DBT is making me angrier and angrier.

I also think DBT is useful for the group component. That's actually the main reason my T and Pdoc want me to go. They know I could teach myself from a book. But I'm not very good with relationships which is a module of DBT. So having to sit in a room with strangers is a lesson in itself for me.

Full disclosure: I have attended DBT groups before, and have not experienced the "aversive consequences" technique that I put on blast. Just from what I've read in books and heard from others it is one of the many things I hate about the modality and it's not one that will ever work for me, but I think it's great that it is an effective approach for many people here and elsewhere. I would never discourage anyone from participating if they think they will benefit from it.

I read all the replies here, and I appreciate them all, and must say, I hope that for those that DBT worked, that they continue doing what works for them , but I went through more DBT and never missed. I truly think this is not meant for some people. I feel so triggered , I have no support I feel all alone, and now even worse im not ALLOWED to talk about whats bothering me...I just have to smell lavender, talk to my group leader about how I distracted myself today and mindfully drink tea.

My CBT T is now bringing up DBT skills to self soothe. I told him that for everyday bumps and scrapes, taking a bath and lighting a candle are all well and good, but for EXTREME pain this stuff is useless.

It actually makes me angry reading the list of distraction tools. It does seem to minimize or make light up the severity of the pain.

THANK YOU because every time I mention this stuff people in that DBT group are acting like this is some kind of religion I am offending. I don't have BPD, and went through childhood abuse....and im supposed to smell some candles and read a nice book and thats my therapy now. Again not invalidating people who this works for, but telling me to put a smiley face on and choose from a list of 200 things to distract myself with.....is offensive and invalidating to my feelings that are ahem, REAL shame on them for pushing it on people it doesnt work on.

See, I read that I'm so very confused because that's not what DBT is saying and I wonder if there's a misinterpretation or if it's being taught poorly.

I've never been told to put on a smiley face and the only skill that *might* come close is the half-smile which isn't supposed to be a fake smile. The half-smile is a relaxed, slight upturn of the lips and is based on actual science which is that we can alter our emotional intensity through certain physical changes. It's one of the harder skills to wrap the mind around and y'know, not everyone goes for it. I've probably run across a handful of times I've used half-smile. I've used willing hands, deep breathing, and one thing in the moment to help me with intense emotional urges.

I don't know if you're familiar with Marsha Linehan at all. This intense pain people feel? She feels it. She's talked about it. She used to violently self injure because her emotional intensity was so high. The point of these distress tolerance skills is to help cope when our cognitive functioning is decreased due to high emotion. The goal is to reduce the intensity so we can deal with the issue at hand in a manner that is skillful and effective.

I'm not saying this to say "OMG DBT works for all the people!" My point primarily is to check the facts. I'm not saying that hasn't been your experience and at the same time, after hanging out on PC for a while, I've realized there are some poorly run groups out there

And I will add, DBT does jack for my depression. I'm very skillful in DBT and I still live with severe, life-interfering depression. DBT helps me cope and keeps me safe. I have a complicated relationship with it LOL.

Definitely though, if it's not working for you, find another therapy. It's not for everyone. I, for example, couldn't tolerate a therapy that was heavy in transference or getting me in touch with my inner child or something :P We all have different needs and there's not one approach for everyone.

I'm sorry it hasn't been a good experience and I do hope you find something that works for you.

This is only my second post, but I really want to chime in and say I agree with those who have had positive experiences in DBT. I think there may be some "not so effective" facilitators out there if you are feeling invalidated by your group and group leaders.

Regarding distress tolerance - first, distress tolerance isn't for "fixing" depression or even distress and it's not a long term solution. It's used when you are in high distress so that you "don't make things worse". If your facilitators are telling you differently, they are incorrect. And self-soothing is only one of the distress tolerance skills. If that one isn't working, there are a number of other ones that might be more effective. And again, it's only to get you through the crisis (when you are in the "red zone"), it won't fix the problem.

Among other things, DBT teaches that there are five options for solving any problem: 1. Solve the problem (change the situation); 2. Fell better about the problem (change or regulate your emotional response); 3. Tolerate the problem; 4. Stay unhappy; or 5. Make things worse. Once you've decided on how you want to deal with the problem, DBT offers a variety of skills to achieve your goal.

Personally, I was not taught these skills as a child and am really amazed at the impact they have had on my life. I am not a "cheerleader" type person, I hate groups and I can barely tolerate therapy, but I truly believe that the skills I have learned in DBT have saved my life...and I truly believe that if it is not working for someone, the fault may lie in the person teaching it.

I have some additional thoughts and comments on the "aversion" piece (which I experienced with a DBT therapist that I ended up leaving), but will post those later.

