What is Dialectical Behaviour Therapy (DBT)?

What is Dialectical Behaviour Therapy (DBT)?

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.

 

 

 

Facebooktwitterpinterestlinkedinrssinstagram
A marriage over and new chapter

A marriage over and new chapter

Writing about how I feel and be honest is something I have found incredibly difficult since my marriage ended in the summer. I feel like I lost my voice and I needed some privacy, whilst I sorted my own head and feelings, but as time has gone by, things have moved forward, emotionally I have found it difficult not having an outlet. I know I need to write for my own sanity, but having the pressure of coming up with content, that reflects me in my current state, that is honest and true to my blog has felt like a massive burden that I have put off. Today I have decided that I need to take the plunge, stop worrying about what everyone else thinks and do something that I love for myself again.

I don’t want to go into too many details, but since my marriage broke down, the months that followed have been the hardest of my life, but also some of the best too. I know I made the decision for the right reason and although painful, it was inevitable. For me my marriage had been over since my suicide attempt at the end of January, but it took months of discovery to finally realise that it was un-fixable and for my own mental wellbeing I needed to end things. Once you fall out of love with someone I don’t think it is possible to ever get it back. I still have the so much respect for my ex husband and think he’s a wonderful father to our children.

A marriage breakdown is incredibly hard and co-parenting children is its own battlefield. With the best intentions of keeping things amicable it’s not been easy for either of us at times and we have pushed each other to the limits. I hope now that we do keep moving forward and keep things amicable for our beautiful children, that we will always share together.

Another big thing to happen in the last few months is to date again, which with two children comes with its own challenges. The right time to date again after a relationship breaks down is different for everyone and I am the first to admit I did move on quickly, but like I have said before I had fallen out of love and hoped to just get back out their and date again. I haven’t dated since I was 20 and I would quickly get bored and move on, but I also found it lots of fun meeting new people and going out for drinks and meals. I took the plunge and went on a date with a guy who I had been messaging and it really was the best thing to happen to me last year. I have met someone who adores me and my children and makes me want to better myself. I now feel like I have a team-mate and someone I can be honest with and doesn’t judge me.

I am well aware for anyone to have a relationship with me isn’t always easy (hats off to my ex for dealing with me at my rock bottom, I do give credit when due), so to find someone who is accepting and wants to understand me better is rare and beautiful. I have borderline personality disorder (also known as emotionally unstable personality disorder), so as a person in a relationship I know I can be pretty draining at times and hard to understand (romantically and also in friendships). My emotions at times can be all over the place, but with the help of DBT (dialectical behaviour therapy) things are far easier to manage than before. I have DBT as a group therapy for two hours a week, which involves lots of homework. I am learning new skills that I am now able to put into practice and although not easy, it is so rewarding being able to see how far I have come in such a short space of time. I still have months ahead of DBT to complete, but I am hoping it’s something I can stick with and I can change for the positive.

Since November I have been getting extra support from the childrens centre and also the health visitor, who have been able to help find me resources and advice that I have needed for the various things going on in my life. I was visited today and after a crappy couple of weeks I was feeling on the teary side, but thinking back now to the conversations we had I think I should be pretty proud of myself. I was reminded constantly today of the various things I have done for myself and children to make our life easier, the extra support I have asked for and my proactive attitude I have had. The problems I have had I have actually managed to fix myself with little help. I have not only been meeting my childrens basic needs, but I have also been meeting their emotional needs. My children are given cuddles, read to, played with and reassured, which may seem small, but those selfless actions help shape them and make them feel secure. I was today reminded of something that I often forget, that despite everything else I am a really good mother to my children and they are loved.

Reflecting back on these last few months I have grown so much and managed to go through an incredible hard things, yet stay positive for the most part. Things are far from perfect and I am forever battling with myself, but I know I am getting things right and I am progressing and learning on the way. I am going to keep writing for me and doing something that I love. I am doing the best I can and that is ok. Leaving 2017 I do have regrets for how I handled certain things and people I upset, but for my own wellbeing I can’t keep dwelling and I just have to accept, learn and now move on to a better 2018.

Facebooktwitterpinterestlinkedinrssinstagram
Mental health awareness month - Borderline personality disorder

Mental health awareness month – Borderline personality disorder

Last month was maternal mental health awareness week and I got an amazing response from my blog post of my battle with postnatal depression, maternal mental health awareness week is part of mental health awareness month so I thought I would share my experience with borderline personality disorder (BPD). BPD is still not really talked about and still has a massive stigma attached, people often don’t understand it and it’s something people don’t like to admit that they have. Like everything on this blog I am open about my personal struggles, but I do struggle to write about BPD myself, so I will try to do it justice by being open and honest.

