This is a series in which I talk about my experience with DBT. I am not naming any names or institutions that the therapy is associated with. I am not a professional in this field, this is all purely based on my experience and impressions. If you are interested in DBT or other therapies, please talk about it to a medical professional.
So… I’ve been put into a therapy group. I know, I can’t believe it either.
I was told by my psychiatrist that DBT, or Dialectical Behavioral Therapy, would probably benefit me more than medication could. I was skeptical. I’d been a part of group therapy before, and I hated it. Absolutely detested it. In fact, not even a month after I finished my first group therapy course with flying colors at 16, I ended up getting hospitalized. It didn’t help whatsoever.
Expressing these concerns earned me a chuckle from my psychiatrist.
“Maybe you just weren’t ready to be a part of group therapy. Do you think you’re in a different place than you were when you were 16?”
“Do you think you still have trouble handling intense emotions and distress?”
I mean… I do.
“Are you trying your hardest to develop the ability to deal with those emotions?”
“Then why not give it a go? It can’t hurt to try.”
I guess not. Maybe the difference between me and the person I was five years ago is that I am actually willing to get better. Back then, I found those sessions insulting to my intelligence. I had certain ideas of grandeur back then, that I knew everything and that therapists were just over-qualified life coaches. I couldn’t be fixed, I thought.
Now I’m an adult… I guess? It’s hard to say.
Nonetheless, I agreed. I applied, and I got in.
Turns out, DBT is nothing like I thought it would be. I’m going to be completely frank and absolutely transparent as I journal MY experience with DBT, my highs and lows, and whether or not it might be right for you.
This is my first week in DBT. Spoiler, it wasn’t what I was expecting..
What is DBT?
For the uninitiated, Dialectical Behavioural Therapy provides clients with new skills to manage painful emotions and decrease conflict in relationships.
The DBT group sessions are led by two qualified psychiatrists, and I’m in a group of under 15 people. I don’t know if this is a universal size of the groups. Also, I’m not naming any names, and I will not mention what this group is affiliated with, to protect privacy.
Fun fact, DBT was actually originally developed to treat borderline personality disorder, before smart psychology people realized it actually helps a whole breadth of people with disorders like bulimia to addicts to people with anxiety or depression. – Psychology Today
Dialectical means “the existence of opposites”. In this context, the opposites are acceptance and change. It is important to accept ones emotions, and what comes with it, but it’s also important to change our behaviours associated with these intense emotions, and acknowledge the wire trips that come with it.
Typically, DBT is done in groups sessions, and you also have an individual therapist checking in on you one to one to make sure you stay on task and that your needs are being addressed. It’s all about support, and motivation. Plus, DBT typically comes with weekly homework, so that you are held accountable and really trying to apply what you’re learning in your everyday life.
I did a lot of research before I agreed to do this, by the way. I found this study from 2014, the results of which showed that “patients significantly improved regarding self-injurious behaviors, number of inpatient hospital stays, severity of borderline symptoms and psychopathology“. These are pretty intense diagnoses, I admit. I don’t have any of these disorders except for a history of self destructive behaviour, but it didn’t dissuade me. If anything, it was encouraging – if these people with those struggles benefit from this therapy, why shouldn’t I?
My first reaction when I heard about DBT might be the same reaction you had reading this – DBT? Sounds a lot like CBT.
DBT is a type of CBT, or Cognitive Behavioural Therapy. It’s a catch all term for therapies that help patients deal with certain behaviours or emotions. For example, someone with OCD would undergo CBT to reduce obsessive behaviours. Someone with OCD, however, isn’t necessarily enrolled into DBT, because it addresses different behaviours.
(I’m not someone with a doctorate, remember – I’m not at all qualified to tell you what is or isn’t right for you, so if you have any questions, take it to a professional. I’m just discussing my own experiences and impressions here).
I was a skeptic. I hate group therapy, and this required it. At this point, however, I was pretty much ready to try ANYTHING to get my emotions under control. I hated the way they took over my life, I hated that I still had traces of the person I was five years ago in me, and I wanted to kick her out for good. I not only needed this, I wanted this. This makes all the difference in the world. You have to want it.
Here’s what I discovered when I walked into the room, one sunny morning.
My Experience With DBT: What Led to It…
Like I mentioned, five years ago I was a very different person. I lost a lot of people in my life because I was unpredictable, I was vengeful, and I was manipulative. This was all stemmed in my own lack of control over emotions of distress, especially connected to my own fears of abandonment.
Plot twist, except not really because everyone could have seen this coming: my worst fear came true.
Since then I actually stopped going to therapy, stopped taking medication. I went on a little bit of a spiritual journey, so to speak, coming to terms with what had happened.
I decided that my coping skills didn’t accomplish anything at all, which is one of the pillars of DBT. It’s about replacing unhealthy coping skills with good effective ones.
I’ve discovered that this is really important. Don’t go into DBT expecting a cure to your mental illness, your sadness, or your anger. It’s not about curing you, it’s about giving you the tools to make the most of your journey of treatment. Someone in the group asked if it was like a band-aid treatment. The group leader explained it was more like a crutch that helps you walk, until you’re able to walk on your own.
Like I said, I was a skeptic. I was expecting bullshit breathing exercises and cheesy group exercises, like the one I had gone to when I was 16. There were breathing exercises (when isn’t there), but nothing cheesy went down. I was pleasantly surprised by the message behind the group. This is what I experienced.
