Re:Bipolar disorder

You will have a very hard time finding any such diagnostic classification in truly Adlerian literature because each patient is seen as unique with their own guiding line. Any person who presents with wide emotional swings is using these swings to support their "fictional goal of superiority". The emotional swings do not just happen. They are created and serve the purpose of avoiding one of the life tasks. There are three life tasks which we must all address.
1) The work task
2) The love (including sexual) task
3) The Social task ... caring for others broadly.
A quote that Dr. Stein uses repeatedly I believe from Anthony Bruck originally is "We don't blow away the smoke, we put out the fire". Thus as Adlerian therapists, we view the symptoms (not those of organic disease) as a smoke screen for the inferiority feeling with the other side of the coin being the "goal of fictional superiority".
An Adlerian therapist will look at these emotional vibrations, to see the purpose they serve. To discern this purpose is often a fairly rapid process, but to disclose it to the discouraged patient in a very gentle, kind and caring manner, can only be done after a great deal of encouragemnet has been given by offering "many small steps" that the patient is ready to undertake. These small steps are determined in a cooperative manner.

These notions are utterly different than the mechanistic, biological and deterministic notions of many other psychologies. Each human is seen as moving according to a unique plan developed in childhood when they lacked both courage and/or encouragement such that they fear playing their full role as humans, more than they fear the apparent discomfort of the symptoms. In dealing with these patients it is important to ask them "Who created your depression and your highs?" I may even, if a very trusting relationship is developed ask, "Do they come in the water you drink or the food you eat, or is it possible you are creating them?"

Another very revealing question to ask would be, "What would you do if should heal right here and now from both your highs and lows, what would you then be able to do?" Be prepared to here some evasive tricks from bright people at this juncture. If they are really honest and you have a good and cooperative realtionship in trust, they will tell you exactly what they are trying to avoid. You might even hear things like
"I would be faithful to my wife."
"I would be able to get a job and support my family."
These are the very things this person in their vanity seeks to avoid. We should "keep them in the style to which they have grown accustomed".
The use of the symptoms is a trick that they are only vaguely aware of. It worked well as a child and if you collect early recollections from these people you will find a "childhood prototype" memory(ies). Our task is to make them fully aware of the hidden goal and encourage them to move in the direction of social interest; to have them move in a useful direction.

Thus Adlerians view causality as future not as coming from the past. The construction ... "Inferiority feeling ...> Compensatory striving ...> Goal of fictional superiority", is called "The Life Style" or "Unique law of Movement" of that individual. Thus the person who is using wide affective swings to put us in their service, or their wife, or their community, or even the whole world will benefit greatly by the dissolution of the life goal and the encouragement of the "Inferiority feeling".

To quote directly from Adler's article "The Neurotic Arrangement" (as translated by Ansbacher):
"The life problem of the neurotic is not: "What must I do to fit into the demands of society and thereby achieve a harmonious existence?" but: "How must I fashion my life to satisfy my superiority tendency, to transform my inferiority feeling into a feeling of godlikeness?"
(The Individual Psychology of Alfred Adler, Ansbacher and Ansbacher, page 118, HarperPerennial).

If you have worked with many "bipolar patients" as they are called in DSM-IV, you will soon see they lead society on a merry chase with their mischief all too often and they will always largely avoid one life task or even two. They will beg past difficulties as causal in ther problem, but will not undertake being fully a fellow man through the methods of traditional medicine. This I have seen too often after being in charge of a ward in a Provincial Psychiatric Hospital in our province (like a State Hospital in the USA). And they reap such rewards. They get sick benefit and social assistance as well. Once such people are fully engaged in this process, they have "much to lose by "getting well" so of course they are problematic in treatment if you wish to "chase symptoms" and not the future cause.

Now we do have a notion from Adler of "organ inferiority" whereby certain organs may not have developed as well in these people as in the larger population. Such a person may have an "Organ Inferiority" of part of the brain. We would accept that some people are more disposed to such a difficulty by genetic deficiency, but this does not excuse the difficulity because a "very sensitive emotional" person can also, when encouraged, become a great writer or artist!

So Jann, the bad news is that there is no "Adlerian treatment" of "bipolar disorder" but rather a unique and specific relationship with the end in view of encouraging "social interest" (German - Gemeinschaftsgefuhl) in any patient with whom we work. Each patient is treated differently. There is not and can not be a "cook book" answer, but rather a very deep understanding of the inner hidden movements of each patient.
I do hope this very brief answer is of some help to you. I am afraid you will not find the answer you were looking for in any responsible Adlerian material.

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