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NT: Have you ever been in psychotherapy and, if so, what was the contribution of therapy to your current way of thinking about bipolar and depressive disorders and why would you or would you not recommend it to others?
TW: I am a strong believer in professional psychotherapy and am currently working with some top doctors to develop a program that integrates the ideas in the books and workshops with a complete system that helps people to achieve the goals set out in the workshops. We plan to launch the pilot program in February 2008. I think professional therapy is a central component to success, but only if the therapist believes that it is possible to live a very rich and successful live. If your therapist is trying to persuade you to accept a diminished life and live in fear that you cannot overcome your condition, it is time to find a new therapist.
NT: To what extent have you and do you rely on medication to manage the symptoms of bipolar disorder and depression and to what extent would you advise others to use it?
TW: Properly used, medication is a powerful tool that can make the difference between success and failure. Overmedicating someone into a zombie state will create a dependent person who will never develop the skills needed to truly manage the condition and realize the advantages. A good doctor will adjust the level and kind of medication as the patient develops critical skills.
NT: Do you promote your ideas to mental health professionals or is your market predominantly made up of people who have been diagnosed with depression or bipolar disorder? Could you explain why you do or do not promote these ideas to mental health professionals?
TW: Bipolar Advantage is licensed by the California Board of Behavioral Sciences to offer continuing education to LCSW [Licenced Clinical Social Workers] and MFT [Marriage and Family Therapists] therapists. The doctors I am working with to develop the integrated program are professors of psychiatry. I am advocating a paradigm shift in the way professionals approach mental conditions. It is one that encourages deeply understanding the various mental conditions instead of avoiding them. This is being very well received by professionals as well as patients, family members, clergy, and others. I strongly believe that the change will only come from within the medical community. We need to stop enabling people to accept a diminished life and to avoid looking deeply at our condition for fear that we cannot handle it. “The old paradigm is for us to avoid emotional pain at all costs while remaining ignorant of the lessons that are available to us.” The new paradigm is that we have been given an opportunity to grow into someone who understands things that normal people will never know exist. It is only through deeply understanding depression and other mental conditions that we gain power over them. Avoidance only gives them power over us. Any therapy that encourages avoidance only creates people who live in fear and never helps them to develop the tools and insight needed to turn their condition into an advantage.
NT: You have written about your relationship with Lee, a senior monk at a monastery where you worked. You describe how he provided quite containing boundaries and a structured way of interacting that forced you to consider your enraged reactions to others before acting on them. It would seem, from your account, that his relationship and the tutoring that Lee provided was very central in your eventually developing your imperative to “become a better person”. Psychological research has long held that the key ingredient in the effectiveness of therapy is the quality of relationship between therapist and client. In light of this, how would you describe the role that Lee played in the changes you brought about in how you managed these difficult feelings?
TW: I agree that the quality of the relationship is very important, but more important is the quality of vision that the therapist brings. Lee repeatedly told me that I have a “condition” and not an “illness.” He set a very high bar for me to achieve and would not accept anything less. He repeatedly pointed out that other people in history were able to overcome conditions worse than mine and they used their hardships as a catalyst to greatness. Although empathetic and without pushing too hard, he refused to accept that I do not have it in me to follow in their footsteps.“Avoidance therapy” is the opposite. By encouraging someone to think that they are incapable of rising above their circumstances, it consigns people to a life that is far less than what is possible. If you are helping patients to remove pain with the goal of complete remission, you are practicing ‘avoidance therapy.”
NT: You have argued strongly that features of bipolar and depressive conditions can promote a greater level of “functionality”. This view might be shared by some psychodynamic thinkers, who would argue that a depression can be a way of processing a psychic injury, forcing one back into a more introspective space that allows the sufferer to process the source of the injury and the concomitant loss. In this sense, they might see the depression as a necessary part of the recovery from the more fundamental psychic hurt or injury. You also speak repeatedly in your writing about the “horrible” things you did under pressure from the annoyance and time-urgency that was part of your experience of bipolar disorder, and describe how you have been able to largely eradicate the worst of these through their aggressive and firm management. How would you respond to the suggestion that some of these “horrible” behaviours are themselves symptoms of a rage that you have felt as a result of an earlier and more fundamental injury, that they are just clues to the potential source of your struggles with mood disorders?