Recovery: Dialectical Behavior Therapy

[Illuminated]

Several people on the forum have expressed interest in learning more about Dialectical* Behaviour Therapy (DBT). It has just about saved my sanity, so it is really working for me. I am not recommending it for anyone – I am not a professional therapist.

It was developed to help people with Borderline Personality Disorder change their way of reacting to situations in life. Since then, it has been used on sufferers of complex PTSD (like some of us suffer from!). Below is information that someone might find helpful. I will make some reply posts to this thread with more information on DBT.

My own definition:
DBT is a technique to learn how to re-train the circuits in your brain to go to the correct place when you face a similar circumstance that you experienced while you were being abused. Because of exposure to abuse and/or trauma, your brain connects memories of the feelings you experienced in the past to a circumstance in the present that mimics a circumstance of abuse/trauma in the past.

Techniques and dialectical thought process are used to both change the circuits and analyse the validity of your thoughts. For instance, when you are in a situation that you have control over in the present, you might flashback to an instance where you had no control during an abusive or traumatic occasion.

DBT teaches you how to really think about your reaction and to determine if it is a valid reaction. You ask yourself a question like: Am I really in that past situation???? No, I’m not. Therefore I refuse to feel this way about my current situation.

Here’s an example of how DBT worked for me:
My hairdresser discovered in November that there was a fine layer of short hairs on my head that were new growth. He asked me if someone had thinned my hair. I said no, and asked him what could cause a layer of short new-growth hair. He said “Stress!” Apparently when I was in Africa, due to the stress and abusive situation, what ever hairs fell out did not grow back in. Only when I returned did they start growing in.

Consequently, I felt sick to my stomach whenever I would look in the mirror and see the frizzy, uncontrollable short new growth hair sticking up from the rest of my hair. It reminded me of my stressful past in Africa. I didn’t even like to brush my hair because I couldn’t make the new hair co-operate – no matter what I did, the new hair still stuck up and was frizzy. (I had no control over the situation)

I told my therapist about this, and she suggested thinking positive about the situation when I looked in the mirror. She said I should think something like: Gosh! My hair is actually growing back! Hallelujah! That’s good! Well, this thought process worked. Now when I see my frizzy hair, I think of my therapist making that suggestion and that she understands me and cares for me, and I smile!


*dialectic: The art or practice of arriving at the truth by the exchange of logical arguments.
*dialectics (used with a sing. verb): A method of argument or exposition that systematically weighs contradictory facts or ideas with a view to the resolution of their real or apparent contradictions.

Take what works :) and leave the rest.

[Illuminated]

Here are a few professionals' descriptions of DBT:

From Dialectical Behaviour in Private Practice by Thomas Marra, PhD

DBT has several core assumptions, regardless of diagnosis. People who sufferer intense emotional discomfort frequently engage in emotional escape and avoidance behaviors. The patient attempts to escape from felling what they feel, in spite of the fact that they may reports intense emotional discomfort.

In spite of expressed emotional arousal that may be gut-wrenching, the attempt to truncate those feelings to what they perceive are more manageable levels. DBT thus assumes… that attempted repression (escape and avoidance) of affect is central to emotional psychopathology.

DBT presumes that the intensity of affect is cause by dialectic conflict between self and environment, defined as inadequate compromises between competing needs and wants; attachment, trauma, and loss experiences of the patient….

Prolonged intensity of affects results in high baseline arousal even in non-threatening environments, frantic attempts to reduce such emotional arousal, and the slow return to the emotional baseline following exposure the threatening situations.

Therapeutic strategies of DBT include both acceptance of the patient’s experiences (validation of their emotional pain and suffering) and offering new psychological coping strategies that include:
+ a refocus on meaning and substance in their life
+ exposure to previously untolerated emotions
+ prevention of emotional escape
+ introduction of a behavior focus – a new goal orientation that appreciates and acknowledges emotional pain and suffering but demands new and different solution-focused strategies to deal with them.

DBT assumes that emotions themselves – intensity, duration, and perceived nonspecific manifestations – are the primary causative factor. Neurobiological data suggests that once emotional pain pathways “fire” the frequency of future firing of those same pathways increases.

