[stopdog]

How to Get to the Heart of Resistance

Admitting they use stories to manipulate. And how they label clients. Nowhere do they indicate the story need be true.

[ListenMoreTalkLess]

What I found useful in the strategy described in the short video was the story about "how to get out of hell." I can relate to the idea of being in the midst of something very painful and being stuck and not knowing how to find my way out of it, and having difficulty even trying to do things differently that might help. That last bit is I think what the Ts call "resistance."

So if the T tells a story acknowledging that the problem with hell is that it's hot and you want to climb out of it, but the ladder out of hell is also hot, and you can try something but it's too hot to climb the ladder so you drop off, but the only way out is to climb up the ladder, that makes sense to me as an analogy of some of the things I have been through. I don't mind the idea of "selling a new behavior to the client" by telling stories about what has worked for you as a T or what you've seen work for other people. My T does this a lot even when I don't feel in hell. I think stories work better if they are true but there's also a cliche that goes "just because it didn't happen, doesn't mean it isn't true."

I think the reason that I don't mind a T "selling" me something is because I see it as my own choice whether to buy it or not. My T has tried selling numerous ideas to me and I might try it if I think it will work for me. But ultimately it is my choice and my T doesn't benefit (unlike a car salesman) from whether I choose to try it or not. She never perseverates on an idea or uses coercion like "but you'd be such a better person if you tried this idea. Unlike a used car salesman, she doesn't try to sell the how my life will be filled with greatness and beautiful women if I just do this. The story method helps me see how I could do something differently but doesn't feel like pressure to do so. And I've been pleasantly surprised when one of these stories or a kernel of it has actually been useful, and implementing it in some way helps me. Though most of them I think I dismiss out of hand, or explain why that thing wouldn't work for me or why I'd never think of doing such a thing.

I guess I can see the utility of this technique, have experienced this as helpful, but for me it's more like T is Johnny Appleseed and most of the ideas being strewn about are not going to take root with me.

[ruh roh]

Geezus. Is she drunk? She is barely coherent. I would have to be on a lot of medication to tolerate that.

[ruh roh]

I liked this comment, "The moment I feel myself trying to “sell” my client this is my internal signal that I have lost the empathic thread of connection. If I find myself feeling like a “car salesman” I have most certainly entered into a dark place of manipulation."

Dark place of manipulation seems to be the main goal of many of the therapists posting on that "training" video.

[Jazz1971]

I don't see the problem in trying to "sell" a new behavior to a client either. The person in the video is Marsha Linehan, who has BPD and is the person who developed DBT therapy. She might be odd, but having experienced many of the same things as her clients and having been in treatment herself, she may have valuable experience and know what may be useful. The clients in question seem to struggle with being "stuck" and may benefit from seeing situations from a different perspective. So these Ts likely eee a lot of repeat self sabotaging behavior along with repeated requests for help with changing the behavior. So, some people get creative. In my case, if some story helped me progress and I found out after the fact it wasn't true, I would not be bothered in the slightest.

[cool09]

The story method helps me see how I could do something differently but doesn't feel like pressure to do so.

My therapist put pressure on me to do what she said. When I brought serious problems up she dismissed them as making excuses for not getting better. And she shot nasty looks at me.

[here today]

Linehan's approach would absolutely not work for me. My conviction/certainty about that comes from years of believing what seemed valid to me, too, that "the only way out is through" and trying to do that in every conscious way that I could.

Linehan's approach infuriates me. She, and people of her ilk, have NOT been there for me. Are not there for me. They have instead pushed me back down to hell, with the additional poison/despair of their shaming, rejecting responses.

After years of (ineffective to harmful) therapy that did not identify or address what I believe were some core issues, I was finally diagnosed with a dissociative disorder as well as PDNOS, a personality disorder not otherwise specified.

But I do not have BPD, in fact it's probably kind of the reverse in some ways, although I can get into a BPD-ish state. Doing that, I thought, was "progress". I was "in touch with" and "expressing" my feelings -- only to be shamed and rejected by therapists!! OK, the behavior and responses I had when in that state weren't always very socialized. And where am I supposed to find or unlock those aspects of myself and try to learn and socialize them before I come to therapy since they are not allowed in it? Absolute catch-22 and insane.

Therapy often put me more in a fiercer, broader hell. And then abandoned me there.

