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Introduction to DBT

QuietMagic October 12th, 2021

DBTuesday

Based on feedback from our recent forum activities survey, we are restarting DBTuesday. This will be a series of posts where we will explore skills and concepts from dialectical behavior therapy (DBT).

This is not a substitute for professional therapy, but there is some research showing that standalone DBT skills training can be helpful for a variety of mental health issues, including disordered eating, mood disorders, anxiety, ADHD, and BPD.

Benefits of DBT

DBT is an empirically supported therapy that is often used in treating BPD, eating disorders, substance use disorders, suicidal ideation, and self-harm. These are a few examples of experiences that DBT can help with:

  • Intense emotions or mood swings

  • Volatile relationships

  • Feelings of hopelessness or emptiness

  • Use of risky outlets for managing stress


Origins of DBT

Marsha Linehan developed DBT in the 1980s while working with clients experiencing suicidal thoughts, many of whom had BPD.

The most respected treatment for many mental health conditions is cognitive-behavioral therapy (CBT). CBT emphasizes identifying and changing problematic thoughts, feelings, and behaviors.

However, Linehan noticed that many clients with BPD grew up in deeply invalidating environments. As a result, the change emphasis of CBT sometimes felt to them like a repetition of all of the invalidating messages they received while growing up: "There is something wrong with you".

DBT tries to resolve this by putting a greater emphasis on acceptance and mindfulness. The reason it is called "dialectical" is because it tries to bring together two opposite things: acceptance and change. Before a person is able to make certain changes that are helpful, they might need to feel as though they have been understood, validated, and accepted as they currently are.


The Four Modules of DBT

DBT skills are organized into four modules.

1) Mindfulness: learning to experience the present moment with non-judgmental awareness

2) Distress tolerance: learning constructive ways of coping with difficult situations and feelings outside one's control

3) Emotion regulation: learning to understand emotions and to find ways of changing one's emotional reactions to be less negative and more positive

4) Interpersonal effectiveness: learning skills for creating healthy relationships where it’s possible to have one’s needs met and manage conflicts

Questions for Reflection

1) Describe a situation where someone tried to change you but it ended up feeling invalidating. Did it make you more or less likely to change in the way that they wanted?

2) Of the four DBT modules (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness), which one feels like it appeals to you the most and why?


Sources:

https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/

https://eddinscounseling.com/bringing-acceptance-and-change-together-dbt-therapy/


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Sunisshiningandsoareyou October 12th, 2021

Hi hi @QuietMagic , this is such a well researched, well articulated thread, thankyou for investing your time and efforts . Much appreciated 😊

Out of the 4 modules, emotional regulation appeals the most to me, I feel that often there can be a fine line between our emotions controlling us and we controlling them , the former part is what can be detrimental to ones emotional and mental health also could affect our relationship with self and with others . So I like the idea of not necessarily "controlling" but regulating our emotional reactions, in a better light , in ways that are not negatively affecting to us or to those around us in anyways!

While browsing for more about this topic, I came across this wonderful article and some useful resources , sharing the link https://positivepsychology.com/emotion-regulation-worksheets-strategies-dbt-skills/ , if anyone wants to check out 😊

1 reply
QuietMagic OP October 13th, 2021

@Sunisshiningandsoareyou

Thank you for the kind comments! There will definitely be more threads like this in the future. 💜

I like the way that you've described regulation as being like a middle ground between a couple extremes:
1) "Being controlled by emotions" = being completely overwhelmed by emotions in a way that feels unhappy, like being on a roller coaster and wanting to get off
2) "Controlling emotions" = trying to rigidly clamp down on emotions in a way that feels unhappy by virtue of being impossible/repressive

Thanks for sharing the article and resources!

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AffyAvo November 17th, 2021

Thank you for posting this!

I found when I came here it was pretty much expected everyone knew what CBT and DBT were. I went through all of my undergrad without having heard these discussed, including an intro psych course (no treatments nor types of therapy were covered). While there are a number of people here with psychological education or experiences with therapy, I think there are also a good number of us who don't have a lot of that.

This is a great explanation where I don't need to go seeking out google to understand some of the information.

1 reply
QuietMagic OP November 17th, 2021

@AffyAvo

Glad it makes sense!

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AffyAvo November 17th, 2021

1) Describe a situation where someone tried to change you but it ended up feeling invalidating. Did it make you more or less likely to change in the way that they wanted?

Yes to the invalidation! There are things I want to change about myself, but I don't find they often match what someone else wants to change. Ie. I'm worried about something - they say don't worry. I would much rather the thing that is causing the worry wasn't there, but I don't want to change how I respond to that thing.

One time I called customer service about an issue with groceries - I didn't have the things I ordered to make dinner. He said it wasn't a problem - without any help in ensuring that I would have food that evening. My response to that wasn't one of agreement. Simply rephrasing it as not a problem certainly wasn't what I was looking for when I called!

2) Of the four DBT modules (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness), which one feels like it appeals to you the most and why?

Distress tolerance - I have a lot of symptoms and if I can't eliminate them, this sounds like a good way to help with coping.