DBT presumes that while the goal of the patient is to escape and avoid the effect of the emotions, their very focus on such processes makes them increasingly attentive to and more likely to respond to affective stimuli. The more they avoid and escape their emotions, the more they experience them. A central principle of DBT is that acceptance of emotional pain decreases it.

In DBT, exposure to emotional pain, together with emotional support and validation is counterbalanced with distress tolerance strategies that help patients to endure the exposure and increased environmental changes that can prompt new and different feeling states.

From http://www.lmhc.org/faq.asp
Dialectical Behavior Therapy (DBT Therapy)
DBT is a compassionate type of behavioral therapy that is intended to help people move toward having a life that feels even more meaningful and worth living. DBT therapy may be used with someone whose nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed. DBT targets the issues that cause distress and teaches skills to deal with them without having to resort to self-defeating behaviors. It does so in a framework that helps us understand that we are doing the best we can, even though we need to learn ways that work better.

From http://www.cnn.com/HEALTH/library/MH/00009.html via the Mayo Clinic
DBT
This is a type of cognitive-behavioral therapy whose primary objective is to teach behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others.

Dialectical behavior therapy is derived, in part, from a philosophical process called dialectics, in which seemingly contradictory facts or ideas are weighed against each other to come up with a resolution or balance. For instance, you might learn about accepting who you are while at the same time making changes in your thoughts and behaviors.


Take what works :) and leave the rest.

[Illuminated]

Here is information about the treatment process of DBT.

The four modules of DBT are:
http://home.everestkc.net/vics/
Core Mindfulness
Emotion Regulation
Interpersonal Effectiveness
Distress Tolerance

Stages of DBT Process
http://www.priory.com/dbt.htm
The course of therapy over time is organized into a number of stages and structured in terms of hierarchies of targets at each stage.
PRE-TREATMENT STAGE focuses on assessment, commitment and orientation to therapy. STAGE 1 focuses on … behaviours that interfere with the quality of life, together with developing the necessary skills to resolve these problems.
STAGE 2 deals with post-traumatic stress related problems (PTSD)
STAGE 3 focuses on self-esteem and individual treatment goals.

The targeted behaviours of each stage are brought under control before moving on to the next phase. In particular post-traumatic stress related problems…. are not dealt with directly until stage 1 has been successfully completed…. Problems of this type (flashbacks for instance) emerging whilst the patient is still in stages 1 or 2 are dealt with using 'distress tolerance' techniques. The treatment of PTSD in stage 2 involves exposure to memories of the past trauma.

Therapy at each stage is focused on the specific targets for that stage which are arranged in a definite hierarchy of relative importance. The hierarchy of targets varies between the different modes of therapy but it is essential for therapists working in each mode to be clear what the targets are. An overall goal in every mode of therapy is to increase dialectical thinking.

The hierarchy of targets in individual therapy for example is as follows:
1. Decreasing suicidal behaviours.
2. Decreasing therapy interfering behaviours.
3. Decreasing behaviours that interfere with the quality of life.
4. Increasing behavioural skills.
5. Decreasing behaviours related to post-traumatic stress.
6. Improving self esteem.
7. Individual targets negotiated with the patient.


Note about the information directly below - these are descriptions of the basic treatment process for teaching DBT. It can be taught without the group meetings or telephone contact during the week. I am learning it from 1 hour weekly sessions and some handouts that my therapist gave me to read.


Dialectical Behavioral Therapy (DBT) consists of two parts:
http://www.palace.net/~llama/psych/dbt.html

1. Once-weekly psychotherapy sessions in which a particular problematic behavior or event from the past week is explored in detail, beginning with the chain of events leading up to it, going through alternative solutions that might have been used, and examining what kept the client from using more adaptive solutions to the problem:
Both between and during sessions, the therapist actively teaches and reinforces adaptive behaviors, especially as they occur within the therapeutic relationship. . . the emphasis is on teaching patients how to manage emotional trauma rather than reducing or taking them out of crises. . . . Telephone contact with the individual therapist between sessions is part of DBT procedures.
(Linehan, 1991)
DBT targets behaviors in a descending hierarchy:
o decreasing high-risk suicidal behaviors
o decreasing responses or behaviors (by either therapist or patient) that interfere with therapy
o decreasing behaviors that interfere with/reduce quality of life
o decreasing and dealing with post-traumatic stress responses
o enhancing respect for self
o acquisition of the behavioral skills taught in group
o additional goals set by patient

2.Weekly 2.5-hour group therapy sessions in which interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills are taught (see summaries of sample worksheets). Group therapists are not available over the phone between sessions; they refer patients in crisis to the individual therapist.

