So... tell me about DBT

[sans qualia]

Has anyone had any experience with it? There's a program at a hospital near where I live, and my counselor seems to think it might be a good idea for me to go, what with my multitude of maladaptive personality traits detroying my life and all. I'm kinda noncommittal at the moment, as I'm having trouble finding any first-hand accounts. So, um, if anyone here has been through it, what's it like?

[ernstbass]

1. I have read about and been to a seminar on DBT

and it seems to be a good approach for people diagnosed with Borderline Personality Disorder primarily. You enter into a detailed time specific contract with the therapist regarding expectations of both you and the therapist. A full DBT proram will offer several skills groups which provide education re: emotional regulation techniques, coping skills, etc. could you go to that hospital to get more info about the program before you commit to it?

[EFerrari]

2. Hey, there

We couldn't find any DBT programs where we lived, so I ordered Marsha's workbook, and we did it at the kitchen table with some supervision from Doug's therapist. Wasn't optimum but better than nada. I needed the skills, too, so it worked out well.

(Another thing we tried in the absence of available treatment was going through the book "Feeling Good". It has great exercises in it although it's not DBP per se. I'd go on t.v. for that one.)

I wonder if that program has any participant feedback that you could look at to help you make up your mind?

[Kashka-Kat]

3. I did 1 round of it

I did it kinda backwards, after having gone thru intense deep-feeling therapy involving recovery of trauma memories-- usually they like to do it the other way around, to have the coping skills in place BEFORE doing the intense therapy (which can be huge emotional upheaval)

I actually found it very helpful after having gone thru the other therapy and having all these incredible insights about where my "dysfunction" originated from... I was kinda left with "OK, so the dysfunctional way of living I learned from my parents doesn't work, now what do I do??" I had missed out on a lot of bonding and socialization so found myself at age 40-something feeling I had to learn what most people learn at age 2! Like how to self-nurture, how to hold on to the "presence" of people when they arent physically there (instead of feeling abandoned), how to perceive what's really happening instead of projecting your abusive father into every situation. It was good for me to hear clearly stated "if this happens do this, if that happens do that, etc." and to get "reality checks" about how I was perceiving things in the world. You get time each week to go over the homework & relate it to problems or things happening in your life.

The only disappointment was that I didn't connect as well w/ the other clients as I mightve liked.

Not just for people diagnosed w/ "borderline personality disorder," but anyone who grew up in similar invalidating environment & hence in need of learning those particular coping skills.... can include people w/ depression & other diagnoses.

BTW there was a couple of dbt groups on yahoo, where I posted the same questions before I started & got some really good responses.

[Tallison]

11. Wow.

That's great to hear. I can't help but think that everyone could benefit a little from the type of work that DBT involves. Same with 12-step work (I'm a recovering addict myself). :D

On edit: a great book on the subject is "Get me out of here" by Rachel Reiland which reads like a journal she kept while undergoing the entire length of DBT. Fascinating and very inspiring. Her results were auspicious.

Link: http://www.amazon.com/exec/obidos/tg/detail/-/1592850995/104-0006067-6511963?v=glance

[rox63]

4. Dumb question

What's DBT?

[rockedthevoteinMA]

5. Not a stupid question rox63...

Dialectical Behavioral Therapy
Marsha Linehan (1991) pioneered this treatment, based on the idea that psychosocial treatment of those with Borderline Personality Disorder was as important in controlling the condition as traditional psycho- and pharmacotherapy were. Concomitant with this belief was a hierarchical structure of treatment goals. Paramount among these was reducing parasuicidal (self-injuring) and life-threatening behaviors. Next came reducing behaviors that interfered the the therapy/treatment process, and finally reducing behaviors that reduced the client's quality of life. In 1991, Linehan published results of a study that seems to do remarkably well at achieving these goals.

