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

Appreciate the warm welcome @Phoenix_Rising 

Haven't done DBT as far as I know it to have been called that, but, there are many aspects of the therapy that I have done with some of the therapists over time. I'm pretty sure the psych the helped me the most used some of these methods. Radical Acceptance is a familiar term and something I've been working on/with/ whatever. and some of the Encounter group therapy I did in the 70's seems to have been similarish. Did lots of work on 'ougths and shoulds' too. 

I'm looking forward to getting into this with this group. Thanks for being here. 

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

With regards to your question @Phoenix_Rising about whether DBT facilitators label clients treatment resistant if they can accept the DBT philosophy......
The first stage of DBT is one on one therapy with the psychologist who will fascilitate your DBT group. Their job is to prepare you for therapy and address issues that would interfere with therapy. Also to discuss briefly the tenets of DBT to assess whether you are suitable for the therapy. In this way, you are encouraged to have an open ness towards the philosophy, this prepares you to learn radical acceptance. The psychologist , in my experience doesn’t label you “treatment resistent” as they are taught not to be judgemental but they would instead try to present the learning in another way.

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

I am in significant crisis at the moment - which is why the next installment of the DBT adventure hasn't appeared yet. Sometimes I wonder if it seems hypocritical that I espouse the value of the DBT skills, while so obviously being in crisis. But then I think about the fact that no one ever said the DBT skills were a magic cure that fixes everything. The fact that I am struggling so much and yet I am not dead, attests to the value of this stuff. Thus I think it is cool that Forum Land offers a space where we can work through the DBT manual together-but-not while at the same time showing the bigness of the struggle in all its rawness. It's hard. It's so so so SO hard. I know how hard it is. But I guess my hope is that as you see me floundering so much on the ocean, it might help you to know that although the DBT skills don't magically take me out of the ocean, they do help me to ride the waves. I know this stuff works because I live it every single day. That's how I know it can work for you to. However big the waves are in your world today, you can do this. You've got this. Smiley Happy

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

One of Marsha’s tenets is that DBT assumes that at any time you are doing the best that you can.
Don’t feel under pressure to write for the rest of us @Phoenix_Rising.
All the more time to read and reread, contemplate, absorb, practise what is already there . 👍🏼

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

@Catcakes yep and that is SUCH an important tenet. Marsha Linehan was quite revolutionary in suggesting that people with BPD were always trying to do their best at any given moment. Most mental health professionals (even now!!!) still hold such horrible negative attitudes towards those with BPD. I find it so bewildering and terrifying when people try to tell me that I'm being difficult, argumentative, attention seeking, manipulative etc. when really, I'm trying to a) stay alive and b) try to figure out what the heck people are saying to me and/or asking of me. 

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

I also very much like Marsha’s take on this because it feels very kind and forgiving in a often very unkind world.
@Phoenix_Rising. And it could only come from one who has lived experience and knows the truth. I have to confess when I was first introduced to Marsha about 7 years ago, I couldn’t cope with her accent, presentation and style but over the years I have grown to have huge admiration for her.

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

So sorry you are feeling this way @Phoenix_Rising  I really admire you because you are so expressive and honest and accepting of others and understanding and all those things while still riding the wave of your own struggles. Heart 

I hope that does not offend you iin any way, not my intention, but y'now, I know how intentions can still be hurtful. 

You're in my thoughts. Wish I could do more. Heart Take care of you please.

PS: The longer the installments take, the longer I have to catch up! Smiley Wink 

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

Mindfulness "How" Skills: Part Two - One-Mindfully and Effectively
Good morning DBT-ers, Smiley Happy
Here we are at the last installment of the mindfulness module. We have looked at the "what" mindfulness skills (observe, describe, participate) and the first of the "how" mindfulness skills (nonjudgementally). Today we are looking at the remaining two "how" skills; one-mindfully and effectively. Ready? Let's go...

