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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dinah on March 18, 2004, at 10:20:18
In reply to Dear diary « Ilene, posted by Dr. Bob on March 17, 2004, at 23:59:48
> >
> > We saw my pdoc on Monday. She lent me a copy of Marsha Linehan's "Skills Training Manual for Treating Borderline Personality Disorder" even though she says I am not borderline. I would like to do the therapy in this book--DBT, or dialectical behavior therapy--because it addresses my objections to CBT (cognitive behavior therapy) and is directed at people who share my characteristics. (I wonder why I'm not borderline, considering.)
> >
> > Linehan says that the core disorder in BPD is emotion dysregulation, which is produced by emotional vulnerability, among other things. One of the characteristics of emotional vulnerability is "a slow return to emotional baseline once emotional arousal has occurred". When something happens to upset me I can't get back to normal for hours, even when I know I misinterpreted something, or I can feel myself over-reacting, or I know I'm seeing the worst in a situation. I'm aware of this when it happens, but I can't figure out a way to make it stop. This makes me question the efficacy of CBT, which assumes that if you recognize your irrational assumptions, your mood will improve.
> >
> > Linehan says an "invalidating environment" is the crucial developmental circumstance in producing emotion dysregulation. Her first example of an invalidating family environment is when a child says she is thirsty, and parents say, "No, you're no. You just had a drink." She must have overheard my mother.
> >
> > There's more, of course.
> >That's exactly how I felt when I first read Linehan's "Skills Training Manual for Treating Borderline Personality Disorder" and "Cognitive-Behavioral Treatment of Borderline Personality Disorder". It was a huge ah-hah moment. No one had ever considered that I might be borderline, but the descriptions of easy emotional arousal, slow return to baseline, and invalidating environment really struck a chord with me.
And I, too, thought DBT was a more validating version of CBT and I might be more likely to stick with it. Unfortunately there are no DBT groups in my area. I brought the skills manual in to try to work with it with my therapist, but other things cropped up and I never got around to doing it on a long term basis.
Is DBT an option for you in your area?
Posted by 64Bowtie on March 18, 2004, at 12:10:23
In reply to Re: Dear diary (DBT) - Ilene, posted by Dinah on March 18, 2004, at 10:20:18
(((Dinah))), I'm not an expert on your therapy. It's your therapy. I am an expert on my recovery. Now, perhaps I still am toooo addicted to cheescake for my own good, but most of my problems have gone away. I keep telling myself there's not enough money in the world for me to buy cheescake. Of course I'm in trouble if they ever start giving it away for FREE!...lol
Over and over I hear reports of therapists did this and pdocs did that, and no recovery. I don't buy the arguement that when we get well, we suddenly get toooo busy to post. Dysfunction is like being a chicken being chased by a coyote. Busy, busy, busy! Many share at times that they feel the wolves are after them. Time is not an excuse. They just don't recover, at all, maybe.
Anyway, according to (((Karen Kay))), I don't use words from the known universe, so I want to say something new, again;...(just a warning).
What I hear here and always seemed to hear in 12 step meetings is that therapists approach clients as misguided children. Well, clients over 15yo are fully fledged genetically/biologically to be adults. There behaviors may be displaying childlike holdover tendancies, but they are better erquipped than children to handle conflict. (Conflicting dysfunctions are a real mess, aren't they. Picture two married dysfunctionals. See what I mean?)
No matter how mentally ill and how dysfunctional and how corrupted the spirit, adult attibutes do a better job of recovery than regressing to childhood limitations, don't you think?
I've seen children asked by the researcher if they can see the problem. They answer yes. When asked to describe the problem, the child doesn't see the problem at all, really. I call it the "monkey-effect"; the child "monkeys" a response so as not to do something wrong, or perhaps to receive the glory by answer as expected.
None of this makes the child-subject a bad child. It's just a common response in children, that some how gets into a research paper written up as, "The child-subject recognized the information and responded appropriately." Meanwhile there was nothing adultlike in the child's response.
