DBT chat

I am leading a chat about DBT at 10:30 a.m. on Thursdays (now). It isn't on the chat schedule, but I will be there if anyone wants to talk about DBT therapy or skills. If you have any experience with DBT, I would welcome your input, and if you want to learn about it, come on in.

Please note that this is a chat intended for informational purposes only, and is not intended to take the place of any therapeutic intervention. I am hoping to learn a lot too.

That said, I am a counselor intern, and I am running DBT groups IRL. I am learning as I go, as I have mostly read the books from Marsha Linehan and I'm trying to figure it out for myself. I am working on how to get more specific training and network with other, more experienced, DBT therapists. I'm also aware that I need DBT Skills myself, and I see this group as a peer group discussion, where I will be just one of the group and I would appreciate support and feedback too.

I would be happy to have any comments, suggestions, requests, etc. from any of you. Feel free to reply to this thread, PM me, come to the chat, etc. If you want to study more about DBT on your own, http://www.dbtselfhelp.com/ is a terrific source. I have found examples there beyond what is in the skills manual, and variations on diary cards that I like better than the one in the skills manual (if you want to use a diary card, go pick one out and print it). My vision for this chat is something like the self-help groups that the author of dbtselfhelp.com talks about. I wish that there were such a live support group available where I live. I would join it.

Anyway, see 'ya in chat!

Rap

((((((((((((((((( Rap )))))))))))))))))))

I promised that I would post an explanation of what DBT is. DBT stands for Dialectical Behevioral Therapy, although that doesn't really tell you a lot. Dialectics are pairs of opposites, or extremes, and the object of DBT is to find those extremes, and balance them, finding the middle ground. For example, you might tell yourself "I am completely worthless" and also "I have to be perfect in all areas in order to be okay." Those are both extreme ideas, and if you hold on to both of those extremes, it would be very hard to ever accept yourself for who you are. DBT would attempt to find the wisdom that is in each of your statements and bring them together into a synthesis such as "I am okay just the way that I am, AND I have things that I would like to work on and change about myself."

In DBT Skills Training, there are four modules, and the skills all fit into those areas.

Mindfulness is developing more awareness of yourself, your thoughts, your feelings, and your environment, very similar to grounding skills. Mindfulness is helpful in managing dissociation, thinking errors, and any problems that you might have in connecting with yourself and real life.

Interpersonal Effectiveness is very similar to assertiveness training. It teaches you to monitor your relationships, identify what is important to you, prioritize, and ask for what you need and want in a way that enhances or improves both the way that others feel about you, and your own self-respect.

Emotion Regulation helps you to understand and manage your feelings or emotions appropriately, rather than shutting them off or letting them blow up and get out of control.

Distress Tolerance is about getting through intense and painful emotions without losing control, shutting down, having a melt-down, acting impulsively, etc.

Although DBT was originally developed as a treatment for Borderline Personality Disorder, it has been found to be useful for addictions, impulsive behaviors, depression, anxiety, dissociation, PTSD, and other applications as well. The skills are basic skills that probably most people have not perfected but people who are effective in life are generally able to use at least some of these skills in ways that work for them (although they probably don't name them and analyze which skill they are using and why on a day to day basis). All of us have some skills, and most people have room for improvement in some areas.

DBT is a Cognitive-Behavioral therapy, that also uses insight and borrows from Eastern philosophy and spirituality. Basically, it is CBT with a kick.

Feel free to jump on in if you have anything to say, or any questions, here, and/or join us next Thursday.

(((Rap)))

Thanks! My T is acutally working on these skills with me. She recently gave me a set of emotional regulation worksheets, has talked to me about wisemind, which I still have trouble understanding. I was hoping that I'd gt a chance to join that chat and learn a little more about DBT skills, more specfically wisemind...so I can actually start making use of that skill, but I am at work Thursday mornings. But thanks for the link

--LLT

Okay thanks for explaining

This morning we talked about Behavior Chain Analysis of Problem Behavior. This is a tool that you can use if you notice a pattern of the same thing happening over and over and causing difficulties for you somehow. You may or may not be aware of your part in the pattern. You can follow these steps to figure out how you might be contributing to what happens, and what you could do to break the pattern, and have more control to get results in your life that are more to your liking.

