For the bipolar patient, who by nature of the disease, becomes less and less capable of reality testing as the disease progresses, it is imperative that they be grounded in the reality of their condition by clinicians across the medical system. Both the International Society for Bipolar Disorders and Diagnostic & Statisticians Manual-5 report that the severity of manic and depressive states worsen with repeated episodes. Cognitive Behavioral Therapy as such does not provide the theoretical groundwork necessary for treatment.  A clinical orientation and relationship from provider to patient that confronts reflexive processes of denial, allows for the bedrock condition of loss to be experienced, mourned, processed and treated is a better solution.