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1. 

   Amanda

   103 Points

   02/10/09

   Hi, lots of questions - I'm used to this - when it feels like you have tried everything its difficult to trust. Yes DBT has been around for a while, although more in the US. Ours is the only group in the South East of England, so its difficult to get into this type of therapy. There are only a minority of DBT therapists in the UK. What I can tell you, is that I am conducting my own research into DBT in treating specifically BPD patients (its also been adapted for eating disorders, substance misuse, and adolescents). Also, many mental health trusts are now looking at implementing DBT as an option to treat BPD to meet NICE guidelines. A year into it, my evidence shows that over 12 weeks BPD symptoms (including suicidal intent and self harm) have reduced for most patients by 56% in some cases stopping altogether, (look up DSM-IV which gives a specific criteria) also Depression and Anxiety recorded before and after treatment reduced by more than 67% on average for patients. Obviously, there needs to be a continued support with DBT over a longer period and many of my patients come to see me individually for some months after group to keep them 'DBT pure' for up to a year after group. The ones that are able to stay in treatment do significantly better and often go on to lead 'normal' lives. What I mean by normal is that they are in essence, still emotional people, understanding that emotionality is a part of them and they can come to accept and appreciate themselves and use their skills to manage their more problematic emotions and behaviours, as they go along rather than avoiding, pushing them away or bottling them up. DBT teaches you to tolerate a higher intensity of emotions therefore giving you more control and making it unlikely that you will 'blow up'. Many of my patients ask the question "why cant I be like other people" because they see "others" as more skilled and effective at handling emotions or imagine that "the rest of us" are not having emotions at all. Others fear that DBT will take away their emotions and that they will be left like emotionless zombies - alternatively some hope and wish for this emotionless nirvana. I am not sure what you are looking for from a therapy but DBT is a skills based psychoeducational treatment it is taught as a class with the emphasis on the here and now so not much digging into the past ... I don't think of people as broken so there is nothing to fix. DBT therapists see their clients as having a lack of skill - I teach skills to reduce emotional vulnerability and increase emotional resilience. I teach Distress Tolerance to help with the many emotional crises that Borderlines experience. I teach Mindfulness to help you gain control of your mind rather than your mind controlling you. I teach interpersonal effectiveness to help borderlines with conflict and toxic relationships so that they can ask for what they want or say no to what they don't want WITHOUT damaging the relationship, damaging their self esteem and gives them the best chance to get their objective. Its all well and good reading about DBT but it really is an experiential therapy - you wont 'get it' until you try it. Some interesting links you may find interesting: Some interesting links for you http://www.behavioraltech.org/resources/whatisdbt.cfm http://apt.rcpsych.org/cgi/content/full/8/1/10
   Original comment »

   02/11/09

   Reply from sybil:

   Hi Amanda,
   
   Thanks so much for all the information. I'm glad to see your research is showing such great results as well! Seriously, its great to affirm there is progress in the area sometimes. ;-)
   
   You'd vaguely asked what I'd have been looking for - as I understand it DBT teaches the skills to supplement the natural emotional checks and balances that other generally have, which BPDers lack. The emotional 'thick' skin as Linehan mentions in her writing. Personally, I do have a control already, and its a concious one, What I had hoped for was a way to eliminate that need for control. To perhaps condition my brain to naturally check my responses as it seems most people can...
   
   It was just a disappointment cause I had a recent 'blow up' which I thought was extreme - but the therapist said my way of handling it, rationalizing the problems and discussing them calmly is the therapy, that its practicing this self-control/self-therapy that we'd have been working on in therapy anyway. So hence my asking you.
   
   Personally, I'm not off the walls, just very tired of using these darned skills and censoring myself cause I know certian reactions are beyond normal etc. But I guess that is why its not totally curable then...
   
   As for the assumption that 'normal' people don't have these emotions I think some of the emotions a BPDer experiences are not the same for normal people though. I mean yea sure we all feel the same things, but a normal person would not look at every nuance of a gesture and read biographies into it within seconds and decipher the otehr person in every interpersonal contact. That extremity is what I censor and tell myself is not fair and I should not be holding on to these things. I don't think the average persons emotional response to such things can be compared to that of a BPDer can it? I mean most people may notice the nuance gesture, but their mind naturally leaves it as an observation right? And in my case my interest in being able to have a mind that can do that for itself without me telling my mind exactly what to do. Do you get what I mean by that?
   
   Anyway, I'm sure you're very busy. If given the chance I could spend days hypothizing on these things as I've had them whirling around in my mind for years. So let me not waste your time. But really just keep up the work, if you do find that cure let me know ha ha. Otherwise all the best.
   
   Syb
   
   PS. If ever you do want to randomly overdiscuss things let me know. Or need survey participants and the like, I would not mind contributing to worthwhile causes ;-) Thanks again.

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