Psycho-Babble Psychology Thread 351645

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Re: Strangeness of DBT crushedout

Posted by Ilene on May 31, 2004, at 13:46:14

In reply to Re: Strangeness of DBT Ilene, posted by crushedout on May 31, 2004, at 13:43:27

>
> Yeah, I think I'm having a hard time understanding the point of some of the stuff, too. And she uses a lot of weird jargon-y sounding language which turns me off. But I think her heart's in the right place, and I trust her ideas are good. I wish she was a little better at communicating them in plain English.

I think she's influenced by Zen or something similar.

I.

 

Re: Strangeness of DBT Ilene

Posted by crushedout on May 31, 2004, at 13:47:37

In reply to Re: Strangeness of DBT crushedout, posted by Ilene on May 31, 2004, at 13:46:14


Yeah, she's definitely into some types of Eastern meditation stuff.

 

the frustration continues

Posted by crushedout on May 31, 2004, at 20:33:48

In reply to Re: Strangeness of DBT Ilene, posted by crushedout on May 31, 2004, at 13:47:37


I don't think this is working out for me. Every time I try to fill out the diary card, I can feel my blood pressure skyrocket and I end up wanting to cry. I don't even know what the skills are, can't remember if I did them, and for the most part, think I haven't, so I put zeros down on all of them and then just feel like sh*t about everything in my life (about which I felt just fine before I picked up the diary card).

I also am frustrated because I know much of our session tomorrow will be "wasted" on talking either about what I put down or my frustration around it, and I have other things that I really need to talk about. If we're going to do this DBT stuff, we need to *add in* time to do it, which I don't really even think I have anymore. And I'm not sure it's something I want to do, anyway. I'm really not convinced it's helpful, not in this format, in any case. Not for me, that is.

 

Re: the frustration continues

Posted by fallsfall on June 1, 2004, at 7:30:48

In reply to the frustration continues, posted by crushedout on May 31, 2004, at 20:33:48

The diary cards are hard to fill out. It is hard to remember to do it. It is hard to be honest on paper. You are just learning the skills, so of course you are a bit confused about them. If you knew all the skills and did them all the time, you wouldn't need DBT. But you don't know all of them. Give it time.

"Standard" DBT includes one individual session (45-50 minutes) and one group skills session (1 1/2 hours). Please do talk to your therapist about the time - this does seem to be an issue for you.

Since you are doing this individually, she should be able to pace it so that you feel more comfortable. Can you divide up the diary cards, and only fill out part of them for now (i.e. the part you understand)? Then you can add more in as you feel comfortable with it.

Don't minimize the difficultly of being honest on paper. It is really hard to look at yourself objectively. It is really hard to write down when you have "failed". But it also does really feel good when you can write down a success. I found that it was really valuable to have notes from each day. My memory is terrible. This allowed me to have a record of how the days were, and I put a short (4 sentances) summary of what went on that day in, too. It let me have a way to look back and see the patterns, and see the progress, and see when I was slipping.

The diary cards were as much for me as they were for her. Sometimes they were a good way to introduce a topic that I knew we needed to talk about, but I didn't want to bring up ("Gee, I was feeling suicidal this week - look at those numbers! Usually it isn't this bad" - and recognize that things DID change, and to be aware of how they were changing). It gave me a better understanding of my own ebbs and flows.

OK. I just went to get my Skills Training Manual to look at the diary cards. There are two sides: the front talks about alcohol, meds, suicidal ideation, misery, self harm. The back talks about the skills.

Since you have just started, of course you don't know what the skills are - that is what you will be learning over the next 6 months. Have you talked about Wise mind yet (P.S. this was the HARDEST skill for me - still is)? After you talk about wise mind, and have a chance to do the homework on that, then that one skill should start to be clearer for you. You can't say whether you have done a skill if you don't know what it is. So, you shouldn't fill out the skill section for skills that you haven't learned yet. Maybe at this point you don't even understand wise mind (I don't...). So, maybe you aren't ready to fill out the second side - or maybe you can only tell if you have worked on one skill, or two (because that's all you have learned). You can just leave the rest blank. You'll use it later.

