Psychotherapeutic Treatment

The news is all a little erratic, as I am only allowed carefully chosen visitors, warranted not to excite, bite, kick, kiss, or anything else that makes life hectic and splendid. *

When Woolf became ill, whether the symptoms included “influenza” or depression, she was typically put to bed, fed milk, meat, and bromides, and ordered to avoid all excitement. Writing time, when not forbidden, was carefully titrated. Woolf generally hated this “rest cure.”

In his efforts to ward off severe breakdowns Leonard Woolf meticulously charted his wife’s moods, weight, temperature, drug doses, sleeping and eating patterns, and onset of menstruation. When warning signs appeared in the charts, Leonard tried to get Woolf to slow down.

Leonard’s notes could be construed as intrusive and his calls for confinement dictatorial. However, consider his efforts in light of current research. Sleep deprivation, social challenges, threats to self-esteem, and disruptive events such as the death of a loved one have all been found to induce mania. Moreover, mood charting in relation to daily activities has become an important part of many therapeutic programs.

If Woolf were alive today, Leonard might still be keeping careful notes, but several empirically supported psychotherapeutic treatment alternatives to the rest cure would be available, including:

Cognitive Behavioral Therapy
change inappropriate or negative thought patterns and behaviors associated with the illness

educate people about the illness and its treatment, and how to recognize signs of relapse

Family Therapy
various strategies to reduce the level of distress within the family that may either contribute to or result from the ill person’s symptoms

Interpersonal and Social Rhythm Therapy
focus is on regularizing daily routines and improving interpersonal relationships



For more complete descriptions of these treatment options go to National Institutes of Mental Health (NIMH).



Goodwin, K.F. & Jamison, K. R. (2007). Manic Depressive Illness: Bipolar Disorders and Recurrent Depression. Oxford: Oxford University Press. Part V: Chapters 22, 23, 24 & 25

Research Papers

Miklowitz, D.J. (2008). Adjunctive Psychotherapy for Bipolar Disorder: State of the evidence. Amercian Journal of Psychiatry. 165(11), 1408–1419. doi:10.1176/appi.ajp.2008.08040488.


___References for this Section____

* Woolf, V. (6 vols. 1975-80). The Letters of Virgina Woolf. (N. Nicolson and J. Trautmann, Eds.). New York: Harcourt Brace Jovanovich.