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Re: What do you think of online DBT? Dinah

Posted by fallsfall on August 17, 2003, at 6:45:08

In reply to Re: What do you think of online DBT?, posted by Dinah on August 17, 2003, at 0:59:10

> >
> > I'm impressed that you found DBT online! How can he say that you are lazy??????
> Because I did it when I should have been working? (grin)

This is a fine line. I might call that unfocused rather than lazy.
> I think for the moment, I'll try using the skills manual without the online skills trainer. The trouble is that my therapist isn't trained in it, so I probably know as much as he does.
He should be familiar with all of the material in the skills training, and should be able to explain it easily after a quick review of the section (to be sure that what he is teaching is what is in the section). He wouldn't necessarily be familiar with the DBT Therapist guidelines (i.e. how to prioritize issues, guidelines on types of communication (i.e. irreverent?), theory of why we are the way we are), but that shouldn't impact his ability to teach the skills.

> If he's willing, I think it would be a good idea to have him help me interpret the skills and think of ways to apply them. Maybe even to assess my abilities at different things. But not to routinely check the diary card or to ask how I'm doing in a routine way. I think that would make him too much one of the father/husband/boss people in my life. He already tread over that line this week. I don't take it well. And heaven help him if he suggests distress tolerance skills when he's the one who's upset me. No, way too much conflict of interest going if he gets too involved with the DBT. He'd only be able to do it from the didactic side, and stay out of the evaluation side.

You are very, very defensive about these diary cards, and I really don't quite understand why. When you go to see him, do you tell him in general how things have been since the last time you saw him? "I've had a terrible couple of days, I just wanted to stay in bed and cry. I had to go to a Cub Scout meeting with my son and I couldn't talk to anyone and kept leaving to go to the bathroom." Or "Life's been wonderful! I cleaned off my desk, finished the big project for work, and went out for a romantic dinner with my husband". That's really all a diary card says. It gives a little more detail about how you are feeling and functioning. It has a place to indicate if you are hurting yourself or feeling suicidal. Is that what you are worried about? Don't you think he should know those things anyway? He won't be there to judge you any more than he is now (which I hope is never). The diary cards just are a more complete picture, and you don't have to worry about forgetting what went on on Wednesday. I always thought that the more information she had, the better off I was because then she could make better decisions on how to help me.

I understand that you are feeling a bit like he is ordering you around. I'm sure that you will talk to him about that. Either it was a mistake on his part, or he is trying to accomplish something - you need to find out which. But I think that your hesitence with DBT/Diary cards pre-dates that (am I remembering correctly?). I guess I'm still not clear what your concern is.

> I'm trying to figure out if it's good or not that I can guess my reactions with reasonable accuracy. I think it must be bad, because it means I'm not willing to change them. Hmmmm.....

I think it is good that you can predict your reactions. That means that you are understanding yourself. It also means that you have some advance notice in case a less desirable reaction is coming - maybe that will give you enough time to change something and make things better.




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