You should be able to fill out the front. This is not pleasant to do - and that makes it hard. But this is where you can see what is going on in your life and identify things you want to work on. For instance, you might decide that you want to reduce self harm. You won't succeed every day, perhaps. But you will be able to see your progress by watching either the "urges" rating go down, or by seeing that even though you have the urges that you are not acting on them. This is why I included a short part on what went on that day. It helped me to recognize what kinds of things were triggering the urges etc.

Maybe even the front of the card is looking hard to you. But the drugs and alcohol columns should be OK to fill out (see filling these out as a reward for your hard work). Maybe you need to add the other columns more gradually.

So maybe, right now, the front of the card is (more than) enough to be filling out (and you can even forget the last column, since you don't know the skills yet, so it is really hard to use them). Or the front, plus one or two skills that you understand. The idea of the cards is to make the things that are happening in your life more obvious to you and to your therapist. The idea of the cards is NOT to frustrate you.

There has often been talk on Babble about doing DBT here as a group. Maybe you will be the catalyst for that! If you tell us about the skills you are trying to learn, we can talk about it here, and maybe things will get clearer for both you and the rest of us! Many of these skills are REALLY hard - requiring you to change the way you see the world or the way you deal with it. Don't expect it to be easy. It would be good for me to review all of this - because I certainly didn't get it all the first time around.

So I look forward to the new continuing "DBT Saga" thread!

 

Re: the frustration continues crushedout

Posted by terrics on June 1, 2004, at 15:50:58

In reply to the frustration continues, posted by crushedout on May 31, 2004, at 20:33:48

Hi Crushed, I am having a horrible time of it too. It almost seems childish. If you are going to do it your T. needs to give you a skills manual and teach you the skills. Supposedly DBT has a high success rate with borderlines if you really work it and if you really want to get well. I am going to give it 2 months and then decide if I am going to stay with it. You are supposed to have a group session also. So not having a group skills trainer makes things even harder. They just found me a group. If you really want to do this, there is a place not far from you where I am doing it. Let me know and I'll give you the info. As usual GOOD LUCK! terrics

 

Re: the frustration continues fallsfall

Posted by crushedout on June 1, 2004, at 18:54:08

In reply to Re: the frustration continues, posted by fallsfall on June 1, 2004, at 7:30:48


Falls,

I find your input on this really helpful. Where did you do all this DBT stuff? With your old T? I didn't know till recently that you knew so much about it.

Last week, my T and I had already decided to scrap the regular diary cards because so much of it was not relevant to me (like drugs and alcohol -- I don't do them or get urges to do them anymore) and some of it made sense to neither of us (like ratings 6 and 7 for the skills, which we still don't get). So my T made up a totally new diary card designed just for me, and while it was an improvement on Linehan's, I think she still made it too challenging for a beginner.

Today I tabled our discussion of the DBT stuff and took control of the session (which was very healthy of me) because I needed to talk about other stuff. We spent the last few minutes on my frustration with the stylized diary card and how every time I look at it, my blood pressure goes up and why. My T said I should just cross out with very dark pen the ones that I don't understand and just do the ones I do. She said the point of it is not to give me a heart attack. I said, yeah, I think we went too fast with this. I need to understand this better for it to feel helpful. She was very supportive (and made suggestions similar to what you're making here, falls). So I feel hopeful that we'll find a balance and a lot less frustrated (especially because I took control of the session, I think).

Although I didn't bring up the time issue (partly because I'm not sure I have extra time in my life to spare anymore), she mentioned an extra session for next week just as I was leaving (God, it's weird how she always seems to offer just when I think I can live without it). So we may have three sessions next week, which will make me feel more comfortable spending time trying to understand the skills.

