BCT and a case of Biopolar Disorder

I have been seeing a young woman in therapy whose husband is divorcing her
because he can not tolerate her Bipolar Disorder, which recently resulted in
her placement in a psychiatric setting for a few days.

This woman was suicidal for several days after release, but seems to be OK
now. She explained to me that she had decided that her husband should be
boss before their marriage. This was based on the numerous conflicts she
witnessed with her parents.

This decision was very frustrating to her, because, in many cases, she
believed that she had the more intelligent opinion on some matters.
Nevertheless, she submitted and did what her husband wanted. An example of
an arbitrary decision by her husband: He did not want to spend the money to
buy curtains for their apartment and did not want her to make them. So they
went without curtains.

The turning point in going from being suicidal to wanting to live occurred
just recently. She had a conversation with her husband in which she said it
was over between them. She instructed him to stop calling her at work, stop
coming over the house, etc.. Even though he filed for divorce, he was
wanting to be friends with her, wanting to touch her, talk to her, have sex
with her.

From the time she had this conversation with her husband, the one girl who

is friends with her and has known her for a long time, said that she became
more like her old self. She had not realized that she was any different.

This case reminds me of Dr. John Appels work and his ideas on the link
between control and mental health. This woman had given up her self in order
to make sure her marriage lasted. In the process, she subjected herself to a
great deal of stress. This stress seems to have precipitated a Bipolar
Disorder crisis, a hospitalization, and the loss of her will to live. The
meaning of life to her was this husband and the marriage. This woman has set
new goals for herself which will require her to spend a few years in the
alive mode. (And needless to say, I am greatly relieved.)

···

From: David Goldstein, Ph.D.
Subject: BCT and a case of Bipolar Disorder
Date: 3/20/99

[From Tim Carey (980323.0600)]

From: David Goldstein, Ph.D.

This case reminds me of Dr. John Appels work and his ideas on the link
between control and mental health.

It reminds me of a classic conflict situation from a PCT perspective. It
sounds to me like she wanted her husband to make all the decisions as
evidenced by:

She explained to me that she had decided that her husband should be

boss before their marriage.

But she also wanted to make her own decisions, as evidenced by:

This decision was very frustrating to her, because, in many cases, she
believed that she had the more intelligent opinion on some matters.

Suicide sounds like one of the options that her reorganising system created.
The solution she eventually hit on however sounds like she changed the
_situation_ she was in. She was no longer in conflict because the marriage
situation that was setting the two references of: 1. my husband should make
all the decisions; 2. I should make all the decisions when my decision is
more intelligent than my husbands, no longer existed as evidenced by:

The turning point in going from being suicidal to wanting to live occurred
just recently. She had a conversation with her husband in which she said it
was over between them.

Furthermore, it seems to me like a wonderful example of a person whose
awareness was focussed at the level of the conflicting references for a long
time but eventually shifted to the level that was setting these two
references and the reorganisation process could finally work at a place
where it would do some good.

The language here is a bit sloppy and I've probably taken a bit of licence
in places but I hope the message of the general process I'm trying to
communicate is clear enough.

Cheers,

Tim

[From Bruce Gregory (990322.1555 EST)]

Tim Carey (980323.0600)

Furthermore, it seems to me like a wonderful example of a person whose
awareness was focussed at the level of the conflicting
references for a long
time but eventually shifted to the level that was setting these two
references and the reorganization process could finally work
at a place
where it would do some good.

I suspect that most of the reorganization we do as adults involves
envisioning alternatives and selecting the one that results in the least
(imagined) system error. This mechanism could well be at work in the
scenario you describe. This mechanism seems more likely to me than one
that generates random solutions (I'll color my hair blue and wear an
overcoat in the summer).

Bruce Gregory

[From Rick Marken (990322.1340)]

Tim Carey (980323.0600)--

It reminds me of a classic conflict situation from a PCT
perspective...

Excellent analysis, Tim.

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

[From Tim Carey (980323.0823)]

[From Bruce Gregory (990322.1555 EST)]

I suspect that most of the reorganization we do as adults involves
envisioning alternatives and selecting the one that results in the least
(imagined) system error. This mechanism could well be at work in the
scenario you describe. This mechanism seems more likely to me than one
that generates random solutions (I'll color my hair blue and wear an
overcoat in the summer).

Yep, this sounds plausible to me as well. I guess the point I was trying to
communicate was that while this woman's awareness was focussed at the level
of two conflicting references, the only alternative she seemed to be able to
envisage was suicide. When, however, her awareness shifted to a higher
level, she was able to envisage an alternative of ending the marriage. This
effectively eliminated the conflict.

Cheers,

Tim

[From Bruce Gregory (990322.1748 EST)]

Tim Carey (980323.0823)

Yep, this sounds plausible to me as well. I guess the point I
was trying to
communicate was that while this woman's awareness was
focussed at the level
of two conflicting references, the only alternative she
seemed to be able to
envisage was suicide. When, however, her awareness shifted to a higher
level, she was able to envisage an alternative of ending the
marriage. This
effectively eliminated the conflict.

Good point. I suspect that her original "solution" is not all that
uncommon. Most of us, however, only entertain it during the dark hours
of the night, as Nietzsche pointed out.

Bruce Gregory