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Let's do Dialectical Behaviour Therapy (DBT)

Phoenix_RisingSenior Contributor26 Sept 2017, 8:31 am AEST

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)

Faith-and-HopeSenior Contributor10 Jan 2018, 2:37 pm AEDT

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

Sorry ..... mis-tagged you @Lt72884 above .....

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

Phoenix_RisingSenior Contributor11 Jan 2018, 5:38 pm AEDT

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

Good afternoon DBT-ers,

So...I still haven't started the next installment of the DBT adventure, but I am moving into the headspace to be able to do it, so I'm thinking it will appear next week sometime.

Welcome to Forum Land, and to our DBT adventure @Lt72884 You are extremely welcome to join the adventure - no fees at all. As you may have read on the first post of this thread, our adventure consists of plodding through the DBT skills training manual. We are not moving particularly fast, mostly because @CheerBear and I, who started the adventure, keep running into muddles that derail us here in the real world. On the bright side, this means there is lots of space between installments to process information and practice the skills that we are covering. When I do finally get around to posting each bit, my posts tend to be absurdly long, so it's probably not a bad thing that they don't appear too often.

I bought the DBT skills training manual (which is the book that tells therapists how to run DBT groups) and the book of handouts (which consists of the handouts that are given to clients in groups) from here: https://www.bookdepository.com/DBT--R--Skills-Training-Manual--Second-Edition/9781462516995 You can also download all the handouts for free from here: https://www.guilford.com/companion-site/DBT-Skills-Training-Manual-Second-Edition/9781462516995

@Adge and @Awpgirl were recently talking about a DBT self-help website. I'm wondering if one them might be so super kind as to post the link for us? @Awpgirl has also been trying out an app called DBT self help.

In terms of being "left hanging," my plan is that by the time we finish the DBT adventure (which could be quite a while away!!!!), we will have the entire DBT skills training manual summarised and sitting here in Forum Land for anyone to explore. However, this is a peer support group and thus people have to be a little patient with the fact that @CheerBear and I have our own muddles that tend to get in the way of us moving through the DBT manual as quickly as we might like to.

Have you explored options around finding a "real" DBT program where you live @Lt72884? @Catcakes has been sharing her experiences of a DBT program with us. I am super impressed that she managed to find one that included all three components of DBT (skills group, individual therapy and telephone support). Where I live, those programs are offered at a couple of private hospitals, but at the time when they would have super helped me, they were beyond my reach financially. They are still beyond my reach, but I'm now in a space where I don't feel I'd benefit from such a program. I tend to learn things best by myself out of a book (I did my entire psychology degree by distance) rather than in a group setting. However, others seem to super benefit from being in a group.

@Former-Member have you tried balancing an egg yet? I think you should try one morning before work. I will write you a late-note: Dear Lunar's boss, please don't be mad at Lunar for running late this morning. She was busy balancing an egg, which really is work because she was role-modelling the mindfulness skill of participating for all of us Forumites.

For @Lt72884, egg balancing is an example of the mindfulness skill of "participating" given in the DBT manual. You can read about it on this page here.

@Former-Member I super like that your cat, Elsie, is helping you with your mindfulness practice by letting you super focus on brushing her. Yay, our list of activities that lend themselves to fully participating in the moment is growing!

@Former-Member I am super impressed that Miss 12 got her egg to balance. I'm also pretty impressed that Mr 10 stuck at it for 10 minutes!

I'm still keen to see more photos of balanced eggs. Go on everybody, you know you want to!

