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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

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

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

That becomes a lot of cookies for me to eat!

I agree with @CheerBear that the "just do it" can be a strength and a weakness. I have often pushed through and I have often been on an apparently unending sea of big feelings which I thought would never stop.

so much depends on context.

If we push through too much we might be denying emotions that need our attention.

I think it is totally acceptable to respect your own inner timing @Phoenix_Rising. Also sometimes we need to lift ourselves off our own tushie.

Sometimes no matter how much we push through and achieve as an individual we lack the listening to others skills and miss clues to improve our connections to others.

It all depends ....

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

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

Good morning everybody,

@Catcakes I think it would be really tricky doing a 16-week version of the DBT program. When @CheerBear and I embarked on this adventure, we spent some time discussing which schedule we would follow (there are several in the DBT manual). We have settled on a 24-week program...and I am anticipating it will take us at least 12 months (although I think CheerBear had some crazy idea that we would actually do it in 24 weeks ). I'm a sea turtle, I'm super used to doing things slooooowly.

So, I've been reflecting all weekend on the idea that other people can "just do it" and I can't. Hmmm...clearly I'm the odd one out here - phew, good thing I'm pretty used to being the odd one out.

I am super curious to know how people make their brain work at a level where they can research and write an essay, when they are super flooded with big feelings. I mean, I can make myself sit at the computer and I can make myself read a journal article or whatever, but I simply cannot make my brain work so that I can process the information.

@CheerBear from what you describe, does that mean that if you had to write an essay in the days before you went to the break place, you'd be able to? I definitely wouldn't be able to do that.

@outlander I've noticed that some times you've mentioned in Forum Land that you can't find your words to write a post. When you are in that space, where you are so distressed that you can't formulate a post, how would you be able to research and write an essay?

I hope it's ok to ask. I am trying to figure out if we are talking about the same thing or not. Hmmm...where is my trusty bridge building expert @Faith-and-Hope???

I can "just do it" in terms of things that don't involve using my brain - such as making myself get out of bed or making myself clean the house, but as to how to do high-level thinking when my brain is flooded with big feelings, I have absolutely no idea.

I wonder if anyone who can do it, can explain how they do it - because I would superly duperly like to be able to do it too.

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

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

I start with mind-mapping @Phoenix_Rising ....I know I have talked to you about this before, but others here might not know what that is ....

Here is one built around the topic of Climate Change.

They can be more simple, like this one centred around Job Search.

This is a visual way to break it down into baby steps.

When it came to writing an essay, you write a paragraph per arm of the mind map. It means you have a reference point to work from, and this is broken down into small steps .... sort of like capturing your thoughts abiut the matter with a butterfly net, and storing them in separate jars to study them a bit, documenting them, before releasing them again.

I hope that helps.

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

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

Hi @Faith-and-Hope, Super big thank you for dropping by.

Um...nope, that doesn't help. I've completed two degrees with near-straight HDs, so I know HOW to write an essay. My question is how does one make their brain function at that high level when it is flooded with big feelings. So, for example, if you suddenly got a phone call to say that your entire family had died in an accident or something, would you be able to sit down and write an essay while filled up with super giant grief feelings? Does that make sense?

The reason my 4-year program took me 12 years was because of my extremely poor concentration. I did most of my two degrees one subject at a time, and I also deferred a LOT of semesters.

One of the things I super want to do is prepare my dissertation for publication. It is 2.5 years since I finished it and I SUPER want to publish it. But in all that time, my brain simply hasn't bee able to function at that level. I truly think that if I can settle with TTT, then the big feelings will settle a bit and then I will be able to do it. But you see? This is an example of me recognising that "I can't do it right now." I super want to know how other people manage to make their brain work when it is filled up with big feelings.

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

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

I think huge grief feelings would derail me entirely @Phoenix_Rising, and I would need to defer my studies.

I know the mind maps are used as a tool for HOW to write essays / assignments ...... however what I was talking about was using them as an ANCHOR ...... so when the big feelings come sweeping past, the mind-map anchors you to the task at hand.

It's similar when I write a three dot point task list for the day ..... I know how to keep a house, manage a family, and paint giant canvases ...... but when I am h-it by the inertia bus, or an emotional cyclone, the three dot points become my candle in the dark.

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

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

Good morning @Phoenix_Rising
I will come back to here. Its abit hard typing longer msgs on my phone so ill be back when i log onto the computer 🙂

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

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

Hi @outlander

@Faith-and-Hope I think this is a big part of my muddle. I think my definition of "big feelings" and others' definition of "big feelings" isn't quite the same thing. I feel better knowing there is a level of big feelings that would derail your ability to "just do it."

I've mentioned in Forum Land before that Fred always told me I was the most severe case of BPD he had encountered. However, I am now extremely sure that what he was seeing wasn't a particularly messed up "borderline," but an Aspie with BPD.

I dropped out of uni (the first time around) when the situation with E (that I shared with you elsewhere @Faith-and-Hope) happened. During that whole situation, people were telling me to "just do it" regarding my studies. Hearing you say that you wouldn't be able to "just do it" if you suddenly lost all the people you love most in the world, is super validating and thus super helpful. Super big thank you.

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

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

I can see that @Phoenix_Rising ..... that a dual dx Aspie plus BPD might have been very confusing.

Mr f&h looks to be a muddle of dx (whenever that finally happens) which has been a major complication to dr's working out that he is unwell. You sort of have to separate out this different aspects, then put them back together to recognise the relationships between them in the one person.

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

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

@Phoenix_Rising, no you're not the only person who cannot study/write when you're feeling unwell.

For me personally, when I'm not feeling well it's like my brain is made of concrete. I cannot understand what other people have written and all I can write is the vile horrible stuff going on inside my head. When I'm really unwell I lose my internal monologue which is a very scary experience. I feel like I cannot control my own thoughts and often at those times I hear voices as well.

I've not read a book since I got sick around 8/9 years ago and studying is very very difficult for me to do. I really really struggle to read, interpret and understand and most difficult of all is trying to remember things. My memory is shocking and I'm starting to realise how much I dissociate my life away. I have weeks, days, conversations that I simply don't remember. When something happens I can't remember if it happened a week ago or 3 months ago and I cannot reoly on my memory to tell me these things.

@Appleblossom wrote a really lovely post to me recently, but it took me a few weeks to be able to understand what she had written cause my concrete brain just couldn't process it.

Mines not so much being flooded with big feelings as being slowed down, frozen and posessed. But I think all mental illnesses are the same in that they impact your cognitive performane and stop you doing what you want to be doing.

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

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

Hi @Former-Member,

I'm super glad to hear I'm not the only one who can't concentrate sometimes! Even though it sounds like our reasons for being unable to concentrate differ, fundamentally it ends up being the same problem. Now all we need to do is figure out the solution to the problem.

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