The adversarial nature of the therapist/client relationship.

I found this phase in a Wikipedia article on DBT:

Is this "adversarial nature" widely accepted, or just Linehan's opinion?

My relationship with T has certainly been adversarial at times, but I thought that was mainly due my own anger and paranoia.

My T and I do not have an adversarial relationship (and we do not do DBT). I thought most therapies stressed the therapeutic alliance.

I've never had an adversarial relationship with any of my T's. They weren't DBT though either. Maybe in working with the clients she specializes in, she sees more issues with this?

I have an adversarial relationship with one but not the other.

Adversarial? Oh my goodness - no. I could never see a T with whom I had that kind of relationship. Sure, we've had our ruptures but I've always believed and felt and experienced total support from my T. And that support does not manifest itself in any way as adversarial.

But, I'm wondering if people who do have this kind of relationship with T bring to the relationship their own adversarial approach. I try hard to work with my t and I try hard not to resist. Of course, if she did or said stuff that I thought was off the wall, I would not only become adversarial, I would probably leave.

I do not have an adversarial relationship with my t, and she is a dbt therapist. She's also not big on the "intersubjective tough love"
She is there when I need her, she helps me get through stuff, but really, there is no tough love involved

Don't know much about Linehan but the adversarial thing seems to be her referring to what she DOESN'T believe in. It's not the T vs. the symptoms, or the T vs. the parts of the patient that need to change. I think she is proposing the intersubjective tough love thing instead (what a phrase !), where it is more like, a T can like and support their patient exactly as they are at that moment, but still want to push them to change... but it's not like a competition....

Adversarial? Hegelian? Assertiveness + Mindfulness? Ummmhh, sounds like a complete, and I do mean complete crock. Yes, it's true, that may offend some people, but I find that kind of unbelievably Madison Avenue fantasmagoria not only beyond belief but wildly, unimaginably manipulative as well.

CantExplain, over the past fifty years there have been all too many snake oil salesmen at work in the glorious goldmines of mental illness. Yours sounds like one of the more egregious. Anyone who combines "adversarial," "Hegelian," and "Buddhist" in the same mental-health-targeted description is selling something neither you nor any other serious person wants to buy.

Take very good care!

My T and i have a good relationship and are on the same side. Definitely not adversarial.

Sounds like a tenure package to me....sorry I am so jaded but I agree with you....fantasmagoria is a great Halloweeny word to use...

This really made me laugh. It's funny on many levels. Imagine a snake oil salesman doing honest work in a gold mine! Fabulous.

I believe the term adversarial refers to the idea that the T sees the flaws in the client's thinking and the client is resistant to accepting the T's views? And this word was from wikipedia, not Cant's T. My T says this view of therapy is changing, not just to Linehan's ways, but to one where the T doesn't stand in judgment - more the unconditional positive regard carp we've talked about here.

Maybe 'adversarial' is a DBT thing? I've heard some aspects of it are what I would think of as harsh, eg: someone said on here somewhere that in group DBT they got sent out of the room if they cry?

Certainly not my experience of therapy/counselling. I couldn't deal with that at all. I see my T very much as an ally.

hankster, I'm sorry if I offended you personally, but having been a lawyer (adversarial par excellence!), studied Hegel, practiced mindfulness, and know something about a number of Buddhist sects, the whole thing grossed me out entirely. A T being adversarial to a patient? I can't even conceive of it. Pushing in the right direction, certainly, but adversarial means (to me, at least) a lot more than that. And yes, I know it's from Wikipedia, which I love, but all of us understand that Wikipedia is a very strange and solitary beast that's not like Encyclopedia Britannica or the Bible. Take good care!

Boy, that's an understatement. You really have to be very cognizant that many of the articles on Wikipedia were written by people with very distinct agendas.

