DBT is making me angrier and angrier.

I started first time doing DBT, I've been trying to figure out why with each session I feel invalidated, silenced, coerced, and ignored. I thought I Was nuts , and then other people doing DBT described same symptoms without me saying anything. I'm sure its not DBT itself that is aimed at doing this but for me, it's made me angry, impatient , and I feel ignored..Once the session is over I'm always glad it is and the only thing I feel good about is not being there.

Anyone feel like this thats done DBT?

I'm sorry. I'm always lost with the anagrams here, What is DBT?

Dialectical Behavioral Therapy.

Sounds like it might be an issue with the facilitators of your group if everyone is experiencing these feelings. I love DBT, but have had very validating therapists run it.

I've had good experiences with DBT. Maybe the group and or T aren't a good match?

Dialectical Behavior Therapy

i haven't had dbt, and i know its different from cbt - but in my experience i find most cognitive approaches invalidating because i feel like a lot of Ts are using it without 'meaning' it...

so, sometimes i had people in my life who would say the words, but what they really were interested in is me changing my experience, not accepting it and not believing that i'm doing the best i can at the moment...

that said, i learned a lot about how to cope and how to deal with SI triggers. how to distract myself. maybe in some ways how to invalidate myself lol - but at the end of the day this helped me get a level of stability that has helped me get a life. and i think was the first step for me - just building a foundation where the behaviors that were getting in the way could end.

not much help, but i wish you luck.

You know, everybody is different, and there is no approach that is going to work for every patient. Maybe DBT is just not right for you. That doesn't make you bad or broken. Some people are helped by it and it works great for them. Doesn't mean that it has to work great for you.

In my experience, many people find any cognitive or behavioral approach to feel invalidating and anger-producing at first. It's not just DBT, but any technique that suggests part of our distress may come from the way we look at things or think about them or believe or act. It feels blaming. At first. I've seen people freak out just reading a standard list of cognitive distortions and feeling like the list was "trying to say it's all my own fault." It's a rough feeling at first. Could any of that apply to you?

But I've also been left cold at times by certain facilitators who lack warmth and humor or the ability to pick up on nuances. If they come on all mechanical, it's a complete turn-off for me, although I highly prefer cognitive and behavioral approaches over others. As others have said, it takes all kinds of therapy because there are all kinds of people and problems in the world.

I can't do dbt because of how closely it mirrors the way I was raised. I can totally relate to feeling invalidated and shamed by it (and I've tried it 7 separate and distinct times, for several months at a time, with different facilitators and in different programs). I find the incessant focus on skills without the ability to process anything that is triggered very difficult to process. I learn by talking about things with someone I trust and processing what happened, why, how to do it differently next time. Dbt never gave me the feeling that my concerns were being heard or that my experience was being understood. All the responses I got when I tried to address the way I felt about it were insisting that I was "resistant" and "wilful" without any meaningful suggestions on how to make the program work for me.
it's definitely not for everyone.

DBT made me feel condescended to, patronized, and infantilized, so you're not alone. I refuse to do the groups anymore. The whole "negative reinforcement" aspect does not mesh with me at all.

I think a lot of DBT groups are run by unqualified people a lot of the time. The last thing you should feel is invalidated and "negative reinforcement" is not a part of it. For some disorders it's an effective part of the treatment and often should be accompanied by individual T for processing.

Negative reinforcement does play a role in the treatment approach of DBT. Not all groups practice it but it is not really that unusual to find in that setting. Positive and intermittent reinforcements coexist with the negative reinforcement but it is just one aspect of DBT that I really just cannot vibe with.

It does help a lot of people and I'm glad they could find a treatment modality that works for them.

Can you define "negative reinforcement"? I'm not familiar with this as a part of DBT either.

Yes, can you explain how "negative reinforcement" would be used in DBT? I've never experienced anything like that as a part of DBT. I've never come across it on the other perspective either (in my studies). It doesn't seem to resonate with the overall concept of it.

CBT does that, DBT doesn't.

Example A: If you're struggling with self-harm, one of the "aversive consequences" (I shouldn't have used negative reinforcements because they're two different things. Aversive consequences would be a more suitable term for this) would be that if you were to indulge your urges to use those behaviors your consequence is not being allowed to contact your therapist for x number of days.

Example B: Not completing homework assignments leads to negative feedback from group facilitators: acting cold and irreverent.

Example C: Storming out of a session = client is "grounded" from therapy and is not allowed to attend x number of sessions.

Those are harsher examples I have heard from a handful of people who have experienced these techniques. I'm sure the majority of DBT practitioners use positive and intermittent reinforcement much more frequently since a lot of people are reflecting on their experience in a positive light. But it is a tactic that is used as a treatment approach.

