Dbt

[roxy]

Hi Em

Good to see your post about DBT. I am on the DBT programme here in the UK at the moment, and would like to offer the following comments ;

The structure of DBT is like no other. It is really rigid - you have to stick to discussing present difficulties which interfere with Therapy and your quality of life. Discussing the past is not allowed. Stopping self harm is the big issue in DBT. Finding other ways of coping.

There is a 'no nonsense' approach to the programme. All topics and issues are discussed matter of factly and you are confronted 'head on'. I think it is quite brutal in some ways. You have to get used to it and go with it.

Homework and the feedback of it is compulsory. No one gets away without completing it. Diary sheets too ...

The methods and ideas that are taught in the group sessions are not rocket science! I was amazed at how so much of DBT is common sense ... BUT, applying the techniques in real life, at crisis point, is VERY HARD.

Trying to learn all they teach,and put it into practice without using the coping mechanisms you have always used, and endure 1 hour of therapy every week, plus living life ... well ......

Anyway, I am sticking with it, reminding myself that I have no choice. I need to get control over my SI otherwise it will be too late.

So if anyone is waiting for DBT ... remember,

It is not an easy ride, or fun, or a 'talking therapy'.It is about learning new skills to cope with life, and it can be difficult, frustrating, confusing, and annoying. Is it worth it? Well I am still here ......

[roxy]

Hi brassed 2 bits

My name is pamela and i live in queensland australia

Having read your post i was wondering if you could

send the link for DBT

tp plyell1@bigpond.com

email on top of message is wrong.

Thanks.

[HayleyINTERRUPTED]

I was just recently diagnosed, so how do I know if DBT is something I might need?

[Ocean Wolf]

As with any therapy, I'm pretty sure it ends up only as good (or bad) as the therapist. Or how you relate to the therapist .

Honestly, I think DBT could be good for anyone. I plan on teaching my kid(s) skills I learned from that just to help with life. I wish it was offered (by good therapists) a lot more.

[piuma]

im meant to be starting it, but it keeps being held off cos im a pain in the but and keep havin set backs like suicide attempts, can someone tell me what some of the ways to cope are? cos all i have had so far is mindful ness and im sorry but sitting and stroaking a rock does not make me feel better, especially when i feel suicidal!!

[Aneurysm]

Mindfulness isn't great if you're feeling suicidal, it's more to prevent disassociation

Distress tolerance and emotional regulation are better.

[piuma]

ok thankyou for that. we'll be kinder to the rock stroaking next time ;)

[complicated]

<b>Dialectical Behaviour therapy</b>

DBT is a therapy with a growing amount of evidence to support its effectiveness. The thing about DBT that stands out from other therapies is that it was developed especially for the purpose of treating BPD. It was developed by Marsha Linehan in 1991 and is based upon the theory that psychosocial treatment of BPD is as important as traditional psychotherapy. A structure of treatment goals forms part of DBT and these include reducing parasuicidal behaviours, reducing behaviours which interfere with the therapeutic relationship and finally reducing those behaviours which directly impact upon the sufferer’s quality of life. Studies have shown that DBT is effective in achieving these goals.

The theory behind DBT maintains that some people, due to invalidating environments during upbringing and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up much more quickly, peaks at a higher level, and takes more time to return to baseline. As a result borderlines experience crisis-strewn lives and extreme emotional lability (emotions that shift rapidly). DBT is a method that teaches skills that will help handle the rapid mood changes more effectively.

<b>Dialectical Behavioural Therapy (DBT) consists of two parts: </b>

Psychotherapy sessions (one per week) in which a particular problematic behaviour or event from the past week is explored beginning with the chain of events leading up to it, going through possible alternative solutions that might have been used, and examining why more useful solutions to the problem were not used.

Both between and during sessions, adaptive behaviours are taught and reinforced especially as they occur within the therapeutic relationship. The emphasis of DBT is on managing emotions rather than crisis intervention.

