We have found ourselves wrestling with a couple of situations where patients seem to be trying to help us come to the “right” conclusion about their problems. For example, one young woman is very adamant about the fact that she does not have bipolar disorder. She has a family history of bipolar moods (her mother was bipolar) and the idea that she might have the some condition of course connects with her fear that she is “becoming her mother”.
At the same time, she really has not been responding to traditional antidepressant treatments, and in fact, has had a few episodes of becoming energized and irritable when starting antidepressants, this suggests at least the possibility of a bipolar mood disorder.
When we first met her, we were struck by how quickly and completely she denied even the hint of any mood variation. Frankly, when people report that there is absolutely nothing that they have ever experienced that is at all like a bipolar mood shift, we are a bit surprised. Most people have at least some of these experiences.
Another woman we’ve been working with for a while is very unhappy about the possibility of switching to a different medication. For that reason, she has been telling us inaccurate information about her symptoms. Because having symptoms would mean that we would wonder about switching medication, she decided that she wouldn’t have symptoms, at least when she talked to us.
Recently we started to notice that she was not doing very well in her relationships and at work. And this made us wonder what was going on. Eventually the true story emerged.
We contrast all of this with a quote that we ran across many years ago from one of our favorite psychologist authors, Carl Rogers. Dr. Rogers wrote a chapter on personal learnings that he had made over the course of his career, one of these was that “the facts are friendly”.
By this he meant that when one engages the facts in a straightforward and direct fashion, the results are positive. Even if initially you had hoped that things might be otherwise.
This learning is really not so much about the facts themselves (I think) but about how one relates to them. If we assume that the facts are friendly, we can be curious about them, face them directly, and play with them (engage our creative mind rather than our fearful mind).
That stance works remarkably well. Even if the facts seem really challenging at first.