Has anyone recieved DBT Treatment?

[*Sapphire*]

Hi

I am due to be finishing my Dialectical Behavior Therapy treatment for borderline personality disorder.

Although I am alot better now than I was when i started and am controlling impulses I do have some issues with it such as that I feel it does not really deal with the underlying causes of bpd. However i have a good therapist who realises i have other underlying problems and she is referring me for further therapy, so i do not have to live a life where i am just using skills to cope and prevent self damaging behaviors, hopefully this therapy will help me to understand and thus prevent me from having the impulses to do self damaging behaviors begin with.

However in saying that other people in my DBT group seem to have come on leaps and bounds and it appears to have really worked for them.

I feel VERY fortunate to be in the program, i am in the first ever group to be run in the area and now there is a huge waiting list of people wanting the treatment. I also feel that the fact that you can contact your therapist from 9am-7pm on a mobile phone for skills training is excellent (although this may vary from therapist to therapist and in different areas) and has been of invaluable help to me. Whereas in the begining i was calling quite often i now hardly ever call because i know what to do and can almost hear the advce she would give me without her being there. I liked their philosophy that crisis's don't often happen whilst you are in the group or seeing your therapist but in real life! - so true!

I was wondering what others thought of it?

I keenly await your replies (if any!)

 

[keepsafe]

Sapphire
I am glad you are getting some help thats nice.
I have had 6 sessione for coping strategies and am waiting for more therapy. I find it a constant struggle to apply the strategies - it was ok sort of whilst I had the therapist there to reinforce things but I have slipped again back in to desperation.
I am glad it is making a positive difference to you
KS

 

[*Sapphire*]

Thank you for welcoming me Keepsafe. I am sorry to hear that you are having difficulty applying the strategies and coping mechanisms, but am glad that you are getting referred for further therapy and I hope that you get it soon.

With regards to your problems of applying your strategies i wondered if applying something i learned might help. In DBT we are given diary cards which we have to complete each day. On these cards are details of strategies that we are taught, and we have to tick each one that we have used that day. We then have to give them scores, of 0= not thought about or used, 1 = Thought, about not used, 2= Thought about, not used, wanted to, 3= Tried, but couldn't use them, 4=Tried, could do them but they didn't help, 5= Tried, could use them, helped, 6= Didn't try, used them, they didn't help and 7= Didn't try, used them helped.

In the begining i was logging mainly 0s, but now i am logging mainly 7s!

The beauty of logging whether you used your strategies and whether they worked or not is that you can personally look back in hindsight and look for alternatives for any damaging behavior you may have done, and/or reasons why you might not have used them so next time you are in that situation you can avoid or pre-empt the blocks that might stop you using a healthier coping strategy.

Also having to look at the healthy coping strategies every day by using the card somehow imprinted them in my mind, so when i was in a similar crisis situation they came to mind quickly.

Another thing i did was laminate my healthy coping strategies, in laminates small enough to fit in my wallet, others to go in my diary, some for the fridge, and some for upstairs, so if my mind was in such a state that i could not recall them i have them written down everywhere and anywhere i go.

I wondered if it would help you to write your own diary card with the strategies you have been taught for your own personal use and as a motivator/reminder to use them.
Even when i finish DBT i think i might continue to use the cards for personal use as they have been so helpful and insightful for me!

Of course I am not a therapist and am certainly not going to undermine anything they may have told you, but in my experience in any therapy, looking back in hindsight, looking at how and why you are not using your healthy coping strategies and re-iterating the skills you have been taught in different forms so that they are accessible is seen to be helpful. In fact in most therapies that I have been in this practice has been advocated.

If this of course contradicts anything you have been advised by your professionals please do ignore me! And again I do hope you receive your further therapy soon and that it is of benefit for you!

I hope that helps!

 

[keepsafe]

Thanks for the post - I have lists of coping strategies written down, I am keeping a mood diary - I just haven't really been applying them all lately - I need to make more effort - I am trying.
I have almost given up filling in the squares every hour - I don;t see what agitation 10, anxiiety 6, low 2 does for me. I am currentlty trying to block my voices with LOUD music cos I am in a bit of a state
Thanks though - of course your post is helpful

 

[Devon]

Arent you the lucky one ?