If you would like to talk about this tool, feel free to post here in the thread, or come to next week's DBT chat. In doing a BCA, it is important to be as detailed as you can. If you think that anything could be relevant, write it down, even if you aren't sure. You have to have all of the data, to find the patterns.

Here are the instructions: (from http://www.dbtselfhelp.com/html/beha..._analysis.html )

1. Describe the specific PROBLEM BEHAVIOR

(flashback, cutting, disassociation, hiding, closeting, panic attack, etc.)
A. Be very specific and detailed. No vague terms.

B. Identify exactly what you did, said, thought or felt (if feelings are the targeted problem behavior).

C. Describe the intensity of the behavior and other characteristics of the behavior that are
important.

D. Describe the problem behavior in enough detail that an actor in a play or movie could recreate the behavior exactly.

2. Describe the specific PRECIPITATING EVENT that started the whole chain of behavior.

A. Start with the environmental event that started the chain. Always start with some event in your environment, even if it doesn't seem to you that the environmental event "caused" the problem behavior. Possible questions to get at this are:
What exact event precipitated the start of the chain reaction?
When did the sequence of events that led to the problem behavior begin? When did the problem start?
What was going on the moment the problem started?
What were you doing, thinking, feeling, imagining at that time?
Why did the problem behavior happen on that days instead of the day before?

3. Describe in general VULNERABILITY FACTORS happening before the precipitating event.

What factors or events made you more vulnerable to a problematic chain? Areas to examine are:
A. Physical illness; unbalanced eating or sleeping; injury

B. Use of drugs or alcohol; misuse of prescription drugs

C. Stressful events in the environment (either positive or negative)

D. Intense emotions, such as sadness, anger, fear, loneliness

E. Previous behaviors of your own that you found stressful

4. Describe in excruciating detail THE CHAIN OF EVENTS that led up to the problem behavior.

A. What next? Imagine that your problem behavior is chained to the precipitating event in the environment. How long is the chain? Where does it go? What are the links? Write out all links in the chain of events, no matter how small. Be very specific, as if you are writing a script for a play.
What exact thought (or belief), feeling, or action followed the precipitating event? What thought, feeling, or action followed that? What next?
Look at each link in the chain after you write it. Was there another thought feeling, or action that could have occurred? Could someone else have thought, felt, or acted differently at that point? If so, explain how that specific thought, feeling, or action came to be.
For each link in the chain, as if there is a smaller link I could describe.
B. The links can be thoughts, emotions, sensations and behaviors.

5. What are the CONSEQUENCES of this behavior? Be specific.

How did other people react immediately and later?
How did you feel immediately following the behavior? Later?
What effect did the behavior have on you and your environment?

6. Describe in detail different SOLUTIONS to the problem.

A.Go back to the chain of your behaviors following the prompting event. Circle each point or link indicating that if you had done something different, you would have avoided the problem behavior.

B.What could you have done differently at each link in the chain of events to avoid the problem behavior? What coping behaviors or skillful behaviors could you have used?

7. Describe in detail the PREVENTION STRATEGY

A. How could you have kept the chain from starting by reducing your vulnerability to the chain.

8. Describe what you are going to do to REPAIR important or significant consequences of the problem behavior.

We are chatting now.

At last, I found this thread. Someone (from the online chat forum) told me about DBT chat on Thursday which I couldn't do it due to work. Is it ok if I'd print this out for myself (I was dx with BPt&BD) I do really need help especially that I'm returned to work recently and the stress is already on me.

By all means. Print out anything that you find helpful. And feel free to participate here in this thread, or to PM me if you like, too. Maybe I'll end up changing the time of the chat so that more can come, eventually.

many thanks rapunzel

is the dbt chat still going on?

I have not been doing chats for some time, but I'm not sure if someone else might be doing a DBT chat.

Ok! Thanks for letting me know!