DBT; Subscribing to the System

I’ve now been through three quarters of the DBT (Dialectical Behavioral Therapy) program and I have started my final chapter; Interpersonal Effectiveness.

That means I’ve been through Emotion Regulation, Distress Tolerance, and Mindfulness. I’d say I entered this program feeling rather skeptical (I hated CBT – Cognitive Behavioral Therapy, and generally disagreed with several of their claims about how the brain works) and while I didn’t know anything about DBT before, I quickly found myself sinking into a system of techniques that only added to my current ones without taking anything (useful) away.

As it turns out, I’ve been “practicing” several DBT techniques for a long time, things like distracting myself through immediately unsolvable emotional crises, or using changes in body temperature to calm myself or bring myself out of a slow depressive stupor. For the most part, I would say at least three quarters of what I’ve learned has been useful in some way -including new ideas, like working not to suppress negative emotions but to sooth myself through them instead. Overall I would say the subject matter has been presented in a very organized way which I really appreciate, and now, 75% of the way through the program, I feel a bit like this system is something I can really subscribe to.

I am really slow to jump on bandwagons, I tend to be too curious about what makes them tick to be able to adapt to them well. I like when I can see results quickly and know why they are happening, I like efficiency, and organization, and have a hard time putting all my chips into something I don’t understand.

So… what’s the problem, right? Up to this point, things with DBT have gone swimmingly! The trouble is that last week we started on Interpersonal Effectiveness. Communication and relationships with others are by far my Achilles heel, so at first I was really excited to get to this section.

The group was instructed to go through a series of statements and pick out which ones were myths and which were facts. I wasn’t born yesterday, the page was clearly headed, “Myths in the Way of Relationship and Self-Respect Effectiveness” and “Myths in the Way of Objectives Effectiveness” (fancy talk for convoluted thinking that keeps people from asking for what they want, saying no, and generally maintaining healthy relationships). So they’re all myths (you tricky teachers you!). I sat feeling quite superior at this realization.

But then, then I started to read them. Confusion began to rise as I chewed on my lip and skimmed through both blocks of text. I admit, I glanced over at the papers of my peers who had checked two or three of the boxes as things that rang true to them, but after everything was said and done I’d checked off at least half of the entirety.

“These are myths,” said my brain. “So why do we (brain and I) believe they are true?”

I sat there, confounded, rationalizing some of the statements.

“Well, I mean ‘everybody lies’ may not be an absolute truth, because… well… maybe some people don’t. I find that hard to believe, but in 6 billion people there might be a few who never lie, so I can accept that as a myth that feels true.”

“How about number 21? ‘Revenge will feel so good it will be worth any negative consequences.’ Well… that one usually feels true but having some experience in the revenge arena I can tell you it doesn’t always feel spectacular, so I can accept that as a myth that feels true.”

When the teacher called on me I joked my way through my response, did a small song and dance, and handed the imaginary baton to someone else. I was still quite disturbed at the discrepancy between the sort of general beliefs that had got me to that point and the fact that they were labeled myths on the page in front of me. It was like someone had told me my green shirt was actually called “orange” and I’d been wrong all along in believing “green” existed.

More seriously than the ones I described were others I could not seem to contradict. Statements like:

“I shouldn’t have to ask (or say no), other people should know what I want (and do it).”

“They should have known that their behavior would hurt my feelings; I shouldn’t have to tell them.”

“Other people should like and approve of me.”

“I should be willing to sacrifice my own needs for others.”

These were all things I could hold in one hand and look at saying, “perhaps this isn’t true,” but in general, when I got down to it, they were all ideas that have shaped the way I interact with others.

I left class last week thoroughly wigged out. My first reaction was to throw DBT under the bus and conclude it didn’t know what it was talking about. I couldn’t understand it, and so I had little ability to trust in it. At the same time (as I mentioned), Interpersonal Effectiveness is definitely the thing I struggle with the most so it seemed more reasonable to assume I am the issue in this situation.

I brought it up in therapy at the beginning of this week and my therapist (one of the teachers of the DBT group) told me to “think of it as an opportunity”. There have been so many areas of my life that I have been willing to experiment on, trying over a dozen new psychiatric medications, trying new techniques to help with mood swings, or falling asleep, or my general health. However, with all of this kind of experimentation I only lost a day, a week, my mental or physical stability for a brief period.

It takes an extraordinary amount of effort on my end to maintain an even vague sort of relationship with another person, so these relationships are extremely precious to me. Frankly, in many ways I am terrified of experimenting with them, it seems that the risk of losing a friend by suddenly behaving differently is more significant to me than losing a day to depression, or a week to hugely swollen lymph nodes. This notion that only bars my better judgement; I know I need to improve at communicating.

I took a French class at a local college in high school and almost failed the class. I had been a straight A student up to that point, but for some reason the very act of having to speak aloud, speak strange sounds and arrangements of words I didn’t fully understand, well it freaked me out. Being able to communicate in a way other than I’m used to is something I aim to learn, but, like French, don’t be too surprised if there is a lot of hacking and gagging involved before I get it right.

 

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6 responses to “DBT; Subscribing to the System

  1. Hi Sarah,
    Another of the insightful posts I have come to expect. What you are learning about is called mindreading in Neuro-Linguistic Programming: other people just know your thoughts and feelings without you having to say it. There may be a more secret way to experiment: at a meal when you want the salt or ketchup passed to you, try beaming the request silently to other people dining with you. Clock how long it takes for them to get the message. You may want to keep eating, though, as your food cools off.
    I’d like to pass on a bit of news for you: Marsha Linehan, one of the creators of DBT is giving a talk at Kane Hall at UW on 4/27 @ 7:30 PM. See you there?

  2. Hey there. I’m actually doing DBT too. Mindfulness is incorporated into all the modules. I just finished interpersonal effectiveness and am doing emotion regulation next. I have already ended up using distress tolerance skills even though I technically haven’t done that training. As for interpersonal effectiveness – I found it interesting. I think part of DBT is to question some of our thoughts that we have made into facts, and really evaluate them again. it’s a practice so we can’t “fix” it, which is hard for me when i feel like every time i don’t use the skill i’ve “failed.” but that’s a problem all on it’s own. Thanks for writing about this. It’s made me want to evaluate my experience as well. I’m also glad that while it is difficult you feel you are getting something from it. It’s amazing how simple some of the skills seem but in practice, how difficult they can be. I’m happy to speak further about IE – I found some parts interesting and practicing it has been a bit odd.

  3. I’m a fellow DBT follower…it can (seemingly) work miracles, when one is willing and abandons willfulness. At least, that is what I have personally found. Good luck to you on your journey.

  4. Hi Sarah, did you go to the Linehan talk? She didn’t get into the details as much as provided her path to her discoveries/borrowings. Very humble and hard working. I wish you well.

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