DBT also involves weekly 2.5-hour group therapy sessions in which interpersonal skills, distress tolerance skills, emotion regulation, and mindfulness skills are taught.

From the Priory Clinic in summary – “Dialectical Behaviour Therapy then is a novel method of therapy specifically designed to meet the needs of patients with Borderline Personality Disorder and their therapists. It directly addresses the problem of keeping these patients in therapy and the difficulty of maintaining therapist motivation and professional well-being. It is based on a clear and potentially testable theory of BPD and encourages a positive and validating attitude to these patients in the light of this theory. The approach incorporates what is valuable from other forms of therapy, and is based on a clear acknowledgement of the value of a strong relationship between therapist and patient. Therapy is clearly structured in stages and at each stage a clear hierarchy of targets is defined. The method offers a particularly helpful approach to the management of parasuicide with a clearly defined response to such behaviours. The techniques used in DBT are extensive and varied, addressing essentially every aspect of therapy and they are underpinned by a dialectical philosophy that recommends a balanced, flexible and systemic approach to the work of therapy. Techniques for achieving change are balanced by techniques of acceptance, problem solving is surrounded by validation, and confrontation is balanced by understanding. The patient is helped to understand her problem behaviours and then deal with situations more effectively. She is taught the necessary skills to enable her to do so and helped to deal with any problems that she may have in applying them in her natural environment. Generalisation outside therapy is not assumed but encouraged directly. Advice and support available between sessions and the patient is encouraged and helped to take responsibility for dealing with life’s challenges herself. The method is supported by empirical evidence which suggests that it is successful in reducing self-injury and time spent in psychiatric in-patient treatment.“

<a href="http://www.bpdworld.org/treatment_recovery.php" target="_blank">Other Treatments</a>

[complicated]

hi i want to ask my cpn to get me to be able to start having dbt if possible, could u suggest where we could apply to for funding,an to give me any, an as much information as possible on dbt places that accept funding, so i can propose a decent argument to my psychyatrist, since ive tried asking my psychatrist about theraputic communities an he just dissmissed them, so i know i have a fight on my hands as such, i want to be fully informed thks. i live in stockport cheshire.

[Elke]

I have given up. Something happened today, it was all to much for me, everything is, and I have just given up...

WILLFULLNESS AND GIVING UP

I do have one question though, directed at someone who has done DBT and maybe can answer. Why is "giving up" "willful"? I dont feel any will left having given up. I dont see the connection about being "willful" about it.

Elke

Edited October 22, 2009 by Elke

[Roses]

it is because you made the decision to give up. i know it sounds wierd but it is a choice. Please don't have a go at me, it's the truth.

Edited October 22, 2009 by Roses

[Elke]

Thank you Roses :wub:

Edited October 22, 2009 by Elke

[ow_my_brain]

I live in Canada and I'm trying to get into a DBT program or see a therapist who specializes in this. I bought a workbook called The Dialectical Behavior Therapy Skills Workbook by Matthew McKay, PH.D, Jeffrey C. Wood, PSY.D. and Jeffrey Brantley, MD. So far the first two chapters have been incredible at preventing self harm and suicide even though I feel like I'm constantly in crisis lately. I have really high hopes for this changing my behavior.

I think this will be helpful for me in particular because I feel like I don't have any major underlying trauma except all the pain I create for myself with my self-destructive behavior. I wasn't abused as a child, just neglected. My biggest problems are with cutting and meaningless sex. My boyfriend just broke up with me after 6 years because of numerous affairs I had and then just swept under the rug. When he confronted me I hardly knew what he was talking about. Now the loneliness and pain is too much and I want to completely destroy myself. I have been managing only because he is encouraging me to get help and not just leaving me outright.

