I slept a solid 8 Hours last night, there is no doubt that was related to my financial needs being met. Mostly I am excited to go into therapy with the sole purpose of getting better.
On Monday, as I was preparing to meet with my therapist, I was triggered by something about an hour before the appointment. I had joined 2 support groups on face book. I had spent some time over the weekend replying to many posts with simply, "You are loved, accepted and supported here" On Monday a new person posted a sad tale of a court ordered evaluation which (According to her) with much pressure by her parents to have her classified "Bi-Polar." Similar to my story that diagnosis felt forced upon her and she was struggling to find a new Psych Dr.
I felt drawn to her story as it had a lot of themes mine does. I encouraged her to see a new Dr., get the correct diagnosis...or confirm Bi-Polar. She responded with her struggles in getting a Dr. to evaluate her. I innocently commented that I understood, that BPD is a tough nut to crack and unfortunately there were still Psych. Dr's who wouldn't treat it.
With these groups come moderators, also all diagnosed BPD. There is a requirement to post ****Possible Trigger**** if posting something that is classical BPD or the depression surrounding it. On Monday both groups went haywire with some real mean posts, mass exodus of members and some frustrated facilitators. One posted, "I really don't need this on the anniversary of my Father's death" Then someone came along after my post and just ripped into me. Said the only reason the Dr's won't see BPD patients is we refuse to do work, refuse to get better, don't IMPLICITLY follow DBT therapy and on and on.
The old me would have ripped into her, my Senior year in HS my partner and I were ranked 2nd in the State for debate, so I can be cruel with my words if I feel so inclined.
I immediately withdrew from both groups. I was in turmoil over the post and felt like it again, puts undue pressure and a TIMELINE for my recovery to which I say "No thank you to both" Initially I felt like I lost by leaving but that was replaced by these observations.
1) Support groups without professional leadership are far more of a danger than a help.
2) Their trigger system is not going to work. Part of BPD is our triggers change, the same behavior one day and it doesn't trigger us then next day it might. We also don't always know our triggers. Which means anything, including "innocent" statements may be a trigger"
3) Again I maintain that I see some benefit from DBT therapy but
a) Let's NOT present it as Pass/Fail
b) I'm still not convinced its the "only answer" and to present it that way carries GREAT risk for those that don't "Get better"
c) It's NOT accepted by every Professional her is an excerpt from Psychology Today
LIMITATIONS OF DBTDBT offers great hope and a way to counter the oft-repeated (and demonstrably false) maxim that there is no treatment for BPD. Many patients say DBT has improved their lives tremendously. However, DBT is not a miracle cure. As you evaluate treatment alternatives, keep these limitations in mind:
• DBT has been shown to lessen suicidal thoughts and reduce instances of self-¬harm. Studies have not shown that it relieves depression or makes clients happier (although many individuals say it does).
• DBT is appropriate only for patients who acknowledge their illness, want to learn about it, and will work hard in therapy. Higher-¬functioning invisible BPs [who often have comorbid narcissistic personality disorder] do not meet this criteria.
• DBT is demanding. Each day, patients fill out diary forms, and most patients spend many hours each week in therapeutic activities. To benefit from the therapy, patients must be highly motivated.
• DBT is not available in all locations. Also, it can be costly (we'll take a closer look at insurance in the next chapter).
Now, add to that copy the following facts about the difference between DBT and "treatment as usual" :
* It's been proven again and again that the expectations of the teacher influence the outcome of the teaching. For example, studies say that schoolteachers who think they are teaching "gifted" students--even though they are in reality only average--expect more and their students excel. Not only are DBT therapists much better trained, but they firmly believe that BPD is treatable, unlike most uneducated clinicians.
* Treatment as usual takes place once a week. DBT programs require participation two times a week plus homework--again for the HIGHLY MOTIVATED PATIENT.
* In group skills training, patients get emotional group support (although that's not the purpose). Support groups provide validation and fellowship. One person I know attends DBT skills training just for the camaraderie. I know how much my online groups help family members; this is an important fact we should not overlook.
In sum, while we know DBT is effective in some respects, I don't think we really know WHY.It's a good bet that if I took highly motivated family members, had them see a therapist once a week, and had them attend a support group once a week where they learn skills from EFG, they would feel much better equipped for the challenges of caring for a family member with BPD. No research dollars need be spent.
In fact, I think the family members would be less depressed and better able to cope if they participated in weekly meetings in which they all go out to dinner, chat about their problems, or do something fun together.
To end this post, I am NOT anti-DBT. Whatever its merits, it has helped revolutionize the way we see treatment of BPD. Before it, we thought treatment was hopeless. Now we know that BPD is one of the most treatable personality disorders. More than a handful of self-help books use the techniques.
I just think that if we know just what makes the program effective, we can use these factors in places where DBT does not exist, is not affordable, or the patients are not qualified.
The Essential Family Guide to Borderline Personality Disorder" and the piece above is an excerpt from that book
Wow. This really explains how I view DBT. I don't discredit it and already use some techniques but to present it as the "only" answer is plain wrong and may leave the patient in worse shape if it's presented that way.
For me, the spiritual component is more important. I do believe God is greater than this. I do believe he will restore me OR help me manage this. I see DBT as a PART of all this. I also admit this statement is true as it applies to me.
" DBT is appropriate only for patients who acknowledge their illness, want to learn about it, and will work hard in therapy. Higher-¬functioning invisible BPs [who often have comorbid narcissistic personality disorder] do not meet this criteria."
Pretty sure this is me. High Functioning, a desire to learn but man I realize how narcissistic I have been (am).
Having said all that....I am eager to really delve into DBT, my recovery and for the first time in a long time I have hope.
One of my faves and I realize I have posted it before
I do dare to believe