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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)

Good morning everybody,


I'm in a better headspace this morning as I prepare to meet therapist-take-thirteen (TTT) for the first time today.


@Shaz51 I'm not quite clear about what you were asking. Aspie turtle brain no compute. I think I am hearing that you are struggling to reconnect at the moment. Do you want to share more about what's happening for you?


Super big thank you for your positive feedback @Catcakes and @NatalieS. NatalieS when you are super struggling, it is a SUPER good time to practice this stuff. Remember though that it is HARD and so it is totally OK to not be great at it. Maybe you should explain to your psychologist that it is SUPPOSED to be hard to focus on the here and now when we are triggered. That is WHY we need to PRACTICE. Helping people say some seriously unhelpful things sometimes don't they!

You mentioned that you feel you need to bring the anxiety levels down before thinking mindfully. I wonder what would happen if you used the anxious feelings as the OBJECT of your thinking. That is, rather than trying to make them go away, super focus on them. Observe how they feel in your body and what thoughts go through your mind, without judging them (e.g. without thinking "I shouldn't feel this way", or "why can't I stop feeling so anxious"). It could be an interesting experiment.


@PeppiPatty, it is super nice to see you joining us here on the great DBT adventure.

@outlander, it seems we were having a miscommunication after all. Based on what you said in your last post, it sounds like for some things you can't "just do it" but rather, you need to wait until you are in the right headspace - just like me. This is a really good example of the sorts of miscommunications I have with people pretty much every time I interact with them. I'm super hoping @Faith-and-Hope can help me learn to get better at building bridges. By the way, I love that my example of essay writing has prompted people to provide others with information on essay writing.


Hi @Adge I am super excited to see you here in the DBT adventure. My subtle hint was awesomely subtle wasn't it!


Yep, DBT is useful for LOTS of things. It was originally developed for people with BPD who struggle with suicidal ideation, but it is now used very widely. If you stick around here Adge, you'll probably see how well it fits with our yoga adventures. Yoga is, after all, a form of mindfulness.

Ok, well I THINK I have responded to everyone. Happy DBT-ing. :smiley-happy:

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

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

I hope this is okay for you @Phoenix_Rising ..... I had a “bridge-building” flash of insight .....

Sometimes honesty of thought or presentation of personal perspective can “shirt-front” other people ..... particularly people who are not forth-right in how they say things ..... and particularly if there is criticism involved, no matter how constructive that criticism may be .....

So what I want to mention is what I would call cushioning. It is pre-emptying forth-right statements, particularly critical ones, with a warning statement of sorts. I am hoping this will work well for Aspies ..... It means starting with a generic protocol such as, “With all due respect ..... “ before launching into the criticism or forthright statement that may be difficult for the listener to receive without a pre-emptive statement.

I am sure that, “With all due respect ....” can be stated in a variety of other ways, such as, “From my perspective I am seeing something else .....” or “If you don’t mind, I would like to share a different take on that ....” or “While I understand what you are saying, this is how it comes across to me ..... “

These are what might be considered social niceties, but they serve a function that I have referred to as cushioning, and many people require that cushioning, whereas I am guessing that Aspies don’t ..... they are very good at simply calling a spade a spade and going right ahead and saying so,

I think cushioning is a large part of the bridge-building toolkit .... and exploring bridge-building is causing me to try to deconstruct it and understand how it works ..... which is a positive methinks.

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

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

morning @Phoenix_Rising

miscommunications are bound to happen and thats ok. i do have to be in the right headspace i cant 'just do it' and lot of the times it takes me more than once to get it to where im happy with the way its written. i do it on here too. in a distressed state, i admit no i dont think clearly and i just write what comes to my head but when i can think i read it twice over before posting. Essay writing was one of the hardest things through school, PEEL made it alot easier becasue it gave me somewhere to start. i could have a thousand dot points sitting in front of me and it would take me forever to write even the introduction.

in regards to other things such as going to work, trying to clean the house, i cant use PEEL to get me started. i need to find the motivation or be in the mood to do so. thats the good thing about working with flexible work- i can set my own hrs and go and do what needs to be done when and where i can. there have been a few times where i did just have to get up and go due to dentistry appointments for the horses and i cant be late, i am always at least half an hour early.

anyways starting to ramble, back to the point no, i cant 'just do it' i need to be in a better headspace. i guess thats why we call it survivial or floating mode where we do what we can manage (even if it means doing nothing at all) until we feel we can cope with a little more

@Faith-and-Hopei like the way you explained cushioning. very good!

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

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

@Faith-and-Hope Oooh that's super helpful! I have recently learnt one of these from @CheerBear's puffer fish. Apparently they use "I don't mean to be offensive but..."

Over the years, I've learnt:

I'm wondering if...

I can hear that...

I'm curious about...

I will write down and memorise the ones you suggested. Super big thank you.

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

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

🎉😁 @Phoenix_Rising ..... 🌐 💃 🎶 (happy-dance)

Other forumites might be able to add to the List of Cushionings for you ....

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

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

@Faith-and-Hope

this cushioning is a fantastic idea, because sometimes I get straight to the point, not always knowing what it is I'm trying to say, and things come out all mumbo jumbly and there are times when people get offended or cautious, so I really like the idea of cushioning...I'm thinking that saying something along the lines of "from my perspective..." or "with all due respect" will give me a chance to slow down and sort my thoughts out before opening my mouth.

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

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

wow, @Phoenix_Rising, that makes so much sense, to concentrate on the anxiety...my psychologist is really really nice but she keeps asking me why I don't feel safe. Weeeellllllll...childhood, not feeling safe with people, not feeling safe in the world, and that's just for starters. She tries to change my thinking by saying things along the line that I am safe with her, her office is safe, the world is safe...maybe to her, but not to me. And she can't understand that I'm highly functional at work, and travel to and from there on public transport, but these are things I've always done from a very young age. If I don't work I don't eat or have accommodation. I don't drive, so if I only walk I can't travel very far. She doesn't understand how difficult I find it to talk to people-especially all the small talk that I just don't get-and be with people that I've worked with for the last 17 years. I agree with you, I think I need to acknowledge the anxiety and own it and accept it ...that's a battle in itself. Thanks so much for this thread!!!!!!

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

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

@NatalieS I had to learn to do something like that for a different reason. There was someone in my life who was bullying me quite badly. I had to train myself to say something like, "I need to think about it before I answer you. I'all get back to you." Or, "I'll need to check my diary and see if we're free" ..... things like that, because they were railroading me into doing what they wanted all the time and demanding immediate answers to things that I hadn't had a chance to consider how I felt about.

It really worked well once I got the hang of it. It was about how to set boundaries, and it grew from there. I hadn't dealt with people who don't resp ct boundaries before and didn't have the skills at first. Steeeeep learning curve.

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

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

@Phoenix_Rising and @Faith-and-Hope

I don’t want to create confusion or ire, but be careful with the cushioning statements. If you’re confronting someone or talking about a difficult topic, I find ‘I’ statements work best.

(For me personally, I like people to be direct and to the point, but not attacking and not condescending and if you say “with all due respect” to me, I’ll assume the worst and either punch you in the face or run away.)

What you’ve written down as “I” statements are, for me, really good and I think a bit better than cushioning statements for more direct and abrasive people like me.

Again, this isn’t everyone, as everyone is by definition an individual and therefore different, but i think your ‘I’ statements avoid aggravating people like me and you can voice criticism this way too - “I have sensitive hearing and I found your music disruptive/loud/annoying, could you please turn it down.”

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

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

Thanks for sharing that @Former-Member. It helps to know which sort of phrase is going to work best from both sides.

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