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Originally Posted by NowhereUSA
If it helps, DBT isn't mutually exclusive with medication. I take anti-anxiety medications and I have a medication for depression (ketamine). The DBT has helped me be able to take less of my anti-anxiety meds - but I still need them. Sometimes my body simply has a panic attack and all the deep breathing and distraction in the world won't bring my body down to baseline. So I'll pop a xanax. I also get terrible anxiety at night and it interferes with sleep - taking care of yourself is a big deal in DBT - so I take a low dose of klonopin to help with my restless leg and my anxiety.
And I get not being in a place or able to do a program. Even the program I went through has a waiting list and I've heard from others that there are cost, time, and availability issues.
The way we did the class (if it helps you to go through it like this), was that we would do the core mindfulness (so we'd go over the mindfulness stuff). Then we'd spend several weeks in a unit, like Interpersonal skills really only going over one or two skills a week and focusing on just practicing them in conjunction with core mindfulness. Then we'd review mindfulness again. Then jump into another unit like emotion regulation. Then back to mindfulness and then into Distress Tolerance.
The core mindfulness skills are the foundation on which it's all based and the hardest of those (I think) is non-judgmental stance. Be kind to yourself. Give yourself grace and room to breathe.
The skills are invaluable. Good job wanting to keep trying  |
Thanks so much for this. It is all very helpful, especially the part about medication. I wasn't sure about that.
I am a little embarrassed to admit I am a certified mindfulness meditation instructor! That is what attracted me to DBT. I wanted to see how Linehan incorporated mindfulness practice into a cognitive behavior therapy structure. Her background is in Zen, mine is mostly in Vajrayana Tibetan Buddhism, although I have done extended (two week) Zen retreats at my local center.
I think if anxiety is present then mindfulness can be distorted and become hypervigilance. Also, there are hundreds of antidotes to mindfulness problems, some address the mental, others the physical. Sometimes distraction is good.
However, if someone is in a highly agitated state it is difficult to do any of these. I was a little disappointed when the medication for anxiety worked instantly. I mean, I was relieved, but the medication did in 20 minutes what I had not been able to accomplish in weeks of DBT work. I was just in too agitated a state, and I wasn't sure of Linehan's take on medication in combination with DBT. The medication calmed my mind down so that I was able to practice some of the DBT skills more effectively. But it felt a little like "cheating" which is simply a stupid thought!!! So it was helpful to hear from you about medication and DBT.
As a meditation instructor I would often refer a student to a therapist or counselor. For years this was not done in the meditation community. There was more of a separation between the so-called spiritual route and the psychological route. But some students had real life problems that needed to be addressed, and could not be "cured" through meditation.
I think maybe that is a problem with doing DBT without going to a therapist. I found only one therapist in my entire community who advertised as DBT trained, and this person worked primarily with adolescents. I was surprised as I am in a community with many therapists. I found the same was true when I tried to find a therapist who specialized in CBT.
Working with the skills books on my own may not be optimal. But it is the best I can do at the present time. I should also add that I have always had meditation teachers but my last teacher of 7 years returned to his home country. So it is the first time in a long time I don't have someone to talk with about mindfulness and meditation practice.
Sometimes all our resources kind of melt away, and we need to rebuild. That's what I am doing. Thank you for responding. You have been extremely helpful.
