memory, I wondered what is the point of memorizing drugs when there are so many other aspects of an integrated approach? If all we focus on are tools to minimize our condition we end up with a diminished life.
It takes careful discrimination to separate the useful sources from those that only create a diminished life. This is a very difficult process that is confounded by the plethora of points of view and the power we give to those who advocate them. While respecting education and experience, it is far more important to look at what results are being proposed. If the outcome is something that you want, consider the steps to success being outlined and determine if it might work for you.
Many professions have a mentor program where the apprentice learns from an accomplished expert. Through books, talks, workshops, videos, and other means, the professional organization builds a knowledge base that helps the students gain proficiency in the field.
The Bipolar Advantage Program is based on the same principles of successful education. By bringing together experts in various disciplines that contribute to a well rounded understanding, we hope to set a new standard for education that leads to Bipolar In Order.
This book is the third in the series based on the advantage concepts from a general perspective. Our team members are working on other books from their specific disciplines. We feel that books are an accessible way to disseminate information to a broad audience.
Other means of delivering educational content include websites, videos, magazine articles, and public forums. We have already created materials in these areas and will continue to do so.
The most effective way to learn is in group settings. This is especially important when integrating new ideas that challenge our existing beliefs. Sharing ideas with each other helps us to sort out our own feelings with input from several sources. Professionally facilitated by someone who knows how to keep the conversation on track, we learn more from each other than we can from hearing only one point of view.
In our workshops, lectures are replaced with guided discussions, brainstorming, games, and other activities. Physical and mental exercises, visualizations, meditations, and more are all woven into an experience that will increase learning, memory retention, and practice of useful skills.
Although each of our workshops can be taken separately, the complete series provides a necessary base of knowledge as well as a shift in thinking that leads to success. The Advantage Program workshop series is primarily for those who experience mental health conditions. Family, friends, and professionals are also encouraged to attend. Workshops are designed to be an intensive, interactive environment that encourages participation.
Bipolar In Order Workshop
Facilitated by Tom Wootton
The Bipolar In Order Workshop introduces the central concepts of the Advantage Program while creating the important paradigm shift in thinking. Changing our beliefs from illness based diminished lives to conditions that have both good and bad aspects is the first step toward changing our lives. We will be stuck in the old paradigm of living in fear that we may relapse at any time until we accept the possibility that we can overcome all of our obstacles and create a fabulous life with our condition.
The central concepts are Acceptance, Introspection, Mind Skills Development, Life Planning, and Getting Help. Defining Results Worth Striving For and the steps to get there are presented as a clear and logical path. Each of these topics are covered in detail and the participants end the workshop with a clear understanding of what it takes to create a life worth striving for. Through accepting our circumstances and resolving to do something about them, we can enjoy far richer and fulfilling experiences in our lives.
Bipolar In Order Workshop topics:
- A clear and meaningful understanding of the bipolar condition.
- The importance of acceptance in resolving to create a better life.
- Expanding awareness of your thoughts and actions.
- The power of Introspection.
- Habits - how they work and the power to change them.
- Mind Skills - exercises that increase our mental acumen.
- Relationships - understanding how relationships work and how to apply that understanding in your own life.
- Identifying Results Worth Striving For.
- Setting goals for physical, mental, emotional, spiritual, relationships, and career/financial aspects of life.
- How to create a Life Plan for success.
- Understanding fears, roadblocks to success, and how to deal with mistakes.
- Getting Help - the importance of an integrated team of support.
This workshop is the foundation of the Advantage Program series. It provides an introduction to the other workshops and a clear understanding of the Bipolar Advantage main concepts.
Mind Skills Training
Facilitated by Brian Weller
Managing the mind is an essential step to gain greater control in life, especially for those with a bipolar condition. A critical key in changing our responses is to change the way we see or interpret situations. What we tell ourselves when we experience any condition either moves us toward or away from a more optimum state of being.
Our thinking and our relationship with ourselves is where we have the greatest potential for breakthroughs. During the Mind Skills training, students learn how to see the mindsets, belief systems, and frames of reference that are operating in their lives and how to develop new ways of thinking.
Managing stress is also an essential part of the training. Some of the finest approaches to both understanding and mastering the stress response are presented. Do we simply react to what happens, or can we learn to use stress breaking techniques and strategies to go beyond our habits and become masters of our experience?
Students learn focusing techniques and how to settle the mind into states of ease and calm. By relaxing the mind and releasing tension, we can become more aware of subtler levels of thinking and more conscious of what is happening, both in the world around us and in ourselves. We teach how to get more in touch with inner knowing, how to use this to open up to deeper feelings, and better manage emotions.
An important part of the program covers Mindmapping, the master note taking skill that develops memory, attention, and creativity in order to be more effective in daily tasks. Mindmapping helps enable students to create Life Plans, be more creative with brainstorming, explore ideas with friends and family, and generally enhance careers.
Memory training is a featured part of Mind Skills. Improving memory for different types of information with short and long term recall builds confidence. We all have vast, untapped mental potential and releasing this in practical ways is both life-affirming as well as useful in the everyday world.
