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Conceptualizing A Cycle Of Ascent Into Mania: A Case Report

Published online by Cambridge University Press:  01 August 2003

Warren Mansell
Affiliation:
Institute of Psychiatry, London, UK
Dominic Lam
Affiliation:
Institute of Psychiatry, London, UK
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Abstract

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This case study describes the collaborative development of an idiosyncratic cognitive model of the ascent into mania in a patient with bipolar affective disorder. The client held the belief that he could rise above his depression and feelings of low self-esteem through the pursuit of highly demanding goals and rewarding activity. While still depressed and anxious, small increases in positive mood and energy triggered hyper-positive thoughts about himself (e.g. “I am back to my attractive, intelligent and outgoing self again”). Consequently, he engaged in a range of “ascent” behaviours that were consistent with the pursuit of this self-view. The direct effects of these behaviours and their effects on other people led to further increases in positive mood and physiological activation, which in turn triggered more hyper-positive self-relevant thoughts. The client reported that he found the model an extremely useful component of cognitive behavioural therapy.

Type
Brief Clinical Reports
Copyright
2003 British Association for Behavioural and Cognitive Psychotherapies
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