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Re: DBT making me miserable crushedout

Posted by fallsfall on May 29, 2004, at 8:47:59

In reply to DBT making me miserable, posted by crushedout on May 28, 2004, at 19:04:18

I understand your frustration. This is one reason that DBT recommends that a separate skills training session be set up with a DIFFERENT therapist. That makes it easier to see that the skills training session is NOT for putting out fires (just like your dinner hour is NOT for putting out fires - most of the hours in your week are NOT for putting out fires. It just gets really confusing when you are in the same environment where you DO put out fires, and even the time boundaries are "loose".) The ideal is to have a special session that is different in as many ways as possible from your regular sessions, and use that for skills training. These are things that CAN be different, but it sounds like you will need to put up with some of these being the same: Different therapist. Special time JUST for skills training. Different room (perhaps you can do this - a different environment can make it all feel different, even if it is the same therapist). Almost a coldhearted focus on skills rather than crises (hard for the patient, hard for the therapist, too). Lots of structure in the skills training session (10 minute checkin, 30 minute review of homework, 15 minute general discussion of last week's skills, 15 minute break, 30 minute lecture on new skills, 20 minute role play/practice of new skills, 10 minute discussion about homework for next week, 10 minute wind down - I didn't add these times up, Skills training is usually 1 1/2 hours or so).

You need to see that learning new skills will be helpful, and be willing to put your crises on the shelf during skills training time. It is hard to do, but determination on your part will go a long way.

The skills ARE hard. They are hard because you didn't learn them when you were 3 or 4 or 5 like most of the rest of the world. It is much harder to learn these things as adults - we have spent so much time dealing with the world in a different way. Don't expect them to be easy. Don't expect to "get" them immediately. DBT recommends going through 2 full courses of Skills Training (or more) because you WON"T get it the first time. With many of the skills, I find that the first time we talk about them the most I can expect to accomplish is to realize that the world that other people live in is NOT the same as the world I live in. This is always a shock to me. We have to talk about things a second time (not the next week - some longer time later, when I've had time to internalize that the world COULD be different from the way I've always seen it) before I can start to look at what makes my view of the world different and how I could possibly change my view (and then I have to deal with being Brave enough to change, and Wanting to change, and then we get to learning the skills to be Able to change).

I have to go to work. I'd be happy to talk about this more with you later.

I would recommend that you get Linehan's book (the book is more effective for this than the Skills training manual) "Cognitive-Behavioral Treatment of Borderline Personality Disorder", and read the whole thing. I think that, based on what I have seen about the way you approach thing, that you (in particular - this isn't helpful for everyone) would benefit from reading this book (more than once). This gave me a better idea of WHY it was hard, and WHAT was trying to be accomplished.




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