Finished With Dbt

[Anarchy]

I found the model used in individual therapy (which is very entrenched in behavioral therapy) to be rigid, condescending, infantilizing and actually harmful. Again, this was my experience and I only saw two DBT therapists.

Hi Stella,
Thanks for the kind input, and sorry that you experience harmful therapy

and apologies to Crowfeather - please say if you'd like me to start a new thread.

In the stuff I'm reading at the moment (Miller, Rathus and Linehan, DBT for suicidal adolescents) it's not meant to be that way. Philosophically, Linehan is a behaviourist, but her experience of conventional CBT / BT, was that her patients were already fed up with being preached at and they found plain vanilla BT to be preachy and invalidating, so they escalated their emotional reactions and didn't stick around.

Can't remember who it was or which conference the video was from. There was a practitioner / researcher who said that in analyses of what feature of DBT it is that makes it effective, where ordinary behavioural therapies fail. It appears to be validation.

People who are highly suicidal are used to being invalidated, and when suddenly, they meet someone who validates, that yes, I believe that you really do feel that, and there is good reason for why you do... it seems to be a game changer.

The Ts are also supposed to stay dialectical rather than slip into becoming judgemental.

The use of DBT for BPD arose from the big overlap between people who are highly suicidal and people diagnosed with BPD, or have 3 or more BPD traits (people with 1 BPD trait had more in common with the general population - 3 traits, had more in common with full blown BPD). The original intention was to treat suicidal folks.

Thanks again.
@

 

[eikram]

Well, I just got off the phone with the woman from where the DBT will take place. I voiced some of my concerns that I had shared on here with you guys and what I've read and she said when I go to meet her next week that I am more than welcome to sit in on the session for that day to see if I think it will be a good fit. She said they aren't as formal or strict and that it's a pretty small group and another person just left to check into residential treatment. The smaller group makes me happy. She also said that DBT apparently just helps you focus on the here and now and that sort of thing rather than digging up a persons past. The only thing I'm conflicted on with that is how I've really been told most of my life or had the idea that I had to go through and work past all of these things and now this woman is telling me that's not true. I'm not sure what to do or which is best but I guess I will find out.

 

[Anarchy]

She also said that DBT apparently just helps you focus on the here and now and that sort of thing rather than digging up a persons past. The only thing I'm conflicted on with that is how I've really been told most of my life or had the idea that I had to go through and work past all of these things and now this woman is telling me that's not true. I'm not sure what to do or which is best but I guess I will find out.

I sometimes joke that the difference between a cognitive and behavioural model of therapy, compared to an analytic model

is about 25 years and $2.5Million.

DBT is about learning skills and applying them in the present time

for a couple of flippant analogies (I think you can guess where my sympathies currently lie...)

if your car has a dented and scratched body panel, if you take it to a behavioural garage, they'll tell you that it needs to have the dent knocked out, smoothed over with body filler then spray painted to blend in with the existing paint and polished, and here's how to do it.

Take it to an analytic garage, and they'll ask you all about when it happened, what colour the other car was, what make the other car was, what direction it was travelling, what the weather was doing, how you felt....

Take it to a Zen garage; "There is no dent, You have no car..." (unfair, I actually do like Zen - if there is any Zen).

Go to an analyst with fears about falling in the river and drowning, and they'll explore why you might have those fears.

A behaviourist will give you swimming lessons.

 

[StellaBlue]

I like your therapy analogies @Anarchy :).

The only thing I'm conflicted on with that is how I've really been told most of my life or had the idea that I had to go through and work past all of these things and now this woman is telling me that's not true.

It's not an "either-or". As @Anarchy said, DBT is about learning skills and applying them in the present time. The skills you learn will help you navigate through the trauma work later, if you chose to do that.

In the DBT model, like a lot of trauma therapy models, the first stage is stabilization - which, in DBT, means learning the skills and eliminating maladaptive and/or life threatening behaviors. The second stage is the trauma work - although DBT doesn't specify how that work is to be done.

For me, having the skills on board has been immensely beneficial and I am taking a very gentle, slow, somatic approach to the trauma.

I think a lot of folks look for a single model or treatment that is going to fix us - and it's not that simple. For example - EMDR - works for some, not for others. I've had to research my next steps in my healing journey and, like many others on this board, have taken a bit of an eclectic approach. It's also taken me a long time to trust myself enough to know when a treatment, approach, or therapist is not right for me and to be able to reject it.

 

[Crow]

Totally agree with @StellaBlue

Dbt helped me stay present in my trauma therapy. I connect on such a deeper level with my T now and that has sped up my recovery. I think dbt works hand in hand with other modalities. Everything is connected.

Have to say that one of the best skills I learned was how to seem like I cared what someone else was saying. And as time goes on, I kinda am caring and interested where before I would have been bored and agitated.

 

[Anarchy]

Hi Eikram,
I found this which gives a very good explanation of DBT. The sound gets scratchy, but the content is good.

 

[Anarchy]

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