I attend the weekly groups that are more like classes as we do share some in the class, but mostly about our homework & how successfully we practiced the skills we have been learning. I’ve been attending for about 6 mos. now. There is learning through lecture & discussion & we follow a manual & have daily homework assignments & are to practice the skills we are learning.
I also started indiv. therapy w/the therapist (Ph.D. who is specifically trained in DBT--this is a must; the therapist must have the proper DBT training & certification, not just read a book or 2 about it).
You can find a trained therapist in your area. It was developed by Marsha Linehan Ph.D. primarily for people w/borderline personality disorder but has been shown to be useful for bipolar, as well. BTW, Dr. Linehan will be speaking at the upcoming NAMI convention in San Francisco in July (nami.org for info.).
Call 1-888-4-TARA APD for brochure "Guidelines for Choosing a DBT Therapist" & also refer you to a DBT program. Also a web site: www.TARA4BPD.org
There are other web sites that have exercises that have been developed by “consumers” (those who are being treated for a mental illness), as well as web sites with articles about “mindfulness.”
A list of therapists trained in DBT: www.behavioraltech.com
Call the head of the nearest University Dept. of Psychiatry or Psychology & ask for a referral to a DBT program.
Call the commission of the state, county or city office of mental health & ask for a referral to a DBT program.
If not available in your community, read books from the TARA recommended list. Attend self-help groups like Recovery, Inc. Seek out others & start a study group. Start a TARA chapter in your community. Contact TARA for help in starting an affiliate. These are all from my manual "The Dialectical Behavioral Therapy Skills Workbook." I know there are other such workbooks available at Barnes & Nobles & one directly aimed at bipolar coming out in July.
This manual is specifically made up for therapists teaching the class as it has DBT for private practice "skills sheets" & pages from other books by Dr. Linehan inserted so I don't know what year this was originally compiled.
There are too many skills & subjects that are addressed but some of them are: emotional regulation (helping to decrease over-reactions & doing rash, irrational & dangerous behaviors from these strong emotions; for example, I am EXTREMELY sensitive to any kind of criticism from my husband {or PERCEIVED criticism} which I seem to be able to perceive from movement of an eyebrow or his saying he liked my earrings meaning he couldn't say anything nice about ME--just my earrings--so, of course, that sends me into the depths of low self-esteem, depression, self hatred; my self-esteem is already in the gutter so it doesn't take much as you can see!!
Or once a father of one of our son's friends came over & saw a wedding photo of me on the mantel & said, "Boy, you sure were cute!" I heard WERE so when he left I smashed the glass-framed photo & tore it up. I was going to tear up our whole wedding photo album, but my husband was able to grab it away from me first. I'd say A BIT of an over-reaction on my part, but that was typical of my rash behaviors as my emotions were way over the top.
I tell you it is awful living like this. It seemed like I could get triggered so easily & could feel so hurt & cry inappropriately. We’d be out to a nice dinner to celebrate our anniversary & I’d be crying by the time the salad arrived, ruining another occasion that should have been joyous. I bought Visine by the case at Sam’s Club. The low self-esteem prevented me from doing so much. I just wanted to avoid life. I felt so inferior.
Medication helped me, not enough as I also had grown up in a not so great family w/a severely bipolar mother who was not able to be helped & committed suicide when I was 15 & alcoholic father who was very uninvolved or helpful w/us kids—mainly dumped us kids in a boarding school after she died (probably would have been better if he did that earlier as she was quite abusive & the home life was chaotic to put it mildly w/her in & out of mental institutions).
Some of the topics & skills learned in DBT: How to analyze emotions in a rational way so as to de-escalate them & feel the appropriate emotion (not the over-the-top reaction that leads you to do destructive behaviors to get relief from it as it feels unbearable; some women in the group are cutters, bulimic, anorexic, alcoholic or drug abusers; I tend to overeat & do rash behaviors like start some kind of fight or crisis or get depressed or start the “silent treatment”). We learn to identify the “real” or “pure” emotion we are feeling & not to stuff it or avoid it, but to go ahead & feel it & not be afraid of it, but not to “feed” it so that it will escalate. Not to add to it by ruminating on all the past occasions that caused our feelings to get hurt or sad or feel lonely, etc. Let the emotion go its natural course as it will decrease on its own. It will not last forever. It teaches what you “feed” will grow so if you feed your emotion by heaping fuel of past hurts or anger or whatever the emotion is on it, you will get mired in it & escalate it.
Live in the “here & now.” Don’t look at the past w/regret or the future w/anxiety. What is going on right now? My family is happy. Things are generally OK. I don’t live in the past (my unhappy childhood; I accept it; it was hard & sad, but I cannot change it). I don’t think ahead about maybe my husband will develop a serious illness. Maybe I’ll feel anxious & uncomfortable on Friday night when we have to attend a wedding (but then I get to practice another skill of DBT—distress tolerance & anxiety reduction!!).
There are the mindfulness techniques, breathing techniques, anxiety reduction, assertiveness while not causing antagonism in the other person, effective communication skills, goal setting & reaching those goals (Are your behaviors helping you reach those goals? When you want to get drunk as you are feeling very upset or yell at your boss, “play the tape all the way to the end” & see what the ultimate consequences of those behaviors will be. Will the end result lead you to be closer to your ultimate goals of having a peaceful life; a good, stable job; being a productive member of the community; staying out of jail; having a good relationship w/your family & friends, etc.?)
Skills to control anger, steps to change negative thinking, build positive experiences & build mastery (which increases self-esteem)…
Practice “wellness” by taking care of your body through stress reduction, exercise, proper eating & sleep; avoiding mood-altering substances (except prescribed meds!); learning how to do the things you fear; getting perspective & acknowledge the other person’s opinion & right to it, even if you don’t agree. Avoid “black & white thinking”; “all or nothing thinking”; perfectionism which basically paralyzes you & prevents you from even attempting difficult or scary or new things; “mind reading”; jumping to conclusions without evidence—those conclusions tend to be negative & catastrophic in scope; accepting that you cannot control other people’s thoughts, behaviors, or emotions.