Yeah, I also find Wise Mind extremely difficult. We've talked about it but I still don't feel like I understand (I'm honestly not sure how good of a skills trainer my T is -- she seems to "get" things but is not always great at explaining them to others). I think Wise Mind is what makes my blood pressure rise more than anything. I want so much to understand what it is and do it, but I have no idea whether I have or not. Argh.

I guess I'm not doing any equivalent to the front section anymore (since she stylized my card). I wonder why. I guess I should ask her.

>The idea of the cards is NOT to frustrate you.

Yeah, that's what my T said today. Phew.

I think doing DBT as a Babble group is a great idea! I'll try to come up with some simple ways to get us going. Or anyone else should feel free to jump in and get us started.

Thanks, falls.

 

Re: the frustration continues terrics

Posted by crushedout on June 1, 2004, at 19:18:55

In reply to Re: the frustration continues crushedout, posted by terrics on June 1, 2004, at 15:50:58


Thanks, terrics. I'll let you know. I assume you have to pay for the group? To be honest with you, the idea of it makes me cringe in pain.

 

p.s. terrics

Posted by crushedout on June 1, 2004, at 19:19:51

In reply to Re: the frustration continues crushedout, posted by terrics on June 1, 2004, at 15:50:58


I think I know what you mean about it seeming childish.

 

Re: the frustration continues crushedout

Posted by Dinah on June 1, 2004, at 21:10:21

In reply to the frustration continues, posted by crushedout on May 31, 2004, at 20:33:48

I like DBT, but when I discuss it with my therapist I am always clear that I want to do what I do on my own. I don't want him to be the mean mommy checking to see if I do my homework. And I don't want to resent him in a new role.

It would be nice to have a regular therapist, and a separate skills trainer. That way there wouldn't be those dual roles that I know darn well in advance that I would not handle graciously.

 

Re: the frustration continues crushedout

Posted by fallsfall on June 2, 2004, at 8:52:31

In reply to Re: the frustration continues fallsfall, posted by crushedout on June 1, 2004, at 18:54:08

My therapist was CBT. She diagnosed me as BPD, and I went to the bookstore and found the skills training manual. I brought it to her, she hadn't seen it before (It was 1996 or 1997), but liked it. Then she got a flier about a DBT Skills class being held in town. I signed up. She went to the weekly therapists meetings (and didn't charge me - I think she saw it as education for her. Worked well for both of us). I went to 6 months of Skill Training. We started with 6 or 8 people, but all but N. and I dropped out. So it ended up being a group of 2.

I looked up my diary cards. I remember them as being helpful in giving me a place to record what happened and how I was feeling. The cards I filled out were NOT like Linehan's. Mine looked like this:

Today I felt (0-9):
Good, Happy
Anxious, Tense
Angry
Depressed
Hopeful
Empty, Alone
Unreal, Disconnected
Physically bad

Today I felt an urge to (0-9):
Kill myself
Binge or purge
Drink or take drugs
Injure myself
Overdose
(also * if I acted on the urge on that day)

Activities for each day

There was a chart for the "I felt" and "Urges" sections - each day I rated each item (i.e Good, happy was a 4, injure myself was a 0).

In the activities section I had a list of things I did:
Slept very poorly
3 kids on the bus
Read
Color
Solitaire
Take daughter to Dr. for urine test
Take her to Volleyball
Xstitch
Solitaire

2 cookies (I was trying to control my junk food intake...)

2 ativan (I recorded PRN meds, or if I forgot my meds)

On the back, I wrote a short paragraph on the day:

Slept really poorly (tried relax tape at 5AM...) If I sat on the couch I would fall asleep. Rested all day. Really didn't think about anything. Comforted by remembering that T said I did a good job. I feel better now than this morning. Junior Coaching starts tomorrow. I hope I have enough energy. Haven't had skates on in 6 months. Hope they fit, hope I can skate.