1 reply
QuietMagic OP November 17th, 2021

@AffyAvo

That's a great point that it can also be invalidating if you're interested in one kind of change but the person you're talking with is fixated on a different type of change that doesn't match what you're interested in.

Love your example of the customer service representative: "My issue isn't that I need your help in changing my attitude toward not getting my order. My issue is that I need your help in changing the fact that I haven't received my order." 😊

I'm also really looking forward to the posts on distress tolerance.

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mytwistedsoul December 7th, 2021

Sorry I'm way late on this. I've tried this before with a therapist and Idk - It's a struggle - so I thought maybe I can work on it on my own - slowly and hopefully I can grasp it better

1) Describe a situation where someone tried to change you but it ended up feeling invalidating. Did it make you more or less likely to change in the way that they wanted? Long story short - I have trouble with emotions and talking and talking about emotions - so when I do it can be kind of a hurrah moment. But I've had someone give me a how dare you speech. They claimed that by talking about my feelings - I was invalidating their feelings - which invalidated mine too - and started alot of problems so I just ended up getting more and more quiet and confused - about all feelings in general

2) Of the four DBT modules (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness), which one feels like it appeals to you the most and why? I actually need to work on all of them lol - but I think since emotions are the biggest problem - I'll go with emotional regulation because I think they affect everything and maybe if I can understand them better - maybe I won't shut them down all the time?

4 replies
QuietMagic OP December 9th, 2021

@mytwistedsoul

Hi, no need to apologize. 😊 Hope that the self-paced exploration feels like less of a struggle.

That sounds like a really hard situation. 💜 After not really being able to express yourself, you finally did but someone ended up getting angry at you for sharing those feelings and said that it was hurting them. So then it's like, you don't get to share anything or feel heard. And all of these things you're already reluctant to share end up getting labeled as bad. And it ended up making sense to share even less (if the result of sharing is that people will react in a way that just makes things more painful). 😟

If you're interested in looking at emotional regulation sooner (since it might be a little while before DBTuesday gets to that topic), here's a link:
https://dbt.tools/emotional_regulation/index.php

3 replies
mytwistedsoul December 9th, 2021

@QuietMagic Thank you for your reply and yes exactly 😢 I read your words and could have cried because that's it exactly. Everything I want to say I question - can I say that? Is this feeling right? And in the end - I just keep it to myself because it's safer that way but I know it's not healthy either

Thank you very much for the link! I'll definitely check it out

2 replies
QuietMagic OP December 9th, 2021

@mytwistedsoul

FYI, if you're ever interested in chatting 1-on-1 (or offline messages back and forth), feel free to send me a PM. 💜

1 reply
mytwistedsoul December 10th, 2021

@QuietMagic I'll keep it in mind Thank You

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StarlitSky4762 December 21st, 2021

@QuietMagic thank you for making this post!!

1 reply
QuietMagic OP December 21st, 2021

@StarlitSky4762

Sure, no problem!

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Sonnenschein2000 January 1st, 2022

@QuietMagic

I want to thank you for the effort you put into researching and writing this thread! I will follow it for sure! It's all so clearly explained and easy to understand, though this doesn't mean it's superficial!

I'm having a hard time regulating my emotions in distressing/non distressing situations, I invalidate and criticize myself to the point it gets overwhelming, and I hope leaning more about DBP will help.

Thank you again!


1 reply
QuietMagic OP January 1st, 2022

@Sonnenschein2000

Thanks for the feedback! Glad that it felt like it was readable while still being informative. 😊

Re: the self-criticism and invalidation, just going to pass along a link to this thread in case if it's relevant.
https://www.7cups.com/forum/PersonalityDisordersSupport_81/DBTuesday_2147/Module1MindfulnessDiscussion8NegativeJudgments_265576/

If you ever want to talk about anything, feel free to schedule a chat with me.

1 reply
WhiteRoses25 January 25th, 2022

@QuietMagic

I like how you’re able to make things easier and understandable. I also liked how you are able to incorporate how others may feel and how it can be addressed. 🤍

1 reply
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purpleTree4652 July 15th, 2022

@QuietMagic

Hi, Magic,

1. my ex would tell people things I intimated to him about them, and sometimes the person would confront me about it. instead of helping me in any way, it made me feel like a child

2. interpersonal effectiveness, because I seem to frequently be at odds with people whom I need to be more in harmony with, like co-workers

toucans July 15th, 2022

@QuietMagic

1. I have been told that I am "too emotional" and have been pressured into what I call the "Stone-wall front." It felt invalidating to me because it was like my coping mechanisms weren't enough and I felt like I was not being heard or taken seriously. It just added fuel to the fire in the long run... I did change in the way they wanted for a bit, but the issue only grew, so when it came to my boiling point, I exploded with emotion. So, I guess in the grand scheme of things, it did make me less likely to change in their way.


2. 2&3 appeal to me the most because I feel like this is where I tend to struggle the most.

patientOwl1988 July 19th, 2022

It’s really great to be a part of this

@QuietMagic Very informative post, thank you for making it available.