Skip to main content

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

Good morning DBT adventurers,

I had been hoping to post on this thread yesterday but the day went a little awry as tends to happen sometimes. Oh well, it is what it is. 

I super love the way @Determined @CheerBear and @Former-Member seem to have teamed up as study buddies through the conversation here. Yay for the power of Forum Land. I almost wish I was still at uni so that I could join in...oh wait...no I don't! Smiley Very Happy

@Determined I think you raised an interesting point about the concept of trauma. When we talk about trauma in the context of BPD, we tend to be talking about complex trauma, which is repeated and/or ongoing trauma rather than a discreet traumatic event. Here is a nice explanation of how complex trauma is generally defined: https://www.blueknot.org.au/Resources/General-Information/What-is-complex-trauma

I'm glad you have found your uni so supportive of your situation @Determined (even if they do use the term "durability support services"!). My uni was also extremely supportive - hence why I was able to take 12 years to complete my 4 year program. 

@CheerBear I'm feeling a little sad that our conversation here led to some stuckness and melting for you, although it sounds like the melting stuckness was ultimately helpful, maybe??? I love that you asked your psychologist my question. Does that mean I owe you some money for the session? Smiley Very Happy

Your psychologist's response that you probably wouldn't be days away from needing to go to a break place if you were writing an essay, made me smile. Back in 2012 I was trying (and not succeeding) at writing an essay. It was due in two days time. I went into crisis and a friend (who has since dumped me) called the crisis team on me, which led to me getting locked up in the psych ward. My friend emailed the lecturer who was super understanding and told me via my friend to forget about the essay, he would give me an extension, it would all be fine. I got out of the psych ward 2 days later, went back to writing the essay which I submitted a couple of days later, and ultimately got 96% for it. The subject? Clinical psychology. The essay topic? A critical evaluation of DBT. Smiley LOL

I SUPER like the picture you posted @CheerBear. I agree that it sums up the "just do it" message very well! I also love your plan to change the world when you find eleventy billion dollars or, failing that, find a giant fluffy unicorn to ride. The conflation of those two ideas made me laugh a lot! Smiley LOL

@Awpgirl I am so super pleased for you that you have a medical team you trust. I can very much relate to the agony of trying to get to that place. I saw my first therapist in 1996. From 1999-2015 I was in a complex and abusive relationship with my psychologist. Since I left him in 2015, I've churned through 12 therapists. So yep, I'm very much hearing you when you talk about how difficult it is to find helpful helping people. Happily, I THINK I've found a good match in the psychologist I met just before Christmas. Around here I refer to her as TTT (as in therapist-take-thirteen). Helpful helping people can help SO MUCH...and unhelpful helping people can do SO MUCH harm. Smiley Sad

How are you going with the app that you found? It sounds like things are super tough for you at the moment. Smiley Sad

@Former-Member Which book are you reading? Is it the DBT skills training manual or the book on attachment that we were talking about elsewhere? Both can be quite a heavy read. I find that when I'm reading super heavy stuff, it works best for me to read only a few pages at a time, and then go and do something else. 

Ok, I think that's it from me for now. I plan to post the next installment of our adventure later today. Smiley Happy

 

 

 

 

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

LoL @Phoenix_Rising@ that was disability support services (blaming that one on auto correct) I think the term disability is a barrier to people accessing the service. It was for me anyway

What were you studying at uni?

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

I found the definition on complex trauma interesting @Phoenix_Rising, my darling would fit the definition of the complex childhood trauma. I had often wondered about that aspect of her BPD diagnosis. 

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

*Important to note that she was raised in a home where she was loved, provided for and looked after. Her parents did everything possible to look after her and still do.  

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

It was coincidental, that at the time we were talking about waves @CheerBear someone else on forum was talking to me about surfing in real life at specific well known beaches. ie not metaphorically.

I do not mean to minimise the damage that tsunamis irl can cause.  I have long been interested in oceanography and not sure a eleventy zillion dollars will calm the seas forever, but I also get where you are coming from. It also was nice for me that the image of an aircraft carrier popped into my mind. It reminded me of positive "memories of my dad taking me to Garden Island to see his old boats and captains. The world felt safer and logical and I felt protected as he showed me around them explaining all the bits and pieces and reasons why. 

It felt so good to just have my mind be as it is, without me having to exert control over it to manage negative thoughts.

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

@Phoenix_Rising thanks for your kind words and thoughts. The app is brilliant. It contains a daily DBT diary a crisis support area practise skills and then for each DBT skills it has a method to input and try it out.