BPD has affected me since my teenage years, but was only diagnosed in January after a suicide attempt. It is thought that around 1 in 10 people diagnosed with BPD will complete suicide, many more will attempt suicide. People really don’t like talking about this and it makes people very uncomfortable. For me I just wanted to end the pain I was feeling in that moment not necessarily end my life, but like most stuff BPD related I act on impulse. Many people who suffer with BPD also self-harm and it’s something that has effected me mildly on and off since my teenage years, again this is something I find very difficult to talk about and so do others.

Since I can remember I’ve had a real fear of abandonment and have taken extreme measures in relationships to stop that happening, which has made things worse and often left me alone. My emotions can me very intense from very happy to very sad and can change quickly. I can start the day feeling elated and end the day with negative, dark thoughts. It’s like being on an emotional rollercoaster and I struggle to predict my own moods. Antidepressants do seem to have made this much more balanced than it used to be, but the dark, intrusive thoughts do creep back in.

BPD affects people in different ways and sufferers usually have problems with impulse control, there are continuing studies into why this part of the brain seems to be wired differently with BPD sufferers. Often PBD sufferers will have an eating disorder, for me I binge eat, I binge so much I physically feel sick, I know if I could be sick I would force myself to be, but I am unable to (I have a strange phobia of being sick and am sick very little even with a sickness bug). My impulse doesn’t stop just at eating it also is a problem with spending, which I am learning how to control. Often drug addiction and alcohol can be become problems for BPD sufferers and it’s something I am very aware of, I did have a mild problem with prescription drugs and have used alcohol in the past to numb emotions, luckily I don’t actually like the taste of alcohol.

With PBD I feel lots of paranoia, this is constant and even amongst good friends, I am forever trying to rationalise these thoughts and worry about what others think of me, It’s pretty exhausting, but I’ve made good progress at coming to terms with this. Questioning these thoughts has helped me understand them better.

Many people still think BPD is a lifelong mental condition and there is no cure, I know I did when I was diagnosed. Luckily with so many advances in treating mental health over the last twenty years there has been a talking therapy developed to help BPD suffers called dialectical behaviour therapy (DBT), which is a form of the better known cognitive behaviour therapy (CBT) that is specialised for BPD patients. I started DBT recently and have found it really helpful, I hope to write a blog post once I have learnt more.

Unfortunately many people with BPD often feel empty and alone and I think the fact that this disorder like many other personality disorders are not talked about just makes the problem worse. Don’t be scared by someones condition, be mindful, open and always caring. People with BPD usually always have great empathy which to me is my greatest personality trait. I understand people and appreciate people for who they are and am great at listening and trying to help people.

Many people with BPD are also diagnosed with another mental disorder at the same time like depression, addiction, eating disorders and anxiety. It might not seem like it at the time but having more than one mental disorder can help work out what care will work best for you.

I hope I have been able to describe how BPD has affected me, but my experience may be different from someone elses, to learn more look at the Mind website  for a full list of symptoms. Keep spreading the love and do everything you can to help mental health awareness month be as powerful as it can be.

Facebooktwitterpinterestlinkedinrssinstagram

The obstacles of accessing mental health care as a mother

I need to have a bit of a rant about the obstacles I have had accessing mental health care as a mother in England. I feel like I am banging my head against a brick wall, trying to get help with my mental health problems, whilst finding someone to look after my child. Just like anything to do with parenting it is a juggling act and since the birth of my second child two years ago I have felt a constant struggle to access support for my postnatal depression, anxiety and borderline personality disorder. Things got so bad for me at points that I was under CRISIS team care twice and I attempted suicide.

After lengthy waits and weakening mental health you finally get an appointment for cognitive behavioural therapy (CBT) and then you are met with the challenge of who will look after the baby? Like so many of us we don’t have access to childcare to go to these appointments and we miss out on crucial help. I have just completed CBT which took 3 months to get my first appointment and between appointments I had a minimum wait of 3 weeks between seeing someone and maximum of 6 weeks. CBT was helpful, but I had to be proactive and help myself as much as I could, which I couldn’t do when I was at my weakest. Not only could I not get appointments with my therapist I also couldn’t find someone to watch my child.

I have found this a relentless battle for accessing mental health care. I didn’t get everything I could out of CBT as I just wasn’t able to see someone enough and on a few occasions I had to cancel appointments when I needed it most, as I had no one who could help me with childcare. Like many people in my generation my parents still work, my other mum friends work and my husband also works long, unsociable hours. Between having the school runs to do with my oldest child and finding someone to watch my son for a couple of hours it was proving impossible at times.