Purpose: In a perfect world adult therapists would treat clients as adults with fully devloped skills to aid in permanently overcoming the afflictions of childhood displayed by their clients. We have grown-up skills that kids can't imagine, let alone "monkey". If we use those adult skills to manage our day-to-day lives, blocking dysfunctional habits at every turn, we can recover; we can get well.
I am living proof. I honor my adult skills by using them daily. I'm not saying I did it by myself. I read books till my eyes hurt. I paced around stewing over what advice I was given till it formed a pattern in the oriental carpet. I went to a couple of thousand meetings all over California. And helped David Peck formulate his theories, meeting with other folks that were in fact credentialled. It all contributed. It took the better part of 20 years my way. I sense there's a better way, yet.
I am still living proof. When I started honoring the adult skills I had, my life changed. Maybe I was really, really, really ready. I don't think that is the only way, to be so ready as I was. I sense that others might be smarter than me and can just "get it" without all the crap I went through.
I only wish great things for you.....
Rod
Posted by Dinah on March 18, 2004, at 13:33:35
In reply to I'm not an expert... » Dinah, posted by 64Bowtie on March 18, 2004, at 12:10:23
I don't quite understand. Are you saying that DBT treats clients as children? Are you familiar with DBT?
Posted by Ilene on March 18, 2004, at 19:17:29
In reply to Re: Dear diary (DBT) - Ilene, posted by Dinah on March 18, 2004, at 10:20:18
> That's exactly how I felt when I first read Linehan's "Skills Training Manual for Treating Borderline Personality Disorder" and "Cognitive-Behavioral Treatment of Borderline Personality Disorder". It was a huge ah-hah moment. No one had ever considered that I might be borderline, but the descriptions of easy emotional arousal, slow return to baseline, and invalidating environment really struck a chord with me.
>I don't fit the other elements of borderline-ality. I also used to have a much easier time remaining calm. I think repeated stressors erased whatever resilience I had.
> And I, too, thought DBT was a more validating version of CBT and I might be more likely to stick with it. Unfortunately there are no DBT groups in my area. I brought the skills manual in to try to work with it with my therapist, but other things cropped up and I never got around to doing it on a long term basis.
>
> Is DBT an option for you in your area?
>I don't know, but since I live in a major metropolitan area, I'd be surprised if there are no DBT groups around here. My pdoc wants me in a partial hospitalization or group therapy program.
I wonder if DBT has been shown to be useful for people who don't have BPD.
I.
Posted by Dinah on March 19, 2004, at 11:26:18
In reply to Re: Dear diary (DBT) - Ilene » Dinah, posted by Ilene on March 18, 2004, at 19:17:29
Well, I may be biased. But I think DBT would be helpful to *anyone*. I think it should be taught in schools. The skills taught in DBT have universal applicability.
Now whether the DBT *groups* would be helpful to everyone, I'm not sure. If the majority of the group were on one level of functioning, and you are on another, it might lead to a less than ideal situation.
Posted by Ilene on March 19, 2004, at 17:02:10
In reply to Re: Dear diary (DBT) - Ilene » Ilene, posted by Dinah on March 19, 2004, at 11:26:18
> Well, I may be biased. But I think DBT would be helpful to *anyone*. I think it should be taught in schools. The skills taught in DBT have universal applicability.
>
> Now whether the DBT *groups* would be helpful to everyone, I'm not sure. If the majority of the group were on one level of functioning, and you are on another, it might lead to a less than ideal situation.I agree with what you are saying about groups. The other thing is that I feel burned by conventional (and unconventional) wisdom. I got aerobic exercise, I went to yoga, I went to therapy, I took meds, I took fish oil, I took vitamins, I tried to get out every day, .... and my functioning got poorer and poorer and my suicidal ideation got worse and worse. I'm tired of wasting time. I want something that's going to work.
Today is a bad day. I feel like a zombie.
This is the end of the thread.
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