Sheri van Dijk - The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life

If you have bipolar disorder (BD), you know that it can have a huge effect on your life and even put your life at risk. The typical treatment for BD involves medications that are pretty effective in curbing the extreme mood swings that define this condition. Still, there is a growing recognition that BD is not something you simply get over and never have again. In fact, relapse and recurrence are common. Living with BD in the long run involves managing it the same way you would manage a chronic disease such as asthma, high blood pressure, or diabetes. You combine medical treatment with lifestyle changes to reduce the risk of aggravating your symptoms and bringing on an episode. You learn to recognize the moments in which you have a choice about something thats going to affect your emotions, and you learn to choose the behavior thats going to help you cope and regulate your mood, even when youre in the midst of the uncomfortable symptoms of bipolar disorder. This involves learning new skills and attitudes.

There is, however, an interesting paradox that arises when you use psychological strategies to manage the difficulties of BD. The very tool required for this workthe mindis often touched by the disorder itself. The behavioral school of psychology has responded to this by sidestepping the mind, instead focusing on behavior and relying on the consequences of that behavior to bring relief. A second approach, cognitive therapy, uses logic and evidence to change the degree to which you believe in your thoughts, which ultimately changes your behavior. Either way, the result is that you come to know your mind and recognize its capacity for choice and change within moments of feeling bipolar symptoms.

The approach presented by Sheri Van Dijk in this clearly written and practical book combines the best elements of behavioral and cognitive work with the fruits of mindfulness training to acquaint you with both the territory of BD and the possibility of coping differently. This workbook starts from the premise that we are often unaware of how unspoken attitudes and beliefs can influence our view of the world around us. To help you cultivate a greater awareness of these silent influences on your behavior, the author provides a number of exercises that help to build awareness of present-moment experience and its corollary, the inevitable mind-wandering and daydreaming that occurs when we attempt to do only one thing at a time. An important theme that is returned to throughout the book is that managing the ups and downs that go along with BD involves learning how to survive a crisis.

Regardless of whether a difficulty is personal, interpersonal, or financial, you can determine whether your reactions will make it better or worse. The first step, that of acceptance, may seem counterproductive or even feel like resignation; perhaps it seems like the last thing you would choose to do. In fact, acceptance is the first step toward responding effectively rather than simply reacting to challenges. Because acceptance requires you to let go of some habitual tendencies to push away or minimize unpleasant experiences, you are able to see more clearly what it is that you are up against and choose healthier action.

Additional sections on emotional intelligence, distress tolerance, and interpersonal effectiveness offer you a wide repertoire of new skills and abilities. A later chapter considers the needs of family members. This is important because the quality of care received by people with BD is often determined by those around them.

Bipolar disorder continues to present a challenge to both its sufferers and the mental health community. There are too few workbooks such as this one, in which the needs of people with BD are placed foremost and an approach for helping them learn how to manage overwhelming emotions is so clearly articulated. I expect it will be a valuable resource for years to come.

Zindel V. Segal, Ph.D. professor of psychiatry, University of Toronto author of The Mindful Way Through Depression

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