A question I’m often asked by new patients during an initial session is: Why have you developed a specialization in providing psychotherapy to people with bipolar disorder?
I’ve always been interested in complex psychopathology. In the 1970s I spent four years working in a large community mental health center and another two on an inpatient psychiatric unit. Those experiences gave me amazing exposure to a broad range of psychiatric conditions.
In 1991 I was hired to create the East Carolina University Mental Health Services. The unit was separate from the University Counseling Center and its mission was to treat students who presented with more complex and acute psychopathology. The staff was small – 2.5 psychologists and one half-time psychiatrist. Due to this unique configuration of clinical services, I saw many more students with bipolar disorder over the course of my nine years at ECU than I would have seen had I been a psychologist at a large counseling center where bipolar students would have been more evenly distributed across a larger clinical staff.
In 2000 I was hired as Director of Counseling and Psychological Services (CAPS) at the University of Virginia. I wanted to continue with some clinical work as opposed to being a full-time health services administrator and given my previous experience at ECU Mental Health Services, staff were glad to refer bipolar students to me and my experience with the population continued to expand.
From 2008 through 2013, I led the bipolar student support group at CAPS. In 2010 I co-authored a book on bipolar disorder. I also began writing a blog on bipolarity for Psychology Today.
In 2013 I transitioned to full-time private practice where about 2/3 to 3/4 of my patients are diagnosed with bipolar disorder. I’ve also been running a support group for professionals diagnosed with bipolar disorder since 2014.
Clearly, my work with bipolar disorder has become my primary area of specialization. I had never specifically identified a bipolar specialization as a long-term goal for my career. It’s more like it has gradually evolved in that direction, bit by bit, since the early 1990s.
There’s another factor that’s probably also had a strong influence. I had polio in 1951 when I was a year-and-a-half old. I mostly recovered though I was left with a very atrophied right leg. Through childhood, on up through my mid-adult years, I’ve worn a brace on one leg and have led a very physically active life. However, since the late 1980s my left leg has been gradually weakening due to the late effects of post-polio. I’m now able to walk some, but not well, and I mostly use an electric wheelchair to get around.
I don’t like living with limited mobility, but it’s also something I can’t change. My only real choices entail how well I accept and adapt to my limitations. My hunch is that my own personal journey with disability has had a strong impact on my capacity to understand and empathize with others who are faced with conditions that they don’t want.