I will email you (or others) a week's chart filled out if you want.

I'm glad that your therapist is being flexible. That is important. Has she done DBT with other patients in the past? If there is a group nearby, I really do recommend doing the skills training in a group.

Don't get "stuck" on a skill that you don't get. Give it a reasonable amount of time and effort, and then go on. Being in a group helps this, because you aren't tempted to keep working on something for an individual since the group has to go on. You can always go back to things later. It is important not to get too frustrated and if you keep moving on, then maybe the next skill will be easier for you. You may need to go through ALL of the skills multiple times (Linehan "requires" 2 6 month Skills sessions - or more). But doing the course in 6 months and the repeating the whole thing in the next 6 months is MUCH better than doing the course in 12 months (due to the frustration factor). The first time through may end up being more of "These are the things that we want you to learn, just get used to the idea that these skills would be helpful for you. Learn the ones that are easy for you." The second time perhaps would be more "Practice the ones that were easy, and learn some new ones".

I really think it is worth sticking it out.

Let me know if you have other questions, either by posting or by emailing.

 

Re: the frustration continues

Posted by gardenergirl on June 2, 2004, at 9:15:33

In reply to Re: the frustration continues fallsfall, posted by crushedout on June 1, 2004, at 18:54:08

Crushed,
I"m sorry that you are feeling so frustrated with this. DBT actually has a very good track record in the programs set up with it. I wonder if I could offer some thoughts/concerns here which may or may not help you understand your frustration?

While I am glad that your T is open to trying new things that may be of benefit to you, I am a bit concerned about this statement:

>and some of it made sense to neither of us (like ratings 6 and 7 for the skills, which we still don't get).

I really think your T should get some education or consulation on DBT before using it. It can be very difficult for a T, not to mention it could be considered to be unethical, to use interventions with a client for which they haven't achieved a certain level of competency. DBT is hard for both the client and the T. That's why the T also has "therapy" in the form of the weekly consultations. In addition, the skills and the diary cards can be hard, and if she is not understanding them, I'm not sure how well she help you with them.

I am just concerned that there is a potential here for more damage to be done to your relationship, just as you are beginning to forge ahead after all of the stress of the past several months with her.

I really liked the way Falls' T did it...by going to a weekly consultation and by having skills training be separate from regular individual therapy. This is how DBT is set up. It is as Dinah said, that skills training should be separate in order to prevent the dual relationship that such very different interventions would set up. At the very least, I believe the skills training should be it's own session, with a skills training workbook, so that your T can "put on another hat" for that sesssion, and can put her regular "hat" back on for your individual session. That way, your frustration with the skills and cards won't bleed over as much into your therapy. Just like you instinctively did, by taking control of your last session in order to get your needs met.

I know when I was doing DBT under close supervision this year, I found it to be a delicate balance. We set it up that a less advanced student on my team conducted the skills training and I did the individual therapy, as we did not have the resources in place to hold a group. Unfortunately, the less advanced student, for some odd reason, did not get adequate supervision (I think due to some miscommunication), and presented the skills training in a way that it did appear childish to my client. It's a fine line to walk, and it takes some extra education and supervision to master this. I attended a workshop at a conference about DBT, which was tremendously helpful. I'm not sure I would have considered using it if I hadn't had that extra work, even with my supervisor's availablility.

I wish you a lot of luck with this. I think there are a number of skills that DBT offers that can be applied to your therapy (i.e. validating much more than CBT, the idea of holding two conflicting, seemingly black and white issues at the same time, etc.) that can be really helpful. But to set up "doing DBT" on your own without supervision or additional training may be a really slippery slope, in my opinion. And that may be why you are feeling so frustrated (and she may be too, from what you have said.)

I wish you the best, crushed. I don't like to appear to be critical of anyone's T, but this is an issue that was beaten into our heads at school...competency, competency, competency. So I am concerned.

