Tuesday, July 17, 2012

William R. Marchand on "Is wellness possible?

At the end of William Marchand's Introduction to his new book, Depressions and Bipolar Disorder (Bull Publishing) he offers a message of hope: "You can expect to get well. Sometimes it takes a little time, but almost everyone with a mood disorder can get better and stay well for life."

That sounded like an extremely optimistic statement to me. I've lived with bipolar disorder for over 46 years and, although my life is reasonably good, most of the time I could not be thought of as stable. I don't think I ever have been, not for any length of time, in spite of learning how to cope well enough so I thought I had wisdom to share, which I did in my books and do in my Living Room support groups. I asked Dr. Marchand to what extent we could hope to be well. Here is his answer:
That's a great question. It is certainly true that many individuals do not achieve full remission (that is - extended periods completely free from symptoms). However - I think of being "well" as having minimal suffering. I do think it is possible to significantly decrease suffering - even when experiencing some symptoms. One approach to that is through practicing mindfulness and decreasing focus on self and symptoms and instead developing the ability to maintain moment by moment awareness of the here and now. Along with this often comes enhanced compassion for self and others as well as greater concern for the wellbeing of others and less attachment to self (also see my answer to the questions below). Of course, one may likely achieve similar results following spiritual traditions that do not involve mindfulness. That said - the evidence for the benefits of mindfulness is extensive and it can be a secular approach to recovery or a component of any spiritual/religious practice.

The book includes some very good explanations of mindfulness therapy, something I had heard about but had not had the opportunity to truly familiarize myself with. I really like how it teaches us to focus less on self. Isn't that one of the worst things about depression? That tendency to be - what I genterally call - self-centered. I've talked a fair amount in this blog about the value of othercenteredness - thinking about others instead of self.

This led to another question:

How important is it to create a meaningful life for yourself? Speaking from experience, I think I have less problems with moodswings when I know I'm doing things that will benefit other people. Maybe this is a spiritual question. I know the Bible teaches us to serve mankind and to try to make a better world. Dr. Marchand's answer?
I haven't seen any research about this - but my own clinical experience is that it is very important for individuals to be engaged in activity that feels meaningful to them. I strongly encourage altruistic activities for individuals that I work with. Along those lines - as I mentioned above, a lot of evidence (which is consistent with many spiritual traditions) indicates that decreasing attachment to self/ego is a critical component for recovery. Thus - I think enhanced concern for others and less concern for self is a key component of recovery.

I LIKE Dr. Marchand's thinking! Don't you?

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