I have a question about taking this in a hospital type program though, is group therapy a major component? I didn't realize this. It makes me sort of nervous because in group therapy in the past I found myself wanting to do all the self-destructive acts I heard others talking about. For example, I never had problems with eating until certain groups. Hearing girls talk about their eating disorders made me think that not eating could be a way to harm myself without drawing so much attention as cutting. I also tend to like belonging to a group of people that relate to me, so I will start to feel like my mental problems are really just my personality. I hope this makes some sort of sense. I was much younger when I took group therapy before, so maybe it won't be so influential.

Any insight to if the group component is necessary/ different than other groups would be appreciated.

[Ulrica]

I would love to have DBT. I think it'd be very helpful for me, and reading what others have wrote and heard others talking about how much it has helped them, I'm even more convinced. The only thing is, there is no DBT where I live if you're older than 25 (I'm 27). This sucks big time. I'm so annoyed that DBT is still so uncommon in Sweden. I even asked why this was to a work therapist I used to have and she said: "Because people don't want to get educated in it as the patients and form of therapy is hard and too much work." Bah, and then people wonder why I am loosing faith in the Swedish MH system. Sorry, stopping rant. Just had to get it off my chest for some reason.

[purple-chick]

hi i just wondered if there is dbt in the SE UK?

as i asked my mh team about this and they said they hadnt heard of it, which i found a little strange!

[Jinxsta]

Hi, im in the south east (Portsmouth, Hampshire) and im in DBT... my therapist helps decide the NICE regulations for BPD.

XxX

[Jinxsta]

I live in Canada and I'm trying to get into a DBT program or see a therapist who specializes in this. I bought a workbook called The Dialectical Behavior Therapy Skills Workbook by Matthew McKay, PH.D, Jeffrey C. Wood, PSY.D. and Jeffrey Brantley, MD. So far the first two chapters have been incredible at preventing self harm and suicide even though I feel like I'm constantly in crisis lately. I have really high hopes for this changing my behavior.

I think this will be helpful for me in particular because I feel like I don't have any major underlying trauma except all the pain I create for myself with my self-destructive behavior. I wasn't abused as a child, just neglected. My biggest problems are with cutting and meaningless sex. My boyfriend just broke up with me after 6 years because of numerous affairs I had and then just swept under the rug. When he confronted me I hardly knew what he was talking about. Now the loneliness and pain is too much and I want to completely destroy myself. I have been managing only because he is encouraging me to get help and not just leaving me outright.

I have a question about taking this in a hospital type program though, is group therapy a major component? I didn't realize this. It makes me sort of nervous because in group therapy in the past I found myself wanting to do all the self-destructive acts I heard others talking about. For example, I never had problems with eating until certain groups. Hearing girls talk about their eating disorders made me think that not eating could be a way to harm myself without drawing so much attention as cutting. I also tend to like belonging to a group of people that relate to me, so I will start to feel like my mental problems are really just my personality. I hope this makes some sort of sense. I was much younger when I took group therapy before, so maybe it won't be so influential.

Any insight to if the group component is necessary/ different than other groups would be appreciated.

Hi Murph,

The group part of DBT is manadatory but discussion of self-harm is not allowed, u cant say I cut last night or any description, or say u intend to, but u talk of self-harm prevention, but its put in a different way "minimising therapy interfering behaviours", self harm is discussed in the 1-2-1 part of it only, where u do a chain analysis with your therapist if u have... which is discussing the vulnerabillity factors, then the prompting event (if any) then whats called the hot cross bun which is describing ur emotions, physical sensations, thoughts and actions before the self harm, then what u could have done differently, what skills u could have used. Hope that helps.

XxX

[sgtsixpack]

Where I am in the SE UK, they seem hell bent on giving you extreme doses of drugs ( I have compared my dose with other's on the same drug) and forgetting about you. They don't seem interested that its a temporary situation which could change. I knew from when I first took drugs that I did not want them. I never got depressed, I feel good most of the time, but they want you to take them indefinitely. I asked the doctor about targetive dykenisia and I gave examples of patients I had seen with it, he acknowledged but tried to palm me off by saying I was on new better drugs. I said "I don't believe you".

