I have had a bit of a blogging break recently whilst I focused on completing my Dialectical Behaviour Therapy (DBT) and wanted to share with you what I have learnt in the last 10 months. I will run a series over the next few weeks of everything I have learnt.
I would like to add that I have taken part in DBT sessions, but I am not trained and this information is for reference only. Please contact your GP for medical advice.
What is Dialectical Behaviour Therapy (DBT)?
DBT is a therapy designed to help people change patterns of behaviour that are not helpful, such as self-harm, suicidal thinking, and substance abuse and is often used as treatment for Borderline Personality Disorder, which I have. It is a pretty intense therapy and usually it’s done in a group setting, every week, in two hour sessions.
What is Borderline Personality Disorder (BPD)?
BPD sometimes known as EUPD (emotionally unstable personality disorder)is often seen as untreatable and is arguably one of the most stigmatised mental health disorders. To reach the criteria you need to meet at least five of the following.
- Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned
- A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
- Distorted and unstable self-image or sense of self
- Impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.
- Self-harming behaviour, such as cutting
- Recurring thoughts of suicidal behaviours or threats
- Intense and highly changeable moods, with each episode lasting from a few hours to a few days
- Chronic feelings of emptiness
- Inappropriate, intense anger or problems controlling anger
- Difficulty trusting, which is sometimes accompanied by irrational fear of other people’s intentions
- Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality
What are the four DBT Modules:
- Mindfulness – Which for me is the core to everything DBT. Mindfulness exercises bring you back to the present moment and help you refocus. Mindfulness is not all about breathing and you will find you can do many different mindfulness exercises using different senses. Not all will work for you and they do take practise and patience.
- Interpersonal Effectiveness – This is to do with how to interact with others. It teaches you how to go about asking for what you need effectively, also how to say no and how to cope with conflict in relationships. People with BPD often have good interpersonal skills, but are emotional vulnerable and struggle under this pressures to effectively to use these skills naturally.
- Distress Tolerance – This skill has been something I have had to use many times and it has made my life so much calmer and easier. Unfortunately sometimes we need to find a way to tolerate and accept distress skilfully and this is what this module teaches. Mindfulness plays a big part in this skill and the two go in hand in hand. With certain distresses we need to find the ability to accept in a non-evaluative and non-judgemental way with our self and the current situation. This module teaches how to survive in a crisis and accepting life in the moment. The skills you are taught are distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus wilfulness.
- Emotional Regulation – With BPD you are emotionally intense and this module teaches you how to regulate your emotions. To do this you learn how to identify and label emotions, identify obstacles to changing emotions, reducing vulnerability, increasing positive emotional events, mindfulness to current emotions, using opposite action and applying distress tolerance.
DBT teaches you how to manage emotions and relieve suffering to stop ending up in crisis. It is long, mentally hard, but also very rewarding therapy. I have made some great friendships within my group therapy and it has changed the way I go about life. MY BPD symptoms are greatly reduced and so is my suffering.