Componets of DBT Training
http://www.portlanddbt.com/pages/info_descriptions.html
Individual Therapy: Through a combination of dialectical, validation, and problem-solving strategies, individual therapy helps clients to inhibit maladaptive, mood-dependent behaviors and replace them with more skillful responses.
Skills Training: A skills training group combines lecture, discussion and practice exercises to develop and refine skills in non-judgmental, present moment awareness and acceptance, distress tolerance, emotion regulation, interpersonal effectiveness, problem-solving and relapse prevention.
Telephone Consultation: Through telephone contact, clients receive "coaching" in how to apply skills in their everyday lives. Telephone consultation can be especially helpful to clients when they find themselves in difficult situations and need assistance in putting the skills to work.


Take what works :) and leave the rest.

[Illuminated]

Here are some more links to further resources on Dialectical Behavior Therapy.

My counselor has worked with one of the authors of this report. It is kind of clinical in language and is reporting the use of DBT with eating disorders, but it mentions the relationship of complex PTSD to DBT:
Integrating Dialectical Behavior Therapy Into Exposure Therapy for Complex Posttraumatic Stress Disorder
http://www.gurze.com/client/client_pages/newsletter12.cfm

Public Relations Press Release:
PSYCHOLOGY PROFESSOR WORKS ON MAKING A TREATMENT FOR POST TRAUMATIC
STRESS SYNDROME LESS STRESSFUL
http://www.trinity.edu/departments/public_relations/tip_sheets/april01b.html

This report is over my head regarding professional terminology. But, it was very helpful for me to work my way through reading it (it took several different visits to the site!) because it discusses the relationship of PTSD – both complex (elaborated) and regular PTSD and DBT. I just skipped the parts I couldn't understand.
Contextual Behavior Therapies in the Treatment of PTSD
http://72.14.209.104/search?q=cache:Y2c-Ycv6ia0J:www.uwm.edu/~jkanter/IJBCT-1-3.pdf+%22Dialectical+Behavior+Therapy%22+PTSD&hl=en&gl=us&ct=clnk&cd=48
http://www.uwm.edu/~jkanter/IJBCT-1-3.pdf.

A Recoverer's Story
http://www.growingstrong.org/mental/dbt.html

A site to learn about DBT on your own. Really helpful.
http://www.dbtselfhelp.com

Take what works ;) and leave the rest.

[Illuminated]

One of the first parts of DBT that is helping me is the concept of Mindfulness.

You can get all sorts of free guidelines, charts, lessons, literature on everything about the concept of mindfulness in DBT practice on this page of the dbtselfhelp.com site http://www.dbtselfhelp.com/html/mindfulness_handouts.html

Here is a pretty good layman’s description of the concept of mindfulness.
From: http://www.behavioraltech.com/downloads/Mindfulness_for_clients_and_family_members.pdf

A Definition of Mindfulness
Mindfulness is “awareness without judgment of what is, via direct and immediate experience”.

If you stop to think about it, you’ll realize that very few of us devote ourselves to living mindfully, meeting each moment of life as it presents itself, with full awareness, letting our judgments fall away. Instead, we do things automatically, without noticing what we’re doing.

We churn out judgments about ourselves and others. We regularly do two or three or five things at once. We frequently get so caught up in our thoughts and feelings about the past or future that we’re lost in them, disconnecting from what is happening right now in front of us.

We also live without awareness because sometimes living with full awareness is very painful. We avoid painful thoughts, feelings, and situations when we are afraid or angry or ashamed or sad because we’re convinced that we can’t do anything to change them AND because we’re convinced we can’t stand to live with them.

So what’s the practice? The practice of mindfulness is “the repetitive act of directing attention to only one thing in this one moment”. And if you are brand new to mindfulness, you may respond with either “I can already do that” or “Why on earth would I do that?’

