Archives for December, 2012
When I first started putting together the protocol for assessing depression and bipolar disorder, I was working with a professor of Psychiatry to make sure the ideas were sound. His advice was to combine both awareness and understanding in the graph to keep it simpler. I am glad that I did not take the advice. Awareness and understanding are different in ways that matter. Expertise might help someone understand why things happen, but does not necessarily lead to increased awareness. An expert on sex, for example, may be totally unaware that his wife is having an affair. It takes awareness (covered in the first article of the series) to know what is going on whether you understand the phenomenon or not. It turns out that understanding is more related to functionality (covered in the next article) than awareness. You may be completely aware that you are sitting in a car, but unless you understand how to operate it you cannot drive. Understanding is not just about knowing the physical, mental, emotional, spiritual, social, and career/financial aspects and their implications, it also includes knowing about the tools. You need to know how the tools work, have proficiency in using them, and understand which ones to use at each stage of bipolar - the disordered stages of Crisis, Managed, and Recovery, and the IN Order stages of Freedom, Stability, and Self-Mastery. I call this functionality-based understanding. Too many people are holding out those who cannot function as the ones we should be listening to. Those who only know bipolar disorder and have not created Bipolar IN Order in themselves or others have no understanding of what it takes to make it happen. They can learn, but many times their beliefs limit their willingness to do so. They keep insisting it is not possible to be highly functional with bipolar and refuse to consider the evidence that contradicts such beliefs.
You can live in the same neighborhood for thirty years and still have little idea of what is going on there. You can shop in the stores, eat in the restaurants, talk with the neighbors, and feel that you know the community very well. But there are still more things going on than you know about. You simply never knew to look for them or were never taught how. The police that work in the area know about crimes that go on right in front of you. The pest control people see things in the restaurants that might shock you if you knew they were there. Everyone from the woman in the plumbing shop to the guy selling pot (maybe even out of your own house) see things going on that you do not. The preacher knows about the spiritual goings on and the neighborhood doctor sees all of the injuries and illnesses. When a thief sees a saint all he notices is his pockets. We all only see the things we have been trained to look for. As Paul Simon famously sang, "We all see what we want to see and disregard the rest." The same thing is happening in the depression and bipolar worlds. Many doctors and therapists only see it as a disease, family members see behaviors, and people with depression only see pain and suffering. There is so much more going on that none of them have been taught how to see. I have been teaching all three groups for ten years and am amazed how little awareness there is about very important details until I show them were to look.