Bipolar disorder is one of the most challenging psychiatric disorders. With moods that often hit crippling extremes and bizarre behavior that is difficult to understand – let alone explain to others – bipolar sufferers can feel very isolated and alone. Medication is often necessary, but has its limits. Individual and family therapy can also be very beneficial, but sometimes those are not enough to help cope with the stigma, medication side effects, and multiple complications that are par for the course. Group therapy can help fill in the gaps from other types of treatment. It’s not uncommon for people to think of psychotherapy as a primarily one-on-one interaction. One in which you spend 50 minutes or so sitting across from a psychologist or other type of therapist, discussing your most private struggles, pain, hopes (or lack thereof) and dreams. You talk; the therapist listens closely and asks a thought-provoking question now and then. (There’s a bit more to it, of course, but that’s the general idea.) Group therapy provides a very different experience. Granted, it’s a bit daunting to some. Those with narcissistic tendencies feel they deserve to be the center of attention for the entire hour. Those feeling slightly paranoid may be quick to dismiss the idea because it feels far too risky to bare one’s soul in a group setting. But for those merely struggling to manage the day-to-day challenges of living with bipolar disorder, involvement in group therapy can prove to one of the best decisions they ever made. Why is that? Following are some of the most salient advantages and benefits:
It’s Not ‘Just Me’ After All
One of the biggest fears of just about anyone with a psychiatric disorder is that they’re even more abnormal than others with the same diagnosis. Already prone to feeling a bit disconnected and isolated at times, individuals with bipolar disorder can feel very alone – despite having family and friends who truly care about them. But they know, deep down, that their well-meaning loved ones will never “get it.” How can you truly convey what it’s like to go through a manic episode to someone who’s never been manic? How do you explain the depths of despair that often accompany a period of major depression? You go to therapy and hope that your therapist (whom you assume isn’t bipolar and just understands it from a textbook perspective) “gets” you. But deep down, you’re pretty sure she doesn’t. But in group therapy, you’re suddenly surrounded by a handful of other bipolar sufferers – people who really do “get it”! When you talk about various symptoms and episodes – and even the difficult side effects of mood stabilizers and antipsychotics – you get feedback and support from others who are walking in your shoes. And finally you realize, “It’s not just me!” You no longer feel completely alone and misunderstood. You no longer feel so weird. A heavy burden suddenly becomes much, much lighter. You stop resenting your therapist (and the group therapist) for not being able to truly understand. You no longer even need him or her to understand – because there are others who do.
No Longer One-Sided
Let’s face it – individual therapy is extremely one-sided. And for clinically sound reasons – so it’s a necessary and good thing. But even though that’s a necessary factor, it can feel crummy at times. It feels like you’re in a “one-down” situation. You’re the “broken,” “messed-up” person and the therapist is the “fixer” – or at least that’s how the dynamic often feels. You have nothing to give – except money in return for your therapist’s time. In group therapy, you have something to offer. Not only are you receiving the benefits of being in the group, you’re contributing to them for the other members. They can benefit from your support, understanding, non-judgment, wisdom, and feedback. Therapy just took on a whole new dimension! You can turn this awful disorder – this negative aspect of your life – into something good. You can help other group members. You’re no longer just the recipient – the “patient” – you’re also one of the givers. And that aspect has tremendous value, especially if you’ve felt the fierce stigma of being bipolar.
Invaluable Feedback From Peers
Group therapy is unique in that it’s a microcosm of your life in the real world. Over time, you’ll find yourself facing some of the same interpersonal dynamics – good and bad – that keep coming up in your day to day life. If it’s hard for you to trust, that will be an issue in group. If you tend to dominate conversations, that will be an issue in group. If you always play the victim, that will show up as well. And while it’s one thing for a therapist to point these things out to you, it’s often much more powerful when it comes from your peers. Not to mention, as you try on new behaviors or learn new skills, group therapy is a safe place to try them out and get invaluable feedback – from your peers, rather than just your therapist. You’ll learn a lot about yourself.
Bonding and Healing
Many people feel a bond with – or a strong attachment to – their individual therapist. That’s important to a degree, because effective therapy needs the foundation of a strong therapeutic relationship. Without that trust and rapport, therapy typically fails. It ends up being a waste of time and little, if any, progress is made. Group therapy, however, takes that all a step further. It frequently elicits a strong sense of community – a closeness among the members. That can be both tremendously empowering and healing. Individuals with bipolar disorder often experience a lot of suffering, in one form or another, long before they are ever diagnosed or in treatment. Family members may have been incredibly unkind; parents may have been unsupportive and, in some cases, even abusive. Kids at school may have bullied you because you were “different.” In a group setting, you can begin the healing process. At least some of the other members will be able to relate. You can share openly without fear of being judged. You can connect in a way that helps old wounds begin to heal. The kindred spirit that often develops in a very focused therapy group (i.e. a group in which everyone has the same disorder or has suffered a similar trauma) can be powerful – it’s like having a second (or in some cases the first real) family.
Unique Yet Shared Experiences
Being in a therapy group with other bipolar sufferers gives you the opportunity to discuss things that are fairly unique to individuals with your disorder. For example, mood stabilizers such as lithium and Depakote – medications used primarily to treat bipolar disorder (at least in psychiatric settings), can have challenging side effects. The same is true for antipsychotics – powerful drugs once used almost exclusively for the treatment of schizophrenia and related disorders, but now used regularly to treat bipolar symptoms as well. Manic episodes also occur primarily in bipolar I disorder. And, unlike a lot of disorders, bipolar disorder is often a lifelong disorder, a fact that triggers many other issues. Group therapy provides the perfect place to both share and discuss these unique experiences that most people – even those with other types of mental health conditions – won’t understand. But fellow bipolar sufferers will understand. It’s the perfect place to bring up and discuss these experiences that feel so unique – yet are frequently shared by other group members.
Being part of a group – especially one in which there is significant bonding and trust – creates a healthy atmosphere of accountability. It’s one thing for a therapist to hold clients accountable. But when a peer – another member of the group does the same – it can be very effective and quite powerful. Group members can hold each other accountable in multiple ways, including in terms of attendance, participation, how each member interacts with the others, and progress.
Let’s face it – mental health treatment is very expensive, and insurance companies limit how much they’ll cover in any given year – and it’s rarely enough to make a significant dent. Group therapy is often a lot less expensive than individual therapy. This is because the one therapist’s time is now spread among several people rather than one. Group therapy can provide much (and sometimes even more) of the benefits for a fraction of the cost of individual therapy. This is a win-win, especially for anyone with a tight budget or limited health coverage, as members can often continue in therapy for a longer amount of time rather than cutting it short or rushing it due to finances. If you’re struggling with bipolar disorder, consider group therapy. You can look online or contact several therapists in the area to see if they know of anyone who is starting one in the near future or conducts them regularly. Depending on various factors, including the therapist’s discretion, you may be able to join an existing group. Even if there isn’t a group specific to bipolar disorder, it might be worthwhile to consider a more general group (in which participants have different diagnoses or issues). Many of the dynamics and benefits will still apply. Just be sure to give it a little time once you start. It can feel a little uncomfortable at first, but the benefits can be significant.