Questions about DBT: What is appropriate and what isn't

New here and have been lurking about on this forum for the past couple of weeks.

Just a brief about me:

- Dx by my psychiatrist,at the veteran’s hospital, as having a Mood disorder back in January of last year though I’ve been running around undiagnosed and in denial for over 10 years now.
I think I’m BPD and possibly bipolar 2.

- Been on lamotrigine, welbutrin (made me extremely irritable!), and now I’m only on citralopram. We haven’t found anything that works or maybe I’m confused as to what is “normal” for me or what it feels like to be “normal?”

- I get to see my psychiatrist once every month to month and a half. Same goes for the counselor. I go through the VA so mental health care for me blows and is far from being consistent. Trying to get on medicaid but I need help ASAP.

- I hallucinate (auditory) badly that it has turned me into a night owl. I sleep with noise canceling headphones, one of those nature sound machines and sometimes turn on the bathroom noise just to keep from hearing the imaginary tv that’s coming through the wall. It’s gotten bad that I get up in the night to listen to the walls to see where it’s coming from.

- I am OBSESSED with Marilyn Monroe, I have even legally changed my name to Marilyne-Monroe, I kidd you not.


I just have a few questions about DBT work. I have tried it with a therapist outside of the VA system and I found some things helpful and some things questionable.

1. Am I the only one that finds meditation and breathing techniques to calm down NOT helpful?? Example of this: I went to my therapist in crisis mode and she had me do 15 minutes worth of deep breathing to get me grounded. All it did was make me seriously annoyed and agitated!! I left the session feeling like nothing was done!

2 My therapist likes to use this “I’m going to be mean to you” method with me which I seriously do not like. Is this method even appropriate?
I don’t like it because I feel that it comes from a place that’s judgmental. This has happened twice with the therapist. First was when I was in crisis mode about finding a job; I was feeling like one big reject, worthless and the list goes on...anyways the therapist seriously said: “You know what, I don’t think you’re making any effort to look for a job.” I sat there with my mouth hanging to the ground when she said that! Needless to say I left that session only to be hospitalized briefly. The second incident was just a couple of weeks ago when she kept accusing me of making things up (she was referring to my thoughts of doom and anxiety). I sat there thinking to myself “Well when was the last time you saw me? You don’t see me consistently it’s sporadic. You don’t even know anything about my past”) This therapist doesn’t seem to understand how much this disorder has ruined my life: I quit my college work, friendships have gone down the drain, I’ve withdrawn from the world, I won’t have a place to live, can’t get a job etc)

3. Isn’t DBT supposed to provide with skills on dealing with people/situations??
Example: I had a fall out with a friend and my usual method of dealing with friendship fall outs is to completely cut the person/”offender” out of my life instead of communicating/reconciling. The therapist has not ever given me anything on how to deal with fall outs or similar situations just this “Well screw them.” This is something I don’t want to keep doing. I’m down to 3 and a half friends now.

3. Shouldn’t DBT at least get a look into your past?
I feel that some of the things I do is a result from the crap that I went through when I was in the military.

4. When looking for a therapist in general, should one look for a therapist that specializes first in the disorder then the type of therapy they offer?
I feel that the therapist I see doesn’t have a clue about borderline personality disorder! Zilch! I don’t think I’m going to wast money or time seeing her anymore.

I’m hoping to find affordable mental health care ASAP and possibly a second opinion on my Dx because the VA doesn’t even seem to be knowledgeable of borderline personality disorder either.

I agree with you. I think you need to find a new therapist. You may also have to find a therapist that will deal with your past first, and then work on the DBT. DBT is kinda...from here forward. But if you feel you need to face your past that maybe you should do so. I don't think the things your therapist have said to you have been constructive, you're right. They aren't supposed to judge. They are there to listen, and give you other things to think about. One thing that used to drive me crazy is that they used to be like, "So what? So what if it does?" I would think, and say, "Am I not supposed to care about anything!!!?" I guess I had to learn that I cared too much. Now I say, "so what?" to almost everything. LOL Find a therapist that is a good fit. If you don't like them..find another. I've written in my blog about a lot of the things you're talking about. www.butterflyamongthorns.com Give it a read if you ever have time. My therapist finding has been tough. Good luck. xoxo

marilynmonroe078 wrote:I just have a few questions about DBT work. I have tried it with a therapist outside of the VA system and I found some things helpful and some things questionable.

1. Am I the only one that finds meditation and breathing techniques to calm down NOT helpful?? Example of this: I went to my therapist in crisis mode and she had me do 15 minutes worth of deep breathing to get me grounded. All it did was make me seriously annoyed and agitated!! I left the session feeling like nothing was done!

Breathing / meditation really wouldn't be appropriate when in crisis mode. If you're in crisis mode, and need to reduce extreme emotions you'd want to use the TIP skills (temperature, intense exercise, progressively relax your muscles). In the state you were in temp or intense exercise would've been more appropriate. you can read more about these on http://www.dbtselfhelp.com.

I'm not able to meditate.. I'm usually to anxious and have to many thoughts going on in my mind.

2 My therapist likes to use this “I’m going to be mean to you” method with me which I seriously do not like. Is this method even appropriate?
I don’t like it because I feel that it comes from a place that’s judgmental. This has happened twice with the therapist. First was when I was in crisis mode about finding a job; I was feeling like one big reject, worthless and the list goes on...anyways the therapist seriously said: “You know what, I don’t think you’re making any effort to look for a job.” I sat there with my mouth hanging to the ground when she said that! Needless to say I left that session only to be hospitalized briefly. The second incident was just a couple of weeks ago when she kept accusing me of making things up (she was referring to my thoughts of doom and anxiety). I sat there thinking to myself “Well when was the last time you saw me? You don’t see me consistently it’s sporadic. You don’t even know anything about my past”) This therapist doesn’t seem to understand how much this disorder has ruined my life: I quit my college work, friendships have gone down the drain, I’ve withdrawn from the world, I won’t have a place to live, can’t get a job etc)

Completely disagree with your therapists approach. Is she trained in DBT? It doesn't sound like it to me. I think she should've been helping by looking at dbt principles, mindfulness, distress tolerance would've been more helpful. Mindfulness would help you determine which thoughts are fact based vs. emotional. Distress tolerance would help you cope with your emotions

3. Isn’t DBT supposed to provide with skills on dealing with people/situations??
Example: I had a fall out with a friend and my usual method of dealing with friendship fall outs is to completely cut the person/”offender” out of my life instead of communicating/reconciling. The therapist has not ever given me anything on how to deal with fall outs or similar situations just this “Well screw them.” This is something I don’t want to keep doing. I’m down to 3 and a half friends now.

Not all relationships need to be reconciled. There's nothing wrong with allowing hopeless relationships to end. The Interpersonal Effectiveness section in DBT is dedicated in how to effectively communicate with others.

3. Shouldn’t DBT at least get a look into your past?
I feel that some of the things I do is a result from the crap that I went through when I was in the military.

I had dbt group, and no it didn't go into my past. It's about learning new skills.

4. When looking for a therapist in general, should one look for a therapist that specializes first in the disorder then the type of therapy they offer?
I feel that the therapist I see doesn’t have a clue about borderline personality disorder! Zilch! I don’t think I’m going to wast money or time seeing her anymore.

Yes, you should!

Take a look at the website http://www.dbtselfhelp.com... It's the complete dbt course online.