… And Why I Stayed
The first thing I noticed was that there was a lot of support items strewn across the table. Coloring sheets with pencil crayons, stress balls, play-doh, and ice packs. This was a pleasant surprise, and I don’t know if this is a universal thing or not, but it definitely added an element of comfort. I won’t be spending the whole session staring pointedly at the table. You can ask your therapist or doctor if that’s a feature in your DBT group, and if not, I would definitely encourage you to bring something to fiddle around with if you’re feeling anxious or emotional.
I liked that we were allowed that. Usually I feel like groups are kind of restrictive, and tell you what you are and aren’t allowed to bring, whether or not you’re paying proper attention or partaking fully in an exercise. No one wants to be told what to think. That’s what I was most weary of.
I took a seat and we started immediately. We had to go through some administrative stuff first, agreeing and signing contracts that ensured we wouldn’t share what we learned about others outside of the group, and that we respect each other’s privacy.
We also all agreed that we wouldn’t attempt to involve others in your own behaviours that may be toxic, much like how in an addiction group when you’re supposed to swear you won’t involve others if you relapse. Addiction can actually be helped with DBT too, so this is fitting. The breadth extends to behaviours from self harm to substance use to engaging in unhealthy eating habits. This also means that if these behaviours come up in the session, you don’t go into detail. You can mention that you had a relapse, for example, but you shouldn’t go into the details of where, how, when, what. It’s all to both protect your privacy as well as to protect others from what could be potentially upsetting.
Then we got into our first exercise. We learned about the “Wise Mind”. Basically, we were told that there are two minds: the emotional, and the logical. If you’re in the group, you probably have a lot of trouble with your emotional mind. That being said, giving too much control to your logical mind can be problematic too, especially in interpersonal relationships.
You want to accept both for what they are, then find an in between that works for you. Listen to your emotional mind, but listen to what your logical side has to say as well, and vice versa.
We were also taught to be aware of our judgement. Having a lack of control of your emotions could result in self-hatred, and low self esteem. We were told that when you are engaging with your inner monologue, we should be aware of what we are telling ourselves and whether or not we are judging ourselves.
I’ve had a lot of people tell me that I should treat myself the way I would treat a friend in distress. Would I tell a loved one in distress that they are stupid, a failure, a monster? No. I would try to do my best to comfort them, or give them the space they need.
It’s important to do that for yourself as well.
Then we learned a whole bunch of coping exercises when you feel emotional. My favorite was grounding, which is to ignore what has happened or what may happen, and focus on the present moment. I actually used this technique later in the week when I started to feel really anxious on the train to work. I started to envision myself as I was. I kept telling myself, “okay, I’m on the train. It’s going really fast from Lawrence to Eglinton. I am wearing a denim jacket and a cozy scarf, which feels warm and a little scratchy on my neck. I’m just a girl, on her way to work. That’s it.”
It really did help. I felt a little lighter, less heavy. It didn’t make it go away, but it definitely made me feel more in control. I got a little bit of a grip on myself.
After a session that lasted just under two hours (with a break in between!), we were given a worksheet that made sure we would apply the wise mind and non-judgmental mindset that week. I’m not going to lie, that bit is tedious. I predicted that I would probably just scribble something randomly affirming on the way to my next session, much like I did all those years ago in the other group. As I’ve told you up above, I actually did use what I learned, and it did actually help a little – much more than I thought, anyway.
With that, we left. No one talked to each other, no one really stuck around. It was time to return to real life, and see how we get on.
My Impression and Outlook
I’m actually looking forward to the second session. I’m wondering if this is just a fluke thing where the first session is great and it just goes downhill from here, but I’m willing to find out. I think this is the major difference – I’m here to give it a go, because really, it can’t hurt.
I didn’t have work after the session, which is actually quite unusual for me. I tend to fill in space with working, and I’m really bad at coping with myself when I have nothing to do. This is what happened after that session. I went on a shopping binge, an impulse I hadn’t actually adhered to in a long time. By the end of the day I had spent almost $400, which is insane. I felt really guilty afterwards.
This is the big catch. When I got home I pulled out the notes I took during the session (yes, I’m the nerd who takes notes in therapy), and the first bit I saw was about judgment.
I was feeling guilty because I was judging myself for relapsing. Did I magically feel better and get on with my day, absolutely not! But now when I look back, I don’t feel nearly as guilty.
Before I would have told myself, “oh God, you’re so dumb, you spent all that money to make yourself feel better, and now look – you’re barely going to scrape by before your next pay day!”
Now, I can tell myself, “Okay, you spent a lot of money to make yourself feel better, and that was ineffective – you don’t feel better, it didn’t work. Now you are facing the consequences of that, which is having less money and feeling like crap for making an emotional decision. What are you going to do differently next time you feel that way?”
The answer is, I don’t know. Next time I feel that way, though, I’m definitely going to be more aware of the long term effects of the decisions I make, and that I should acknowledge the emotional part of my mind, but I should also pay heed to the logical side, find that compromise, and use that joint wise mind.
Will it work? I’ll tell you next week when I see how I did at my second session.
Leave your thoughts and opinions down in the comments, I’m really curious to know if you guys have any experience with DBT and what you think about it! Also, any words of encouragement are appreciated ❤️