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

Hi @Determined ROFL!!!!! I initially assumed it was supposed to be disability services, but then when @CheerBear responded without drawing attention to it, I figured it must be some new politically correct term for disability services. That is super funny. Smiley LOLSmiley LOLSmiley LOL

At my uni, the counselling service was distinct from disability services, which I always thought was very odd. I approached disability services once and they had no idea how to support me. However, the uni counsellor was awesomely amazing and I am continuing to grieve for her two years on from my graduation. I did a BA with a psychology and philosophy double major, and then went on to do my honours in psychology. 

@Awpgirl That app sounds super cool. I am keeping a running list of resources to add to this thread at some point, so I will add that one to my list. Smiley Happy

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

Mindfulness "What" Skills: Describe and Participate.
Good afternoon DBT adventurers, Smiley Happy


Hands up who can remember where we were up to in our DBT adventure? Given it was LAST YEAR that I wrote the last installment, I will forgive you for not remembering (plus I may possibly have had to read back on the thread to remind myself where we were up to!).Smiley Very Happy


So, a quick recap. We are looking at the first DBT module, which is mindfulness. Linehan identifies three "what" skills (i.e. what we do in mindfulness) and three "how" skills (i.e. how we do mindfulness). In my last summarizing-the-DBT-manual post, we looked at the first "what" skill, namely observing. You can read that post here.


In this post, I'm going to look at the two other "what" skills and then next week I plan to cover the three "how" skills. Of course, based on my track record to-date, when I say "next week" that could mean that the next post is anything up to a month away!

 

The mindfulness skill of describing.
Why describe?

  • Describing involves putting into words that which is observed. The benefit of describing a phenomenon is that it helps us to distinguish between what we are actually observing and our thoughts about what we are observing. For example, suppose your partner arrives home late from work on the night you had planned to go out to dinner together. In such an instance, it can be easy to have thoughts such as; my partner doesn't even love me enough to make sure they are home on time. However, this is a thought ABOUT the event rather than a description of the event itself. An accurate description of the event would simply be, my partner is late getting home
  • Describing events to other people gives them the opportunity to correct or validate our perceptions and descriptions. 
  • Writing down descriptions of our observations allows us the chance to observe the information. That is, when we write about something, the very act of writing often helps us to process what we are observing. 
  • Research has shown that when a person labels and describes their emotions, this in itself helps to regulate emotions.

Describing: What to do
NOTE: If it wasn't observed, it can't be described.

When describing an observed phenomenon, the aim is to stick to the facts. Now...I am a bit stuck on this next bit, so I'm hoping some of you are going to help me out. According to Linehan (2015), although we can observe and therefore describe our own internal experiences (e.g. I observe a feeling of sadness arising), we can only ever guess or make assumptions about what others are thinking.
I totally understand and agree with this. However, what I don't understand is how this concept fits with the concept of theory of mind. That is, it is often said that people with autism have a poor (or totally lacking) theory of mind, meaning they can't "mind read." But isn't Linehan saying that NOBODY can mind read? That is, that people can only ever guess what another person is thinking? So...isn't it better to not guess at all, than to make guesses which are likely to be incorrect?


I know I DETEST it when people try to tell me what I am thinking or feeling. One of the situations where I often experience this is if I go into crisis in response to something that someone says. The person will often tell me "you just don't like what I have to say." That is simply not true. If you say something and in response I drop to the floor and start screaming and self-harming, it isn't because I don't like what you said, it's that an intense trauma-related memory has been triggered in my brain by whatever you just said.


Another area where I super notice this is in the tendency for people to describe the behaviour of others as being "manipulative." This is a bit of a hobby horse of mine - you can read about that here. I find it intriguing that people think they can "know" that another person is being manipulative. Linehan addresses this issue on p. 191 of the DBT manual where she explains that the statement, I feel manipulated often gets translated into, you are manipulating me. It is perfectly legitimate for someone to describe their own internal experience of feeling manipulated, but this does not mean they can then infer that the other person is being manipulative. No one can observe the thoughts, feelings, or intentions of another person.


Questions. 
Can you think of any times when someone has told you what you are thinking or feeling?
Can you think of times when you've told someone else what they are thinking or feeling?

Practice Exercises for Describing.
These exercises are taken from Mindfulness handout 4B in DBT Skills Training Handouts and Worksheets (Linehan, 2015, p.58).

  • Lie on the ground and watch the clouds in the sky. Find and describe cloud patterns that you see.
  • Find things in nature (e.g. a leaf, a drop of water). Describe each thing in as much detail as you can.
  • Describe what a person has done or is doing now. Be very specific. Avoid describing intentions or outcomes of the behaviour that you do not directly observe. Avoid judgmental language. 
  • Describe your feelings as they arise within you. For example, "A feeling of anger is arising within me."
  • Describe your thoughts when you feel a strong emotion. For example, "I feel X and my thoughts are Y."
  • Describe thoughts, feelings, and what you observed others do. For example, "When you do X, I feel Y, and my thoughts are Z."