My episodes are so few and few between, and are not harmful to anyone. Yet drugs which will destroy mind to muscle connection (tip of the iceberg), for a man who likes to lift weights is absolutely intolerable. Have you heard Whitney Houston or Amy Winehouse talk lately? They are wreaked intellectually, have difficulty not acting spaced out even when not on drugs. Its like senile dimentia brought forward 50 odd years to a young person. I know its different drugs, but I see patients act like that. I even acted like I was half sleeping while I was coming off quetipine/ semisodium valporate. I think it was the quetipine though as its the first time I had it and I don't remember these really strong symptoms when I went cold turkey from semi-sodium valporate or from lithium for that matter.

Drugs are for dummies.

[Roses]

I am finding you increasingly upsetting to read Megatron. By the sounds of it you find us mere mortals hard to stomach, and you come across as very arrogant in your posts. Stating "drugs are for dummies" could be very upsetting for people who find these drugs helpful, or for people who have to rely on them to help them in their day-2-day lives. I don't think there are many people who enjoy taking their meds and it is very upsetting to read your immature and uneducated opinions on this matter. Could you please think before you type or at least put a trigger on your posts first.

Edited November 1, 2009 by Roses

[Villan]

i agree wholeheartedly with Roses... meds may not be the complete answer for some people, but they helped me get through my day to day life whilst i was sorting out my issues... without them, i would have lost my job and spiralled out of control...

i am sorry that your experience with meds has been so painful, but I AM NOT A DUMMY... meds helped me get through a tough tough time as i am sure they also do for many many ppls here...

it aint nice relying on a lil blue pill to exist... but it is probably the reason i am still here and fighting...

[sgtsixpack]

All I am saying is, don't think of them as a permanent fix. Anyhow I will take my view and start a new topic, don't read it if you don't want to be informed.

As far as me being "arrogant", check out what I have to put up with:

http://forums.overclockers.co.uk/showpost.php?p=15225579&postcount=3548

Edited November 2, 2009 by Megatron

[Roses]

We all know they are not a permanent fix thought Megatron THAT is what is insulting and niave of you, thinking that we disagree with you. I think most people on here would agree with you - they are not the answer. But drugs make us stable enough to accept the therapy we need to change. There is no good giving a highly unstable person a load of therapy cos often it does not sink in. Myself and many others on here have actually been refused the therapy we so badly need, until we are stable on the drugs. So you tell us - WHAT ARE WE SUPPOSED TO DO????? I have read all your stuff and all your links and it is nothing I didn't know, and nothing that changes anything for me. I am exercising, eating the diet of a person who is committed to training and keeping fit, I sleep with the drugs, I occupy my mind, I help out at the school - I DO FUCKGIN EVERYTHING yet I still want to die. Please, if you have some secret cure let me know.

[louby31]

im on the waiting list for dbt, ive realy got my hopes up that it helps me. im so desparate to be able to control my bpd better, from what ive been told and read you realy have to want it to help for it to help, and its not a cure but a way to help control the dpd rather than it control you.

[Jinxsta]

Yeah u have to really want it because theres quite alot of work involved not just emotionally but you have to do a mood diary daily, record skills usage daily, and record urges and if they are carried out, daily, then u get homework from group and homework from individual therapy session. You genrally have four target behaviours to conquer (mine are Hurting others, suicidal acts, self-harm and OCD urges)...that is the main focus of it, minimizing those behaviours...and the skills u learn are apparently what people without BPD have already..... some seem obvious, some alien, some impossible.

DBT is a long old journey, and ur correct its not a cure...but even if u can just minimise one target behaviour by the end of it, i suppose thats good. My T says the core skill is mindfulness, after mastering that the rest should pretty much fall into place...so maybe if u haven't done so already u could read up on that. Feel free to ask me anything and if i can i'll answer.

XxX

[purple-chick]

just found out they dont do dbt in my area :(