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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

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

BlueBaySenior Contributor26 Feb 2018, 11:15 am AEDT

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

Thanks @Phoenix_Rising for all the info you put up. There is a lot to read. But it's all coming back to me!!! 🙂

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

Phoenix_RisingSenior Contributor26 Feb 2018, 11:24 am AEDT

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

@Catcakes what you are describing fits perfectly with my understanding of how DBT is supposed to be done - i.e. being able to call your psychologist for help between sessions. You were really lucky to find somewhere where they did the whole program like that. As I've mentioned before, most psychologists who say they do DBT, only teach the skills - they don't provide that between-session support. To me, that is an essential part of DBT.

I really struggle with the fact that I have zero between-session support - hence why my once-a-week call to the HC was so important to me. I feel even more alone now that that has been taken away.

@BlueBay @Faith-and-Hope @Former-Member Giggle. You do know that that post took me about a month to write, don't you? It's not designed to be absorbed right away. The super cool thing about Forum Land is that we can come back to things whenever.

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

Unknown userMember26 Feb 2018, 11:25 am AEDT

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

This is great @Phoenix_Rising

You did really well dealing with your emotions with the car tyre people, good job 🙂

'People Savvy' - interesting term, I look forward to hearing how others get around this, does it relate to emotional intelligence and being aware of other emotions?

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

SnowieSenior Contributor26 Feb 2018, 11:30 am AEDT

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

Thanks @Phoenix_Rising , my pdoc has suggested that I go do DBT so this is really helpful

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

AppleblossomSenior Contributor26 Feb 2018, 11:42 am AEDT

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

@Phoenix_RisingI will come back for another read of that very impressive post.

Sorry you are in crisis. Hope the forum and DBT have been some help.

In last 3 months I have been allowed to contact my mh worker between sessions. I NEVER abuse that privelege. I ahve done therapy for 30 years and I never had that option. It was not offered or asked for. However this brings back a memory of dead sister who did phone her psych once when we were talking about the fanily. I was amazed then and still so glad I had that year with my sister where we talkied endlessly about family issues and listened and played piano and tapes. NOT GOSSIP. We were the ones gossipped about. Ah the old days of tapes and vinyl. It is good to be able to remember her without tears, even a quiet little smile. I think that is important and a form of recovery for me. She died 32 years ago. Thank you.

Take Care ALL

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

CatcakesSenior Contributor26 Feb 2018, 11:54 am AEDT

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

I was also impressed with your handling of the tyre situation @Phoenix_Rising, both the tyre itself 💪 and the tyre man.
I understand that it is very frustrating to have something taken away from you that you found supportive and helpful.
I also understand from my own experience that I have abused such priveleges many times resulting in great shame. It got to the stage whenI would start with a new psychologist , I would tell THEM the boundaries they needed to maintain. This works for me.
I have a better relationship with my current therapist because she is very good at maintaining boundaries and this helps me to feel Safe.👍🏼

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

Phoenix_RisingSenior Contributor26 Feb 2018, 12:17 pm AEDT

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

@Catcakes for me it isn't "frustrating." Rather, it is immensely re-traumatizing due to my history and my current social isolation. Also, just to clarify, the HC haven't banned me from calling them because I somehow abused the privelege. I was super good at sticking to the once-a-week rule. It's because there's something wonky with my communication and they couldn't cope with it. I don't really understand...I just know I'm too wonky for them to want to talk to me once a week. TTT said I'm not too wonky for her though, so that's something.

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

CatcakesSenior Contributor26 Feb 2018, 12:22 pm AEDT

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

Thanks for clarifying that @Phoenix_Rising.
I guess that just shows that TTT is very right for you then. I’ve never actually spoken to the HC people so I can’t even guess why they found you too wonky to talk to but right from when I first started my own tentative forays into forum land I have found you warm and supportive🌿👍🏼

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

Unknown userMember26 Feb 2018, 1:05 pm AEDT

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

Truly awesome presentation @Phoenix_Rising

Your TTT sounds like she is perfect for you. I'm so pleased for you that you have TTT.

Much to take in, and respond to, very timely info for me to revisit. Will come back to respond when I'm not so shaky.

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

Unknown userMember26 Feb 2018, 2:12 pm AEDT

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

"Linehan makes the point that one can be living fully in the present and yet still plan for the future."
I'd so like to be able to more fully action the whole of this 'One-Mindfully' thing.

Ages ago, I worked out that making an appointment to get back to the worrying aspect worked for me. Doing that, and keeping the appointment, enabled me to deal with my work scenarios and keep things together. Maybe I can revisit that idea as I have let it lapse somewhat.

It's always made sense to me that the planning for the future take part in the present, because the present is where things that will affect the future are happening; and, using the knowledge gained from the past is also sometimes useful in planning for the future so as not to repeat actions that don't have the outcomes I am planning for.

I too get so tired of the over-focus on 'the present' without an eye to the future, or to the past. We learn both positive and negative behaviour/ thinking patterns from the past, and can plan for a better future if we carefully consider those past interactions, decisions and their outcomes and use relevant information for the decisions and actions needed to be made in our present.

I used to have a really pretty "This is the first day of the rest of your life" wall poster, those words helped me move forward in the 2 or 3 years following the bad thing. Many years later, in a work situation, a client mentioned they had that poster and used the words to remind themselves that "yesterday did not matter and tomorrow would not happen, today is all there is."

For them, considering the possibility of learning from anything that had gone before, as well as contemplating making plans for the future were simply out of the question. I had never thought of those words in that way, for me they had been a reminder to 'be aware of how my today can be affected by my yesterdays, and how my todays can be used to effect a better tomorrow."

Cooking is one of my favourite one-minfulness activities, because if my attention wanders mistakes can happen. (burn myself, miss ingredients, miscalculate amounts)
Serving customers was another area where being present in that moment was important for the client and for me to get best outcomes.
Crocheting because letting the mind wander can mean disaster for the pattern outcome.
Gardening
Watching a sunset
Eating a specially prepared meal or food, truly savouring the flavours textures etc. I can't always do it, but I've been working on it.

Do the above activities fit the description? or do I just think they do?
Each cleaning job (as part of cleaning the house) and washing the dishes, hanging laundry all work for me, but a bath, pool etc are problematic reminders of 'stuff'.

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