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.

Effect of Compassion-Focused Therapy (CFT) on Blood Cortisol and Cognitive-Emotion Regulation in Drug Abusers

“…The analysis of covariance results showed that both treatments had a significant effect on decreasing cortisol levels and increasing cognitive-emotion regulation. The results on the effect of compassion-focused therapy on cortisol levels are in line with the results by Brooks et al (23), Neff and Germer (24), Goss and Allan (25), and Lowens (26). The results of the effects of compassion-focused therapy on cognitive-emotion regulation were also consistent with the studies by Kamalinasab and Mohammadkhani (27), Saeinia et al (28), and Dashtbozorgi et al (29).…”

Buffering against maladaptive perfectionism in bipolar disorder: The role of self-compassion

“…A self-compassionate stance acknowledges the suffering and pain that is experienced by the self, in the context of the human condition. By fostering self-kindness and selfacceptance through actions such as meditation, writing, or challenging negative self-talk, a selfcompassionate approach may theoretically buffer against the harsh and self-critical style associated with maladaptive perfectionism (Lowens, 2010). Empirical data from non-clinical populations is supportive of this idea.…”

Psychosocial Functioning in Bipolar Disorder from a Social Justice Perspective

“…Studies show that CFT can promote self-soothing and decrease shame, social anxiety, depression and self-criticism in personality as well as mood disorders (Gilbert & Procter, 2006;Pauley & McPherson, 2010;Van Dam, Sheppard, Forsyth, & Earleywine, 2010). In BD, it may also promote affect regulation (Galvez et al, 2011;Gruber et al, 2009;Lowens, 2010). Given CFT's potential to diminish shame and self-criticism, future research may therefore wish to examine the effects of CFT on internalized stigma in BD.…”