Take care and let us know how it continues.

gg

 

Re: the frustration continues crushedout

Posted by terrics on June 3, 2004, at 14:30:05

In reply to Re: the frustration continues terrics, posted by crushedout on June 1, 2004, at 19:18:55

Hi Crushed, My insurance covers group and individual. Do you have insurance? I think this DBT has a little brain washing aspect to it. Keep posting. terrics ps The one good thing is that the T will take calls til ten, seven days a week.

 

Re: the frustration continues crushedout

Posted by terrics on June 3, 2004, at 14:35:12

In reply to Re: the frustration continues fallsfall, posted by crushedout on June 1, 2004, at 18:54:08

P.S. I do not get 6 or 7 either. They seem contradictory. I will ask Mon. [grp] or Tues. [T]. terrics

 

Re: the frustration continues fallsfall

Posted by crushedout on June 3, 2004, at 21:23:40

In reply to Re: the frustration continues crushedout, posted by fallsfall on June 2, 2004, at 8:52:31

Hey falls,

Just some follow-up questions, mostly out of curiosity.

> My therapist was CBT.

This was your last therapist? The one you saw for like 9 years, right?


>We started with 6 or 8 people, but all but N. and I dropped out.

Who's N.? I feel like I'm supposed to know this, but I don't.


> I looked up my diary cards. I remember them as being helpful in giving me a place to record what happened and how I was feeling. The cards I filled out were NOT like Linehan's. Mine looked like this:

How did you come up with these diary cards? Why didn't you use Linehan's? Do you remember?


> I will email you (or others) a week's chart filled out if you want.

I would love to see one if it's not too much trouble.


> I'm glad that your therapist is being flexible. That is important. Has she done DBT with other patients in the past?

I'm pretty sure she hasn't but I don't actually know. It's a good question and I want to remember to ask her this soon.


> Don't get "stuck" on a skill that you don't get. Give it a reasonable amount of time and effort, and then go on.

Very good advice. At my T's suggestion, I crossed out the skills I don't "get" with magic marker (the ones that make my blood pressure rise) and on my own initiative, I added in a few that are relatively easy and/or stuff I know I usually do anyway. It helps to make me feel like less of a failure. For example, I added a new skill this week: "Breathe." That's pretty concrete, I can do it regardless of the circumstances, and it's not that hard, yet it's very helpful and I often forget to do it.

 

Re: the frustration continues gardenergirl

Posted by crushedout on June 3, 2004, at 21:32:50

In reply to Re: the frustration continues, posted by gardenergirl on June 2, 2004, at 9:15:33


Hmm, I really don't know what to make of your concerns, gg. If I bring this up as a criticism of her, I'm sure it will cause problems in our newly comfortable relationship. And I'm not really sure what danger she's putting me in by doing this without training. I'm not even sure she *doesn't* have training, although I strongly suspect she doesn't. I also know that if I simply bring these questions up, she will probably get defensive. Which puts us back in a weird place.

And now I'm making her sound bad again, which I've been trying hard to avoid doing.

But I definitely appreciate your concern and input. It's food for thought certainly, as I watch things progress. I'm just not sure what to do with it *right now*. Any thoughts you might have on this I'll certainly appreciate, but don't worry about it.

Thanks, gg.

 

Re: the frustration continues terrics

Posted by crushedout on June 3, 2004, at 21:35:24

In reply to Re: the frustration continues crushedout, posted by terrics on June 3, 2004, at 14:30:05


Hey terrics,

Yep, I do have insurance. I dunno if it covers group -- I guess I oughta find out. Good to think of.

Also, terrics, I'm so relieved that 6 and 7 make no sense to you as well. I thought I was being stupid. (And my T.) I guess either we're all missing something or they make no sense (I'd put my money on the second one).

