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Janelle Caponigro and Erica Lee

Erica and JanelleJanelle Caponigro, M.A. and Erica Lee, M.A.

Janelle M. Caponigro, MA, is a doctoral student in clinical science at the University of California, Berkeley, specializing in the social and emotional functioning of individuals with bipolar disorder and schizophrenia. Erica H. Lee, MA, is a doctoral student in clinical science at the University of California, Berkeley, specializing in the socio-cultural and contextual mechanisms underlying child and adolescent development and family functioning. Together, Janelle and Erica have designed and led bipolar psycho-education groups and written a self-help book, Bipolar Disorder: A Guide for the Newly Diagnosed, which was published by New Harbinger Publications in September 2012.

Erica and Janelle, two UC Berkeley psychology graduate students, became interested in helping people with bipolar when they worked in a mood disorder specialty clinic at UC Berkeley, organized by Sheri Johnson. Together they ran a 16 week bipolar group and they found that group to be a very positive experience.

Since then, they have written a book designed to help people who are newly diagnosed with bipolar disorder. (Bipolar Disorder: A Guide for the Newly Diagnosed. Janelle M. Caponigro MA, Erica H. Lee MA, Sheri L Johnson PhD, Ann M. Kring PhD).

Later, Janelle started working with Judy Moskowitz who has developed a program for folks who have recently received a medical diagnosis designed to help them develop more effective coping skills.

They modified that intervention to come up with an intervention that would be helpful for people with schizophrenia and more recently developed a group for people with bipolar disorder. For more information about that group you can check out this handout. (The group they are currently running is designed for people with bipolar 1).

Sheri has done some research showing that people respond to positive emotion in different ways. One way is to just avoid positive emotion. This might be a response developed out of negative experiences (finding that emotions that are too positive can lead to mania and then hospitalization, for example). These people will decide that they won’t go to the wedding or accept the promotion or do things that they think might trigger an episode.

Others seem to just seek out positive emotions. They want to keep having intense positive emotions.

The challenge has been to see if there is a middle road that is neither about seeking out intense positive emotion, nor about avoiding it.

The group they are running is founded on the notion that positive emotions (and negative emotions) can be rated not just in terms of how positive or negative they are, but also on how intense they are. Where intensity refers to a high level of energy or arousal. They seek to help people with bipolar increase their experience of low arousal positive emotions (calm and contented), since many people with bipolar become preoccupied with high arousal positive emotions (either seeking them out or avoiding them).

They have developed a toolbox of skills to help people with bipolar get into a state of low arousal positive emotion. The skills are derived from Judy Moskowitz’s work and, more generally, from what is called Positive Psychology. So far the feedback they have gotten has been that this approach is very helpful for many people.

The group consists of ten 90 minute sessions. There is a didactic session and then an opportunity to practice in the group and finally group members are given home practice assignments.

First two groups are really about assessing where people are at in terms of bipolar disorder. They want to make sure that everyone has an understanding of basic concepts such as mania and depression. Then they talk about how we can measure positive and negative emotions and about the emotional intensity scale. Emotions are important and necessary, but for people with bipolar it can be important to balance intense emotions such as irritability, anger, determination or enthusiasm with low intensity emotions.

There is one group that teaches people how to notice positive events and savor them. One group is focused on the practice of mindfulness. There is a group about how to rethink negative experiences and develop a more accurate appraisal of stressful situations. One group is focused on gratitude, small acts of kindness and compassion. There is a group devoted to setting up small attainable goals. Finally there is a wrap-up group which is designed to support people using and further developing their new skills.

I asked them for examples of how people have reacted to the group.

One person has found it very helpful to think about high arousal  and low arousal positive feelings. He had not thought about the two kinds of positive emotions. Now he is practicing what he calls “LAP” (low arousal positive emotion) skills. Before the group he was very intense, pushing himself all the time and often irritable and sarcastic. Now he realizes that it is important to take a break from his go-go-go nature, and that there is a lot of value in taking that break.

One group member who is really involved in her treatment team and is really motivated to stay well, but also has a tendency to be pretty self critical found that most of the skills were not new. But participating in the group allowed her to take the next step and come up with a plan for really implementing changes. In particular, the group on positive reappraisal was helpful because she was able to practice ways of moderating her tendency to be self-critical. She learned not only how to notice when she was being overly critical but also what she can do when negative thoughts are coming up.

The group sounds like an excellent resource for people in the Bay Area (they are starting a 2nd group in October 2013 and are hoping to hold a 3rd group in the Spring of 2014).

I asked the two of them who might not be a good fit for this kind of approach and they both said that it was definitely not an ideal group for someone who really wants to focus on experiencing just  high arousal positive emotions.

 

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