What Do I Talk About in Bipolar Therapy?

November 25, 2014 Natasha Tracy

Recently, someone visited my website asking the question, “What do I talk about in bipolar therapy?” I suspect this person hadn’t started therapy yet and was trying to psyche himself/herself up to do so by gathering background information. I understand this. It’s something I might do myself. But it is a good question, what are you supposed to talk about in front of a degree-laden stranger? This question actually comes down to two answers and it depends on what type of bipolar therapy you’re getting as to what you’re likely to talk about during a therapy appointment.

Interpersonal/Psychodynamic/Talk Bipolar Therapy

The traditional therapy people usually think about when the envision therapy is “talk” therapy. It’s where people explore all aspects of themselves, including their history, feelings, thoughts, relationships, actions and current state. It’s been around for decades and used to be pretty standard.

There are many kinds of bipolar therapy, but what do you talk about if you go to bipolar therapy? Is bipolar therapy all about the past?In this type of bipolar disorder therapy there’s a fairly extensive “getting to know you” phase as the therapist wants to know about you and your history in an in-depth way. This means knowing about your family and your childhood all the way up to the present.

After this is done, the therapist will help the patient work on his or her issues by dealing with past problems and traumas and putting a mirror up to the patient so he or she can create his or her own solutions to the problems he or she are facing.

This type of therapy tends to be long and drawn out due to the method and what the therapist is trying to cover. That being said, this type of therapy is absolutely appropriate for people who need to work through experiences from their past such as abuse, neglect or trauma.

Action-Focused Bipolar Therapies

I call this group of therapies “action-focused” because, normally, they are focused around a short-term goal and on your immediate situation. Evidence-based examples of this type of therapy used in bipolar disorder include cognitive behavioral therapy (CBT), prodromal detection therapy, psychoeducation therapy, interpersonal and social rhythm therapy and family-focused therapy.

Each therapy is different but they all focus on what is happening now. What are your relationships like with your family and friends? What are your bipolar symptoms? What are your thoughts and feelings when a certain event happens? What do you know about your illness? And so on.

For these types of therapies you tend to talk about what is going on around you right now and how you think and feel about it. If, for example, you are having trouble getting your spouse to understand your illness, that might be something you would talk about so you could find new ways of communicating with him or her about it. If, for example, you expressed unwarranted anger at your boss, you would talk about that so you could figure out why and how to avoid it in the future. While you past may come up in these therapies, it is not the focus.

These types of therapies tend to be short and leave you with some sort of action plan and there’s often homework and assignments involved.

What to Talk about During Therapy?

Ultimately, what you talk about during any therapy is up to you but I will say, the more you are willing to put into the therapy the more you will get out of it; so, if you’re having multiple affairs because of your hypersexuality but don’t mention it, then the therapist can’t possibly help you in that area; and if you hide the fact that you use alcohol six times a week then you’re leaving out a vital part of the puzzle that can keep therapy from working.

My advice is to talk in bipolar therapy about what is comfortable for you, at first, and then work into the less comfortable areas as you move on. This is how therapists generally try to structure things. But the important thing is to be honest and if you really feel like you can’t talk about something then just say so. That’s much better than lying about it. Remember, your therapist is there to help you, not judge you, and you openness and honesty is what is going to make the treatment work.

You can find Natasha Tracy on Facebook or Google+ or @Natasha_Tracy on Twitter or at Bipolar Burble, her blog.

APA Reference
Tracy, N. (2014, November 25). What Do I Talk About in Bipolar Therapy?, HealthyPlace. Retrieved on 2024, June 18 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha is also unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, mid-2024.

Find Natasha Tracy on her blog, Bipolar BurbleX, InstagramFacebook, and YouTube.

December, 29 2014 at 7:07 am

I encourage people to do therapy if the subject comes up. Usually the ones that appear to need it most are the least likely to do it.
I've seen quite a few therapists over the last three decades so I should share an observation: many therapists suck. They should not be in the business of healing.
As stated above, be honest no matter how hard it is. Trust me, therapists have heard it all.
Try not to get discouraged because you will find help. It's worth it. You have to kill the static in the attic.

December, 6 2014 at 12:08 pm

I told her such an attitude was counterproductive. I have been paying her $70 a week for 23 years. I told her to back off, though she obviously means well...

Renee Hughes
December, 2 2014 at 5:21 am

Action focused therapy I'm 62 and have decided no more long interpersonal therapy. Been in and out of therapy for 35 yrs. I am who I am from a lifetime of experiences starting with most really bad memories at around 5 yrs of age and on. Bipolar type 2 with major clinical depression. Took three month course in DBT. The absolute best tool for my treatment. Still take meds, but a lot less since taught to recognize symptoms of depression before complete meltdown and tools to stop the downward cycle. I was hospitalized for the first time 5 yrs ago with an episode I still can't understand, except I hated my psychiatrist at that time. By pure luck my new psychiatrist is directer of DBT facility. DBT takes a huge commitment, a lot of work including homework every night, but the whole process helped get me out of my own head.

December, 2 2014 at 12:51 am

soooo what's something personal you shared in therapy?

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