EXAMPLE: Perhaps you’ve decided to take a break from working so you can make yourself some tea; as you stand at the stove, your mind wanders off and ruminates about a conversation you had yesterday. You don’t get a break because your mind isn’t on the tea;your mind is worrying and carrying you away.

EXAMPLE: Perhaps you are sitting in a session with a therapist who cares about you and has a kind expression on her face; but you’re not looking at her face…not really. Instead, you are feeling so self-conscious and ashamed that you begin to “space out”. You miss out on a moment of connection with a person who cares for you and instead have one more moment of rejecting yourself.

“The repetitive act of directing your attention to only one thing in this one moment” means training your mind to pay attention to what you choose to pay attention to instead of letting your mind hijack you.

ILLUMINATED’S OWN EXAMPLE: When I sit at the computer and work for a little while, I find my mind wandering and I space out. Where does my mind wander to? It wanders back to the situations of trauma and spiritual abuse I experienced a year ago. Then I realise I don’t want to think about those things or I will get very upset.

To stop my brain from going back to those upsetting memories, I immediately get up from my work and go do something completely different. I go outside and water the plants, or I go the supermarket (whether I need to or not!), or I do a load of laundry, take a shower, play with my dogs, etc.

When I first started using this ‘distraction’ technique, I thought it was pretty stupid because it seemed so simple. But I really wanted to be able to keep my mind in the present and focused on one thing, so I used the technique. Boy! Does it work!!!! It keeps my brain in the present, and stops those circuits to the past from ‘firing’ !

Hey! Hornblower! Maybe you could tell us how the DBT techniques worked for you when you went shopping with your daughter?? ;)

Take what works :) and leave the rest!

[hornblower]

Illuminated........Im trying of course no therapy yet and just reading and trying to grasp it so Im not doing very well........so can I run this by you and ask you if this is what you are talking about when you are talking about mindfulness?

So this morning as you probably know I wake up with a memory from some church abuse......I dont know where it came from but it was my very first thought not ebven time to really open my eyes. Maybe I had a dream about these men or this man..........anyway I did as you have been saying I tried to picture the thoughts just as clouds drifting by not judjing any of it just letting it go out............that was the literature I read that made the most sense to me was about those clouds. It was harder than yesterdays experience with that but finally it was all gone and down stairs for coffee and my daughter has spent the night................

here it goes........so far so good..............she does her bible study thing...........then starts all of her messing up of the house her cooking and right away I start getting agitated and start the screaming.................try this thing again being nonjudjmental of her or me..............calming down then and I cant go into it but I went into this one room and she had done something that hit on every nerve of talking care of my parents...........I go upstairs try to do this stuff see the clouds its not working just feelings and what I call red hot condemnation pouring into me over and over again until Im finally crying and crying screaming again at her wanting to end it all big time.
I fianlly did have the presence of mind to go up into my room and do the one thing I always hope will help very seldom does but I called my husband at work bless his heart hes swamped too...............of course cell phone answering service is all I get still it helped just to call.
All the way to driving to have lunch with my sister the condemning goes on. I shouldnt have gotten mad at her I said horrible things how can God ever love me after this.........I know He does but not inside in my emotions it feels like Im a Motherless child inside always. Whats worse is I do the same things to her that my Mother if my Mother was as bad as I am with her mouth would have said to me and did!
Ok my back is now killing me I have to stop good thing huh?
So is this condemnation thing????????is that what Im suffering from? Is that all of this judjmental thing you are talking about?

[Willow]

Illuminated... I was wondering if you had gone through this kind of therapy. How did it work for you? What was it like? How did you feel?

I know you're posting lots of references... but I'm a bit overwhelmed with all the techincal info. I want to hear from your personal experience if it's OK.

[Illuminated]

Illuminated........Im trying of course no therapy yet and just reading and trying to grasp it so Im not doing very well........so can I run this by you and ask you if this is what you are talking about when you are talking about mindfulness?

