How long do you try

That is a good point, and one that I have absolutely considered. It's probably one of the main reasons that I have stayed as long as I have. Is this the therapist I don't like or the therapy? I do know that DBT is directive and it is true that I have normally not liked directive therapy. But I also wasn't progressing as well as I wanted to in talk therapy and I researched exactly how the therapy was done and it looked like something that made sense to me.

I think one of the main problems was and is that she doesn't seem to be doing what the videos and the books say she is supposed to be doing...like chain analysis. The books say that you are supposed to look at thoughts, feelings, situations, vulnerability factors, consequences all around a particular behavior that happened that week. The theory is that every behavior has a cause and is thus understandable. I kept the diary card religiously, but we never did any chains. Instead she'd say something like "oh you were having suicide thoughts on Thursday, did you consider opposite action or improve the moment or soothe with the five senses?" And I'd say "I don't know how to do those skills."

This started from the very beginning, when I got to thinking she hated me (one of the reasons I went into therapy...I often think that people hate me for no apparent reason) and she'd say in a harsh voice "You need to check the facts." It was two more weeks until I figured out that "check the facts" was an actual skill. My response to her was "how am I supposed to know the facts of if you hate me or not?" But no...you are supposed to go through this complicated set of instructions to figure out the "facts," and it is actually kind of helpful.

So in order to avoid being scolded for something I didn't know, I thought it'd be nice to learn the skills. But she says that she wasn't scolding me, only it sounded like scolding and viscerally it felt like scolding, So either she is scolding and lying or I'm crazy. Either way isn't a good thing.

I'm quite sure that I'm a part of the problem, maybe even the majority of the problem because after all, I'm the "sick" one. But one thing I like about DBT is the assumptions and one of the assumptions is that "Clients can't fail at DBT." When a person dies of cancer after chemotherapy we don't say "she failed at cancer treatment." We say the treatment failed or the doctor wasn't skillful enough. But in therapy they often blame the client: she didn't try hard enough. DBT says that the treatment can fail or the therapist can fail, but the client can't fail at DBT.

It is possible (likely actually) that I am overly critical. And I do freak out about not being in control. But I do think before I give up on this treatment that I think sounds so promising that it might be worth trying with another therapist. There is the personality portion too.

@maybeblue, a couple of things you said have jumped out at me. You say that she isn't "doing what the videos and the books say she is supposed to be doing" (emphasis mine). You also say "I *think* that is an incorrect use of self-disclosure" (emphasis mine).

What caught my attention is these are very black and white statements, and suggest you have a very rigid view of what "correct" DBT looks like. This kind of rigidity is pretty normal for someone with BPD.

Don't get me wrong - DBT as described by Linehan is very strict and regimented. There's a process for everything, and you have to do things a certain way. However, it sounds like this therapist doesn't do DBT (at least individual sessions) in exactly the way you want it/think it should be done.

Perhaps (part of) what is happening is that your expectation of what DBT "should" look like is colliding with what the therapist is trying to do, hence her comment that "you aren't letting me do DBT". AKA, you're trying to direct the therapy more than she thinks you should.

It definitely sounds like you are not the only one who is frustrated and feeling this is not going well. It’s good that she has been discussing this with the team - they’re helping her to not fail you (or, if not you, to not fail the next client0

Some thoughts for if you want to continue trying with this therapist. I would go into your next session with some notes. Be very direct and avoid accusations, just neutral observations. Comb through your posts here and pull out some bullet points about what you're struggling with. Something like: you've asked me if I’ve used skills like check the facts, but we never went over it together.

That said, she seems emotional and defensive. You might have better success if you can word your feedback in such a way that it is not “how am I supposed to know how to do xyz if you don’t teach me” but more “you said when I feel x, I should do y skill. Can we go over how to do that?” When she comments on your diary card and asks did you try these skills - instead of just saying “I don’t know how” (which she may interpret as kind of shutting down/digging in), maybe ask if you can practice with her so you know what opposite action looks like for next time.

Thank you for your response. It is likely that her method of doing DBT is not meeting up with my expectations. Like I said, I have only read books which are somewhat rigid.

Also, not that it really matters, but I'm 49 years old and have never been diagnosed with borderline personality disorder. I don't meet all the criteria. But I have had depression off and on since I was 12. I also had a trauma about a year ago which has really escalated my fears of being out of control. And I have extreme interpersonal sensitivity and am very sensitive to criticism. Also I eat too much. So I met the criteria for DBT easily, just not BPD...mostly because I don't typically have anger outbursts or self-harm or make suicide gestures or attempts.

I have brought up my concerns with her many times. I've tried writing them all down on the diary. I've tried reading her stuff. I've tried emailing her. I have tried to be very specific and objective. She did walk through a skill with me once. It was very helpful. I asked her several times if she could be more validating and reinforcing and she was for a little while. Then the team told her the same thing. So it was ok for about half the session last time and then she got frustrated.

I really have tried to work it out. But another problem is that I'm terrified of her. And it really might be just something about her demeanor reminds me of an abuser. I sent her a very non-dialectical and angry email though, so maybe she'll fire me and save me the hassle of making a decision.

Apologies - I only mentioned BPD because I thought you'd mentioned you had that diagnosis. I was wrong, and I'm sorry. Rigidity and black and white thinking are very common among others too - depression, trauma history... all of that.

And... I stand by my first post in this thread. You get to decide, whenever you decide, if you want to continue. It certainly sounds like you've made a strong effort to work with this therapist. If it's not a match, it's not a match. That does not make you a bad person or a bad client. It just means it is not a good fit.

Thanks. I wasn't upset by the comment about BPD. I've wondered, but a couple of therapists didn't think so.