The Mind Skills workshop is designed around core principles based on well established mind/brain research. The style of the training is fun and highly interactive with lots of practice in the skills, including work individually and in small groups. As an integral part of the Bipolar Advantage Program, the Mind Skills workshop integrates and enhances much of the information from the other educational workshops.
Nourishing Relationships That Work
Facilitated by Maureen Duffy, PhD
For better or for worse, relationships influence our overall personal well-being, our health, our jobs and careers, our finances, our view of ourselves, and our feelings about the future. When our relationships are going well, our lives are significantly better than when our relationships are troubled. We all want to have close and satisfying relationships with our friends and family members. Yet, for many people, the work of developing and maintaining positive relationships requires skills that they have never learned or can't quite put into practice in spite of a strong desire to do so.
Nourishing Relationships That Work is a professional relationship training program that will give students the skills and support to bridge the gap between wanting better relationships and actually having them. The program focuses on relationship assessment, relationship goal setting, and on an ongoing process of reflection and action (praxis) needed to achieve desired relationship goals.
In this workshop, students learn how managing themselves and their own emotional responses are key parts of positive relationship building. Understanding and managing our own emotional responses happens when bipolar is "in order." Nourishing Relationships That Work helps us to get there.
Disruptions in relationships are inevitable and there is no such thing as a "perfect" relationship, but "good enough" relationships are essential for keeping bipolar "in order." Developing positive relationships requires us to know how to ask for what we need, to have the humility to accept caring from another, and to consistently act in ways that demonstrate honoring and valuing of human relationships.
Nourishing Relationships That Work topics:
- Stop blaming yourself and other family members for family problems.
- Stop feeling guilty, ashamed, or stigmatized.
- Increase the quality of communication within your family and friends.
- Learn how to successfully handle intense emotion in relationships.
- Develop highly effective non-blaming conflict resolution skills.
- Learn how to develop an appreciative perspective and be in the relationships that you have always wanted to have.
- Strengthen and deepen the bonds of connection within your family and friends.
- Create relationships in which you can turn to each other for support, caring, and love.
- Become a hope-filled family that experiences life deeply while recognizing and celebrating the uniqueness of each family member.
Biopsychosocial Workshop
Facilitated by Dr. Peter Forster, MD
More than 30 years ago, the internist George Engel wrote an article in "Science"1 calling for a new approach to health. He spoke of developing a biopsychosocial model which recognizes that biological, psychological (for example, thoughts, emotions, and behaviors), and social factors (abbreviated "BPS") all play a critical role in how people deal with or adapt to disease or illness. This is in contrast to the traditional biomedical model of medicine that suggests every disease process can be explained by simple physical events (such as an infectious agent entering the body).
In an article in 2004 reviewing George Engel's legacy, Francesc Borrell-Carrió, et al, wrote: "The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. At the practical level, it is a way of understanding the patient's subjective experience as an essential contributor to accurate diagnosis, health outcomes, and humane care."2
In the Biopsychosocial workshop we identify key biological, psychological and social issues that affect people with mood disorders. Topics include:
- Brain and Mood - We summarize the literature that shows how mood and mood disorders relate to brain functioning. We also present some interesting data that shows that the simplistic notion of "biological" or "non-biological" depression (which somehow predicts whether to treat with medications or psychotherapy) is contradicted by data that shows that psychotherapy works by changing the brain.
- Mood charting, how and why to do it - In this section we discuss why it is important to keep track of mood on a regular basis, why it is often difficult to remember how we were feeling later, and what some of the barriers are to paying attention to mood in a constructive way.
- Social rhythms and the importance of routine - One of the most effective treatments for people with bipolar disorder involves systematically examining and modifying daily social rhythms. Many people with mood disorders find that their lives fall into patterns that may not be that healthy, with too much isolation and too little exposure to the outdoors. We explore how to make changes in this area.
- Circadian rhythms, light, and sleep - In this portion of the workshop we expand on the topic of our body's "clock" and how it can easily malfunction in our technological society. This malfunction can play a critical role in the development of depression, mania, hallucination, and delusion.
- Dealing with stress and mindfulness - Most of us "filter" our experience through the lens of thoughts, ideas, fears, beliefs about the world, and our place in it. Often these beliefs lead to unhappiness. We explore how a practice of mindfulness can lead to a clearer sense of the world and a feeling of strength and peace in the face of stress.
- Interpersonal issues and patterns - Moods and mood disorders have a big impact on relationships. Those who are close to us adapt to how changing moods affect them in ways that may or may not be healthy. Here we examine some common patterns in relationships.
- Approaches to anxiety - Anxiety often accompanies a mood disorder. In this portion of the workshop we highlight ways of dealing with anxiety, especially approaches that don't involve using medications, such as cognitive and behavioral interventions.
- Substances, use and misuse. - Half of those who have mood disorders also have trouble at times with substance use. We explain why this is true and what can be done about it.
