Psychiatric Quarterly [psaq] PH015-294624 March 29, 2001 22:2 Style ﬁle version Nov. 19th, 1999
Psychiatric Quarterly, Vol. 72, No. 2, 2001
BIPOLAR ILLNESS AND THE FAMILY
James A. Hyde, Ph.D.
The purpose of this article is to introduce family systems therapy and “fam-
ily focused treatment” to clinicians working with patients who are diagnosed
with bipolar illness. The characteristic traits of healthy family functioning are
identiﬁed as a template for the clinician to work with the family toward man-
agement of bipolar illness. Nathan Ackerman’s model of how families handle
crises and Carter’s and McGoldrick’s work with family life cycles provide a guide
to understanding family systems work. The focus is on the family system and
not just the patient. The issues of bipolar illness are addressed in the family
context. Based on the research of Goldstein and Miklowitz and others, treat-
ment of bipolar illness is differentiated from other chronic mental illnesses.
Family focused treatment is offered as a model to manage dynamics off bipolar
illness. An essential component of therapy with the patient and the family is
addressing grief. Interventions and treatment suggestions are offered.
KEY WORDS: bipolar; family systems therapy; family focused treatment; family crisis.
We must begin with the premise that chronic disease by deﬁnition cannot be cured
that indeed the quest for cure is a dangerous myth that serves patient and prac-
titioner poorly. It distracts their attention from step-by-step behaviors that lessen
suffering, even if they do not magically heal the disease. To the extent possible,
the goal should be to reduce the severity of exacerbations in the course of chronic
James A. Hyde, Ph.D., is Associate Professor of Psychiatry, University of Louisville
School of Medicine.
Address correspondence to James A. Hyde, Ph.D., Department of Psychiatry & Behav-
ioral Sciences, University of Louisville School of Medicine, Louisville, KY 40292.
2001 Human Sciences Press, Inc.