Apparently I am not severe enough to be one of the lucky ones to receive this treatment.

but then Mental Health is a cinderella service in Devon.

 

[*Sapphire*]

Arent you the lucky one ?

Apparently I am not severe enough to be one of the lucky ones to receive this treatment.

but then Mental Health is a cinderella service in Devon.

Hi Devon and to the forum!

Yes I do consider myself very fortunate to have the treatment. And I am so sorry that you do not have access to it yet. However with the successes of the treatment in other pilot areas as well as ours I do hope that the treatment will become more widely available and that the numbers allowed to take it up will increase. I am certainly going to continue to advocate it in the hope that other areas will see its value so more funding is available to increase numbers, so I am your side! All i can say that may help you in the meantime is that I have found a website that describes the skills being used in DBT Therapy which may help you. Of course I do realise that it is no compensation for receiving the actual treatment itself but you may find some value in the skills described there. The website is:

http://www.dbtselfhelp.com/

I have been in the mental health services for over 15 years and in my experience you can have some impact on the treatment you receive regardless of how hopeless it may feel and how long it may take, so if you can, please do keep on pushing for it. I am sure there are others experiencing the same predicament as you in Devon so with your pressure along with others they may realise that the need for the treatment is exceeding the help they are providing. In the meantime please do keep on posting, there is a wealth of help, knowledge and experience available on this site.

 

[TabbyToes]

My psychiatrist suggested DBT yesterday. I think he picked up on the fact that the idea went down like a lead balloon with me and dropped it pretty quickly.

In my favour, I am starting to see a psychologist tomorrow. If there's the opportunity, I'll talk to her about it and see what she says.

I just don't do good in groups, which is what this would have been. I don't really understand what DBT is ~ from the little I've read, it's used for people with borderline personality disorder (that doesn't sound right) and as far as I know, I don't have that.

 

[*Sapphire*]

Hi TabbyToes

Yes DBT is mainly used for people with a diagnosis of BPD, however it uses a variety of strategies that are accumulated from all sorts of different therapies, so it is not unusual for it to be suggested as a form of treatment for other diagnosis.

The group is usually run once a week and lasts approx 2 1/2 hours. However apart from going through your skills card, in my experience there is little you have to contribute. What you receive is known as 'Skills Training' where they teach various coping mechanisms, and strategies to help you deal with crisis and general every day life. They of course do encourage participitation however in my experience if you are having a bad day they do account for that.
In fact many people in my group were also adverse to attending a group, however as we are now at the end, many of them are saying that they rather wish it would continue! A complete reversal!

There is alot on the web about DBT, personally I have found it most helpful and I know there are alot of others that have too that do not have a diagnosis of BPD.

 

[TabbyToes]

Thanks. I think I wouldn't mind too much a group if the facilitators could get a grip and run the course the way they say they will, instead of letting the people on the course do their own thing.

I worry a great deal about upsetting others and I know that I have and do upset people... and it really doesn't help when they say one thing and do another.

 

[*Sapphire*]

Ahh to put your mind at rest TabbyToes, in order to prevent the persons attending the group from taking over and doing their own thing, as well as potentially upsetting others there are strict rules about what you can and can't say. You have to sign a contract about this, and it is discussed in your first group. This is something every DBT group has as defined in the DBT manual they all work off designed by Marsha Linehan the developer of DBT.
For example if you have self harmed and you need to discuss it, you are not allowed to say how you have self harmed etc.
There are also strict rules governing relationships with the persons within the group, even outside of the group times. These include not mentioning past/current behaviours, or discussing specifics of your therapy. And also includes not having a mutually exclusive relationship that excludes other members of the group. Some groups have gone as far as banning group users from contacting each other on facebook.
This is nothing to get alarmed about, I have found it most helpful and in my experience if someone has gone beyond the group rules then the group therapists do handle it tactfully.
I hope that helps to put some fears you may have at rest. There is alot about DBT on the web if you want to look it up.