ETA: DBT was useless, counterproductive for me, too. I wonder why? But none of the therapists ever did. I guess they "knew". I was "resistant"? It's what they've got these days for "personality disorders" -- why bother even having different ones spelled out in the DSM? -- so when I tried an intensive outpatient program a few years ago, that's why they put me in. The entire thing was a waste of money which I -- desperate -- paid out of pocket.

[stopdog]

I always find the comments to those videos interesting. I liked when the one therapist who said she saved a client was corrected by another that the client saved herself with the first's help. I doubt the first even helped -but the second therapist was being generous.

Perhaps an interview technique to use when hiring new therapists would be to show them the video and ask them to comment. Those who think the idea is brilliant would be immediately struck off my list.

[missbella]

Lineham’s through-hell’s-ladder-to-redemption law is, to me, an example of sophistic thinking in therapy.

In my campaign to be the bestest little therapy client ever, I did sadness on demand. I dived into every misery and meanness to me I could remember. (So don’t the competitive scolds admonish me about doing the work; I maybe made myself more miserable than you.)

And you know what living with the sadness taught me? It was a masters degree in how to be a depressive. It habituated self pity.

Frankly the true picture of most lives is some mixture of joy, sorrow, drudgery and discovery. I don’t think reliving the most awful of it even a true picture. I wonder what therapy might have been if I relived the happy and lucky parts of life.

I wish I’d been more—resistant.

Edit: Here Today, just read your post. Think we came to the same conclusion.

Deception from someone I'm hiring to help me is disturbing and triggering.

[healinginprogress]

Eh, I don't see an issue, per se. I think that change is hard for a lot of people, and a lot of people have problematic behaviors that can be addressed and they can be "sold" a different behavior. The fact that therapists aren't flawless can throw a wrench in this idea, but I don't think it means the entire idea has to be dismissed.

It's not the right approach for everyone for sure.

[MRT6211]

I actually really liked what Dr. Linehan has to say. The hell analogy was great and very pertinent to me. My T practices DBT and now I can see that she really did use that technique to break my resistance behavior. I don’t see it as manipulative, I see it as her being good at her job. She was able to do what no one else before her could. She was able to bring me back from pretty much non-functional to my highly functioning self. She can use whatever technique she wants for that, hell, that’s what she went to school to learn how to do. I’m so grateful for it.

[Jazz1971]

Originally Posted by missbella

Lineham’s through-hell’s-ladder-to-redemption law is, to me, an example of sophistic thinking in therapy.


In my campaign to be the bestest little therapy client ever, I did sadness on demand. I dived into every misery and meanness to me I could remember. (So don’t the competitive scolds admonish me about doing the work; I maybe made myself more miserable than you.)


And you know what living with the sadness taught me? It was a masters degree in how to be a depressive. It habituated self pity.


Frankly the true picture of most lives is some mixture of joy, sorrow, drudgery and discovery. I don’t think reliving the most awful of it even a true picture. I wonder what therapy might have been if I relived the happy and lucky parts of life.


I wish I’d been more—resistant.


Edit: Here Today, just read your post. Think we came to the same conclusion.

Whether or not the concept of sitting with emotions is helpful depends on the clients' presenting concerns as well and skill level of the therapist. In my opinion, the skill level simply rests in knowing when to try something and when it's not working. Sadness and anxiety are normal feelings that everyone needs to cultivate a certain level of tolerance for if they are to survive. That's the basis of DBT. But DBT is definitely not for everyone and skilled Ts should know this. What one person finds useful is a nightmare for someone else. In my experience I liked a T or pdoc who pushed me outside my comfort zone but that's the nature of my personality. I think that's what the Ts in this thread are going for although some of them seem more arrogant than others.

[missbella]

Originally Posted by Jazz1971

Whether or not the concept of sitting with emotions is helpful depends on the clients' presenting concerns as well and skill level of the therapist. In my opinion, the skill level simply rests in knowing when to try something and when it's not working. Sadness and anxiety are normal feelings that everyone needs to cultivate a certain level of tolerance for if they are to survive. That's the basis of DBT. But DBT is definitely not for everyone and skilled Ts should know this. What one person finds useful is a nightmare for someone else. In my experience I liked a T or pdoc who pushed me outside my comfort zone but that's the nature of my personality. I think that's what the Ts in this thread are going for although some of them seem more arrogant than others.