So this morning as you probably know I wake up with a memory from some church abuse......I dont know where it came from but it was my very first thought not ebven time to really open my eyes. Maybe I had a dream about these men or this man..........anyway I did as you have been saying I tried to picture the thoughts just as clouds drifting by not judjing any of it just letting it go out............that was the literature I read that made the most sense to me was about those clouds. It was harder than yesterdays experience with that but finally it was all gone and down stairs for coffee and my daughter has spent the night................Yes, HB! The example you gave is an example of a couple of the techniques you can use to create 'mindfulness' in your brain. You visualised the thoughts as clouds that were just 'sliding through' your brain and were not staying around.

And, you did not judge the thoughts - your OWN thoughts. Wonderful! You did not think something like "Good grief!! That abuse was so long ago, why on earth am I thinking about it now??? I must be really stupid because I can't get over it!!" Intead you just kinda thought something like "Eh! I'm not going to worry about those thoughts, I just going to let them drift out of my brain like clouds going through the sky." In other words, you didn't let those thoughts cause your brain to go to the place where those bad feelings and memories are stored.
...but I went into this one room and she had done something that hit on every nerve of talking care of my parents...........I go upstairs try to do this stuff see the clouds its not working just feelings and what I call red hot condemnation pouring into me over and over again until Im finally crying and crying screaming again at her wanting to end it all big time.Hmmm... remember, I am not a professional mental health person, I am just a friend trying to give you my thoughts on your experiences.

You analysed your reaction to your daughter's action very well. You used your 'wise mind' - another DBT technique. You realised that you were mad because what your daughter did caused a trigger - it caused your brain to go to the place where a memory of you taking care of your folks is stored - and that was not a good memory at all.

I think what upset you so much was the old memory of your folks. It wasn't really what your daugher did - it was the memories in your brain that were stirred up when your eyes saw what your daughter did. Those memories brought back feelings of condemnation. Hmmmm.... that means that probably you felt condemnation when you were taking care of your folks???

Your eyes caused your brain to cause you to 'slip into the past' again, and that past is not a good memory or feeling for you. In fact, it sounds like you really went beserk! I think you did the exact right thing in this case. You knew you couldn't control yourselfl in the situation, so you left the situation. That is your 'wise mind' once again telling you that the circumstances you were in were not good for you today.

You are just starting to try and use the DBT techniques, so you can expect for some of them not to work, believe me. When the "cloud technique" doesn"t work you could try another distraction technique.

More in another response....
Take what works :o and leave the rest!

[Illuminated]

Illuminated... I was wondering if you had gone through this kind of therapy. How did it work for you? What was it like? How did you feel?...I know you're posting lots of references... but I'm a bit overwhelmed with all the techincal info. I want to hear from your personal experience if it's OK.I know - those references can get pretty technical. I just try and wade my way through them, and when I can't understand the vocabulary and technical words, I just skim through the paragraphs until I get to a place where I can understand.

Then, maybe later, when I've managed to read through the whole article, I go back and read it again, and I can usually understand the technical words a little better. I usually have to read the technical papers/references at least twice before I can learn what the authors are talking about!!:confused:

Right now I am working with a therapist who is an expert in using DBT to treat PTSD. She knows how to handle flashbacks and whatever physical conditions happen during them. When I first started learning about DBT, I thought some of it was silly because it seemed so simple.

Then, the first time I tried a distraction technique to bring me back from dissociating and going into a 'fugue' or fog, it was very very very difficult. I felt like I was physically pulling myself back into the present and my legs were staying in the past - dissociating.

The distraction technique was to look at the surrounding environment - in this case I was driving and I focused on a Taco Bell sign. I noticed the colours and nice bell shape on the sign. I noticed the flowers planted around the base of the sign. And I was able to think of how much I like eating at Taco Bell. I came back to the present!!! My mind was not in a fog.

It sounds so silly, and for the first week - I discovered I was dissociating about 50% of the time - it was very very hard, and I felt really stupid having to resort to noticing signs!!! BUT - IT WORKED!!!! I stopped spacing out so much, and it is wonderful to be in the present more than in the past.

OH! By the way, folks! The course of this therapy usually takes a year! AGGGHHHH!