One-Mindfully: What is it?
One-mindfully means being completely present in this one moment. The past does not exist in the present. We may have lots of memories and super big feelings about things that have happened in the past. Those thoughts and feelings are happening in the present, but the events themselves are in the past. Of course, where it gets tricky (for me at least) is when present events replicate those of the past in key ways.

The future also does not exist in the present. Linehan makes the point that it is totally ok to plan for the future, but this should be done while recognising that the planning is a present-moment activity. That is, the planning happens in the present, but the things we are planning for are in the future.

When I was reading this bit, I could feel myself feeling angry at the fact that so often, this idea of staying in the present gets misinterpreted as suggesting that we shouldn't think about or plan for the future. This is largely why I am in the mess I'm now in. Every time I tried to get some guidance around future employment, I was told to just focus on the current uni assignment or exam. This is how it is that after spending twelve years at uni, I don't have the slightest idea what I'm supposed to do with my degree and at 40 years old, I'm basically unemployable. This is not helpful! Similarly, I get really sick of psychologists/counsellors etc. not wanting to talk about the future in any way. I get really sick of them going on about how I should focus on just getting through the day. What is the point of struggling through one day, only to then struggle through the next day? I believe that many people remain stuck because they are not supported to move forward. Rather, the focus seems to be only on continuing to exist, rather than on actually creating a life worth living. Therefore, I really like the fact that Linehan makes the point that one can be living fully in the present and yet still plan for the future.

One-Mindfully: Why do it?
⦁ Doing one thing at a time and focusing fully on that one thing enables us to achieve more. Multi-tasking is inefficient!
⦁ The pain of the present moment is enough pain for anyone. Sitting with current pain is hard enough without adding to it by ruminating about past pains or worrying about future pains.
⦁ Being fully present in the moment enables us to more fully experience the good parts of life.

One-Mindfully: How to do it?
⦁ We need to be present to our own experiences rather than trying to avoid or suppress them. We need to allow ourselves to fully experience our thoughts, our feelings and our emotions. I don't know about anyone else, but I find this HARD because big feelings HURT. However, I have learnt that letting myself feel them and to ride the waves of big feelings actually makes them settle faster than trying to push them away. A lot of you probably know that I spend a lot of time riding the wave and I always super appreciate the fact that others ride alongside me. I truly do know from having done this for many years, that riding the waves is a more effective way of moving through big feelings, compared to trying to suppress them or avoid them by engaging in destructive and/or impulsive behaviours.
⦁ Do one thing at a time. If you are driving, drive, if you are walking, walk, if you are eating, eat. Linehan also suggests that when we are worrying, we should be just worrying, and when we are remembering, we should be just remembering. One example of how to actually do this is to set aside "worry time" in your day. That is, actually allocate some time to sit and worry. That way, when worries start distracting you at other times of the day, you can tell yourself that it is totally ok to worry, just not now. You might even like to briefly write down what you are worrying about so that you don't forget to worry about it during your allocated worry time. Then you can get back to what you were doing.

Ideas for practicing one-mindfulness.
Here are some examples of activities you might like to try doing one-mindfully. Remember, the trick is to super focus on each tiny detail and sensation of the activity, rather than thinking about other things while mindlessly doing the activity.
⦁ Washing the dishes.
⦁ Cleaning the house.
⦁ Taking a bath.

Can you think of any others?

 

Effectively: What is it?
Acting effectively means doing what works in order to achieve your goals.

Why act effectively?
Acting effectively helps us to achieve our goals, reduce our suffering and increase our happiness.

Effectively: How to do it.
First, in order to achieve your goal, you need to identify what your goal is! Linehan makes the point that this can be tricky when we have big feelings. For example, when we are afraid of doing something, we can mistakenly think we don't want to do it.

In order to act effectively, we need to know and react to the actual situation that we are facing, not what we think the situation should be. Oh look, we seem to be back to the concept of "should." Can anyone think of an example from their own life of what Linehan might be talking about here? Here's one I was dealing with a few weeks ago...