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

Shaz51Senior Contributor11 Jan 2018, 5:59 pm AEDT

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

have you tried balancing an egg yet -- I did @Phoenix_Rising

and @Former-Member ii here in forumland

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

CatcakesSenior Contributor11 Jan 2018, 7:46 pm AEDT

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

I wanted to let you know @Phoenix_Rising that although I’m still reeling from aspects of your story, I’m glad that I know it now.
I didn’t realise how lucky I was to find an intensively trained DBT therapist and complete the course with her.
I don’t see that therapist any more.
Like you, I have had many and sometimes the therapy was terminated in an abrupt and harmful way. I have reported one therapist but it was a pretty useless exercise.
I’m pretty happy with my current therapist who is smart, skilful and copes well with my different moods.
I haven’t tried egg balancing yet but doing other things mindfully. Thanks for your ongoing commitment 💪

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

Phoenix_RisingSenior Contributor11 Jan 2018, 8:39 pm AEDT

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

@Catcakes I am super excited that our DBT thread is inspiring you to practice doing things mindfully.

Yes, I can well imagine how tricky the process of reporting a therapist is. There are complex reasons why I have chosen not to report Fred - it's all a bit of a muddle! I did spend three years going through the legal process of suing a church though, and that process was hellish, so I have some sense of how challenging such things can be.

Having therapists terminate contact abruptly is SO harmful. I'm sorry to hear that you have experienced that too. With therapists 1-12, some dumped me and some I dumped. They ranged from unhelpful and a poor fit, to re-traumatising and unethical. Yep, therapist shopping is a nightmare. However, I super hope that the fact I have now found TTT, will help other people to know that there ARE good therapists out there - they are just sadly few and far between and the only way to find a good one is to keep on keeping on.

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

CatcakesSenior Contributor11 Jan 2018, 9:06 pm AEDT

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

To be honest @Phoenix_Rising,
I often feel that I would be much happier if I never had to set foot in a professional suite ever again but there’s a problem.
I have an aversion to health professionals and I have several medical issues that require medication and monitoring 😩
Not only that but I am frequently required to accompany family members to appointments.
I even have trouble relating to the @Former-Member here so I have trouble accessing help .
I envy your ability to reach out and accept help.
Well, that’s enough 💐

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

AwpgirlSenior Contributor12 Jan 2018, 12:54 am AEDT

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

For some reason I can't wrap my head around the egg task
Could someone explain it to me?
Is it an observe activity or something different,?

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

CheerBearSenior Contributor12 Jan 2018, 10:13 am AEDT

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

Hi @Awpgirl 🙂 From my understanding the egg activity is a participating exercise.

For me to get the egg to balance (and not turn it into scrambled smashed egg on the wall), I had to 'enter' in to the experience. That might sound really fluffy and I half want to face palm myself that those words are coming out of my mouth (fingers).

It was a "focus on this and this alone" kind of activity for me. I noticed when I let go of my want to get it right, my questions about how to do it etc. and I started "doing it" I could feel the insides of the egg shifting around and how they kind of moved and settled. I wasn't thinking about much more than the egg and what was happening right then and there. That's when I felt like I was "participating".

Does that help at all?

Do you have any other activities you do that you kind of "enter into" in that sense? (You may have already mentioned them and I have missed it)

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

AwpgirlSenior Contributor12 Jan 2018, 12:05 pm AEDT

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

so you guys are all using the force from star wars. Teach me the Jedi ways😀😀

@CheerBear I make the star wars reference only because that is how my brain related the description you gave.

I feel like that when I play computer games; do art; play a musical instrument; snowboard and dancing

I usually visualise or use a candle flame to help me bring my focus back.

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

CheerBearSenior Contributor12 Jan 2018, 12:15 pm AEDT

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

Haha I would say yes with the Jedi ways except that I have absolutely no idea whatsoever when it comes to Star Wars @Awpgirl!

I remembered in an intro of yours that you were a gamer and was wondering whether you felt that "participating" feeling when you played. I can definitely see how dancing/sport are other great ones for being able to involve yourself fully in the experience of 🙂

The candle flame to bring focus back sounds interesting. I use (used to use a lot more) a Stop sign visualisation which is a skill from the Distress Tolerance module. (Edit to say that the STOP skill is a DT one, not necessarily visualising a Stop sign 🙂 )

🙂

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