Tag: DBT

Leaving DBT

I’d heard such good things about DBT and the wide array of issues it can help with. But once I began the therapy things very quickly went downhill for me. My voices were so loud in the group, defiant they wouldn’t be silenced, that it was difficult to concentrate, and I had so many questions that didn’t feel welcome. I felt like I was expected to just absorb the information given and make it work.  The skills of Dialectical Behavioural Therapy seemed to contradict each other and some sounded like they were straight out of ‘The Little Book of Calm’.

One of the skills ‘Radical acceptance’ is about just accepting the past. I wondered why anyone is in therapy at all if radical acceptance is the ideal cure. Society constantly asks us to radically accept whatever has happened to us. But I don’t know anyone who has found the societal kicking to ‘just get on with it’ healing. I became more and more sceptical of some of the skills, no matter how open minded I tried to be. It made me realise that in order to be more mindful I needed to understand myself and get properly assessed. Until this happens I can’t put everything aside and ‘just be mindful’ as DBT asked me to.

Another of the barriers for me was that my mood does not tend to swing violently on a day to day basis. I could go weeks or months where I didn’t have a real life depression to practice skills with. I practiced anyway, several hours on each homework and two visits to the clinic every week. However when there was a real life situation where a skill could be used, I found that dissociation meant I couldn’t apply any techniques. I found it increasingly more and more humiliating going to one to one sessions and hearing about all the things I should have done, when at the time I wasn’t aware of being in my body; let alone the whereabouts of my DBT worksheets. My OCD and general perfectionism made me incredibly anxious about the whole process. I tried bloody hard, but I couldn’t be the perfect DBT student. This alone made me despise myself even more than I did already. My mind had set me up with that goal, but unfortunately that goal became a big part of my DBT process failing.

DBT works for a lot of people and this is only my opinion. But the more I went to DBT the more I felt like I was in a sitcom about therapy. Everything from the clinking of the chimes at the beginning and end of a mindfulness activity and even some of the skills would have made great comedy material. One of the more notably bizarre skills was half smile and willing hands in which you look slightly sinister and wait for serenity to come upon you. My uncertainty as to whether DBT was the correct path for me seemed to frustrate my 1:1 therapist greatly. She said that by trying to get me involved she had been utilising the ‘foot in door’ technique and now she would move on and use the ‘door in face’ technique by suggesting I move on. I said that sounded like mind games. She said: “that’s DBT”.

In the end I realised that the amount of hours I was putting into something that was rendering me totally miserable was stopping me from being able to do things that did actually make me feel better. Energy is a precious commodity and after about two months and many hours I couldn’t sacrifice anymore of it. I did meet some lovely people in the DBT group who I admire immensely and wish the best of luck in their therapy. In the meantime I am having more assessments to work out what to do next. No therapy works well for everyone, we are all individuals. I was absolutely terrified that me leaving the therapy would mean I would not be offered any help again. This luckily did not happen and everyone working with me respects my choice and my right to receive treatment.  The ‘Mouse Does DBT’ category will now become ‘Mouse Tries’, a series of blogs about different techniques that may help people with mental health problems.

A mouse with crossed arms and closed eyes with the words 'oh well' above it's head

 Did Somebody Say DBT?

Recently I’ve been having assessments to see if I’d benefit from a therapy programme that uses DBT and Mindfulness. After many worksheets and conversations I have been put forward for a full programme. This means one skills group and one 1:1 session a week for about a year.

What is DBT?

Dialectical Behaviour Therapy is all about breaking down negative and destructive cycles and creating better ways of coping for yourself. It has foundations in Mindfulness and Cognitive Behavioural Therapy and allows people to develop a more in depth understanding of their negative thought and behaviour cycles. It involves practical skills of how to take action to avoid dangerous behaviour. It is also about helping you to accept your struggles as part of the make up of who you are, but not your whole definition.

The Assessments

What came over very strongly during the assessments was how much hard work DBT involves. It means two sessions, plus my CPN appointment and then homework on top- every week! From what I gather it seems the skills need to be practiced near constantly (even when they aren’t required) in order for them to develop into instinct at times of need. It’s about acknowledging the problems you have, why they may be valid, why they may not, and finding strategies to overcome them.

During the assessments I had to talk about some very difficult things that I find painful. The assessment is important because it ensures that you are suitable and will benefit from the therapy. I think the wonderful Ruby Etc. shows the trouble in seeking help from services perfectly in this diagram. In mental health services you are either ‘too mad’, ‘or not mad enough’. Luckily(?) for me during this assessment it appears I struck the middle ground.

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I’ve wanted for a while to include more help and advice on Upside Down Chronicles. I’d like to be able to share skills and strategies with others and enable people to try techniques for themselves. I know how hard it is to get the help from services, so maybe getting second hand skills from UDC might just help someone. Obviously I’ll be writing as a person experiencing the therapy- not as a therapist or expert myself.  I don’t know when there will be a space for me to start the course, but I am very excited to be finally offered some formal help.

If you want to have a look and a head start, the book the programme uses has been published online for free here.