In peace...

starlight

I do find her story interesting, and I am aware that she has gone through a lot herself. It does baffle me that someone who shares pain intensity with many of us could find these things helpful in a crisis.

What I really like about DBT is that even the skills that I did know & use, it reinforced that what I was doing worked....Validated what I was doing.....other skills I had the concept of but I didn't have them put together in a logical sort of way....I was winging it.

Distraction skills I always pick & choose what works for me & I have other distractions that aren't even part of their presentation that are part of my life.....that's the good thing about DBT is that it doesn't limit the application......gives the overview of what is needing to be accomplished & it's up to us to implement what works individually.

I was a high IQ, high functioning career computer engineer for 15 years so anything that would have come across as putting down my intelligence, I would have reacted to VERY NEGATIVELY.

The thing with DBT skills is that they are skills that EVERYONE uses even without mental illnesses because many I was using just to cope with the stress level of my career before I ever had to deal with anxiety or depression.......but I now realize just how dysfuyctional my parents were when I was growing up & they never provided the knowledge of any skills....they were just things I had to figure out that worked for me long before any mental illness hit me (it was situational).....the interpersonal effectiveness skills were ones that I had actually put into practice just functioning in my career.......DBT skills are just logical, common sense ways of handling situations that we all experience in life with or without mental illness dealings......they are actually skills IMO that everyone should be taught by their parents or if not....in school in order to learn how to deal with real life situations.

As for high pain dealings....I have continuous migraine pain (it doesn't come & go) & there is nothing that controls it other than medication & there is nothing that lessens it either....but DBT isn't meant to control pain.....however there are times when I do distract myself that I can tolerate the migraine pain now that the pain is more controlled by medication....but it if wasn't already at the lower level.....there would be NOTHING to control it.

I refuse to try DBT because in my opinion it's too much about learning to live with the pain and not enough about the pain going away, which is my ultimate goal.

The thing about DBT, especially in the group setting, us not designed to address the problems or traumas that brought you to therapy in the first place. It is all about interpersonal relations and distress tolerance. In short it is to give you the tools you need to help you navigate through life in a way that feels healthy and productive. If you need to do more specific, deeper work, you need individual therapy as well (most people in DBT groups that I've run are in therapy). I have never been to one, observed one and hopefully not run one where people feel invalidated. It's possible that the group dynamic is not a match for you and in that case Id find another. I hope you can find another method that helps you more.

DBT teaches you to identify levels of pain, as there are some people who tend to experience it disproportionately to the situation. Most people can navigate this stuff naturally - there is a lot of gray area and they do it unconsciously - they are hard wired to respond a certain, appropriate way. Like I said it's just interpersonal skills that are usually modeled to us as children, depending on the upbringing. If we weren't in a family that taught us then these skills have to be taught (which I'll admit can sound condescending to some people). People who have trouble self regulating and who experience things as all good or all bad can have a lot of difficulty maintaining good relationships and DBT is great for helping people find balance. Pain doesn't go away but you can learn to accept it or continue to suffer. It's very difficult and takes a long time to master this stuff. But for those that need it and are willing to try, it really helps them improve their quality of life.

So, I'm fairly new here and have tried posting this twice already...this will be may last try and then I'll assume the universe doesn't want it posted!

There are so many things I'd like to respond to, but I think my main message is, I am not a "rah rah" cheerleader" type of person, I hate groups and I am not terribly fond of therapy...that said, I can say unequivocally that DBT has saved my life. It's taught me skills that I wished I had had the opportunity to learn as a child. It has also given me the ability to ground myself and regulate my emotions so that I am able to do my trauma work.

There seems to be this misconception that DBT is all about distress tolerance. Distress tolerance is only one skill (and there are many different pieces or things to try within that skill) and it's not meant to be a way to end distress nor is it meant to be used constantly. It is a tool to use when one is in the "red zone" in order not to make things worse. And if self-soothing doesn't work, there are other ones to try. Once you're out of the "red zone", then you look at different skills to use in order to reach your goal.

Breadfish wrote "I refuse to try DBT because in my opinion it's too much about learning to live with the pain and not enough about the pain going away, which is my ultimate goal." (sorry , don't know how to use the quote feature). That's simply not true. In any situation, you have one of five choices: 1) solve the problem (change the situation) 2) feel better about the problem (change or regulate your emotional response) 3) tolerate the problem 4) stay unhappy or 5) make it worse. Once you decide on your goal, DBT provides the tools to achieve it.

I feel very sad when I read about people's negative experiences with DBT (and I have had a couple), but I think it's about the therapist and/or facilitators not being skillful rather than DBT itself (or the client).

And I agree that some of the "aversion" tactics used by some therapists are shaming and infantilizing - but, again, I believe that it's the therapist, not DBT.

