By Lisa Dietz
Before you begin DBT, it's good to know what to expect. I didn't have this information available to me when I started, so I struggled for a little while. For those of us with Borderline Personality Disorder, being emotionally reactive makes understanding how DBT works a process. I am hoping that by telling you about my experiences you can avoid some of the pain I had.
First of all, DBT is not group therapy. I had been in group therapy before I started and when I started DBT, I was at a particularly difficult crisis time so I was very disappointed and triggered by what seemed to me to be invalidation.
The truth is, DBT is cognitive therapy. That means you are going to hear an informational lecture for the first hour. In the second hour, you share about practicing the skills. Once again, this is cognitive (changing your thinking, not emotions) and it is not personal. You have to approach it as if you were taking violin lessons. It's kind of strange because people with BPD are very emotional and in crisis a lot. So it is natural to feel the angst of your life situation and want to share that in the group, but this will only lead to disappointment.
I had been in "talk therapy" for many years when I started DBT. We talked about my past and the current issues in my life and how they related to my past. What was the most helpful difference about DBT was that I was being given options about practical skills to do during the many difficult times in my life. Once I understood that the program was about learning life skills in the same way as learning to play a musical instrument, I was able to change my expectations. For me, this meant putting up a bit of an emotional shield during classes because the underlying issues that brought me to DBT had to be set aside so that I could learn about optional skills to perform in my life. It seems backward, but eventually it was effective.
During my second DBT experience, it reinforced that I was being expected to LEARN something, not get help, compassion and validation on an emotional level. Previously I had not experienced DBT as a long term once-a-week program. As I entered this longer term, more committed environment, I was nervous about how to relate to the others in class and I felt I was different (in an odd way) from everyone else. But I began focusing on more or less memorizing my lessons. Thus, I started to understand the meaning behind each skill. They were becoming concepts in my head. I still found it very difficult during the "homework" sharing because it was hard to "practice" a skill when practicing meant intentionally using a certain skill in my life during times that were emotionally disturbing. I had to stop my instant reactionary behavior, stand back, and consider if I had learned a "skill" that applied to moment.