Welcome to Bipolar in Focus, I'm Jane Pauley.
Many families dealing with bipolar feel helpless because their loved one refuses treatment. Psychologist Xavier Amador is the author of "I'm Not Sick, I Don't Need Help." So I hope you can help.
You and I got to do something to make this very difficult process easy sounding at least. You have some techniques that you have given names to like LEAP, for one which stands for?
Listen reflectively and mirror back the person's experience what they're talking about. Empathize strategically. If the person says,
"I don't want to take these medicines. They make me fat. I hate them." You empathize. "Oh, that must make you really frustrated when everybody tells you to take them. I'd feel the same way."
The A in LEAP stands for agree and what you're looking to do is to find those areas where you both agree.
So you're not going to agree that person has bipolar disorder but where you can agree is the person needs to stay out of the hospital. The person wants to work again.
There's lots of common ground and the P in Leap is partner. You partner on the common ground. So if I was talking with you and you were acutely ill and you said, "I don't have a problem."
I wouldn't talk to you and try to convince you that you have a problem. Instead I'd say, "What are your problems?" and you'd say,
"Well, you know everyone is trying to get me to go to the hospital. Everyone is trying to give me to take medicine."
I'd listen reflectively, "So everyone is doing this to you? Do I understand you and it's upsetting you?" You know I'd be upset too Jane. I'd be really frustrated.
Well, let's agree. Let's see what we can agree on. What we agree on is that you don't want people to bother you.
We can agree on staying out of the hospital and we can partner on those things and that's when you bring up the topic of treatment.
What are the three A's? This is a different strategy.
Here's the three A's. You know, I'm sorry, I could be wrong. Okay, you "Apologize". You "Acknowledge" your fallibility and you ask the person to "Agree" to disagree.
You do want to give your opinion but you don't want to rush to give it. In fact when somebody asks me, "What do you think?" I delay giving my opinion and then as long as possible, right?
And the reason for that is an opinion that's been asked for carries a lot more weight than an unsolicited opinion.
So if I go in with both guns blazing, you've got a mental illness, you're probably going to have to take a mood stabilizer for the rest of your life, I'm going to lose this person.
When the person ask me, "Well, do you think I need to take medicine?" do you know what I say as a doctor and as a brother of somebody with bipolar disorder.
I say, "You know what? I think your opinion is more important than mine. I promise I'll answer your question." Because I do want to give my opinion of course, you know.
And when you give your opinion, use the three A's. You apologize for your opinion because it's going to be hurtful when I tell somebody I think they should be on medicine or see a doctor.
You acknowledge that you could be wrong because that helps the person save face, it gives them dignity and respect. And I don't know everything I could be wrong, right?
And then you ask them, "Let's respect each other, let's agree to disagree. I'm not going to try to convince you you're mentally ill.
You break it down into, pardon the expression but, smaller pills that can be swallowed.
Dr. Amador, thank you very much. And thank you for watching Bipolar in Focus.