Integrating Pharmacotherapy and Psychotherapy in the Treatment of a Bipolar Patient

M ost contemporary psychiatric literature describing the longterm treatment of bipolar illness emphasizes the benefit of pharmacotherapy. Although reference may be made to the need for concomitant psychotherapy (1–3), the techniques and problems in integrating these two therapeutic approaches are seldom discussed. The following case report, describing the treatment of a woman with bipolar disorder, illustrates problems common to the management of bipolar disorder and the usefulness of psychotherapy in the following aspects of treatment: 1) establishing a therapeutic alliance, 2) helping the patient overcome denial of illness, 3) addressing issues in transference and countertransference, 4) balancing therapeutic drug doses and side effects, and 5) encouraging significant others to provide ongoing mental status information.