Maybe it's effective for some. It would infuriate me.

Here's one source for you and here is another. If those don't link directly to the relevant paragraphs let me know and I'll try to fix it

ETA: The first link is supposed to direct you to "contingency management" and if you scroll down you'll find it.

I have. I think you have to have a certain kind of behavioral patterns for it to be a good fit. When I was in DBT groups, I'd think, "What, do you guys think I'm ignorant or something? I know what all this is, I already do this stuff, it's common sense for me. You don't need to make me repeat this and give it a new name just to repeat it again"
The things they teach are.... really kinda average for a lot of folks. They're already subconscious habits for handling stressful situations (or I thought so for myself, at least). It seemed like some kinda marketing ploy or something, almost; like they had to make it some kinda fancy anagram in order to "sell it" or whatever. They took basic coping and grounding skills and stretched it out into this unnecessarily long and complicated process. I mean "ACCEPTS", "DEARMAN", "GIVE", "FAST", "IMPROVE ", "PLEASE MASTER", "MASTERy" ??? C'mon son, you know that's whack! I honestly think that DBT is for a select group people who need those skills broken down and rebuilt, not for those people who have the skills on a solid foundation and just need them strengthened. Idk, it might just be a shot in the dark here, but I think DBT is too widely used.

Yes. I should have used something more like "adverse consequences" since "negative reinforcement" is ambiguous and can be comprehended differently.

Ah. I've heard that some therapists enforce a 24 hour waiting period for contact but my understanding was that there was some means of support, perhaps through another therapist. Our group has a hotline with a T always on call although my T doesn't do any of that 24 hour stuff.

As for B & C, I'm surprised. My facilitators just try to discuss what got in the way of doing the work and reinforce the "no judgment" aspect of DBT. I guess some groups run differently but these two seem to feel counter to the effectiveness of it. Bummer.

This comment came across as kinda condescending. It's not a marketing ploy, it's a helpful way to remember the skills, particularly for those of us who came from emotionally unhealthy backgrounds. Yes, for the emotionally stable, many are intuitive (my husband looked at the skills and was like, "Oh yeah! I do these!") but for some of us who came from households that invalidated us or where we were taught to ignore our emotions (as I was), these skills and their acronyms are immensely helpful.

If you want to critique the method, that's fine, but Marsha Linehan who wrote it suffers from mental illness herself (she was hospitalized for a significant period of time in like the 40s and they said she was schizophrenic, although I think she would be accurately diagnosed with BPD if I recall reading it right). She wrote DBT to help people like her - a far cry from a marketing ploy.

I don't have BPD. I have depression and anxiety and I've found it useful. Not everyone will, I will give you that, but no, I don't think it's whack. It's saved my life on more than one occasion and has helped me help friends who were going through crises (the acronyms help me keep the skills straight).

DBT has never been suggested for me nor would I ever consider it from what I have read about it, but acronyms are not usually something I find useful.
I think CBT treats clients like they are complete morons. Some people really like CBT and give it credit for helping them.
If someone finds those methods useful, then good. I think is is always bad not to have choice at all, but certain choices works for some and not for others.

The DBT group I was involved with for 2 years was handled in a very college like atmosphere which was something that I needed.....I needed the intellectual aspect & learning how the brain actually works & how the DBT skills & thought process in mindfulness actually functions in the brain & how the broken brain works & how it can end up being fixed by reprogramming the neuropathways that haven't been working or there wouldn't be the mental illness in the first place.

The good thing about the DBT is that I learned that I did have some of the skills already that I had been using much of my life anyway.....but it also taught me other things that I had been wrongly understanding from the way I had been thinking about things from the time I was growing up.

Like I thought people were either logical or emotional because my mother was emotional & I was always logical & I never saw logical come from my mother.

I had never dealt with any mental health issues all my life until it was like a switch that flipped at the age of 42....& all of a sudden I couldn't function any longer because of a situation that I had gone through.......then there was another trauma that hit 10 years later that just added onto what I had been dealing with. Since there wasn't a medication out there that didn't give me bad side effects....I figured that there had to be a switch that could be thrown again & it would make me all better.

DBT actually validated what I had gone through & it helped me understand that my reactions weren't so out of touch with reality & that any normal person would have reacted in a similar way that I did. It also opened up my mind to new ways of perceiving things & understanding how the mind really works in given situations.