Well, just-some-girl, I'm an old guy who's been somewhat familiar with a number (not all!) of therapy regimes over the past fifty years. It's a big business, face it. And it's sad to say but true that a number of people do treat it as such. Something to make a fortune from. Why should psychopaths ignore mental health in their quest for power, control and jollies?
And mental health consumers, like you and me, need (very, VERY unfortunately) to be aware that there are wolves in the sheepfold. People to be wary of. Ideas that may not really be helpful. And with the new developments in neuroscience and its combination with psychoanalysis and attachment theory, well, the sky's the limit. Did you know that approximately 97% of the products you'll find in a health food store will NOT improve your health, mental or physical? Yeah, it's true.

Bottom line: We all need to be very careful when we choose a T and a "school of thought" (to which T may belong). Take care and good luck to you and yours!

Absolutely! And they change all the time! I love watching the power struggles on Wikipedia as to certain specific topics. There are who knows how many different points-of-view struggling for control, to get their view in. And they change it this way, and that way, and the other way. Me, I find it absolutely fascinating! I wouldn't DREAM of trying to find the stodgy old TRUTH in Wikipedia. Except in articles dealing with entirely uncontroversial subjects. Like Lindsay Lohan's date of birth. Or when George Washington was inaugurated for the first time. As for President Obama's place of birth, well, who knows?

Thanks Ygrec, not quite sure what you're trying to get at here? But yes I think you're right in that we need to keep our wits about us - there are indeed wolves in the sheepfold. There are a lot of 'schools of thought' in the mental health field, and I have my own opinions about some of them. I'm happy with my T, and I believe we have a good therapeutic relationship - but I don't check my opinions or intelligence at the door

That's good, and that's necessary. I'm concerned about the not so insignificant number of therapy aspirants who know nothing at all of what they're getting into, as I was when I was 14 years old and first tried therapy. Today, here in the States, people's insurance companies have a lot of say in just what kind of therapy anyone is going to get. And together with the multiplication of "kinds" of therapies, that makes the task of the therapy aspirant much tougher than it was in the past. Things may be very different in the UK. As to you yourself, I'm sure you know your way around and can take care of yourself. Judging by myself when I was 14, that isn't always the case! Take care.

Yes, I believe it's our responsibility to be as informed as we can be, to avoid letting someone take advantage. Unfortunately those seeking therapy are often vulnerable. Here in the UK there are professional bodies for therapists/counsellors in private practice, that mean they are under supervision and meet ethical standards, etc. Of course I checked my T met these requirements, (as well as my own! Haha!) Not sure how it runs in the USA... Sounds like you got 'burned' when you were younger? That's too bad at 14 I don't think anyone can expect to 'know their way around'...

Don't even get me started on the issue of insurance companies getting to decide for us what kinds of therapy we need, or more importantly what they'll pay for!! I believe that the consumer should get to decide what works for them or what they are comfortable with after doing their own research. Unfortunately, more and more in the US, insurance companies are making these decisions based on "how quick can we stop having to pay for this client's treatment?"

That said, I believe that Hankster is correct in her interpretation of Linehan's approach. The DBT therapist might see the flaws in the client's thinking, as in seeing her cognitive distortions or interpretations, but the DBT therapist accepts the client where she is at that moment and time. She doesn't try to push or entice the client to change--sending a client out of the room because she is crying wouldn't be Linehan's approach. She might not stop and process what that particular client is experiencing at that moment and time, but she wouldn't banish the client from the room as if she had done something to shame herself. She simply works toward meeting the client where she is, getting her to clarify what's working and what's not working, teaches her coping skills and applaudes and encourages progress toward use of skills that bring relief of psychiatric/relationship pain. That's dialectics--the ying and the yang--it's okay to be where you are but you can move toward change that you welcome or embrace because it's what you want. And it's definitely okay to step forward and step back, as long as you continue to engage in the process. DBT doesn't see the regression as negative.

