DBT (briefly) explained

The individual letters D, B &T
stand for Dialectical Behavioural Therapy. This therapy was originally created by Marsha M. Linehan.
She is a respected leader
in the field of Psychology.

by Orla-Maeve

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Marsha, (from what I’ve read, rather painfully- and possibly; reluctantly) embarked on her own ‘journey’ to recovery. She, herself was a sufferer of a personality disorder. She was hospitalised, isolated and almost written off by every professional involved in her care.

She was labelled as ‘hopeless’ and ‘one of the most disruptive patients’ in the IOL (Institute of Living), a hospital in America.

After a long while, she managed to strategically; figure out the connection between her thoughts and emotions which in turn, lead to her suicidal behaviours- and how she might have to alter that if she wanted to ultimately: get out of hospital & build a life for herself that she would consider as: worth living.

This is usually the purpose of DBT- to help the sufferer, (usually a highly suicidal individual), initially find out what their aspirations are and the aspects of their life (behaviours also, possibly) they’d want and need to change to simply: want to be alive and actually enjoy it.

Now, I understand that for personality disorder sufferers- without a clear description of what that actually means; it can be perceived as a ‘process’ that is invalidating and, almost designed to make the sufferer feel that the way they speak or ‘behave’; is ‘wrong’. This, however; is not (and shouldn’t be) the case.

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From my personal experience of DBT, the most effective way of it being facilitated was through structure. I was initially assessed; (after years of suffering) at 23 years old by a fantastically dedicated, empathetic and extremely knowledgeable therapist (one of the leading personality disorder experts in the UK) with whom I was lucky enough to eventually engage; he works in the private sector of mental healthcare. I was originally diagnosed by NHS mental health at the age of 18.

As someone who tends to feel intense and overwhelming feelings of (mostly unjustified) guilt, shame and emptiness (amongst others), it was a big deal for me to speak so openly to yet another (lol) therapist. Bearing in mind, this was in the midst of the pandemic- so the assessment, as well as the year of weekly therapy sessions (groups and 1:1’s) that I made the promise to myself to attend (even though I sometimes really didn’t want to)- were all via Zoom.

I’m sure lots of you, as readers, can relate to how daunting it may be- (it definitely was for me!) to find the courage and take the plunge to just go for it and join; observe, describe & participate particularly in the group sessions (especially for the first time) with people: other sufferers- that you don’t know.

I know what it’s like to feel self-conscious and fearful of being judged. After a little while, I came to realise that there was nothing to worry about in that respect- I had to remind myself that everyone else was in pretty much the same boat, experiencing similar feelings and was there for their own, valid reasons- just like me.

Going back to earlier in this article, where I mentioned the effectiveness of structure- I’d like to emphasise how important it really is… to me, anyway.

I’m going to give you guys an idea of how a typical DBT group session, which would last for an hour and half- was laid out:

We’d join the zoom call- it was very important to Darryl (the expert/therapist; who has a great attitude and is funny af, by the way) that we all be right on time. This showed me that he was persistent, caring and really wanted us all to benefit as much as we could from the sessions.

We would take part in a short mindfulness activity with Darryl’s guidance… (such as a body scan, a meditation or a practical activity which would involve using a pen and paper, for example).

We’d then do a quick feedback describing how we felt, which emotions or bodily sensations came up- that we noticed and (honestly) whether we enjoyed it or not- free of outward judgement, which is helpful! Immediately afterwards, we would take part in skills training which was the main focus of the group.

There are different modules (such as interpersonal effectiveness, distress tolerance etc.) with different sets of skills very nicely formatted (by Marsha, thank you! 😂) in a rather text-booky looking skills training manual that one would refer back to during the sessions and outside of the sessions, as each week we were set a ‘homework’ task- usually to practise a different skill, or listen to a different audio (or both) and then return the following week to give homework feed back (which if I remember correctly was either right before mindfulness or sometimes right after the skills training part, before the end of the group).

We’d talk about what we did and how we found it, somewhat in-depth; whether it was challenging or not- to put it simply.

It’s imperative to be made aware that the variety of modules, including the range of skills, may be more applicable/appropriate to different individuals. As your own individual, you will eventually figure out what skills (or sets of) may be most effective for you- or most fitting to combat or prevent a specific negative emotion, action or event. You would also learn how you might be able to effectively problem-solve and regulate your emotions, in conjunction with each other when stressful or emotional situations (such as being made homeless, a loved one dying, a nasty breakup- just to provide some examples) arise in your life.

Another important thing to remember is that you are worthy of feeling better, it’s difficult- you must persevere with the therapy as difficult as it is. You must be patient with yourself. You deserve to give that to yourself and maybe to others- that is if you exhibit criminal, dangerous or ‘problematic’ behaviours.

Some of the skills are actually designed to cause a small amount of distress- (not so much *hopefully!* that you reach crisis level), but just a bearable amount to enable you to assess which skills are appropriate to use, when to use them and how to put them (usefully for yourself) into practice. Personally, I found it best to arrange my sessions as follows: Monday evening I would have the group- I would have my 1:1 with my other therapist on the following morning, so that what I learnt along with any difficult emotions that came up during, were still fresh in my mind and I was free to rant accurately… I hope that makes sense!

must fully disclose that I am not, by any means, a mental health professional or licensed therapist. I am just sharing with you what I found useful when I was suffering. I’ve learnt and absorbed that in life there will always be the possibility of pain; emotional or physical. But as humans, it’s okay to ask for support, be truly listened to (and heard!) and acknowledge that we might need that- to not let the pain turn into ongoing suffering; and when we are trapped in suffering, how to reduce that.

Quote of the day

You cannot control how others feel about you,
you cannot control if other people like you,
you can simply be the best version of yourself"
- Alicia Menendez

I hope you’ve found this insightful, motivational & inspiring....sending love 💚

Reading time:5 minutes

Keywords: DBT, skills, sessions, therapist, group, therapy, homework

Words: 1,260