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Let's do Dialectical Behaviour Therapy (DBT)

Let's do Dialectical Behaviour Therapy (DBT)

Good morning Forum Land,

So... @CheerBear @Zoe7 and I have decided to embark on an adventure of working through the DBT skills training manual together but not. That is, we all bought the manual at the same time, but we will probably work through it each in our own muddled puddled confuddled way. Consequently, who knows how this thread will end up looking. That's ok, that's why it's an adventure.

We would super love other Forumites to join us on this adventure if they want to. You definitely don't need to own the manual to join us, though if you want to, this is the book we are working from: DBT Skills Training Manual (second edition) by Marsha Linehan published in 2015. The manual has LOTS of worksheets in it, but happily, you can download those for free from this website: https://www.guilford.com/companion-site/DBT-Skills-Training-Manual-Second-Edition/9781462516995

It is important to be aware that this manual is not a self-help book. This is the manual designed to train therapists in how to deliver DBT to clients. Therefore, it can make for challenging reading at times. Personally, I find it hugely validating reading the way in which Linehan addresses the all-too-common negative and stigmatising attitudes that many mental health professionals have towards clients with Borderline Personality Disorder (BPD). However, others may find it distressing realising just how pervasive these attitudes can be across the mental health profession.

DBT was originally developed specifically to treat people with BPD. However, there is now a strong evidence base showing that is effective across a wide range of mental health issues. This is due to the core focus of DBT being on emotion regulation. DBT has also been shown to be effective in helping non-clinical populations manage their emotions. It may be of particular interest to some people in Forum Land, that DBT skills training has been shown to be effective in helping the carers of those with mental health issues cope with the challenges associated with that caring role.

As I said, I'm really not sure how this adventure is going to pan out...but we will never know if we don't try, will we! The manual begins with an introductory chapter outlining the theoretical basis for DBT. It has lots of nice little subheadings which breaks it up into easily manageable chunks. Thus I'm thinking @CheerBear and @Zoe7, that we could tackle the introduction based on these subheadings. Ideally I would love to do a little bit each day, but given the muddle that is my world, that is unlikely to happen. I expect it is far more likely that some weeks I will have a lot to say, and at other times, weeks may go by where I have nothing to say. I am guessing it will be the same for you...and that is a bazillion percent ok.

I superly duperly hope that some other Forumites decide to join us. But if not, that's ok too. I'm just as happy playing by myself.

And on that note, let the adventure begin...

Finding your way in the DBT adventure.

The following is a bit of a guide to navigating your way around what I anticipate will end up being quite a lengthy thread. The link will take you to the relevant page. Here in Forum Land, there are ten posts per page so you may need to scroll down a little way to find the actual post. The relevant headings are in large blue font to help you find them easily.

What is DBT? (This bit is on this first page so just scroll down).

Understanding Emotion Dysregulation

Are People With BPD Manipulative?

Accepting Our Emotions

The Consequences of Emotion Dysregulation

An Overview of DBT

Orientation, Goals and Guidelines

Pros and cons of learning and using DBT skills

Pros and cons of using DBT skills versus self-harming

Introduction to mindfulness

Mindfulness "What" Skills: Observe

Mindfulness "What" Skills: Describe and Participate

Mindfulness "How" Skills: Part One - Nonjudgmentally

381 replies

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In response to: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

Thank you @Phoenix_Rising

yes and as for me to ride out my Husband`s MI muddle as well as staying strong for myself is hard

Mr shaz has had to learn to say" No " instead of pleasing everyone , He does not like letting people down

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

I've only read a little bit, but this is a very interesting thread. I might check out the book and see what it's like.

Thank you everyone for sharing your experiences and thoughts - it's nice to hear what others are going through.

I just found it interesting that some people can have one experience and have one result and obviously others must therefore have exactly the same experience and a different result. I relate to much of what is said here about developmental environments and experiences, but I feel that my own personal adaptation and coping to the experience is the complete opposite to yours.

E.g. I suppress my emotions, don't express my needs, pretend that everything is okay so much so that I'm not even aware I am even feeling negative emotions when something bad happens to me. I pick myself up, dust myself off and shove any and all feelings I have inside of me deep deep down so no one will ever know (until they explode out on the forum later - seriously this is the only place I express much emotion, which is why I need the forums so much). I don't feel that I am valid enough, or worth enough to have any feelings, let alone have my feelings expressed and acknowledged or even my needs met.

The whole idea of expressing my emotions and being vulnerable enough to say that I have needs and I need someone elses help is so overwhelmingly terrifying. FULL BLOWN PANIC terrifying!

But it's so nice to know that I'm not alone.

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

Hi @Catcakes @outlander @Shaz51 @Former-Member

Ooooh I'm excited to hear that you've done DBT @Catcakes. I would super love to hear more about your experiences of it - only if you want to share.

@outlander Thank you for sharing your thoughts. I found it interesting that you differentiated between riding the waves and practicing mindfulness. To me, riding the waves IS doing mindfulness. That is, when riding the waves of big feelings, I focus on the big feelings. I.e. the feeling is the object/experience that I'm mindfully experiencing. Rather than trying to distract from the feeling or avoid it in some way, I focus on it. Have you ever tried doing that? The idea is that by sitting with it rather than pushing it away or doing something to alleviate it, we get to find out that even the biggest feelings won't k*ll us and will actually pass. Indeed they pass quicker if you sit with them, than if you fight them. Do you have any thoughts about that idea?