At the times I thought I was doing great things, and the therapists collaborated in the folly. But my bottom line is my self-efficacy, and therapy only set me backwards. Wallowing in my sadness only habituated depression. It literally taught me to be depressed. And it distorted my memories of childhood which had happy moments as well.

I thought Lineham presented the dive into sadness as an absolute principle for "recovery."

[ListenMoreTalkLess]

Originally Posted by cool09

My therapist put pressure on me to do what she said. When I brought serious problems up she dismissed them as making excuses for not getting better. And she shot nasty looks at me.

I would consider telling someone they are making excuses and shooting nasty looks as coercion or pressure. I do not doubt that therapists pressure and bully clients. But telling a story does not by itself constitute pressure. I would not stay with any therapist who was pressuring me or telling me what to do. I've never been the type of client who wants to be the star, please the therapist, or grovel for their attention. I've always been directly in the driver's seat.

[here today]

Originally Posted by missbella

At the times I thought I was doing great things, and the therapists collaborated in the folly. But my bottom line is my self-efficacy, and therapy only set me backwards. Wallowing in my sadness only habituated depression. It literally taught me to be depressed. And it distorted my memories of childhood which had happy moments as well.

I thought Lineham presented the dive into sadness as an absolute principle for "recovery."

Self-efficacy is key for me, too. I say that now having lost a lot of self-efficacy in the name of getting "help". I would have thought therapists might want to be aware of the possibility of that. The principle of "Do no harm". But, hey, in my experience, that's not on their radar.

[Jazz1971]

Originally Posted by missbella

At the times I thought I was doing great things, and the therapists collaborated in the folly. But my bottom line is my self-efficacy, and therapy only set me backwards. Wallowing in my sadness only habituated depression. It literally taught me to be depressed. And it distorted my memories of childhood which had happy moments as well.

I thought Lineham presented the dive into sadness as an absolute principle for "recovery."

I agree and I would draw a line between experiencing sadness versus wallowing in it. One encourages self sufficiency and the other does perpetuate self pity and probably depression. DBT strives to encourage distress tolerance and letting go, but whether his is actually the outcome depends on a lot of different things. I think a therapist that pushes clients to wallow in negative emotions doesn't know what they are doing and would do more harm than good.

[missbella]

Originally Posted by Jazz1971

I agree and I would draw a line between experiencing sadness versus wallowing in it. One encourages self sufficiency and the other does perpetuate self pity and probably depression. DBT strives to encourage distress tolerance and letting go, but whether his is actually the outcome depends on a lot of different things. I think a therapist that pushes clients to wallow in negative emotions doesn't know what they are doing and would do more harm than good.

I was tolerating the stress already by going on to other things and through humor. I'd already moved on, and nothing was served by going backward.

[JaneTennison1]

I always reject the idea that if a person is resisting it is because they do not wish to heal rather than the method described may not work for them. I am not afraid of whatever I have to go through but to say because I am not willing to do A and A is the way to heal, I am therefore resistant to getting better is an annoying idea. I have found that B works for me and through finding a therapist who does B also we have made great progress. This one size fits all approach can be so patronising.

It also blames the client a bit as they are selling their best idea and doing their best work but you are not getting better, it must be because you resist and don't work as hard and that is why it fails. My ex T 2 took that approach, that she had done her best for me, ,my failure to get better was mine alone. Just because a person does their best doesn't mean it helps you. (as an aside if that was her best I would hate to see her worst, yikes)

[BudFox]

I don't know how anyone can listen to therapists talk this way and not wonder what is wrong with them (therapists). It's not normal to be so convinced you can fix people.

Notice Linehan says "the only way out is to go through the painful things". I assume she means go through the things in therapy. There is no only way out of anything. This is a sign of disordered thinking.

And using creepy language like "resistance", which evokes images of coercion and indoctrination, seemingly without awareness of those connotations, likewise is troubling.

I would not let either of those women inside my head if you paid me.

[zoiecat]

I'm going to go against the grain here. DBT has helped me tremendously with emotion regulation of which I learned nothing as a child. I do not have BPD. My therapist has used yhe ladder out of hell scenario to illustrate to me that he understands how painful my emotions are for me and ro show me hope for the future. He told me upfront it was from Lineham's DBT program.

