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DIALECTICAL BEHAVIOR THERAPY
|"DBT is a life enhancement program, not a suicide prevention program." ~ Marsha Linehan, PhD.|
DBT Day Treatment 11-21-13
N.A.M.I.'s Mobile Community Education 2-18-12
More about DBT and Dr. Linehan 7-16-11
DBT Treatment Overview 3-18-11
In-Depth Discussion of DBT Skills:
(Radical Acceptance is discussed here, under Emotion Regulation)
Mindfulness, Interpersonal Effectiveness, Distress Tolerance, Emotion Regulation
Dual-Disorders Treatment Centers (Addictions & BPD)
Treatment Centers in Indiana 8-13-12
Treatment Centers in other States (not Indiana) 8-30-12
DBT-Trained Therapists there still is a deficit in this area
Is DBT Enough?
MOBILE, Alabama — NAMI Mobile's February Community Education Program is "Borderline Personality Disorder" with Debbie Kingrea, National Education Alliance for Borderline Personality Disorder. The presentation is Feb. 20 at 7 p.m. at Springhill Baptist Church Activity Center, 11 S. McGregor Ave. It is free and open to the public. Light refreshments will be served. For details, visit www.nami mobile.org.
NAMI Mobile also offers two
free support groups. The Family Support Group meeting is designed to
offer support and education to those living and coping with a
mentally ill family member. Contact Diane Kent at 251-591-8021 or
firstname.lastname@example.org for more details.
Email Greta Sharp at
email@example.com. For more Mobile events, including club
meetings, view the BayWatch calendar at www.al.com.
Today's more modern approaches including Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) have been used, quite successfully, to treat personality disorders previously believed to be incurable. Recently, many in the psychology field have been applying this treatment to a wide range of psychological issues with great success. Those include depression, anxiety, substance abuse and various compulsive disorders. While I'm not a professional in the field, I have studied CBT and DBT to resolve several issues in my life including a devastating compulsive gambling habit. I don't consider myself "cured" yet, but do know it's in my future. This site is dedicated to educating others, like me, who are truly dedicated to ridding ourselves of these damaging behaviors.
There are a number of reasons why we do these self-destructive things over and over again, even knowing how bad it is. Why do we do it to ourselves? Because there are things in our lives we simply can't, or don't yet understand how to deal with. We may have even resigned ourselves to the fact that we'll never be able to resolve them. For each of us it's something different. It may be an abusive childhood or relationship, it may have been a traumatic event like war or rape, or quite possibly it's just dissatisfaction with the life we are living, such as an unhappy marriage, unachieved dreams or a chronic depression.
How did we get hooked? Many of the behaviors began as something social... a feel-good thing. For example we begin to do things like gambling, shopping, eating, taking drugs or drinking alcohol often for fun and enjoyment. We associate great times and good feelings with the behavior. When we're feeling down and can't cope, we desperately want to feel good again so we reach out and cope with the nearest feel-good behavior. They are an escape and our problems don't exist while we're doing them. We make an unconscious choice: face the painful reality of life, or do this fun thing.
At some point, our lives and the stressors become a burden to us. The more we avoid the issues, the bigger they grow. They don't go away, they just get worse and eventually snowball out of control. The worse they get, the more we need to feel good, so we reach more and more for those things. It's not enough to gamble a hundred or so, we need to gamble with thousands. A couple of beers with friends isn't enough, we drink all night even alone. Eventually, these behaviors become so ingrained, we just go on autopilot, we just do it.
We might hit rock-bottom or just see it ahead of us and want to fix it. We simply just don't know how to go about it. Studies show that, in any given year, roughly 5% of us are able to stop on our own, with no therapy, no programs, nothing but a personal decision and commitment. My father was one of those people. He not only kicked a chronic drinking problem but also kicked a three pack a day smoking habit cold turkey. Most of us, however, try to stop on our own but fall flat on our faces. The vast majority of us find a church group or twelve-step program. There, we find others in the same boat. People we can share our experiences with and support. It's nice to know we're not alone and that there's help. In my opinion, the issue with those types of organizations is that they focus on the behavior and managing urges, rather than learning how to get rid of the urges once and for all. As I stated above, talking about our addiction or our compulsion can keep those thoughts alive in our mind and at times even act as a temptation.
I've heard people talk about gambling, alcoholism, drug addiction, eating disorders and many others as if they were incurable diseases which we must constantly work to suppress. In my view, and the view of many, this can serve as a justification for "falling off the wagon". Hey, I can't help the fact that I have this disease, I wish it wasn't there but it is. It's not a disease, it is quite curable, but only if we learn how to effectively manage our own emotions and distress.
Think of your specific behavior as a leak in your ceiling. Water is dripping down on the floor and your belongings. Everyone who gets close enough, can see the drip and knows the water is going to cause damage to your floor, furniture and other belongings. So what do we do? Clearly, we need to stop the water from messing up our stuff. We put a pot under the drip to catch the water. That works for a while, but soon the pot fills up and begins to overflow. So, we change the pot. That's what most recovery methods, do.
Some recovery methods go a little further. Some try and help us patch the ceiling and paint over the water stain. The water does stop for a while, but eventually the leak seeps through the patch and begins to drip again. We learn new, better and quicker methods of changing the pot, without spilling. We learn how to patch the celling quicker and better, stopping the drip for a little longer. The water builds up and sooner or later, it is once again dripping on our floor and belongings.