I've given some personal examples of my experiences with DBT so far in the posts 'above' located here:
http://www.christianrecovery.com/vb/showpost.php?p=33448&postcount=1
http://www.christianrecovery.com/vb/showpost.php?p=33489&postcount=5

I've got an example of a technique that didn't work today that I'll post tomorrow!:(



Take what works :o and leave the rest!

[Illuminated]

... the condemning goes on. I shouldnt have gotten mad at her I said horrible things how can God ever love me after this.........I know He does but not inside in my emotions it feels like Im a Motherless child inside always. Well. Now you are judging your emotions and self. That is a no-no. Ya gotta stop doing that!!! I am going to argue with you a little bit - some of the dialectics part of the therapy.

Let's use our 'wise minds' here. Why shouldn't you have gotten mad at her? I think your anger is justified! I don't know what she did, but it probably was not a good thing to do. It p-ss-d you off. You have a right to feel angry.

Now, should you express that anger??? I dunno, because I don't know if what she did herself was deserving of your anger. However, I do know that it triggered you, and that you have a right to feel anger about the memories that surfaced in your brain.

God loves you no matter what you do. The only unpardonable sin is to mock or deny the Holy Spirit. Did you do that by getting angry and yelling at your daughter? No, you didn't. Therefore, God must still love you, silly woman!!! So, in this case, my wise mind tells me that your feeling that God doesn't love you is invalid. He does love you.

Feeling like a motherless child is ok. For one reason, you are motherless right now because your mom is no longer around. So in my opinion, it is ok to feel like a motherless child! Don't condemn yourself for that emotion.Whats worse is I do the same things to her that my Mother if my Mother was as bad as I am with her mouth would have said to me and did. So is this condemnation thing????????is that what Im suffering from? Is that all of this judjmental thing you are talking about?Wow, you are pretty smart HB. You have already realised that you are mimicing your mother's actions towards you in your behaviour towards your daughter. I think that is perfectly nomal - I think maniy women turn into their mothers as they mature.

Now, do you want to turn into your mother? What does your wise mind tell you about turning into your mother??? You may have to think about the answer to this question for a while, because it is pretty personal and complex.

Hmmmmm .... I'm glad you asked about the condemnation feeling, because if you didn't, I was going to ask you about it!:D Don't judge yourself for feeling condemned. It is actually very good that you have a name to put on the feelings you have. Right now it is ok to feel condemned.

What you will have to do is to delve deeper into that feeling and try and figure out why you are feeling condemned. THEN.... we can use our wise minds to determine if the feeling of condemnation is a valid feeling or if it isn't.

So, my question for you is ...... Why do you feel condemned? When do you feel condemned? What in the present makes you feel condemned? How does that what relate to your experiences in the past?...Ok my back is now killing me I have to stop good thing huh?Yeah, you've had an emotional two days. It is good to rest after you experience difficulties, even if you do handle them as well as you did! Oh.... by the way.... back pain can be a sign of depression. Yes, it can!:o

Take what works :) and leave the rest!

[butterfly]

DBT:D I have friends who have gone thru this therphy and have learned alot to help themselfs.

:D When I saw "sound mind" I said ahh DBT.

The sound mind skill helped when I was going thru a very hard time.
My friend shard some of the skills she learned.


She is in a group with other woman for DPT, butterfly

[Willow]

Ahhh... thanks Illuminated and Butterfly. This brings it on a much more bite-sized level to me. I had become overwhelmed, but do want to understand it in case I'm in therapy again and want to ask about it.

[Illuminated]

I have friends who have gone thru this therphy and have learned alot to help themselfs. :D When I saw "sound mind" I said ahh DBT... The sound mind skill helped when I was going thru a very hard time.Wow! If you are still in contact with your friends, do you think you could ask them some details about what part of DBT helped them the most? Then you could let us know here what they said. How did the sound mind skill help you?
I had become overwhelmed, but do want to understand it in case I'm in therapy again and want to ask about it.I have to take the DBT process step by step by step because all of those handouts overwhelm me too. For instance, I don't even use all those acronyms that are supposed to help you remember what your mind is supposed to do. I can't use them, because my stupid messed up brain can't even remember the letters that make up the acronyms.:eek:

I just work on one concept, like mindfulness, at a time. And, I haven't gotten much further than that! :rolleyes:

You don't have to wait for a therapist to teach it too you - that cost alot of money - you can try and learn it on your own if you want.