And, finally, I agree that not all therapy modalities fit everyone. I am not borderline and I fought forever not to go to DBT. What I found was a set of tools that have benefitted me far more than I would have ever imagine (and there are some in there that don't resonate with me, so I don't use them).

Just my personal thoughts...and I still make "Marsha Marsha Marsha" jokes during group.

I started to read Mindful Motherhood by Cassandra Vieten to learn coping skills for when I get pregnant. Mindfulness is the core of DBT so I think this quote from the book sums up the purpose of DBT:

"In a way, mindfulness is like learning to surf. By riding the waves of experience, rather than fighting them, you get a lot less battered about. You still experience each of them, to be sure -- a big wave still feels like a big wave, and a small one feels like a small one -- but learning how to let go and ride the waves helps keep you from being caught up in the riptides of agitation, obsessive worrying, rage, or avoidance that can come from wrestling with those wave." (pg 4).

I also relate it to being stuck in quicksand in a swamp by yourself. You're still alone in a swamp, but you don't have to be stuck in the quicksand. Instead of fighting it (which will make you sink), you stop fighting and try to float. Then you can gently get out of the quicksand and start working on finding a way out of the swamp.

The one thing that really helped me in DBT was emotional regulation.....it wasn't the regulating emotions that I had an issue with....I wouldn't allow myself to feel emotions because my mother was totally emotional & I wanted to be NOTHING like her.....so I shut off my emotions & logic was the only thing I allowed myself to think I used to deal with life.....I knew my anger emotion & very seldom a happy emotion....but I had no idea that all the other emotions even existed so I could never express how I was really feeling because I didn't have the words.....going through all the emotions & learning what they were & how they react in our lives was the best thing that ever happened to me.....I could finally analyze what emotions I was feeling instead of being in denial that I was feeling anything.

Mindfulness was something that fit right in with my logical mind so I didn't struggle too bad with that....but what DBT did most of all was to help me put words to what was going on in my life....all aspects of it & I started to learn the definitions of things....like I knew I was angry at the way a past T related to me regarding a trauma I went through....it wasn't until I got into DBT that I learned the term about being invalidated......it opened me up to be able to totally express myself & what was going on with me.....that was worth absolutely everything.

However.....where I have therapy, one has to be in private therapy then they suggest the DBT group along with the individual because Group isn't set up to take about the details of the issues......Group is to make you aware of them so that You can work with your private T on the details.

"Among other things, DBT teaches that there are five options for solving any problem: 1. Solve the problem (change the situation); 2. Fell better about the problem (change or regulate your emotional response); 3. Tolerate the problem; 4. Stay unhappy; or 5. Make things worse. Once you've decided on how you want to deal with the problem, DBT offers a variety of skills to achieve your goal."

I find this sort of thing to be incredibly condescending from those therapist guys- of course these are the choices one has. Who does not know that - and I never find having the obvious stated to be useful for me.

Just because people know what needs to be done doesn't mean they do it. DBT is for people who have particular difficulty navigating the coping mechanisms that come naturally to most people. Most people have a certain amount of resilience, or in DBT terms "distress tolerance". People who benefit from DBT do not, hence the need to cope through other methods that are self destructive. The intention of the method is not to insult the intelligence of clients or to blame them. It's just helping to learn the skills they need to emotionally cope in the world and maintain relationships. This is not an issue for everyone and everyone doesn't need DBT. It's like social skills groups. The material they cover about day to day human interactions and societal expectations is just common sense to most people. Bit of you have Aspergers or something similar, it works.

of course it does not - but stating the obvious and being controlling and punishing is not going to mean I do it either. People get to choose not to do something. I would disagree with the what "needs" to be done wording.

DBT does not use control and punishment. Maybe some bad Ts are use this but I've never heard of DBT in those terms until this forum - and in those cases it's unfortunately done poorly. There I've never seen a group leader tell anyone what to do. For people who use DBT it's valuable guidance and advice to help them lead (hopefully) more fulfilling and peaceful lives.

I would see it as condescending, except I didn't know these were my choices...and I'm not a stupid girl...just someone who thought things "just happened" and that I had no control over anything. These are things that maybe most folks "get" from an early age but I didn't. So, having it spelled out it an easy way was very empowering for me.

I deal with some pretty complex things in my day to day life...for my "internal" stuff, I need it simplified a lot. So, having DBT explain these skills that, in an ideal world I would have been taught as a child, is very helpful.

If it worked for you - good.
I have not tried it and don't think there would be any point for me to do so. I have read some of Linehan's stuff.
But if someone wants to try it and finds it useful for them, I would not say it was not a good thing. But there are those for whom it does not appear to work and sometimes is even harmful.