The Theory
Basically, DBT maintains that some people, due to invalidating environments during upbringing and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up much more quickly, peaks at a higher level, and takes more time to return to baseline. This explains why borderlines are known for crisis-strewn lives and extreme emotional lability (emotions that shift rapidly). Because of their past invalidation, they don't have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this task.

http://www.palace.net/~llama/psych/dbt.html

There's more there, and they explain the process. It is used a lot in behavior modification, most often in Borderline Personality Disorder. Though I believe it used as well in other cases/illnesses. I *think* it's mostly used in cases where the person is involved in self injurous behavior. I have heard it has a very good success rate, of course, I have never know anyone who has done it - I have been told by psychologists that it works well.

Hope that helps! :hi:

[DemExpat]

6. Thanks, I also had never heard of this.

DemEx

[sans qualia]

7. Thanks to everyone who responded

My counselor seems to have made the decision for me. My intake appointment is on Friday. :scared:

[rox63]

8. We're pulling for you

:grouphug:

[rockedthevoteinMA]

9. Good Luck!

:hug:

[Tallison]

10. A great book to read on the subject

by an increadibly bright woman who underwent the treatment herself is "Get me out of here" by Rachel Reiland. At 400+ pages it reads like a journal she kept throughout the process. Her experience with it was very positive.

Edit for link: http://www.amazon.com/exec/obidos/tg/detail/-/1592850995/104-0006067-6511963?v=glance

[mopinko]

12. thanks for this thread, i am trying to figure out what my kid needs

i do not really know too much about her pending dx of borderline, but i am frightened and upset by it. bp is one thing, you can take a pill for that. but knowing that part of this is my fault, and the fault of the dysfunction in the family. blech.
in her case, tho, i think she was born this way. i can see how it cycled around, and fed itself. but i don't think there is a mother on the planet that could have adequately nurtured this kid.

[Kashka-Kat]

13. not just environment

Its the person's hypersensitive easily aroused nervous system *in combination with* the invalidating environment which creates the "disorder." The intensity of pain drives a lot of the behavior... The therapy involves both learning the social skills as well as managing the intense &volatile emotions (which btw is not "suppressing" them necessarily but accepting/ finding proper place for them in ones life-- its like surfing on the waves & learning to ride them out w/o acting on them.)

[mopinko]

15. i know it is not my "fault"

she was different from the time she was a baby. she was just inconsolable. she is the only kid that i lost most of my "baby pounds", because we were constantly walking her. almost every night my hubby or i walked with her for at least an hour. usually we walked until we couldn't take it any more. we had a tiny apartment, and got to know all our neighbors that summer, cuz we walked up and down the block. i don't remember if she was better when she got bigger, or if we just gave up when winter arrived.
lots of other things i can look back on and realize that they were "over the line" she had an invalidating environment because she was invalidatable. nothing good i ever did sunk in. and the things she did caused a lot of invalidation. a self licking ice cream cone.

[DemExpat]

14. I am borderline.....and if one of my kids was diagnosed with this

I would certainly look carefully into this approach mentioned above before turning to medication or other therapies.

I agree with the post below about it being a combination of hypersensitivity mixed with negative envirnonmental influences - no need to feel guilty for this as a parent either, most families have negative stuff flying around IMO.....or repressed to look like there is none...

I have lived a good adult life as a "borderline", and did the best after I kicked my meds when I got pregnant with my first child.

All the best - but make sure that this diagnosis is the correct one - maybe get second opinions? - and take it from there.

The movie (or the book) "Girl Interrupted" could have been a movie on my young adult life - watch this and see if you can see some of your daughter in it.

But I do remember how rebellious I was, and I actually rejected my parents for a decade (not seeing them) before seeking reunion with them as I got older. :-(

:hug:

DemEx

[mopinko]

16. she liked girl interrupted

i will have to get it. she did say she identified with it.
i am hoping that we can get her a residential placement for next year, and maybe they can set up some support for her for college.
i have been more than rejected for quite sometime, accept when she needs something. at least i know now that there is no sense in my groveling for crumbs of acceptance from her.
i'm sure her dad is in for a shit storm from her. he seems to be believing me, and seeing how things are. he is supposed to talk to her social worker, and get some info. but he is sorting out how much she has been influencing him about me, and other things. quite the knot. but he seems to realize that there is no real placating of this kid, just delaying the next storm. no more giving in to her temper tantrums.
i can easily accept that being away from us will help her sort things out for herself. she needs to have as few people to blame for her problems as possible.