I don't have BPD.......so DBT definitely works for depression, anxiety, & for my PTSD & dealing with the trauma that came from being in a bad marriage for 33 years. What DBT also did was give me words so that I could describe what I had been feeling for so long but had no words to explain. I would go into therapy & say that I was feeling horrible....but would have no words to explain what was causing that horrible feeling until I got into understanding emotions & how emotions work & what in the world they even were.......I remember sitting down with several pages of emotion words one time.....& I just started writing down the one's that applied to how I was feeling & then putting the why's with each word. I ended up with 2 pages of emotions that I was finally able to put words & explain why I was feeling them.....first time in my LIFE.

I do seriously think that it's all in how the DBT is presented....& the things like:
are not normal ways of handling a DBT group....they are arbitrary requirements placed on the group by the leaders......I don't know if it has anything to do with the age bracket of the people involved but all of us in our DBT group were 50 + with grown kids of our own....so we were mature adults who didn't need those childish restrictions placed on us & there wasn't anything like those EVER considered as necessary in the group.

We were actually a very intimate group of people who were able to open up & share our experiences & learn how to express ourselves & what we were going through using the common DBT terminology so that we would all know what each other was talking about.....but we needed a lot of help with that from the group leader because we would all come in & say what we had to say in our own terminology.....then she would help us figure out how it actually worked in terms of DBT.

The DBT helped me put words to what I thought & what I was experiencing & what I had experienced along with reinforcing skills I already had & learning new ones that would help when the others I already knew didn't work.

I do seriously think it's all in how it's presented & taught & all of us were college grads who had high paying careers before becoming disabled..& the DBT was presented in a way that it related to us...not us having to lower our intellectual level down to some lower standard of presentation.

I think that was a serious key to why I was able to relate to the DBT group I went to for 2 years & also the Next Step group that I'm going to now that helps us continue thinking about what we are experiencing in terms of the DBT we learned.

Thank you for this. This might sound really odd, but it makes me feel better about my DBT group. A isn't an issue because I'm keeping my own T and she would never do that to me. B and C won't be a problem either. The group T told me that if I don't want to talk at all, I don't have to. And her supervisor told me that I can take a break at any point I need to. Homework won't be an issue just because I will be motivated to do it to show my T I'm trying. Still scared of group, but at least I know I won't have to deal with the things you listed

[quote name="roimata" post=4229473]Example A: If you're struggling with self-harm, one of the "aversive consequences" (I shouldn't have used negative reinforcements because they're two different things. Aversive consequences would be a more suitable term for this) would be that if you were to indulge your urges to use those behaviors your consequence is not being allowed to contact your therapist for x number of days. <br />
<br />
Example B: Not completing homework assignments leads to negative feedback from group facilitators: acting cold and irreverent. <br />
<br />
Example C: Storming out of a session = client is "grounded" from therapy and is not allowed to attend x number of sessions.<br />
<br />
Those are harsher examples I have heard from a handful of people who have experienced these techniques. I'm sure the majority of DBT practitioners use positive and intermittent reinforcement much more frequently since a lot of people are reflecting on their experience in a positive light. But it is a tactic that is used as a treatment approach.<br />
<br />
Maybe it's effective for some. It would infuriate me.<br />
<br />
Here's one source for you and here is another. If those don't link directly to the relevant paragraphs let me know and I'll try to fix it<br />
<br />
ETA: The first link is supposed to direct you to "contingency management" and if you scroll down you'll find it.[/QUOTE]<br />
<br />
Ah. I've heard that some therapists enforce a 24 hour waiting period for contact but my understanding was that there was some means of support, perhaps through another therapist. Our group has a hotline with a T always on call although my T doesn't do any of that 24 hour stuff.<br />
<br />
As for B & C, I'm surprised. My facilitators just try to discuss what got in the way of doing the work and reinforce the "no judgment" aspect of DBT. I guess some groups run differently but these two seem to feel counter to the effectiveness of it. Bummer.<br />
<br />
[quote name="OliversTwisted94" post=4229494]I have. I think you have to have a certain kind of behavioral patterns for it to be a good fit. When I was in DBT groups, I'd think, "What, do you guys think I'm ignorant or something? I know what all this is, I already do this stuff, it's common sense for me. You don't need to make me repeat this and give it a new name just to repeat it again" <br />
The things they teach are.... really kinda average for a lot of folks. They're already subconscious habits for handling stressful situations (or I thought so for myself, at least). It seemed like some kinda marketing ploy or something, almost; like they had to make it some kinda fancy anagram in order to "sell it" or whatever. They took basic coping and grounding skills and stretched it out into this unnecessarily long and complicated process. I mean "ACCEPTS", "DEARMAN", "GIVE", "FAST", "IMPROVE ", "PLEASE MASTER", "MASTERy" ??? C'mon son, you know that's whack! I honestly think that DBT is for a select group people who need those skills broken down and rebuilt, not for those people who have the skills on a solid foundation and just need them strengthened. Idk, it might just be a shot in the dark here, but I think DBT is too widely used.[/QUOTE]<br />
<br />
This comment came across as kinda condescending. It's not a marketing ploy, it's a helpful way to remember the skills, particularly for those of us who came from emotionally unhealthy backgrounds. Yes, for the emotionally stable, many are intuitive (my husband looked at the skills and was like, "Oh yeah! I do these!") but for some of us who came from households that invalidated us or where we were taught to ignore our emotions (as I was), these skills and their acronyms are immensely helpful.<br />
<br />
If you want to critique the method, that's fine, but Marsha Linehan who wrote it suffers from mental illness herself (she was hospitalized for a significant period of time in like the 40s and they said she was schizophrenic, although I think she would be accurately diagnosed with BPD if I recall reading it right). She wrote DBT to help people like her - a far cry from a marketing ploy.<br />
<br />
I don't have BPD. I have depression and anxiety and I've found it useful. Not everyone will, I will give you that, but no, I don't think it's whack. It's saved my life on more than one occasion and has helped me help friends who were going through crises (the acronyms help me keep the skills straight).<br/>

