I’ve been applying this method of mindfulness + positive reframing (somewhat unaware that I was using it) for my bipolar disorder for the last year. It’s unbelievably effective. Paired with a six-week ketamine therapy, my depressive symptoms have almost completely disappeared, and my mania is far more manageable and stable. I’m not on medication, and a combination of imaginative, behavioral, and cognitive techniques like this have worked remarkably well for the past 6 months. This has been more successful and longer-lasting than any other therapy I’ve tried. The book Bipolar Breakthrough also has more specific advice for managing bipolar disorder, and the author uses a similar approach as Burns in Feeling Great.
Further, I don’t just think positive reframing is useful or helpful therapeutically. Yes, it is, but it’s also true. These disorders are genuinely adaptive and valuable—or have been in our evolutionary history—and there are good reasons for most ‘psychopathological’ responses. Often, seeing and experiencing the value of a ‘mental illness’ just requires some relatively minor adjustments, either from you or from your social context. Someone already mentioned Good Reasons for Bad Feelings, and it contains some great argument for this view. But what really convinced me of the adaptive value of mental disorders was Giudice’s Evolutionary Psychopathology—see Book Review: Evolutionary Psychopathology | Slate Star Codex.
The thought-emitting and thought-assessing parts of the brain that you mention here might correlate to the generative and evaluative processes involved in creativity? See The Sparks of Generative Creativity in Mental Disorders. This also suggests a potential continuum of mental disorders, between ‘generative’ disorders that involve over-activation of thought-emitting systems (bipolar mania, ADHD, Tourette’s, schizophrenia) and ‘evaluative’ disorders that involve over-activation of thought-assessing systems (depression, anxiety, possibly autism). This might map onto the continuum that psychiatric research has arrived on, between approach-based (generative) and avoidance-based (evaluative) psychopathologies (cf. Baas et al 2016, Mad Genius Revisited). I think the predictive theory of depression is promising, but it may not explain all forms of depression—I suspect the disorder is far more heterogenous than indicated by the DSM-V major depressive disorder construct.
Jeremy Hadfield
Karma: 40
Apologies for the late response! Well, you could say that. But I wouldn’t consider a constant “hell yeah this thought is amazing!!” evaluative. After all, there isn’t really an evaluation of the content of the thought—just a generic affirmation. The main point is that the kind of critical assessment involved in evaluative thinking is under-activated in mania, and over-activated in depression. These are distinct cognitive and neural systems that are somewhat competitive with each other.
Yes. Agree. Let’s try to overcome conformity biases