Introduction to DBT
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
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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@QuietMagic
Me and my DBT therapist were just talking about invalidating experiences today! I talked about how, in short, wanting revenge on my abusive ex was invalidated by my current bf who didn't want me to act out in anger towards my ex. I really wanted my ex to understand the depth of pain he caused me and being told to let it go and move on was invalidating. This was earlier this year so my emotions have settled and I'm just stuck with embarrassment at being such a resentful person. Sure, he was abusive, but that doesn't mean I have the right to stoop down to his level. Even though my ex will never validate how sorry I wish he was, I can validate myself and so can my bf and therapist with validating my true, deep pain and trauma from what I've been through.
I'm most interested in Mindfulness as a module because I've struggled with this for yearsss and I keep being told in individual and group that it's so important for anxiety and I'm just not very good at being mindful yet so I need a lot of practice.
@StrawberryShaken
Yeah, you had good reasons for feeling angry (being abused by ex). And being told to let it go and move on is sort of like "You shouldn't be feeling angry." 💜
Maybe it was fortunate that you didn't end up acting on those feelings and taking revenge because you'd have felt worse about yourself in the end (i.e. stooping down to his level). But it certainly makes sense that you wanted revenge and that you felt angry.
I wonder if there's something about mindfulness that makes it feel really difficult for you. For me personally, sometimes it feels like, "If I check in with my body right now, there are going to be uncomfortable feelings." So it kind of becomes a question of "do I feel safe letting myself be vulnerable/sensitive right now".
@QuietMagic That last part was really helpful for me, thank you !! I think that's been my issue with mindfulness too
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?
It was happenning within my family. My parents were used to be not happy how I react to things which are really painful for me. I am quite sensitive person and back then my reactions were called hysteric and dramatic. The causes of reactions and my actual feelings were ignored. Their actions were directed more to getting me silenced and preventing even remotely showing my reactions out. It didn't make real change for me, more it caused hiding my reactions. To extent that even crying while not alone would end in the shame. Of course, it is not what anticipates the change in a positive way.
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?
Basically everything, more or less. To distress tolerance and emotional regulation I'd put the most focus though, mainly because recently or so I realized my emotional sensitivity and struggles when it is a distress. I realized how it was and keeps beating me. I feel things (emotionally) so sharply that I almost immediately get into the feeling, it lasts much longer and being more intense than for people around me.
@windSpirit
Sorry that your parents were so dismissive of your feelings. ☹️ Yeah, it didn't resolve the feelings but rather just added a new layer on top of "I can't show this around other people or else bad things will happen".
I hope you're able to find things that help with that emotional sensitivity, whatever that ends up looking like (e.g. feeling like it's safe to be sensitive, noticing things that make the sensitivity less painful, distractions/self-soothing to have some ability to shape the direction of feelings, etc.) 💜