- Medications - What they can and what they can't do. When dealing with something as nebulous as depression, mania, hallucination, and delusion, it is easy to feel frustrated and to hope that a doctor can find the "perfect" medication regimen that will take away all of our problems. In fact, some people come to see doctors hoping that they can figure out the perfect treatment without having to talk with them, sort of like taking your car in to the mechanic and leaving it there to be fixed.
- The value of psychotherapy - We summarize the literature on the effectiveness of psychotherapy for people with mood disorders. We also talk about how enduring patterns can develop in how we perceive the world around us (schemas) and how these patterns may relate to chronic depression.
- Diet and health issues - What we eat matters more for those with depression, mania, hallucination, and delusion than those without. People with mental conditions often have nutritional deficiencies, weight problems, diabetes, and a host of other problems related to diet.
Spirituality Workshop
Facilitated by Scott Sullender, PhD
Spirituality in the context of Bipolar in Order is defined as:
...that aspect of ourselves that seeks to connect us with a transcendental reality that gives our lives ultimate meaning and purpose. We celebrate these ultimate meanings in rituals, myths, and values, and we act out these meanings in moral, ethical, and symbolic behaviors in the world.
Spirituality is not the same as religion. Spirituality is universal. Everyone has some sense of spirituality, either developed or underdeveloped. Religion is the attempt by groups of people who think about ultimate meanings to organize, structure, define, and thereby limit, their experiences of spirituality. We may or may not ascribe to an organized religion.
Spirituality is highly individualistic. Each of us is on a unique spiritual journey. We are not here to tell you what you ought to do or believe, but to help you explore some spiritual resources that you might use to better enable you to deal with your depression and bipolar conditions.
There are no experts in the realm of spirituality. Spiritual wisdom is found in a variety of faith traditions. In this workshop we try to honor the diversity of various spiritual traditions.
We will do two things in this workshop. First, we will discuss various spiritual principles and how these principles might be applied to your struggle with depression in ways that would enable you to transcend your "disorder."
Secondly, we will introduce various spiritual practices or behaviors that, if practiced regularly, would help you build up the habits, attitudes, and inner strengths you need to combat depression. Some of the topics or issues we will discuss will include:
- Finding meaning in your depression.
- Finding a purpose for your life beyond your condition.
- What is a spiritual crisis?
- Empowering you to forgive yourself and others.
- Use of meditation and contemplative prayer practices.
- Spirituality vs. delusions and hallucinations.
- The life giving attitude of gratitude.
- Developing serenity in an age of desires.
- Sustaining inner peace during depression.
Addictions Workshop
Facilitated by Michael R. Edelstein, PhD
This workshop presents the Rational Emotive Behavior Therapy (REBT) approach for overcoming practical, emotional, and behavioral aspects of addictions. An addiction is defined as any repetitive behavior which interferes with, blocks, or sabotages long-term goals. Addictive behaviors progress from initially harmless, pleasurable activities, to compulsive, driven behaviors that are self-destructive to emotions and life.
REBT posits that addictions are not caused by a dysfunctional childhood, disease, addicted friends or partners, or even by strong cravings for a substance. Rather, they're caused by unrealistic thoughts, beliefs, and attitudes in the present. REBT helps identify addictive thinking and offers a cognitive-behavioral alternative to the 12-step model.
Issues discussed include:
- Moderation vs abstinence
- Tapering vs cold turkey
- The self-esteem trap
- The roles played by disease, environment, and genetics in addiction
- 12-steps and powerlessness
- Avoiding relapse
- Secondary disturbance
Participants learn to:
- Clearly identify those behaviors which are addictions and those which are not.
- Set realistic goals in harnessing addictions.
- Identify the irrational beliefs causing addiction problems.
- Master cognitive concepts and strategies for overcoming addictive thinking.
- Master behavioral tools for overcoming addictions.
Life Planning Workshop
Facilitated by Tom Wootton
This workshop is about creating a plan for our future. Each participant leaves the workshop with a written two year plan that includes Physical, Mental, Emotional, Spiritual, Relationship, and Career/Financial goals. The plans are individualized with clear steps on how to achieve the goals. The Life Plan is the basis for getting life "in order."
By working together to explore both possibilities and steps to achieve realistic goals, the participants learn from each other while writing their own individual plan. The plans are as personal and private as desired, while having the benefit of ideas brainstormed by the entire group. This helps us to not only see what is possible, but to get feedback about the reasonable steps to accomplish the final goals.
The Life Plans are very detailed. Starting with long term dreams, the milestones along the way are clearly spelled out so that we can make our dreams become reality. The end result is a carefully written plan that runs from concrete actions to take on day one, to measurable milestones for one month, three months, six months, one year, and two years.
The Life Plan is further refined and adjusted with guidance from the assessment and treatment team. In the assessment process (outlined in the next chapter), the Life Plan is refined to create clear and achievable steps. In the treatment phase (outlined later), support and insight is provided to help overcome the obstacles that stand in our way.
Bipolar In Order is about defining the life each person feels is worth striving for and having the support and resources to make it happen. Further details are in the Life Planning chapter later in the book.
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