i am pretty confident of the dx, although we have not talked to her psychiatrist yet. she is out of town. she has been seeing this t-doc for 3 years, and i think he is good. he sure has kept her confidentiality, beyond reason, imho, but. the social worker said she thought he was crazy for almost a year. and she has done so great in school. but she slowly saw the typical behaviors coming out. and when i told her the munchausens story, that was the last bit of evidence she needed. a "second" opinion would likely just muddy the waters, since this is so hard to dx, especially with an actress like her, and with her bp.

she probably is also bp, and she was doing better when she was taking just depakote. i agree that a lot of the meds they gave her did no good, and some did some harm. those damn cocktails were the worst. but meds to help the bipolar part would help. no sense arguing with her about this, tho.

it's a big comfort to know that you have this, de. right now i feel like i have lost a child.

[DemExpat]

17. I am sure that my behavior hurt my Mom deeply.....

not that she didn't deserve my anger....:evilgrin: Sorry, sometimes humor helps....and my family was very "dysfuntional" as they call it.

But at a later date in our lives I sat down with her and honestly and lovingly explained how I had experienced life with her as a Mom.....how I was sorry that things went as they did, but that I loved her with all my heart on a soul level, and thanked her for giving me life.

After our reunion where we were both honest with each other, I was hoping to visit more often and enjoy some good years together, but then suddenly she had a brain aneurism and died within 24 hours....:cry:
I am so grateful that I told her that I loved her.....:cry:

Hang in there, you will probably have to let go a lot and let her fight it out herself like I did, but it is great that now there is a diagnosis that might help out.

Under her behavior and suffering there could be much deep love for you, mopinko.....hopefully it will come out when she finds her balance.

:hug:

DemEx

[mopinko]

18. i'm sure you are right

the social worker assures my that my place as target #1 is a sign of how she feels about me. if she can ever see that she felt unloved because she couldn't feel love, not because there was none, she will be able to see that it was there.
right now she feels that my giving her life was the most useless and stupid thing i have ever done. blech.

[Liberalynn]

19. I've done DBT Therapy Twice

it has helped me tremendously. I have been diagnosed with Severe Anxiety/OCD which triggers Depression. While I still have some major "issues" that I am working on, I found that it has made a difference in my day to day life.

As far as interpersonal skills at least with my family, I have started to speak up when they do something that upsets me sooner rather than just keeping it inside and beating up on myself with it, which was my usual pattern. Or my secondary way which was just as ineffective where I get into a big emotional/argument scene with them. That happens less and less.

I also use mindfullness a lot and acting opposite to negative emotion.

Also a key for me was radical acceptance. Learning that no matter how much we may want it to be the world is never going to be 100 percent fair and some people around you may never change, but that I can make the choice to accept those things, and move on myself.

It has helped me stop a nearly 15 year old nervous habit. So I'd rate it a success for me.

It also depends a lot on the counselors. We had a really great one who ran both sessions and she said she sensed that I had a great sense of humor and encouraged me to use that more as a skill, even though it wasn't specifically listed and that was kind of a turning point for me.

Still haven't gotten the hang of not judging myself but I am working on it.

I'd like to take another session in group form, but right now, my insurance won't cover the sessions, but may again in the future. Right now though I am still working on it with my individual therapist. It gives at the very least a good guideline, IMHO.

Good luck to all of you just starting or considering starting DBT.

[DemExpat]

20. About the acceptance part of your post.....this is a big issue IMO.

My last counselling (about 15 years ago) was from a woman who gave me advice that has really helped me out tremendously. She told me to accept myself and my handicaps and try to just make my "postage stamp" size portion of the world as best as I could and to my liking - not to try to change the "whole world", or too many things outside my personal power. For some reason this was a real eye-opener for me!

The best bit of advice I have ever received, and one that I still use in my daily life.

DemEx