I do think many therapist SAY they are trained in DBT but they truly aren't. Many have gone to a one or two day workshop on DBT, read the manual and textbook and on the basis of that, they think that they can "do DBT". It's not like that. In fact, I've read articles by Linehan's instituate on DBT that says that going to a one or two day or a week long workshop is NOT being trained by Marsha Linehan. DBT is an art and the training is expensive and extensive. The team that goes for training pays a LOT Of money and they have to submit supervision tapes before they are certified as trained. Unfortunately, anyone can hang out a shingle and say that they do DBT, CBT, indepth psychoanalysis, Schema Therapy etc. All a person needs is the initial degree/license: PhD clinical psychologist, Licensed Clinical Social Worker LCMSW, Mental Health Counselor, Psychiatric Nurse Practioner, Psychiatrist MD.

I don't know about all of you, but when I struggle to ask a therapist what their credentials are . . . what they are certified in . .. what their education level is . . . this astounds me because I am a very educated person but when it comes to my "inner functioning" I go all wonky and whimpy. I guess I need to become a better consumer.

Unfortunately, You do not even need a license to hang a shingle that says your a counselor,or therapist where I live. No insurance company will accept them but if the client wants to self pay, anyone can do it. The sad part is not many people know this. My T told me this recently.

On a different note, and just for information purposes, Marsha Linnahan spent quite a bit of time in a Psychiatric Hospital herself at one point with many problems. Some of here work has some personal experience behind it. I know and have done some DBT , not enough that I can express an opinion on it.

Sorry, Ygrec, I guess I did a bad job of hiding what I DIDN'T want to say, and a bad job of showcasing what I DID want to say! Just another day in hanksteritaville. BTW, my T loves wikipedia, FWIW! You can't blame women for it, though - it's a men's club - article earlier this year in nytimes about whose updates "stick", very interesting.

You are right on, nannypat. What people claim is not always what it seems to be. We as consumers need to be more aware and sharp about what constitutes "certified" in a particular therapy. You're also spot on about Marsha Linahan coming out this past summer as a person with a diagnosis of Borderline Personality Disorder; she reveals that she was hospitalized as an adolescent for more than two years. It's significant in my view that an intelligent, well educated, articulate woman refrained from talking about her own mental health history for YEARS because of her fear of being dismissed and marginalized by her intellectual colleagues! How sad is that? If a woman with this kind of intellect, determination and educational/experimental backing is afraid of "coming out", how do people in the trenches ... .the everyday man or woman with mental illness fight the prejudice that is out there in regard to a mental health problem? I respect her for "coming out" and admitting to her own mental health history, but it makes me so sad that she . .. and myself . .. and many other individuals have had to hide from our psychiatric diagnoses.

I have never felt that my relationship with my therapist has been adversarial. I've had my moments of needing space and time to myself, but I've never viewed her as the enemy. . . can that happen? Definitely. I personally feel that many of us reenact our childhood attachment patterns in the here and now. What worked for survival when we were children, isn't so effective or workable now. Can that be changed or readjusted? I believe it can.

Hey, Jaybird,

I appreciate your post, and I believe, rightly or wrongly, that I understand what you're trying to say. I don't know whether you'll agree or not, but my problem is very much with the flashy intellectual code words that the DBT spectrum (not just Linehan) people seem to use. On some things I flat out do not agree with what I think is your position. Dialectics? Yin and Yang? Please! Neither these nor "Hegel" nor "Buddhism" nor "adversarial" apply to what anyone means by "therapy." They're just ridiculously pretentious words for what are essentially very simple concepts. The users may well do differently from what others do in therapy but under no circumstances do their methods require or justify description in that kind of affected language. The people using these words are implying that they have an intellectual pedigree that is a flat-out lie and contemptible to boot.

Sorry. This bugs me. People who have never studied Hegel or Buddhism or the Anglo-American legal system in college should not be false-flagged into this or any other kind of therapy. It's hard enough for a normal (not average, normal) person to understand what is meant by psychodynamic psychotherapy or CBT. The code words probably mean nothing to most new patients, but they do give me (I think) some insight into the mindset of the people propounding these varieties of therapy. And that insight is not at all pretty. Well, take care of yourself!