I took a tyre into the tyre fix-it place to be repaired after it got a very large nail in it. I left the tyre there on Saturday and the guy told me he would call me on Monday morning to let me know if they could repair it or if I would need a new one. I waited and waited for his call, but it didn't come. He SHOULD have called me. Thus, I had the option to either a) sit at home getting angrier and angrier that he hadn't called or b) pick up the phone and call him. I chose to call him. I then found out that my tyre was fixed and ready for me to collect. Again, I felt angry that he hadn't called me...but instead of exploding at him, I thanked him and went and collected my tyre (and felt relieved I was no longer driving around without a spare tyre!). It would have felt good to explode at the man for not calling me, but it wouldn't have been particularly effective. Being polite about it means the relationship is intact and I know I'll be able to go back to the place next time I need to, which is really good because it is a five minute drive from my house. If I had exploded, raged about the amazingly bad customer service and told the guy I was never coming back, that would make my life more complicated next time I need a tyre repaired (or my pink slip done - they do that too). Yay for being effective rather than exploding! As a completely random aside, that Saturday was the first time I have ever changed a tyre on my car. I felt like such a genius, you'd think I'd just invented tyres! Smiley Very Happy

Knowing what will and won't work.
I'm struggling a little as I write this bit, so hopefully others will jump in with thoughts, ideas and examples. To be effective we need to actually know what will and won't work in order for us to achieve our goals. According to Linehan, sometimes, if we are unsure, the most effective thing to do is to ask for help. I recognise that I get a bit stuck here because my "I need help" statements don't seem to be well-received. Also, if someone does attempt to explain to me how to navigate a situation effectively, I tend to then need them to explain their explanation and then explain their explanation of their explanation and then explain their explanation of their explanation of the explanation and then...well you get the picture. By that time the person is generally ready to strangle me and I am superly duperly struggling with the frustration of not understanding. Clearly neurotypicals need to speak more clearly so that this little aspie turtle can actually understand what they are saying!!! {Phoenix_Rising waves shyly to @NikNik}.

Linehan also suggests that being effective means being people-savvy. Again, this does not work well for this little aspie turtle. I really am a simple little turtle and I have no idea when it comes to being people-savvy or "playing politics." Hopefully someone else has some examples of how they have gone about this.

Finally, Linehan suggests that being effective can sometimes mean sacrificing a principle in order to achieve a goal, and to play by the rules, particularly when we find ourselves in low-power positions (e.g. as an involuntary patient in hospital). I have got a bit of an idea about the playing by the rules bit. Over the years I have learnt that rather than try to convince the police that I don't need to go to hospital, I just go, knowing that I'm going to sit around for hours and then either be sent home or locked up for a night or two. It super sucks and it isn't right...but the reality is that once the police are on my doorstep, it's inevitable that a whole sequence of events is going to happen so the most effective thing for me to do is just play the game. Can anyone think of other examples where they have had to sacrifice a principle and/or play by the rules in order to act effectively?

Hey, guess what? That brings us to the end of the mindfulness module. We did it!!!! Yay for us! Given that it took slightly ridiculously longer than the two weeks it "should" have taken and everyone's probably forgotten where we started, here's a little reminder...

First we looked at the idea of reasonable mind, emotion mind and wise mind

wise mind.png

 

Then we looked at the concept of mindfulness. We considered what it is that we actually do when we are being mindful (observe, describe, and participate) and how we do it (nonjudgmentally, one-mindfully and effectively). 

mindfulness summary.png

And thus endeth the DBT module of mindfulness. Smiley Very Happy

Now, in theory @CheerBear will be all set to dive into teaching us all the next module, which is Distress Tolerance. Right, CheerBear??? Er...CheerBear??? Smiley Happy Yay for things getting done when they get done...and that's ok. Smiley Very Happy

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

Thanks so much @Phoenix_Rising, and hi to everyone else who follow this thread.

There is a lot to read and digest here, and I thank you for making it all available for the benefit of all. I cant take it all in right now, but will come back and work my way through it over time.

Again thank you.

Sherry

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

Same.

Thanks @Phoenix_Rising 🌷