Linehan (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991) compared one group of 22 females (aged 18-45 years) with BPD who underwent DBT for 1 year and 22 matched females with BPD who underwent treatment as usual in the community. The subjects were assessed at pretreatment and at 4, 8, and 12 months posttreatment. There was a significant reduction in the frequency and medical risk of parasuicidal behavior among subjects who received DBT compared with subjects who received treatment as usual. The number of days of inpatient psychiatric hospitalization was fewer for subjects who received DBT than for controls, resulting in greater cost-effectiveness for DBT in spite of DBT intensive treatment design (that includes both individual and group psychotherapy, as well as accessibility for telephone consultation between sessions, for a one year period of time). While DBT was not shown differentially effective in improving patients' depression, hopelessness, suicide ideation, or reasons for living, the reduced parasuicidal behavior intensity and frequency, together with fewer psychiatric hospitalizations (lower cost and greater ability to sustain patients in the least restrictive environment) is impressive.
***Research showed that DBT did nothing to eliminate depression or hopelessness, suicide ideation or reasons for living? I thought that was what it was DESIGNED to do? It did, however, decrease hospital stays..
Well, from my personal point of view, it made my depression and SI/SIB WORSE! And I've NEVER been hospitalized for any "mental illness" Ever!
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I've never been hospitalized for anything other than childbirth (knock on wood - may I say the same when I'm 90). DBT made me worse, too. I came very close to overdosing again after that last exposure. I was considering ending it all just to make the whole thing stop. I couldn't take it anymore. The bottom line is - it's all about denial. Even DBT admits that. They call it 'functional denial' or 'constructive denial' or something like that. What's really, really sad is that people would not NEED that anymore if they had someone to really listen to them who would not shame them or shove a bucket in their face. The whole thing is just so goddamn sad.
ReplyDeleteI realize your blogs were written a while ago but I hope you find this comment so that you can reply. I am developing DBT programs for my local community for Adult ADD, depression, anxiety, & related symptoms.
ReplyDeleteIt would be profoundly useful for me to learn what it was about DBT that made your symptoms worse. I would like to avoid creating something similar to my group members. Thanks, Dean.
I also hate DBT! I have BPD/ DID, and I did a few years of Schema therapy on and off, and absolutely loved it. It was validating, gave me names to describe the abuse and it taught me how the abuse turned into BPD. Just being validated alone, helped me recover a lot. I stopped self-harming because I truly believed I didn't deserve it any more. I became a lot more healthy and stable, and felt very empowered now that I understood my disorder and abuse.
ReplyDeleteI wasn't treated like 'a Borderline'. I was treated like a human being with an abandonment and abuse schema. Just taking that label away and viewing myself as a human being and not a label was amazing.
I then went to a therapy group that used DBT from the Marsha Linehan book, and wow, what a mistake. So traumatizing and stressful.
It triggered memories that I wasn't able to deal with, and offered no talking therapy to help me cope. Schema therapy was much more gentle.
I even relapsed back into self-harming and my dissociation went through the roof. It was invalidating and I felt I was being pushed back into having the BPD label and I felt dehumnaised again. The distraction techniques worsened my dissociation
I've seen ML write some really messed up things about the cause off BPD. That we are 'born sensetive' and it's how we react to things. I have yet to meet a person with BPD who hasn't suffered severe abuse, sexual, emotional or physical, or abandonment. I am sick of reading about biology.
Abuse, abandonment or any form of childhood trauma will cause chemical changes in the brain. There have been loads of studies in it. The brain gets caught in 'fight or flight' response and damages the amygdala and then turns into BPD behaviour. This is the area that control emotions, anxiety, mood. Narcissists are just as 'sensitive' as BPDs, just that we all display it differently.
While Schema therapy taught me the tools to help myself and it was a very loving and gentle process, DBT made me into an unfeeling robot.
The self-soothing advice was ridiculous. How can you expect someone who has self-harmed since childhood to start lighting candles? You have to teach someone to care for themselves, explore where that self-loathing comes from. It's a slow process.
I got to the point where I was constantly monitoring myself and being critical of my responses. It was very boring and my life felt mechanical.
And don't get me started on her whole 'finding God' bullshit. As an atheist who also struggled with religious delusions as part of my DID, I was very triggered by that aspect of it.
Also the part about empathizing with you abuser and thinking what their life has been like. WTF!
Luckily as I'd had Schema therapy I was able to rebuild myself, but it was hard. I can't imagine what it must be like for people who go through it first.
You can learn Mindfulness on your own, go to a class or read about it. And combine it with Schema therapy.
Read: Reinventing your Life by Jeffrey Young and Change for the Better by Elizabeth McCormick.
Dbt made me worse. 10 months into my treatment now and feel a million times worse than I ever have been. Think I feel I've been issued a life sentence. Being around others with it has compounded the reality. Genuinely feel suicide is probably going to be the only way out eventually.
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