I tried for over a year to get better by seeing various people, counselling, CBT and a private therapist and each time I had to stop before I felt ready, because of childcare. I am now starting diareltic behavioural therapy (DBT) which will be for 2 hours, once a week between 2-4pm, this is a group sessions and only runs once a week, so my hands are tied. I am doing everything I can to sort childcare, but I know I probably won’t be able to attend all sessions because of childcare issues. DBT is a fantastic therapy for people who suffer with borderline personality disorder and will give me ways in which to control my emotions and impulses. I have been desperate to start this since January and think it really could change my life for the better.

What annoys me most is that I may be seen as someone who isn’t using these services properly and that I am wasting time and money. I need these therapies to be a better person mentally and overall a better mum, yet nothing is done to help me go to these appointments. I feel I am doing all I can in my power to get help, yet I am forever struggling. I feel like I am wasting time and money and I am powerless to change things. How can I get childcare when there is none available?

It annoys me that I can’t drop my child off in a nursery (pre booked without a contract) for a few hours and pay for it as I go. I literally have my hands tied and no way of accessing the help I need. I am wasting NHS money. Wouldn’t it be worth the government looking at group CBT sessions for other mentally ill mum’s that had a crèche. All mum’s grouped together 1 hour a week whilst the children are watched. Wouldn’t this save the NHS money and also help mothers be seen quicker. After all we are a mother and we need our mental health to be looked after quickly and effectively. Could we not utilise the children’s centres we already have around us to make this a reality?

It still feels in this day and age as mother you are just expected to suck it up and get on with it and this infuriates me. I tried to do that and I had a mental breakdown in the process and then required CRISIS team care with daily visits, costing the NHS dearly. If I had been able to access the care I needed earlier I probably wouldn’t have needed this extra support and hospital admissions. In this country the go to support from the doctor is a prescription of antidepressants and possibly a visit from the health visitor. Things need to improve and become easier to access.

I would love to hear your thoughts and experiences on this and what you think could be done?

Facebooktwitterpinterestlinkedinrssinstagram
How i'm learning to accept my personality disorder

How i’m learning to accept my personality disorder

Recently I’ve been asked how I’ve been able to be so accepting of my borderline personality disorder diagnosis. I’ve sat back and thought openly on why I have accepted it and why I haven’t let it destroy anymore of my life. The answer is I have accepted it as for me a diagnosis was almost a relief to know why I acted this way, why I was so emotional unstable and why I was so impulsive. I’m not saying I love this diagnosis or I am happy to be like this, but finally in my life I feel I’ve learnt to understand a big part of my personality.

Borderline personality disorder has ruled my life since I was a teenager, but like many people I was unaware, I just assumed I was just a really emotional person and even at times I was a bad person. The thing with borderline personality disorder it’s not always bad, I feel emotions really intensely the good and the bad. At times in my life I have felt such overpowering, wonderful emotions of happiness and love. I have at times cried happy tears and have felt so happy, I feel euphoric and like I can do anything I put my mind too. The other side is that at times I feel the lowest of the low and have intrusive and suicidal thoughts, but now I know that I have borderline personality disorder I do know that these mood instabilities are only temporary and they will even back out again.

Like most people with BPD I also deal with depression and anxiety. These disorders are all separate, but are strongly linked together and play a big part. Before I was diagnosed with postnatal depression after the birth of my second child my anxiety had already been causing massive issues for me throughout my pregnancy. Once my son was born it was quite apparent that the PND was making my borderline personality disorder worse. At the time I had no idea that I had borderline personality disorder, but looking back I was emotionally very unstable and would sit holding my son feeling a rush of love and crying with happiness to then feeling resentment towards him and complete detachment. It was an emotional rollercoaster and it all came to head this January when I tried to end my life. I have now started to recognise my triggers, which unfortunately I cannot avoid, but I  can understand a little better why my symptoms of BPD are getting worse at times.

Most people also assume like I once did that BPD was for life and that you could never be treated for it. Only twenty odd years ago BPD was thought to be a lifelong condition with no treatment. BPD sufferers have a high suicide rate, around 1 in 10 people and for someone who suffers with it I can see why that number is so high. The most effective treatment for BPD is dialectic behavioural therapy (DBT) which was created in the late 1980’s. DBT works in a similar way to cognitive behaviour therapy (CBT) which works well for anxiety and depression. DBT in a nutshell is about accepting yourself as you are and making positive changes in your life. I won’t go into much more detail because if I am honest I really don’t know enough about it yet, as I am yet to start sessions. Knowing that there is a form of treatment does give me hope.

BPD has been a large contributing factor in me sabotaging goals in my life and that is why I have to write about it, as it is such an important therapy for me. Not only does it help me deal with my feelings, it potentially helps someone else, raises awareness and also keeps me focussed on a goal. So yes, I am accepting BPD as I have hope that one day I can say that I no longer have it and that I have overcome it.

Facebooktwitterpinterestlinkedinrssinstagram