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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)

@Catcakes Ooooh I am so excited that you are posting your first ever picture here on our DBT thread!!!! I'm about to go and have a shower, so hopefully the triangle of doom will have transformed into your picture by the time I check in again.

ROFL at the fact you are more impressed by my egg balancing skill than you are by the absurdly long post that I laboured over for days.

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

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

Hi @Catcakes,

I SUPER like your drawing!!!! Thank you so much for posting it. Having now seen your picture, I am even more excited that you chose to post your first-ever picture here on the DBT thread.

I am wondering which person in the picture represents you - but it is a bazillion percent ok if you don't want to share.

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

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

Ha ha @Phoenix_Rising,
I could be any of them but I’m going to say the one with ‘help’ on her lap.....

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

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

@Catcakes That was the person I was thinking you might be. It looks like some of the other people were finding it tricky being in the room too, given the positioning of their arms.

I am heading off to bed now. I'm super glad you are joining us on the DBT adventure, Catcakes. Don't forget to practice balancing an egg! When I was doing it, I got the sense that the egg knew when I was getting frustrated! It is definitely a super cool mindfulness exercise.

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

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

Love the drawing @Catcakes ......❣️

And love that you drew your DBT group ...... I think that’s really cool .....

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

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

Thanks @Faith&Hope,
It helps...

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

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

Hello DBTers ☺

I was going to reply to the conversation I sort of dropped out of, but it could make this thread a little scattered. So a big hi to everyone and a wow @Catcakes - your drawing is fab! That's an awesome way of feeling more comfortable in a group ☺
I'm currently practicing a skill called Opposite Action when you do something that is the opposite to how you're feeling, in order to (hopefully) bring about positive change. Right now I don't feel like being around people, I do feel like retreating, and I don't feel like doing much of anything etc - so here I am. It's one of my favourite skills because I find it often works (though it can be SO annoying to try out sometimes).
Mindfulness skills I struggle with sometimes (lots of the time), particularly when I feel extra not-great. I get so frustrated trying to sit with anything when I desperately want something to be different. Fighting for things to be different doesn't always make them different though and it just leads to more and more frustration for me. I have no idea what the point of me writing that was except maybe to say that mindfulness can be an incredibly difficult practice sometimes, but maybe a helpful one also.
I love the concept of flow @Phoenix_Rising ☺. Funnily enough it is where I was looking for the answer to the question about how to "just do it" as I have an awesomely cool text book on performance psychology which is all about the factors that play into "flow".
One of my favourite ways of 'participating' mindfully in an activity is when I am crocheting. Sometimes I really have to push myself to sit and crochet but often when I do I find myself engaged in it, feeling the movement of my hand, the yarn being wrapped around the hook, the hook going in and between stitches. As you said Phoenix_Rising - I simply do. Flow states are very cool ☺
Regarding your questions about telling people what they are thinking or feeling - I can understand how and why you would detest this. My psych and I have clashed a few times with this one. I am ok with people trying to work out what I am thinking or feeling (to an extent) and sometimes it can be helpful to have some prompting to understand it myself, but if I try to correct an assumption and it isn't met with respect or understanding, it doesn't tend to go down well. No-one except me knows what is going on inside me. Just as I don't know what is going on for someone else.
In terms of me telling someone what they're thinking or feeling, my kids stand out to me here. I try to support them to have the language to be able to identify and express what they are thinking and feeling, but it has often come from getting it wrong with them. One of mine can completely lose it when I get it wrong (and fair enough!). One however, is quite open to considering others views which can make them easily influenced. Seeing this happen, highlights to me how much better a position of respectful curiousity can work than one of authority.
Thank you for your post Phoenix_Rising and all of the work and thought you put into it. I really enjoyed reading it ☺
Oh and I have this to drop off here:
I started this off with a whole lot of "stuff this egg, I hate this egg, I want to smash this egg, maybe I am doing this wrong...". Then I stopped and started to notice how the egg felt, and how it's insides slightly shifted around in the shell, and it gently tapped my fingers trying to balance etc. It became just me and an egg and we were kind of one (I'm totally normal) 😉.
I will definitely be looking for more activities like this to "do" mindfully!

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

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

Hi everyone, I don't know each person yrt to individually tag them in.

I am using an app called DBT self help and at the moment using it to record my daily diary and to get a feel for which skills I can already do and which I need to practise.

I do my best to practise mindfulness each day as part of my spirituality.
I am focussing on distress tolerance and inter personal effectiveness as at the moment I feel those are my two areas that require most focus.

My case manager suggested I ask my psychiatrist of of I could do a course of DBT as an inpatient or to see if there is an outpatient course at a time and place Ivan attend.i see him this week so fingers crossed.

Last night I had a huge fight with boyfriend.
I am staying with him for the weekend.
I had been drinking (not much but enough so that I found hard to mamage my PTSD flashbacks)

I packed my stuff to run away however with his support I calmed down and stayed the night.
We have just got up and apogised to each other and made up.

I feel im making progress!!!!!

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

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

Thanks @CheerBear for the compliments on my drawing. Reading these posts brings the DBT skills to mind and I have tried to practise some mindfulness again.
In my DBT class we usually started and finished with a mindfulness exercise .
Sometimes it involved a single square of chocolate, or a young green leaf, a birthday candle, an ice block,
A piece of music, a word.....
I must look out my notes...

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

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

Fantastic thread @Phoenix_Rising. I am still reading through it all but wanted to say thank you for starting it as it is hugely helpful and informative

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