[butterfly]

Yes I will ask my friend what helped her the most about DPT.


Will have to get back to you next week because she has gone to visit her Mom.

I will get back to you on how the sound mind helped also because she used another mind skill with it.


:o It helped but I always have to have her repeat the mind skills names to me.

So when I get the other part then I will beable to share.:)

:( :( My mind is sleeping right now.

Im in my not sleeping stage. butterfly

[Illuminated]

As I have been learning all about DBT, I have been focusing on the Mindfulness aspect of it. That's all I can handle at this time 'till my brain starts working better!:o

As I've been reading some of the Guidelines for Accepting Reality and learning to do some of the 'exercises', I found out that I didn't want to even try the Breath Exercises (http://www.dbtselfhelp.com/html/dt_handout_2.html) for relaxation. I don't know why, I just had no interest in trying them - to me they were scary.:o

Well, yesterday in therapy I wanted to work on my going to church trigger and work though it and process it. So, my therapist said 'Great! First let's do the breath awareness exercise and then we'll visualise you going into the church and...'

I tried it with her verbally walking me through it, and I started going beserk - I was going to go into a really bad flashback, so I said I can't do this. I was a little upset and felt stupid that me, a grown woman, couldn't even do the excercise without freaking out.

However, my therapist said 'No problem! Now I know where you are in your recovery process!' I guess sometimes in our recovery we aren't ready to do something we think we should do, and we should just not try it.:o

Take what works and leave the rest :o - like the breathing exercises!

[Illuminated]

I will get back to you on how the sound mind helped also because she used another mind skill with it.:o It helped but I always have to have her repeat the mind skills names to me.:( :( My mind is sleeping right now. Im in my not sleeping stage. butterflyThanks for checking with your friend. I am looking forward to hearing what she has to say, and what you have to say also.

I can't memorise all those skills either - my brain won't do it. You can view some of the skills at http://www.dbtselfhelp.com/html/dbt_skills_list.html and then follow the links to the different skills.

Sleeping is good, no matter when you can do it! :D

Take what works :) and forget the rest!

[Sheep]

Okay, everyone. I've gone through DBT therapy for PTSD. Six months weekly group therapy and about a year and a half of individual therapy. Overall, I've got about 18 new tools to add to my recovery toolbox! I discovered I was already using distress tolerance techniques for our son with high functioning autism - as loud noises, crowds, and flashes of light trigger neurons in his brain. Now I use them for myself! Especially one night when I drove past a house where I had been molested as a little girl. I started to have a flashback, but focused on the details of the Christmas decorations of the house. I also took notice of the woman sitting in the living room which made me recognize that there were no blinds or window coverings. I could even make out the different colors of that room from when I had been there as a little girl over 30 years ago! As I turned the corner of the cul-de-sac I was so very proud of myself for having stayed present! Another tool I like is the one where you think of your mind as a Teflon pan. Kind of reminds me of "in one ear and out the other"! This has been helpful for me when I've had difficulty letting things go and tend to obsess about a situation. You know, the gerbil wheel thing? Wow! I just realized something...I don't feel so alone with this PTSD stuff anymore!!!!

Sheep :D

[hornblower]

Illuminated. I hope that my good day today is a result of working on this stuff however small my experience with it is, it does seem to help a lot.
Here is what is helping me.
Im still having flash backs but now instead of resisting them and feeling condemned in it I say to myself this is ok.............I can let this thought or this feeling come and experience it and think about it and not be afraid of it. Today when one thought or flashback came back to haunt me I just let it come instead of fighting it so hard.
Oh yeah I know what the biggy was today. I called my daughter in law and as usual talked way too much.........I can barely hear her when she says something.......so anyway she had to go like she always does, when I hung up I felt so alone and here it comes all of the SHAME. Yes shame and guilt for talking and telling about my problems. I must have a lot of judgements and I dont live up to my own standards I put on myself. This time I just kept saying now its ok its justy ok...........you didnt do anything wrong its allright..............ok so I talked too much I cannot judge myself...........this isnt the end of the world.............on and on. I know its such a little thing but for me it was huge I mean to tell ya HUGE!