 

my T's bargain with me

Posted by crushedout on June 3, 2004, at 21:46:00

In reply to Re: the frustration continues terrics, posted by crushedout on June 3, 2004, at 21:35:24


So, y'all know how I've been wanting a third session with my T for, like, ever and she's for some reason given me the runaround about it? Even though we used to do three and then after the CD debacle she suggested we go back to two and I stupidly agreed? Remember?

OK, so today she offered me a "deal": If I do my DBT homework every week sincerely and with effort and then spend the first 15 minutes of my Thursday session talking about the skills with her, then I get to have a third session the following week. Each week it will be at a different time and it will always be conditional on me doing the DBT stuff. (She said this makes the third session "worth it" for her. Weird choice of words.)

Aside: Alright I feel bad because I think I'm making my T sound bad again and I was trying not to do that.

Anyway, here's what I think: Of course I'm gonna agree to that! I mean, I want this third session so badly!

But here's what else I think: 15 minutes???? per week??? is that really enough time to do DBT?

And I feel sort of like I'm being treated like a child or a dog or something with the reward system she's using. I dunno. It's just making me feel kind of funny. But I'm not mad or anything. I'm just not sure what to make of it. I'm psyched because I have three sessions next week (since we spent 15 min. on DBT today).

Any thoughts out there?

 

Re: my T's bargain with me

Posted by TexasChic on June 4, 2004, at 15:11:27

In reply to my T's bargain with me, posted by crushedout on June 3, 2004, at 21:46:00

My T pushed me pretty hard to make some goals and complete them, and I was kind of irritated about it at the time. But now I realize she was trying to force me out of the vicious cycle I so badly wanted to be out of. She was actually doing what I was paying her to do. Your T is probably pushing because she knows the outcome you want, and is trying to help you achieve it. I can understand why it makes you feel like a child though.

 

Re: the frustration continues crushedout

Posted by gardenergirl on June 4, 2004, at 18:02:31

In reply to Re: the frustration continues gardenergirl, posted by crushedout on June 3, 2004, at 21:32:50

Hi crushed.
Thanks for being understanding. I'm not sure that I would bring it up with her. I mostly wanted YOU to know. Perhaps if the opportunity comes up, you could ask how Linehan's program is set up, just to talk about how you two are making it individualized for you. This would give you the opportunity to be an informed consumer, which is always good. But I certainly understand how this could throw a curve into a relationship that's trying to repair.

As always, I wish you the best,

gg

 

Re: my T's bargain with me crushedout

Posted by DaisyM on June 4, 2004, at 18:17:56

In reply to my T's bargain with me, posted by crushedout on June 3, 2004, at 21:46:00

crushed,

I have been reading this thread, but since I don't have any DBT experience, I haven't intruded. I do want you to know that I feel your frustration and it seems to me that you are trying really really hard.

I'm glad you are getting the third session you've been wanting and maybe the compromise is worth it. If you stay open to learning something new, you never know, it just might help.

I hope you have a calm and peaceful weekend.
Daisy

 

Re: my T's bargain with me crushedout

Posted by Aphrodite on June 4, 2004, at 20:19:48

In reply to my T's bargain with me, posted by crushedout on June 3, 2004, at 21:46:00

Crushed,

I could see how the reward system would make you feel childlike and create an authoritative kind of atmosphere. I know, though, that when I am depressed, any kind of incentive helps in getting out it. And since more contact with your therapist is what you need, perhaps this will help you get there faster.

I don't know anything about DBT, but I am interested to here more about how it works for you. Fifteen minutes doesn't seem time enough to do anything though.

 

Re: the frustration continues crushedout

Posted by fallsfall on June 5, 2004, at 12:55:38

In reply to Re: the frustration continues fallsfall, posted by crushedout on June 3, 2004, at 21:23:40

> Hey falls,
>
> Just some follow-up questions, mostly out of curiosity.
>
> > My therapist was CBT.
>
> This was your last therapist? The one you saw for like 9 years, right?

