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Dr. Bob is Robert Hsiung, MD,
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Posted by Penny on October 3, 2003, at 8:43:34
Dinah,
I know you had gotten the DBT workbook - how's that coming? What do you think?
Does anyone else have any more thoughts on DBT - groups, working on it on your own or with your individual therapist, etc? I have a friend here who was in a DBT group but didn't like it, and she stopped going, but I'm afraid that I wouldn't do that even if I didn't like it - that I would feel that need to stick with it regardless, but I'm not sure how helpful that would be...I don't know what I think of this. Is it useful if you don't engage in SI? Or if you're not actively suicidal?
P
Posted by Dinah on October 3, 2003, at 10:09:58
In reply to DBT - Dinah? Others?, posted by Penny on October 3, 2003, at 8:43:34
I think DBT could probably be useful for anyone. In fact, I think CBT/DBT should be tought outside the mental health arena as well as within.
That being said, I think your therapist is totally right about not wanting to be the one checking your homework. My therapist thinks DBT is good for me too, but when I told him I didn't want him nagging me about my diary cards, he agreed. I have enough disapproving authority figures in my world. If I want another one I don't have to pay for it.
I'm not sure that I'd like a DBT group either, but I think it would be good for me (if I could find one). I did my diary cards like three times before hitting a depressed phase and stopping. Haven't looked at DBT since. A group would give some structure. From what I can tell, DBT is heavily reliant on the skills of the DBT practitioner. If it's used as a boilerplate model by therapists without humor and empathy, it's probably not going to be all that great. The manual even calls for those skills. :) But if you can find a well run group, it might be really useful. At least look into it before writing it off.
And congratulations for bringing it up with your therapist.
Posted by Penny on October 3, 2003, at 13:47:56
In reply to Re: DBT - Dinah? Others? » Penny, posted by Dinah on October 3, 2003, at 10:09:58
Yes, I don't really want her to have to take a hard-line stance with me. Not that we're 'friends' or that we ever will or should be, but there is the whole 'mother'-like feeling that I think would be ruined if she was the one really enforcing my compliance with the DBT rules.
At the same time, I was just reading an article today by Marsha Linehan (from 1999 - Journal of Clinical Psychology) about DBT and she was using case examples, and one of the things she said was that most of the patients she has done DBT with (mostly BPs, I guess) do things like purposefully not complying with treatment assignments, threatening to SI, threatening suicide. I don't really have a problem with those things - I do have a problem with the anger at myself, berating myself, can connect to the invalidating experiences from childhood thing, and so on.
But, I can certainly see how some of the treatment goals - self-soothing, for example - could be very helpful to me. The university library here has two copies of Linehan's book and one copy of the manual, but the manual is checked out along with one of the books. I'd like to look more at them before buying or committing to any of this. I'm wondering if, by some slim chance, Barnes & Noble or Border's here would carry them, so I could at least take a look.
Funny - I don't know what it is about this that makes me uncomfortable. I guess it's that the formality of committing to a DBT program removes some of the freedom I have right now in my therapy. Perhaps I am too comfortable in therapy right now...hmmm...
Thanks.
P
Posted by fallsfall on October 3, 2003, at 17:14:11
In reply to Re: DBT - Dinah? Others?, posted by Penny on October 3, 2003, at 13:47:56
I was not actively SIing or suicidal when I was in the DBT group (I don't think I was... Long time ago). You do have to have tolerance for people who are at that spot, though. Because you will see it in the group. Sometimes you wish they would just start being reasonable, but that really is what they are trying to do. I found that the most unreasonable people dropped out. My group dwindled down to 2 of us. That was 8 years ago, and I dropped in on the other member on Tuesday to watch a movie.
DBT forces you to think about the details of how you see the world, and how you react. It gives you skills (suggestions) for how to make your life easier. I didn't get all of it (the mindfulness went right over my head), but I drive the friend who is doing DBT in therapy right now crazy by responding to her laments with "Gee, I think there is a DBT skill for that".
It gives you a chance to meet other people who have similarity to yourself (I'm not a traditional BPD person, but I have enough of it so that I could see why we were all in the same room). It can help you feel not as alone.
It also gives you access to an additional (or probably 2 additional) therapists. This is really helpful if you have a real problem with your regular therapist and haven't been able to get it resolved with her. Sometimes a second opinion is really helpful. It also gives you someone to go to when your therapist is on vacation. (I went to see an old group therapist (not DBT) 7 1/2 years after the last group I attended. She had missed a lot in the 7 1/2 years, but she still had a sense of who I was, and I was comfortable talking to her - we had already gone through all that trust stuff.)
It might be worthwhile (and it may be required) to meet with the therapist(s) before you commit. That way you can see if they have the right personality for you, and if you think they could handle the group. If they have run the DBT group in the past, I would strongly suggest that you talk to someone who was in that group. They would be best able to let you know what it was like.
I think the hardest part for me was being patient while other group members threw tantrums. I just wanted to get on with the lesson. To some degree, though, it was helpful to see where I could be if I didn't work in the group and in therapy.
I got my Skills training manual at a small bookstore. I've seen both books in larger bookstores. I bought my Skills Training manual because it has a really awesome list of emotions (how may ways can you say "fear"?). I've entered the words in my computer and make "Emotional Confetti" by cutting each word out. I've used my Emotional Confetti at least 3 different ways. Sometimes when I feel like the world is completely out of control and I need to know that someone understands and that there is hope, I read my book or manual - and they calm me down. OK, so I'm strange.
You seem like you are in control of yourself enough so that you could really learn the skills.
Good luck, Penny
Posted by deirdrehbrt on October 3, 2003, at 22:13:29
In reply to DBT - Dinah? Others?, posted by Penny on October 3, 2003, at 8:43:34
Penny,
I never had the opportunity to go to the DBT classes, but my Therapist did teach them. She uses some of the DBT skills in the context of therapy.
I do SI, and I have been very suicidal. At the times when I remember to use the skills, they do help. They have kept me out of the hospital more than once, and when I do manage to stay out, I think that I learn important lessons.
During my last hospitalization, I went to a hospital where some of the staff was experienced with DBT. We worked on DBT there. I have a long way to go, and perhaps more than one or two hospitalizations are in my future, but the DBT is at least helping me to know when I am in trouble. I can deal with the things that come upon me from a distance much better. The ones that hit me hard from nowhere are giving me a great deal of trouble still.
If you can find a class, I think you should at least look into it. There is one about 60 miles away, but until I'm able to drive again, I have to wait.
Good luck Penny,
Dee.
Posted by Medusa on October 6, 2003, at 10:13:30
In reply to DBT - Dinah? Others?, posted by Penny on October 3, 2003, at 8:43:34
I went to one or two DBT group sessions when I was hospitalized, and the leader was h-o-r-r-e-n-d-o-u-s.
I have the DBT workbook but not the book. I've learned a lot just from reading the workbook on my own, but don't have anywhere to discuss it or guage how I'm doing at putting it into practice.
Is this board a place where we can actively discuss specific DBT tools and so on?
Posted by Dinah on October 6, 2003, at 10:54:31
In reply to Re: DBT - Dinah? Others? » Penny, posted by Medusa on October 6, 2003, at 10:13:30
>
> Is this board a place where we can actively discuss specific DBT tools and so on?Sure, and I could use some reinforcement myself.
Dinah
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