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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)

I also wanted to say @Phoenix_Rising, that all of us found it difficult to be in the room at first and I’m sure the psychologist and her co-facilitator had a degree of trepidation as well. There were certainly moments that certain emotions overwhelmed each one of us but at other times we laughed and supported one another. Since we were not allowed to form relationships outside the group, I have no idea how the other participants have fared since.

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

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

Love the drawing @Catcakes

I am back into action again @Phoenix_Rising , crazy last few weeks , I am showing signs of carer / Wife burnout xxxx

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

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

Hi @Phoenix_Rising and everyone

Haven't participated much here but there is so much information to absorb and pracitce which is fantastic. So it'll be good to return. I'm finding it really interesting (when I'm in the right headspace, though things seem to be improving) when I'm not so distracted.

Thanks so much for putting it all together, what a great effort!

And I love the egg thing, though I don't think I'm ready to have a go just yet.

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

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

I hope my doctor can refer me to a DBT class.
At the moment I'm doing my best with the app I have
Whilst it helps a bit I think old benefit from a class setting

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

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

ok @Phoenix_Rising @CheerBear

Here is my egg!

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

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

Yay to @Former-Member for balancing an egg!!!!!!!!!!!!!!!!!!!!!!!!!

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

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

Good morning DBTers.

So...you know that plan I had of posting the next bit of the DBT adventure this week. Yeah...given it is Monday morning and I haven't started writing it yet, that won't be happening. Still, given that when I do write, I seem to end up writing a trillion word essay, it's probably not a bad thing that the next one is at least a week away. Yay for turtle pace! Anyway, I'm assuming everyone is super busy balancing eggs. Thus far @CheerBear and @Former-Member have risen to the egg balancing challenge. I'm super hoping to see some more egg photos.

Hey @Former-Member @Former-Member @NikNik @Former-Member @Former-Member @Former-Member I think you should all do some egg balancing in the SANE office. It counts as work - it is role modelling mindfulness for Forumites. Go on, you know you want to!

@CheerBear it is a bazillion percent ok if this thread becomes scattered. That is why I am creating a table of contents, so we can bounce around all over the place and still end up with a thread that can be navigated usefully.

Mindfulness is definitely super hard and I think it takes a super gigantic amount of practice. That's why I find is sad when people say they tried mindfulness and it didn't "work". I think it is sometimes sold as an instant solution when it really really isn't!

I can definitely see how crocheting would be a cool mindfulness activity @CheerBear. Flow states are definitely very cool. It is logically impossible to be experiencing icky big feelings while in a state of flow.

I agree that I am fine with people trying to work out what I'm thinking/feeling, so long as they are open to me saying "no that's not right." I simply do not understand how someone can claim to be "right" about what I am thinking/feeling. It is absurd and super infuriates me! I super like how your LF help you to have a position of respectful curiosity when supporting them to figure out their feelings.

I love how you described going from hating the egg to becoming one with the egg. I think that is super cool!

@Awpgirl It sounds like you feel you'd super benefit from a DBT group. I super hope you are able to find one that you can get to.

@Catcakes I am super excited to hear that our DBT adventure is reminding you of the skills you learnt in your DBT group. Skills take a LOT of practice (just ask my neighbours how much I practice my violin playing skills ). It is cool to hear about your experiences in a DBT group. I wonder if you did any of the "participating" activities when you did the mindfulness module? Along with egg balancing, some other examples include calligraphy, writing backwards and origami. There are also a whole lot of group activities such as dancing (those are the ones that I looked at and thought "I don't think so" ). I really like the examples of mindfulness exercises that you did at the start and end of your DBT class. I think it is super helpful for others here in the DBT adventure to hear about people's experiences in a real live DBT class, so super big thank you for sharing.

I smiled at your comment that the facilitators probably had some trepidation at the start of the group. I'd say that is highly likely. Linehan spends a LOT of time in the DBT treatment manual talking about the challenges of facilitating a DBT group. This is why she is very insistent that therapists who do DBT need a good professional support network.

Catcakes what do you think about that rule re. not forming relationships outside the group? I'm not sure what I think about it. I can see the rationale for it, but I'm not entirely sure that I agree with it.

@Former-Member super big thank you for your positive feedback regarding the DBT adventure. I have to admit, it is a little more work than I had initially anticipated, but so super worth it!

@Shaz51 It's super to see you back here in the DBT adventure. I'm sorry to hear you are struggling with carer/wife burnout. I think burnout is the topic for topic Tuesday this week over in Carers Town isn't it?

Hi @NatalieS, it is super good to see you here. It is a bazillion percent ok to just read along. I am certain you are not the only one doing that.

Happy DBTing everyone.

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

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

Thanks for the mention @Phoenix_Rising.
I think I remember a few “participate” activities from my DBT group.
One was drawing with eyes closed and another was with a partner, looking into each other’s eyes. A bit confronting that one.
The psychologist running my group was pregnant so she was hoping to get the group finished before baby arrived. The co facilitator had completed DBT herself as a client.
There were several sessions that emotions got a bit tricky and that I’m glad the facilitators has supervision around those issues because sometimes things could be handled better.
We also had an individual session with the psychologist each week so you could also talk about how you were going with DBT there.
I can understand the reason for not forming relationships outside the group as that could compromise the group but at the end of the group I guess there could have been an opportunity to connect. I’m not sure if this would have been helpful.
I do think about some of the other group members and wonder how they’re going.
As I have said, I have all my notes here somewhere😩
Some boxes I still haven’t looked at since I moved.....

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

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

I think burnout is the topic for topic Tuesday this week over in Carers Town isn't it?-- this week or next week @Phoenix_Rising, I will have a look

super glad to be back and ready to go

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

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

Good morning,

@Catcakes that is super cool that you found a DBT program that included individual therapy as well as the skills group. Did it also include between-session telephone contact? One of my big gripes is that so many private therapists say they do DBT, but they actually only do the skills bit. DBT is supposed to also include between session phone support. Linehan states very clearly that if a therapist can't provide between session support, then they can't do DBT.

I like the idea of drawing with your eyes closed as a participating activity. Given that no-one can ever tell what my drawings are supposed to be when I've had my eyes open, I'm sure any drawings I did with my eyes closed would turn out to be truly abstract.

Yesterday I spent all day playing with some data and it occurred to me that this is another activity where I experience a sense of flow. I know this is a little atypical, but I find it superly duperly calming. I also find making pictures on the computer a super cool participating activity - super big thank you for teaching me that one @Zoe7.

Thinking about this got me wondering if anyone else can think of some more activities that they find they get completely absorbed in? @CheerBear mentioned crocheting. What about colouring in? I'm not really into that, but I know a lot of people find it super calming. I'm guessing maybe you get into a state of flow when you are painting, @Faith-and-Hope?

I wonder if anyone else has been egg balancing. @Former-Member I read over there --> that you were thinking of getting your children to try it. That sounds like a super idea. And as a bonus, if they drop eggs all over the floor, you will get a chance to practice distress tolerance while you clean up the mess.

Hey @Former-Member @Former-Member @Former-Member @Former-Member have you tried balancing an egg yet? I super think everyone at SANE should try it. Maybe the ability to balance an egg could be a selection criteria for next time you guys are recruiting new people.

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