bpd · mental health · therapy · Uncategorized

Recovery’d out & why DBT works for some & not others.

I am shattered. If my post doesn’t make sense then that is why! My whole day has been based on recovery and I got home at 7:15pm.

I got up and went to DBT group and we did the ‘what skills’ in mindfulness. This is basically teaching you how to practice mindfulness. I will admit, mindfulness is the module out of the 4 DBT modules I find the most boring. However, I’ve read studies that show without mindfulness being incorporated into the other skills BPD symptomatology does not decrease as well as it would otherwise. So it’s a core element of the therapy. The benefit of the group ironically for me isn’t the teaching part of the session (where the facilitator goes through the handouts and explains the concepts) it’s the little parts that are customised for you. I get to ask questions related to what we’re covering in class in relation to how it affects me personally. It’s not a talk therapy and it’s not a 1 – 1 but that little extra explanation helps me fit it into my life. It also helps to hear their responses to what other people experience in class. I’ve already studied mindfulness on my own through youtube DBT talks and reading articles online and mindfulness meditations so Im familiar with the concept (so if you’re not in DBT but wish you could be you can do it on your own with some reading and determination online for free!) but today I got to ask her how it fits in with dissociation. Mindfulness is about being ‘one’ and ‘present’ with your current present experience and since dissociation is mentally removing yourself from your current situation I asked her why would it be good for me to be present in situations I don’t even want to be in in the first place?

She told me it would help me learn to tolerate situations that my mind is telling me I can’t and this way I get to be in control and have more choice available to me. She also said that if we dissociate over a long period of time (i.e. you have been using it as a coping strategy for many years/all your life) your tolerance level actually decreases because your brain keeps lowering your distress threshold and so your dissociation will be triggered more frequently. Another lady in group confirmed that that’s exactly what has happened to her. I thought about it and realised dissociation makes me less effective in the situation that I’m in because I’m so busy trying to get away from it I’m not focused.

I also wanted to add my thoughts on DBT to hopefully help someone out there because I’ve read some people with BPD found DBT to be unhelpful and others have sworn by it, written books because of their experience and success with it etc. and I think I am starting to understand why there is a divide plus I have talked to my therapist about my views on DBT for me and my recovery and she confirmed what I had to say. I’m not saying this is definetly correct – I’m not a professional after all but it’s an observation that I think at least partly explains it. I studied DBT a year ago, listened to talks on all 4 modules and understood the ideas perfectly but it didn’t really help me at all. It didn’t help because it’s not a theoretical thing in as much as it is a practical thing. So some people go to group, get the books and learn it but then do not apply it to any situation they’re experiencing. You have to apply DBT skills and the more you apply them then you see a difference and see their true effect, it’s not a passive thing and it takes effort to remember to use a skill, to apply it in situations where you’re used to using your usual coping strategies and then have the energy and courage to try something new.

I’ll give just one example of where it’s helped me. I had a break up a couple of weeks ago and usually the pain and thoughts of my ex linger in my mind and I ruminate and obssess, missing them, going over every interaction, fun times we have shared, and usually try to keep some level of contact, because hey, I have an issue with letting go and this only prolongs the pain and keeps the emotional fire burning. But this time, the day after the break up I went to my DBT book and checked an emotion regulation worksheet on how to handle the emotion of ‘love’ when it’s not effective (in this case it’s not effective because you’re broken up so staying with those feelings just makes you feel worse) and I used the ideas in the handout (e.g. distract yourself from thoughts of the loved one) and following the ideas helped me break the mental pattern and I handled this break up better than I ever have done and did not get back in touch with him. It didn’t make it 100% pain free – that’s not the idea – but it did make it a hell of a lot more bearable and compared to my break up last year which triggered a self-harm episode this was way better.

DBT also doesn’t help with underlying long-term factors e.g. if you have past traumas that trigger certain behaviours, it can help you not to act on the triggering situations and stops you from making things worse but you would still need to deal with the trauma in therapy. Hence why I’m seeing a psychologist as well.

So for the rest of my day… (man I am writing an essay!) I then had to wait about 2 hours before I could go to see the psychiatrist. He was awesome. He was personal and friendly and didn’t act weird (i.e. the no touching thing, never talking about themselves so they feel like some kind of mystery, he swore at one point which all of a sudden makes therapists seem so much more appealing to me). He also confirmed I had BPD told me to get off the fluoxetine because he agreed I don’t seem ‘depressed’ (I told him I’m not) and he’s put me on Quetiapine. He’s also started me on a low dose because I said I’m worried about weight gain (that would be so triggering for me esp. since I kind of am still counting calories) and he said I can e-mail him whenever and that honestly I’ll know by wednesday whether this dose is helping me or not and he can always up the dose if need be. I’m trying not to be overly optimistic but I am feeling so much better that I went and that I’m getting help and that maybe just maybe these meds will be what will help me with my racing intrusive thoughts at last.

 

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