So, what's the solution? The real solution is to learn how to find the source of the water. Is it a hole in the roof, a broken pipe in the ceiling, or something else? Then, we must learn the skills and get the tools needed to fix the leak. It's not really that important to know what caused the damage...only that the damage exists, how to find it and how to fix it. There are no magic pills or quick fixes to remedy issues that have taken us many years to develop. There are, however, very effective methods of learning those skills to fix whatever leaks might spring in your life. Once we've learned this, and are able to ingrain them in our minds, we can truly consider ourselves cured.
•Protect us -- Before we can
really get on top of things, we need to be safe. That means, we need
to do whatever is necessary to stop the dangerous behavior. If we're
gambling, we have to find whatever means we can to stop gambling....
at least long enough to start rebuilding.
may be the most hopeful and helpful of any new therapy available for
people with BPD. Many people with BPD have problems trusting others,
have “failed in treatment” or have been dropped by former
therapists. When DBT is not done as designed, the results may not be
the same, causing the person with BPD to lose hope and trust and
then be reluctant to ever try DBT again. If DBT is not practiced
according to the research model that produces effective change but
is practiced “my way” by a therapist without adequate training, it
probably won’t produce the same kind of results as the research
programs. Outcomes from this kind of DBT will not justify additional
DBT training or new DBT programs in the community. Currently. Dr.
Linehan is working on a way to certify therapists who practice DBT
so that people can determine if a therapist is truly qualified to
• Have you completed a
10 day intensive DBT training ?
answer to these questions should be yes. You have a right to
check on the therapist’s credentials; to know if the therapist is
licensed in his/her state; to know the extent and nature of the
therapist’s education and training; the extent of the therapist’s
experience in treating clients with similar problems; the
therapist’s arrangements for coverage or emergency contacts.
Dialectical Behavioral Therapy (DBT): Is it Enough? by Tami Green
We recently featured an article which provided an extensive list of DBT inpatient facilities. Our reporter, Kara Kelly, spent considerable time researching these places and the result is a valuable resource for you. Readers since then have also suggested a few other DBT centers and hospitals, and we’ve added them to the bottom of Kara's article for you.
I also received a lot of feedback on that article from folks who have benefited by non-DBT treatment options and it occurred to me that I’ve given most of my airtime to only one recovery alternative.
front, to set the record straight, DBT is not the best treatment
option for Borderline Personality Disorder. It is one of many, and
arguably not the best for some. However, it is possibly the most
widely-available option in the United States at this time, one I
used, and I have also seen it transform many lives in my on-line
With DBT alone, I would not have a life worth living, because, while the skills reduced my symptoms enough to be able to move on to the next stage, it did not assist me in developing a strong sense of self nor a game plan for getting my relationships, body and career on track. I used life coaching to help me get in touch with who I was and what I wanted in life. The result of coaching, and also some non-DBT therapy, is that people and circumstances now don’t knock me off course—I know me, and that remains constant.
So what exactly is DBT and where might it fall short?
a compilation of practical, yet brilliant, skills to be practiced
each week, with one building upon the other. The most important of
the skills is mindfulness, which is the ability to focus entirely on
the present, while pushing all distractions more
For many, reality is hard to accept. Unexpected and overwhelming events like lost jobs, physical illness and financial problems can make us want to give up or refuse to acknowledge the realities of our circumstances.
In Dialectical Behavior Therapy, the ability to accept life, the reality of circumstances in which we find ourselves and the painful events that each of us must endure is taught as a skill.
These skills can be difficult to teach and learn because the ability to respond to the world as it is, is an underlying attitude towards life. These skills, taught in the Distress Tolerance Module of the skills training group, include strategies to get both our bodies and our minds into more accepting attitudes. Below are a few exercises on acceptance:
To cultivate a more accepting state of mind, increase awareness of your body. Start by simply bringing your awareness to the position of your body. This can be done any time and any place. Whether you are walking, standing or sitting, notice your position. Become aware of the purpose of your position. For example, are you folding your arms across your chest in a defensive stance or are you tapping your foot in anxiety. If you notice that your mind has drifted, bring your attention back to your breath. It can be helpful to practice breathing exercises, such as counting each breath or saying “in” with each inhale and “out” with each exhale.
Turn Your Mind
Acceptance requires a choice. You have to turn your mind towards accepting reality, rather than rejecting and judging reality. You must commit to accepting the current situation and reality over and over. Each time your mind tells you it’s unfair or shouldn’t be as it is, you must turn your mind towards acceptance.
When the world seems unfair and you’re feeling stuck, depressed or frantic, it’s natural to want to give up, try to fix what can’t be fixed, or simply refuse to tolerate the situation. Instead of trying to impose your will on reality, focus on doing what works. Do just what is needed in each situation. Your job is to simply do your best, whatever the world throws at you.
Accepting reality can become a habit. If done regularly, it can reduce stress and anxiety and improve your ability to identify and solve the problems in your life. What helps you accept life as it is?
M.M. Skills Training Manual for
Treating Borderline Personality
Disorder. New York: Guilford