Posts tagged DBT
Posts tagged DBT
These are two quasi-scientific terms I now just find incredibly irritating. I am approximately 1/50th as likely to actually follow a piece of advice that includes those words, versus similar advice that manages to avoid including them.
Other words that produce this reaction: “homeopathic,” “survivor” (in the context of trauma, psychiatric treatment, etc.,) and “resistance” (as in “the client is being resistant.”) That’s just off the top of my head, but yeah.
My therapist was sort of flummoxed when I told her that I don’t believe, from a philosophical point of view, that all that many things are impossible to change. She thinks this is a big part of why I don’t like DBT and CBT - and I am inclined to agree (I’ve even said as much here.)
Examples I gave: going off to fight in a war that will probably be lost, Einstein’s work on relativity and gravitation, fasting and prayer for rain. I fundamentally interpret DBT (for instance) asking me to “accept” something (that’s actually changeable) as it asking me to give up - to declare that I’m not capable of making a difference and that I don’t care to do anything about that. And when I feel that I have a moral or ethical obligation to make a difference… well, I have a real problem with “accepting” the status quo, and yeah, I really believe that my problem is totally justifiable. It’s wrong to accept things that are wrong.
Note: I believe my obligation to try to improve things is not an obligation to solve them. The obligation exists separately from any realistic likelihood of my success as an individual acting in complete isolation, in part because everyone else has that same obligation themselves. The parable of the good Samaritan and all that: that we cannot save the world doesn’t mean we shouldn’t save the suffering man in front of us today.
Note also: one of my miscellaneous current obligations is to point out to people that DBT isn’t a magical bag of pure golden awesomeness. It has its good points and its bad points, and the part where it tells me to just notice stuff and turn off the part of me that cares how it all turns out? One of the less-good points.
(I am baffled by the fact that I’ve been seeing her for 3.75 years and she only noticed this just now.)
This is a continuation of my thoughts on the “standardization” implied by/discussed in that article I linked to earlier. That study basically said that having patients go through a standardized course of treatment at a mood disorder worked better than discharging the patients directly into care in the community. It’s important, sort of, to recognize that the study was done in Denmark, BTW: the treatment in the community probably didn’t involve the same issues that it does here in the US.
Like, when T’Pol is all crying about having too many emotions, I’m all, DUDE. This is exactly what that stupid acronym “ACCEPTS" (which is actually about distress tolerance, and distracting yourself, and has nothing whatsoever to do with acceptance) is for!
This is extra amusing because I feel like the whole point of DBT is to turn traumatized young women into Vulcans.
And it’s super-extra amusing when you find out that DBT people love telling you to distract yourself (using this exact skill) by pretending you’re in another place - and they often specifically refer to the Holodeck.
All of which leads me to remind you all that I love Star Trek and hate DBT.
She’s going to be out of the office this week, so I’m going to send this to her, because she should probably know how I’m feeling about DBT (and whether or not I will stick with it) sooner than two weeks from now.
Today I went to my first group therapy session not in the hospital. And it was… downright survivable. I even spoke a little!
I made a lot of functional improvements in the partial program (it’s been six weeks since I was discharged, by the way.) Stuff like taking out the trash, getting places on time, taking a shower right after first waking up in the morning, doing my laundry before I was completely out of clothes - it was all happening. I wasn’t really trying to make myself do any of those things, they just… happened. So I knew I was getting better.
And now they’re back to not happening. It’s not yet as bad as in May to August, but it’s definitely a step back from where I was. This week at work has been really hard in terms of staying focused on a task, caring about the “boring” part of the job, etc. I hardly did any filing, in part because I had the excuse of taking care of other things. It’s hard to explain, but I am very disappointed in myself because of it.
Probably the biggest single factor is the reduced effort in the DBT/CBT area. I haven’t done an inner critic exercise in weeks, I haven’t filled out worksheets, etc. Part of that has been NaNoWriMo, part of it has been work taking up a good chunk of my “fill out paperwork and do as you’re told” capacity, and part of it is that no one is sitting there telling me to do it.
So NaNoWriMo ends in five days, and I may soon be starting up with a DBT group where they WILL sit there and tell me to fill stuff out. Can’t do much about the work thing except continue to change meds around so I have a better shot at doing things when I get home.
And I need to make a concerted effort to take care of my psychological state - I’ve been catching myself in negative self-talk and proactively complimenting myself out loud to avoid becoming mired in the “Demeter stinks” narrative, and that’s good. I need to do more of that. And I need to mention this to my therapists and EAP counselor (I believe I have upgraded from “support team” to “army,” by the way.)
Met with J, my therapist, just now. We’re going to work together to find me a group therapy setting of some kind over the next two weeks. I have a bunch of places I’m supposed to research to see what they offer. I’ve also been given homework - I have to go over the notes from the program each morning like I was still there. I think this is a really wise idea; I have floundered today with the lack of structure. And this shouldn’t be too terribly difficult to pull off, even with my concentration skills being in the pits as they are. I’ve decided I’m just going to take two or three of the worksheets each day and re-do them on my own. Maybe throw in some stuff from the DBT skills workbook if I’m feeling up to it.
Speaking of feeling up to things - I do not think I’ll be getting to the laundry today as previously scheduled. I’m having bad chills and I feel like I’ve done an awful lot of stuff, and I’m OK with putting it as a top priority thing for tomorrow. I have high hopes of feeling better tomorrow, though they say discontinuation syndrome can last for several weeks.
Oh, and J thinks I should be able to get an appointment with Dr. E (psychiatrist) sooner than the 31st. I’m supposed to talk with A, the case manager at the program, tomorrow - she might be able to help me with that.
This one, I also own, and I was finding it helpful before I went into the PHP program. I didn’t really get that far into it, but I think I can second this recommendation anyway.
Another book recommendation! This one I can especially support because even though I completely forgot about it, I actually own and have used this.
holykindergarten says: “I recommend people pick up a copy of the DBT [dialectical behavior therapy] workbook for bipolar disorder. DBT is a therapy…