Gently Bursting Bubbles and Raining on Parades: Working with Positive Beliefs About Mania and Overly Optimistic Thinking Patterns in Bipolar Disorder

A unique challenge for therapists working with bipolar disorder is that some individuals may be reluctant to stop getting manic, or ambivalent about this, due to perceived positive aspects of (hypo)mania. This chapter reviews the research on this area and discusses techniques in therapy, in particular from Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI) when working with positive beliefs about mania, in order to enhance relapse prevention work. Another unique element of working with mania can be working with overly optimistic thinking patterns, especially during (hypo)mania, which can feel quite different from challenging the overly negative cognitions which therapists are used to working with in conditions such as anxiety disorders and depression. This chapter overviews therapy techniques and adaptations to CBT which can be used to challenge such thinking patterns, while maintaining a strong therapeutic relationship.