 

[TabbyToes]

Thank you. That's actually helped a lot. As I said, I'll talk to the psychologist about it tomorrow, but I don't think I really want to add anything else to the pot right now. It will be useful for the future though.

 

[thebubbles22]

Hi Sapphire77,

I am also in DBT with the diagnosis of BPD. I have been seeing my individual therapist for about 10 months, and have had 5 weeks of group sessions. It's all still relatively new to me. I do the exact same diary cards as you, which I'm struggling with as I still don't know too many of the skills.

I was just wondering how long you have been in DBT for and what sort of therapy they are recommending for you to have after to deal with deep seated problems, as I may also have to do that.

Love and Hugs

Bubbles
x x x

PS. For all you others who are in DBT and who especially struggle with being judgemental, what we do in my group therapy is we have one of those types of metal bowl things that you can chime, and it is chimed every time someone says a judgement, and you have to rephrase it in a non-judgemental way.. Eg. "I hate my life" could be rephrased to "I'm struggling to see the good aspects of my life" or something... Sounds daunting and a bit unnatural at first, but it does actually help in the long run!

 

[*Sapphire*]

Hi Bubbles

I had the 'skills training' for 18 months. My group repreated the 'skills training' twice, so that you really get to grips with them.

I have personally found it life changing, and so helpful doing it twice as it really re-emphasised things I may have missed before.

That is such a good idea chiming the mindfulness bell every time you make a judgement, our group didn't do that, but I might recommend doing that to my therapist as our group was the first to be run in our county and they actively encourage feedback like that and I think that might be helpful! So thank you!

I finished the group two months ago, however am still having individual therapy for a while as my life had changed so much since I started DBT, in a good way but I just want to make sure things have settled before I finish. That is the beauty of my DBT, that finishing therapy is a joint decision and is not based on funding but on a needs basis. I also found the mobile contact so valuable. If you have that option do call them if you are struggling because as they say the skills have to be applied outside of therapy in real life, rarely when you are in therapy. Now I rarely need to call, because I know what my therapist may say and can apply the skills accordingly! My therapist used to tell me off if I didn't call and I was struggling, which was great because I didn't feel guilty about calling after that!

With regards to my deep seated problems my therapist and I are writing a letter jointly to the psychotherpists in the area to get me some long term therapy to deal with my underlying problems. As they quite clearly state DBT helps you deal with the current damaging coping mechanisms you might be using but rarely deals with the underlying causes. I have a long history of PTSD and problems so hopefully this long term therapy will help me not have the urges to use damaging behaviours to begin with. But as they say in DBT there is no point entering therapy before DBT, because therapy might bring up so many memories that you might have the compulsion to use damaging behaviours which could be viewed as therapy interfering behaviours which could jepordise your therapy. I now feel confident that I can bring up those memories without engaging in some form of self harm to cope, if that makes sense??!

Some people on my course are getting specific PTSD therapy and some are getting the second and third elements of DBT as a result. What is good about DBT is that they refer you to further treatment to accomodate your needs. In my experience they do not dismiss your ongoing needs but validate them and do what is seen as in your best interests which is usually a joint decision.

Please do let me know how you get on with it. I had some criticisms with it, which have been acknowledge by the course therapists and they have amended the next course as a result, it's not perfect but in my experience it has been life changing

 

[*Sapphire*]

PS if you want to be reminded to do practice mindfulness every hour of every day you can download a 'mindfulness bell' to chime on your computer every hour. This has been great for me. If you type it in google you can download various ones.

Mindfulness has been the greatest (if hardest) skill that they have taught me. It is hard, but do keep at it, once you have got it, it has so many benefits!

 

[thebubbles22]

Thanks so much for the inspiring and positive post, Sapphire77!

I agree with the DBT before any other kind of therapy. There is no way that I could deal with my deep rooted problems without learning how to manage my self damaging behaviour.

I will let you know how it goes

Love and Hugs

Bubbles
x x x