My T uses many techniques including DBT, CBT, and EMDR in addition to general talk therapy. He tries very hard to get through my hard-wired negative thoughts. He knows that this is a slow tedious process due to the number of years I experienced repeated traumas and my advanced age.

For those who say different techniques would never work for you, out of curiosity I ask what techniques do work for you?

Not everything

[ruh roh]

What works for me is an adult conversation, being listened to, and examining what's happening today in light of where I have come from. What doesn't work is any kind of behavioral therapy, coaching, and manipulation/reframing of my experiences, which I find insulting and ineffective.

[JaneTennison1]

Originally Posted by zoiecat

I'm going to go against the grain here. DBT has helped me tremendously with emotion regulation of which I learned nothing as a child. I do not have BPD. My therapist has used yhe ladder out of hell scenario to illustrate to me that he understands how painful my emotions are for me and ro show me hope for the future. He told me upfront it was from Lineham's DBT program.

My T uses many techniques including DBT, CBT, and EMDR in addition to general talk therapy. He tries very hard to get through my hard-wired negative thoughts. He knows that this is a slow tedious process due to the number of years I experienced repeated traumas and my advanced age.

For those who say different techniques would never work for you, out of curiosity I ask what techniques do work for you?

Not everything

Long term therapy definitely helps me more than 6-8 sessions, I would like to try EMDR and I'm sure some CBT/DBT techniques would work if only applied slowly and not thrown at me like a formula I must follow to get better. Therapists who see failure to get better as my failing rather than just that CBT/DBT isn't working really have no place for me

[missbella]

Originally Posted by BudFox

I don't know how anyone can listen to therapists talk this way and not wonder what is wrong with them (therapists). It's not normal to be so convinced you can fix people.

Notice Linehan says "the only way out is to go through the painful things". I assume she means go through the things in therapy. There is no only way out of anything. This is a sign of disordered thinking.

And using creepy language like "resistance", which evokes images of coercion and indoctrination, seemingly without awareness of those connotations, likewise is troubling.

I would not let either of those women inside my head if you paid me.

My way out was to work, solve problems, do good deeds for friends and family, put my creative product in the world and stop feeling so beholden to assumed authorities and experts. Feeling more efficacy was the opposite of rehashing my woes under someone’s instruction who’d consider me noncompliant if I failed to follow her formula.

[here today]

Originally Posted by zoiecat

I'm going to go against the grain here. DBT has helped me tremendously with emotion regulation of which I learned nothing as a child. I do not have BPD. My therapist has used yhe ladder out of hell scenario to illustrate to me that he understands how painful my emotions are for me and ro show me hope for the future. He told me upfront it was from Lineham's DBT program.

My T uses many techniques including DBT, CBT, and EMDR in addition to general talk therapy. He tries very hard to get through my hard-wired negative thoughts. He knows that this is a slow tedious process due to the number of years I experienced repeated traumas and my advanced age.

For those who say different techniques would never work for you, out of curiosity I ask what techniques do work for you?

Not everything

I learned numbing out and over-control as a child. Some negative emotions were not there but what was left was well regulated.

I got into therapy originally when I was 15 and developed an eating disorder, overcontrolling my food intake to the point I was starving myself nearly to death.

Early therapy, instructing me to "get in touch with my feelings" helped some. Also the family therapy, when my parents were encouraged to be more supportive and less perfectionistic. I moved on, went to college, went to work, got married, had children.

But I still felt something wrong inside. Felt somewhat broken. Didn't have close friendships or many relationships, much, except for family. Had little sense of direction. Kept going to therapy, off and on, looking for answers. When my late husband died I got very serious about therapy because I didn't have a good sense of who I was and how I would get along in the world, what purpose there was for me.

DBT did not work for me because I could depend on cutting emotions off when they were too intense. The interpersonal effectiveness module which I had some hopes about when I first heard about it just didn't "take" with me. I felt like I needed some pre-requisite for the class that I hadn't had. I told the leader and she just scoffed at me and told me to keep trying.

There really are no techniques that are recognized as having a solidly good prognosis for personality disorders other than BPD that I have found, despite extensive research. Schema therapy seems to offer the most hope, from what I can tell but there are no therapists who are certified in my area.