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My Journey With DBT: Part 1

By: Allison Strong

 

 A year ago, I wrote about Zen, Mindfulness and Dialectical Behavioral Therapy (DBT).

DBT is an update on Cognitive Behavioral Therapy—both written by Marsha M Linehan, Ph D. Originally, DBT was strictly for the treatment of borderline personality disorder, a condition for which there is no medicine. Today it’s applied much more broadly to include conditions like substance abuse, anxiety, chronic pain, etc. Dr. Linehan’s textbook is available online. It’s called “DBT Skills Training Handouts and Worksheets.” One doesn’t need to be a Zen Buddhist to be Mindful or be in Dialectical Therapy, but Mindfulness is central to making progress in DBT.  

Because I have bipolar disorder, I’m often encouraged to do individual work, but get very little benefit. Over the years, I’ve tried and tried, but just can’t make headway. After rehashing my problems in private over the course of eight or ten sessions, I’m always more broken than before.  I was ready for something new when I got the assignment to research and write about Dialectical Behavioral Therapy, (DBT). Now, I’m finally in a DBT program. It’s the hottest ticket in South Florida, with a three month waiting list.  DBT is comprised of several different modules. They all last about 12 weeks with a month break in between. The minimum time commitment is one year, but most of the people in my class have been there for two or three!

DBT does require weekly one-on-one therapy to monitor your progress using the skills. The focus of treatment is based on a Triage system with the most urgent and life-threatening habits first; the logic being the client can’t benefit if they’re dead. Makes sense, right? For example, if the focus is substance abuse and you arrive intoxicated, you might be admitted to class but not allowed to share.  After all, that’s the problem you’re working on!

My current skills building track is interpersonal communication incorporating conscious choices, i.e., Mindfulness. I originally wrote Mindfulness off as a catchall or buzzword. It’s not. It’s pure Genius. Mindfulness is a feat in and of itself. It turns out that being in the moment is NOT our default setting. Behavioral scientists recently discovered human beings forecast the future through the tinted lenses of the past. This is called “Prospecting.” We spend three times the time ping ponging yesterday and tomorrow back and forth than being present for today. This limits us to the patterns we learned as kids. We can’t realize our potential for growth, or choice, even.

DBT promotes what’s called “Wise Mind.” This is the opposite of “Emotion Mind,” where we’re trapped in that echo chamber of past/future, past/future. In “Wise Mind,” we “Prospect” a little bit, but not overly so. Almost as if we’re trying on clothes, we contemplate the outcomes of using or NOT using various skills we’re being taught. We’re given worksheets to practice scripts we create.

But before we write our lines, we prioritize the big three: Do we,

A: Want something from the other person?

B: Want to strengthen a relationship?

C: Wish to Maintain Self Respect?

What you choose depends on the situation and your priorities, not someone else’s.

It’s completely up to YOU.   

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