 

The mindfulness skill of participating.
The third mindfulness "what" skill is participating. According to Linehan, "participating is entering wholly and with awareness into life itself, nonjudgmentally, in the present moment. Participating is the ultimate goal of mindfulness" (Linehan, 2015, p. 192).

Have people heard of the concept of "flow"? It is a state of mind wherein you get so completely absorbed in an activity, that you lose all track of time. I super like being in a state of flow. Anyway, this is what Linehan means by participating. When you are in a state of flow, or, as Linehan describes it, participating, you lose a sense of yourself as being separate to the activity you are doing. This means that fully participating in an activity is mutually exclusive to any sense of being self conscious. You just "do" without thinking about the doing. You don't worry about what others might think of you, or whether you look silly or whether you are doing the activity right...you simply do it.


I really notice how much I mindfully participate when I'm playing my violin...and I notice how much I make mistakes when I stop mindfully participating. That is, I often mess up a piece in a lesson even though I could play it perfectly fine at home. I know this is because at home I simply play, whereas at my lesson I think far too much about my playing and consequently I mess up (and then tell my teacher "awwwwww but I could do it at home!!!!"). Smiley Happy

Can you think of any activities you do (or would like to do) that particularly lend themselves to practicing the skill of participating fully? Along with my violin playing, I find that I get into a state of flow when doing yoga, playing in my garden, and doing jigsaw puzzles. When my brain is working well, I also get into a state of flow when I'm learning something new about, well, pretty much anything really. I super enjoy learning for learning's sake. Smiley Happy


A participating practice exercise
On pages 194-198 of the DBT manual, there are a whole lot of suggested exercises for "real" DBT groups to do. Reading through the list, I have to say that if I was in a group and was asked to do some of these things...yeah...that wouldn't be happening! This is because they involve physical touch, such as group members holding hands. Nope, this little turtle would definitely not be doing that! However, there is one suggested exercise that, when I read it, I thought it sounded super fun. So...I've tested it out and I can highly recommend it.


For this exercise you need a raw egg and a flat surface such as a kitchen bench or a bare table (no table cloth allowed!). Now, all you have to do is balance the egg on its end (the larger end). Here's my egg yesterday.

balanced egg.jpg

It took a while. I don't know exactly how long because, well, I was mindfully participating and thus lost track of time. If your egg ends up splattered on the kitchen window after you throw it in frustration, it might be helpful to practice observing and describing your emotions a little more before having another go at participating in this exercise. Smiley Very Happy
Have fun! I would super love to see photos of people's balanced eggs.

When to observe, when to describe, when to participate.
One of the key points about these three "what" skills is that we can only do one of them at a time. That is, we are either observing OR describing OR participating. So, how do we know which skill we need to use in any given situation?


According to Linehan (2015), when we notice a problem in our life, we first need to observe the problem and our response to it, and then accurately describe the problem and our response. This will help us to figure out what we need to do differently and/or what skills we need to learn to solve the problem. Once we know what we need to do and have the skills to do it, we can dive in and actively participate in the situation.


I can see how my violin playing exemplifies this. When I'm learning a new technique, I practice super slowly, super focusing on every tiny detail of it (and sounding like a dying cat in the process!). But then, once I have got the hang of the technique, I can use it effortlessly in the piece of music. At this point I would have shifted from observing and describing, to participating. Does that make sense?

Here endeth the lecture on the three mindfulness "what" skills. So, now all we need to do is PRACTICE!

Here is a cool video that summarizes the three DBT "what" skills: https://www.youtube.com/watch?v=vmnI6pPBmfA

I'm super keen to hear people's thoughts, ideas, reflections and anything else you may want to share. Happy DBT-ing! Smiley Happy

@Awpgirl @CheerBear @Faith-and-Hope @Determined @Appleblossom @FiFiNash @Shaz51 @SGde3a @mentalstuff @Gypsy7 @Former-Member @Neelix @Former-Member @outlander @NatalieS @Catcakes @Former-Member @Adge @Former-Member @Former-Member @Former-Member @NikNik @Former-Member @Former-Member

 

 

 

 

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

You’re clever @Phoenix_Rising !
As you know, I have completed all modules of DBT, but it’s been a while.
I need to reread this later when the household isn’t so busy 🤓

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

@Catcakes thank you for saying I am clever. Do you think I am clever because of the post I wrote, or because I can balance an egg? Smiley LOL 

I feel I've really added to my skill set here. I can balance an egg, stand on my head, and do inferential statistics. Wow, I really do excel at the important things in life. If anyone happens to see a job that requires that skill set, can you please let me know? Smiley LOL