Tag: therapy

 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.

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.

‘Metaphorically Working for DynoRod Without a Toolkit’

“No negativity” Karen* says for the fifth time this afternoon. She is doling out post it notes onto the two tables at which we are sitting. She disappears to the lounge, where most of the patients still remain, to remind staff that no fun was to be permitted whilst the group was running. “Let’s make them wish they were here” she whispers to us before closing the door on the group therapy truants.

There are only four of us in the group, it is half term and I do not fancy a ‘Solution Based’ workshop. But I was woken at 8am in order to ‘be on track’ for this 2pm group and not having fun in the lounge sounded even less appetising. Every time Karen barks ‘No Negativity’ I push back my personal tidal wave of hopelessness with copious amounts of tea. The tide thrashing makes me cynical.

“I don’t want to hear about problems!” Karen, the psychologist for the entire unit, announces. In my head are many retorts, most around the fact she is in the wrong career if she is going for a negativity boycott. “This is about SOLUTIONS!” She enthuses.

Task one is working in teams to shout out ‘well done’ in as many different ways as we could. ‘Good job old chap’, ‘excellent’, ‘spiffing’: we had them all. On the compulsory group flip chart Karen listed all of our efforts. And then Karen began explaining to us, for a much longer time than necessary, how the best solution to most things is finding something that works and keeping doing it.

*Unloads barrels of scepticism*

I would say the major flaw in this theory, though I’m no psychologist myself, is that if you don’t have anything that works in the first place you’re stuffed. Considering we are all under eighteens being treated for mental illness, I’d say ‘can do’ strategies were not going to be in abundance for Karen’s niche. We find ourselves metaphorically working for DynoRod (famous sewage problem busters) without a toolkit. To find such solutions I imagine that one would presumably have to go soul searching in Thailand or gain some renewed perspective on life whilst working for a charity on minimum wage.  Karen left us to ponder this issue for a while before she suggested that if you haven’t found anything that helps you, you could ask someone else what helps them..

So in more metaphors:

Everyone has a set of Alan keys lying about somewhere. Most people have no idea which key fits what, but that something you own, somewhere in the house, requires them. If your new bike needs it’s seat heightening you try all your keys but none fit. You know from your own attempts that the key needed would be somewhere between the sizes you’ve got. What I think the message of the group was is that your Alan keys are your solutions and sometimes the ready-made solutions you have won’t fit into every problem. However, go ask your neighbour if you can borrow their useless bunch of Alan keys and you might find the answer.

I guess the theory is that a solution can be found in any problem if you just ask enough people. Which is true, I suppose. At the end of the session Karen asked for feedback.

“But remember we don’t deal with NEGATIVES or PROBLEMS.” She says as she hands out the sticky notes. What a good criteria to give out when asking for a critique!