I super like @Sans911 idea of the worry box. I totally agree with you that having something tangible like that is more helpful than visualising it.

@Former-Member It is super cool to see you here in our DBT adventure. DBT was originally developed specifically for people with BPD who were at high risk of suicide. Thus it does tend to focus on super strong emotions and how to manage them in ways that don't make muddles more muddled. I have had the first edition of the DBT manual for many years and it doesn't really say anything about suppressing emotions. However, DBT has evolved a lot since the first edition of the manual was published in 2003, and in the new edition of the manual, it does talk about how DBT can be useful for people who suppress emotions. I super hope you will continue along on this adventure with us @Former-Member.

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

afternoon @Phoenix_Rising

hmm im not sure if i have done that exactly

i do remember doing an exercise that might be similar to that.. the aim of it was to name the feeling i was having (one at a time) and to actually feel it. describe where i felt it in my body and how it was affecting me. is that sort of like what your talking about? if not then i havent quite focussed right on the feelings. acknowledge them that they are there and they are big emotions but get on with the day as well sort of thing is the closest ive done other than that exercise i described just now.

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)


@outlander wrote:

afternoon @Phoenix_Rising

hmm im not sure if i have done that exactly

i do remember doing an exercise that might be similar to that.. the aim of it was to name the feeling i was having (one at a time) and to actually feel it. describe where i felt it in my body and how it was affecting me. is that sort of like what your talking about?


@outlander Yep that sounds like the sort of thing. This is actually what I'm up to reading about in the DBT manual so hopefully (assuming my brain works!!!) I will post about this very thing on Monday.

Being able to acknowledge your feelings and still get on with your day is a super cool skill to have. I often can't do that. To me, that would be like trying to get on with my day with my clothes on fire - the feelings are simply too big to be able to function with. That's when I rock and stim etc.

Thank you so much for sharing, outlander.

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

not a problem @Phoenix_Rising i tend to 'run' from my feelings more often than face them. ive always had my feeling invalidated so in a way ignored them myself. never really understood them and when they become too much i panic and try to rid of them. it is only recently that i can only for the less strong emotions can say 'i am feeling like s**t but i have to do this today'

i think ill take more a read later on tonight more of this thread for more info

In response to: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

Hi @Phoenix_Rising,
My psychiatrist tried to get me to do DBT many years ago. I had too many obstacles, five young kids, lived an hour away from city, working and no health insurance.
Then a few years ago I was in a better situation to attend and really needed the therapy 😔
I completed 16 weeks but it was tough.
The other participants didn’t alway turn up,
The psychologist was pregnant, the assistant was pretty ineffective,
One of the participants was pretty disruptive,
BUT...... I could see how helpful the skills could be.
The difficulty for me was remembering the skills as the acronyms are complicated and my brain was s bit muddled.
Ideally I should have repeated the modules but the psychologist didn’t run the course again.
I may do it again someday.
I have all my notes and my current therapist encourages me to revisit the skills.
Ask me anything 👍🏻👍🏻👍🏻

In response to: Re: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

Hi everyone Feels good to be here on the DBT adventure again. Great to see you all here.

I found it really interesting to read your question about using skills to achieve what we want to @Phoenix_Rising. I think that one of my strengths that is also a weakness is being able to push through things or "just do it" - maybe a little of what you touched on @Former-Member.

I think the biggest factor for me in just doing it, is a version of what you mentioned @outlander - putting things in boxes (I guess that's compartmentalising in a way). It is a decision to focus solely on what is in front of me right now and completely absorb myself in it. I have realised over time that I have done this throughout my life and that it has been helpful but it has come at a cost.

I too think of study when I consider this. Early in my course I had moved house, was learning to be on my own with really little people, and I had major surgery. I was so determined to not let anything impact my study that I just did it. I pushed through it and completed the units with great grades. It came at the cost of no sleep, incredible stress, pain, exhaustion, detachment from everyone beyond the walls of the house, risking detachment from the kids, making unwise "big" decisions, and running myself into the ground. No doubt my recovery from surgery was much longer than it needed to have been because of it, and some of those big decisions haunted me for a long time. At the time I think I was using reasonable mind and completely ignoring emotion mind.

So I think in terms of using skills to "just do it", my position is that I may be much better off using mindfulness to turn my "I can do anything if I focus on it and it alone" attitude that leads to high gain in some ways at huge cost in others, into one where I can work on accepting that right now maybe it is best for me if I don't push through it. If I stop and zoom out I can see a clear bigger picture as it stands in that moment, and if I stop and zoom in I can recognise how I myself am really going right in that moment. That place seems like a much more rounded and balanced place to make a decision about what is right for me to do at a given point in time. My challenge can be to not completely crumble and fall apart with emotions when I do stop though!

I am not so great at it yet, but I am trying. Like so many things, it seems to take a long time and a lot of practice

I think Cookie Monster has the right idea in terms of mindfulness

In response to: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

Cookie monster has the right idea 😉 @CheerBear

In response to: Let's do Dialectical Behaviour Therapy (DBT)

Re: Let's do Dialectical Behaviour Therapy (DBT)

I agree ❣️

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