*** yes
>
>
> >We started with 6 or 8 people, but all but N. and I dropped out.
>
> Who's N.? I feel like I'm supposed to know this, but I don't.
>
*** nansun58 (she posted here briefly 6 months or so ago)
>
> > I looked up my diary cards. I remember them as being helpful in giving me a place to record what happened and how I was feeling. The cards I filled out were NOT like Linehan's. Mine looked like this:
>
> How did you come up with these diary cards? Why didn't you use Linehan's? Do you remember?
>
*** My skills Training therapist handed these out
>
> > I will email you (or others) a week's chart filled out if you want.
>
> I would love to see one if it's not too much trouble.
>
*** coming to an email box near you, soon!
>
*** adding "easy" skills for positive reinforcement is a good idea!

 

Re: my T's bargain with me crushedout

Posted by fallsfall on June 5, 2004, at 14:18:47

In reply to my T's bargain with me, posted by crushedout on June 3, 2004, at 21:46:00

> OK, so today she offered me a "deal": If I do my DBT homework every week sincerely and with effort and then spend the first 15 minutes of my Thursday session talking about the skills with her, then I get to have a third session the following week. Each week it will be at a different time and it will always be conditional on me doing the DBT stuff. (She said this makes the third session "worth it" for her. Weird choice of words.)
>
*** I may not be remembering all your details, so correct me if I'm wrong. I don't remember hearing about *you* resisting learning or working on DBT skills. I know you don't understand them all, I know you feel like you have too many crises to "give up all your time" to skills training (what borderline patient doesn't?). Have you refused to cooperate with her in the past? I guess I'm not quite sure why she feels the need to "make" you work on this stuff. You have always sounded self-motivated to me.

As I read her books, I read that Linehan thinks that homework practice is very important. Her tact seems more to be to figure out what the obstacles are to getting people to do the homework, and to resolve those obstacles (this lets the therapist put pressure on the client to do the homework without the therapist appearing punitive. The therapist is always appearing in a "helping", "facilitating" role.)

There *are* rules in DBT designed to force compliance (like if you don't go to skills training you get kicked out of individual therapy, too) - and these could be seen as models for your therapists "deal", I suppose.

The only thing I found in her books that seemed relevant was "It is, of course, important that the leader resist the temptation to collude with a client in punishing herself for not practicing". ("Skills training manual for treating Borderline Personality Disorder" p. 20)

>
> Anyway, here's what I think: Of course I'm gonna agree to that! I mean, I want this third session so badly!

*** Of course you do!
>
> But here's what else I think: 15 minutes???? per week??? is that really enough time to do DBT?
>
*** Why don't you spend the whole Thursday session on skills training? That way it would be clearer what was Skills time, and what was Individual time. 15 minutes is not enough time to review skills and learn new ones. If she hasn't done skills training before, she will need to do some work before each session to prepare - is she willing to do this? I would strongly recommend that you try to allocate one complete session for skills and have two for individual. Are you committed to learning the skills? Any client in DBT will have certain weeks or certain skills that just don't go right. That is why Linehan puts the emphasis on figuring out what prevented the homework, and finding a solution so that the same thing doesn't cause a problem again. So I am a little nervous that she will "punish" you for doing what a Borderline client can be expected to do.

> And I feel sort of like I'm being treated like a child or a dog or something with the reward system she's using. I dunno. It's just making me feel kind of funny. But I'm not mad or anything. I'm just not sure what to make of it. I'm psyched because I have three sessions next week (since we spent 15 min. on DBT today).
>
> Any thoughts out there?

*** It sounds a little weird to me, but *you* could make it work well, if you really want the skills training. As long as she won't NOT give you the 3rd appointment if you were honestly trying, and just having "normal" Borderline difficulties. I definately think you should try to get a whole session for skills (sit in different chairs, or borrow someone else's office so it is clear to both of you that this is the "skills" session). And don't let her or you slide into crisis managment on those days - you'll have the other two sessions for that.