Oh another thing about my daughter and me getting mad at her........ it came to me on the way out that day, while I was driving...........one of the things that absolutely has to be done is that she has to go back to her home and not stay in mine. This is for her good and mine and my husbands and everybodies. I dont like it that she is poor but she isnt alone in that lots of people are I used to be it didnt bother me when I was.

She said and this was from her mouth not mine.........I thought about this. She said........."Ill have to leave if you keep yelling at me!"of course i said, "yeah well thats the point isnt it? yes, do please leave here, now!" So then I realised I was doing the only thing that will work to get her to go home.
I always feel guilty and ashamed for doing that.

About my back, some doctrors say I have depression because of fibromyalgia some say I have fibromyalgia because Im depressed. I dont care what causes what I would just like the pain to stop PLEASE!!!!!!!!!!!!!!!!!!
Im telling you the absolute truth when I take antidepressants the pain is unbearable for me. Nothing makes it worse than those pills doesnt matter which ones I take. I have a store of them.

This mother from mother thing is not new to me. I have been in therapy in one form or another since I was about nineteen. Not constantly but Ive learned a lot. This is one of the major things I have always done.......when I react to something in an anxious way, screaming, crying, anger.............big time. I go over what was said and then what caused me to flip. Sometimes that could be very hard to do because the event can be so devastating I dont remember what was said to me. Or done to me. This seldom happens lately for years now I would think. Except with my husband its still happening. Then and this is from therapy I always think what does that remind me of in the past.
Used to be whan I would get the true thing the memory of ehat that experience was I would change and not have that reaction any more. I always felt that this was because the truth shall set you free, Right?
This is not working too well for me any more. Ive delved so much there isnt anything to delve to any more.
So now this has got to change for me Ive got to find a healtheir way to be. I need to start taking care of myself. This morning I got into the Boundaries book just as if God Himself was leading me into it to specific places.
I called my daughter and I told her new boundaries. No more bathing at my house. She takes 2 to 3 hour baths sometimes from
12:00 untill 3:00 in the morning when she stays here uninvited I might add. Then I told her she cannot come over here to cook EVER! She agreed. I told her I can understand that I have a griddle and she wants to make pancakes so I will try to find her a griddle for herself.

None of this is what she did........its so bad i cant tell you what it is.
You have to understand though she is sick...........I am not enabling when she isnt an alcoholic........its hard to know where to draw a line especailly when Im all alone in it. So now Im reading parts of the boundary book to my husband too so he will understand.
Man he was in there big time and me too.
Anyway I just cant thankyou enough for all of this Illuminated. Oh I did call the rape crisis center for a support group and counceling...they've got me on a waiting list. Its a start. I was calling all over the US for something. Now Ive also got to call NAMI back for help about my daughter. They would give her counceling too if she will go. The rape crisis center will. She wasnt raped though ok? Actually I think he did something worse than that. If there is a worse than that?
I wish somebody could help me find where and what has happened to him. He was never prosecuted for anything you know?
Oh well bed time my back is a burning firebed.

[Jerry]

Oh yeah I know what the biggy was today. I called my daughter in law and as usual talked way too much.........I can barely hear her when she says something.......so anyway she had to go like she always does, when I hung up I felt so alone and here it comes all of the SHAME. Yes shame and guilt for talking and telling about my problems. I must have a lot of judgements and I dont live up to my own standards I put on myself. This time I just kept saying now its ok its justy ok...........you didnt do anything wrong its allright..............ok so I talked too much I cannot judge myself...........this isnt the end of the world.............on and on. I know its such a little thing but for me it was huge I mean to tell ya HUGE!


Dear Hornblower,,,,
What a wonderful event for you :D We all tend to project what other people think and in a way , I think this is the "Root" of Shame. It is such a self-destructive system of thought that we seem to so easily fall into. The truth is that we can never really with certainty know what they think.Realisticly that is a wonderful blessing and no curse at all ;) ,,,,,,,,because if we could somehow know every little thought no matter how fleeting that others ever have about us,and at the same time took those thoughts to heart,,,,,,,,,,,,,,,,,,,,,,,,,,,HA !!!,,,we would be friends with no one ;)
Love Jerry