Sorry if I came across as condescending. I was ripping on the method rather than the people who like and use it. When I was writing my original comment out, I kept running into a roadblock on how to say it so it wasn't mean or condescending to anyone, but I guess that fell on it's bum. So, sorry for that (I'm an vibrant speaker, most times I use my hands and gesticulate a lot when I talk, so I have a hard time saying what I need to online. Easier to explain in person and whatnot. But I digress....)
Point is: sorry if I came across as mean or condescending to anyone, I just meant to rip on the method a bit. All I meant was that DBT only works for certain people, because they have the mind for that kinda thing, ya know? That many acronyms only serves to make me volatile and closed off to everything, so that's how I was trying to relate to the OP.
Again, sincere apologies for being a jerk. Sorry for any upset I may have caused anyone on this forum.

I admit (sorry!) the acronyms seem stupid. BUT...many have actually helped me in school. PEMDAS (order of operations), SPA (Socrates, Plato, Aristotle), "King Henry Dances Better Drinking Chocolate Milk" (metric units), MVEMJSUN (planets), "Kids Playing Chicken on Freeways Get Smashed" (taxonomy order), KISS (keep it simple stupid), ROY G. BIV (colors), IPMAT (stages of cell division), HOMES (the great lakes), etc. I even remember songs I learned in Spanish to tell the difference btwn ser and estar (I won't write it out ).

Even here on the forums, we use a ton of abbreviations: T, Pdoc, SI, SUI, ED, BPD, DBT, CBT, ACT, CSA, BTW, BTWN, OMG, IDK, LOL, W/O, ASAP, WTF, etc.

So I guess they work. And I figure if I had to memorize the prologue of Canterbury Tales in Old English (which sadly I still remember the first 4 lines), DBT will be much more useful to memorize

But I can see how it would deter some people from learning it.

[QUOTE=OliversTwisted94;4229494]I have. I think you have to have a certain kind of behavioral patterns for it to be a good fit. When I was in DBT groups, I'd think, "What, do you guys think I'm ignorant or something? I know what all this is, I already do this stuff, it's common sense for me. You don't need to make me repeat this and give it a new name just to repeat it again"
The things they teach are.... really kinda average for a lot of folks. They're already subconscious habits for handling stressful situations (or I thought so for myself, at least). It seemed like some kinda marketing ploy or something, almost; like they had to make it some kinda fancy anagram in order to "sell it" or whatever. They took basic coping and grounding skills and stretched it out into this unnecessarily long and complicated process. I mean "ACCEPTS", "DEARMAN", "GIVE", "FAST", "IMPROVE ", "PLEASE MASTER", "MASTERy" ??? C'mon son, you know that's whack! I honestly think that DBT is for a select group people who need those skills broken down and rebuilt, not for those people who have the skills on a solid foundation and just need them strengthened. Idk, it might just be a shot in the dark here, but I think DBT is too widely used.[/]

DBT is intended for people who lack emotional regulation skills, so you are right - if you have these skills already then it is probably not what you need. It's not a reflection on intellectual level by any means and can be useful for the most intelligent people as well as people with challenges. It's all about building a skill set that some people for whatever reason might struggle with. You could be right that it's over prescribed sometimes. It's also possible that some people are resistant to it because intellectually the concepts appear to be so common sense it sounds strange. However just because some people understand them it doesn't mean they use them. Not everyone needs it but when you do, it can be amazing.