Just my 2 cents.

 

Borderline Personality Disorder and Abandonment terrics

Posted by corafree on October 11, 2004, at 5:09:13

In reply to Re: the frustration continues crushedout, posted by terrics on June 3, 2004, at 14:35:12

T - Been needing to talk. I started in emotional regulation in DBT. I have my fourth group session coming up. One thing is for sure; I believe I've identified my strongest emotion, and it is fear. After my Dad died in Feb., my fam of origin abandoned me, I think you know that? That fear, going through that all that grief alone, is awful. Finally, after my last 'stupid' attempt to 'REACH' my mother, brother, and three sisters, ... my so-called advocate, one of my daughters, wrote them an email w/ her 'wise mind.' I think they're dumbfounded. This is good - it helps me to put an end to them, as they did me. I have never, ever, felt soooo much fear, fear of change, fear of what my mother may do. I have also ended a very long, toxic relationship, that always scared me, and now am even more scared ... freaky?! Toying w/ idea of filing order of protection w/ local courts. With the help of my 'advocate', I got the 'umf' I to try LET THE FAM GO, LET THE TOXIC BOYFRIEND GO, GIVE MYSELF CREDIT FOR THE EFFORT I AM MAKING. I saw a new Pdoc while all this was happening and he allowed me 6Klonopin daily, so that helps somewhat. The Effexor has always helped, but he did mention a possible increase in the future. I'd rather not do that tho'. Oh (sigh), 'once upon a time' seems like it never happened, but those things that happened to the real ME, and now this ME needs to know what I apparently never learned. I didn't realize I was so fragile. But now I believe I suffer as tho' I was a soldier returning from war to no job, no family, no congratulations. Once in a while I will think, is it legal for a wealthy family to dump the 'mentally ill' members of their families into the system? Without them invalidating me and w/o the ex scaring me, I think DBT will help, although I don't think I consciously realize that it already may be doing that. I don't feel like it is, but the counselors (in their weekly mtg), or as my T says, say I'm doing well. Sometimes I really just feel like nothing is getting thought to me. I want to live a good and friendly life with a good 'buddy'; w/o so much fear, anger, and sadness. By the way, I also identify strongly with anger and sadness. I'm so thankful that my daughter put her fam' reputation on the line for me, and hope it doesn't hurt her; but, no one would listen to me. My T revised my diary card, adding topics - Feeling of Rejection/Invalidation; Physical Pain; Feeling Thankful (all is so negative on diary card). I do pray to my Dad. Sometimes I feel every bad feeling lifted from me, and feel loved, okay w/ myself, and able to give people the benefit of the doubt. That is chilling! That's when I feel thankful. Do you agree sacrifice=resurrection? I must be doing something right to feel good and calm, even if it is fleeting. Right now as I'm writing to you, fear is at my 'center', with all this change. I would like to hear how you're doing. Miss you all. Best wishes from CF

 

Re: Borderline Personality Disorder and Abandonment corafree

Posted by terrics on October 11, 2004, at 12:51:30

In reply to Borderline Personality Disorder and Abandonment terrics, posted by corafree on October 11, 2004, at 5:09:13

Hi Cora, You have written the script of my life with a few minor changes. I was never 'dumped' as a child just ignored when I needed something and smothered when I did not. (There is more which I can't bother with because it is too long). Fear is also my BIGGEST problem, then sadness. My father died when I was 8 and every yr. on that day I go into a severe depression. I used to think I was imaging it. It is also my husbands birthday. I have been doing DBT for 5 months and wonder if it is worth it. It almost seems faddish and hokey to me. I am petrified of the the T. but they won't let me switch yet. I hope your suffering is eased. Do you believe in a God? Don't ans. if too sensitive a question. I really wish you WELL, physically and mentally. terrics (dogsandcatsmany@yahoo.com)


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