DTB is a form of therapy formed in the 1980s by a woman named Marsha Linehan (History of DBT). It was first developed to treat Borderline Personality Disorder, but has since been used to treat a wide variety of psychological disorders, including Bipolar Disorder (History of DBT). From what I gathered through going to DBT group therapy sessions is, DBT believes that actions increase our thoughts and feelings, and our thoughts and feelings increase our actions. In essence, it's a way to achieve balance. It's got five tenents: mindfulness (being aware and present in the moment), Distress tolerance (how to avoid the explode), Walking the Middle Path (balance, turning either or statements into AND), Emotional Regulation (how to balance emotions) and Interpersonal Effectiveness (establishing boundaries for yourself and how to meet your own needs).
When my therapist originally recommended I start DBT therapy, I rolled my eyes and protested. The whole concept sounded way too zen to me--I mean, walking the middle path? Mindfulness? What the hell was I going to do with that? It sounded to me like she wanted me to drink some sort of Kool-Aid and I was less than keen. However, after some real pushing, and having the director of the DBT program come in and speak with me, I didn't really feel as though I had a choice. Fine, I decided. I would go there, but I didn't have to like it or participate.
Needless to say, I went into my first DBT group with zero enthusiasm, zero goals to achieve, and generally a bad attitude towards it. I had my binder, which I was able to decorate (I ordinally would have enjoyed decorating it, but I was mad, and felt like I was being treated like a Pre-K student), and sat down at the table with my fellow DBTer's. They had all been in the program longer, so they were trying to be friendly, and I wanted no part of it. I was friendly enough, I guess, smiled appropriately. But I honestly didn't want to be there.
When group started, it was led by N., a very good therapist who I happen to respect. I found my bad attitude starting to go away. She ran the group much like a college lecture, she gave information, we filled out notes. We shared and discussed. I came during a unit, Emotional Regulation, that I severely need work on, and N. reminded me of that when I was getting a bit too snarky. When she called me out on my bullshit, I respected her all the more, and decided to actually listen and give it a go.
D., another therapist, also runs the DBT group, and I took immediately to her sense of humor and her not by the book approach. She personalizes all the skills, and gives us her own real world, concrete example of how each can be used. We also share our homework and discuss with her, but it's a little more laid back.
I've sat through three DBT groups so far, and the three skills I learned saved my life this weekend. First, the skills, then how I implemented to keep myself sane.
The first skill was actually naming, and understanding your emotions. At first, I was like, um I
learned how to do this back during my Sesame Street days, but N. immediately changed that thought as she started to teach us the myths and the facts of emotions. For example, there is no "wrong" or "right" emotion for a given situation, and emotions don't ever just happen, our thoughts create them. We had to think of an emotion that we really struggled with (mine was anger) and we had to act like Sherlock Holmes, and mentally observe ourselves in that emotion. We had to figure out the physical reactions of our body during that emotion, our thoughts during that emotion, how the emotion holds us back, and how it helps us. Since I have a background in Laban Movement Analysis, it wasn't hard for me to go back in my mind and visualize myself angry. What did surprise me was the fact I hadn't thought to do this before. I hadn't realized, on a conscious level, anyway, that my body fully reacted to strong emotion--or at least I never paid attention to it before.
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| My work: Describing my own anger |
The second skill is called "Riding the Wave" (of emotion). This skill is really hard, because it doesn't involve you doing anything. There are no coping skills to be used. Instead, you have to sit in your emotion, and like Sherlock Holmes, analyze yourself in it. Emotions last only 10-12 minutes in their highest intensity, so if you can hang on through that, then they'll dimish. So you start the at the bottom, when the emotion starts, you ride it through its climax (the peak of intensity), and then you
ride it through the descending part. It's at the descent that you can then grab a coping skill and help calm yourself. The idea behind this is we often shut off our emotions, grabbing a coping skill before we even experience them, so the energy of the emotion never fully dies. It just continues on this vicious cycle and it never really diminishes, so it just kinda hangs out, and not in a good way.
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| My work: Riding the Wave |
People with mental illnesses aren't the only ones who shut off their emotions. Everyone does, no one really wants to feel "negative" emotions often or in their fullest intensity. Instead, everyone tries to cope as opposed to experience. This sounds weird, and easy, but it's really not. It's hard as hell to have an emotion, and feel it all the way through its 10-12 minute crest. It's even harder for me. I have Bipolar Disorder, so riding the wave can be like sitting on a razor blade. If it gets too much, and I don't use a skill, I can go manic or depressed. D. emphasized that for really intense emotions, skills should be used first and foremost. But for the lesser ones, riding the wave can help you understand your body, your thoughts, and what is happening to you while you're in this emotion.
The third skill was understanding the model for fully describing an emotion. It started with
"vulnerability factors" things that make us more predisposed to feeling an intense emotion. Some of these can be not sleeping well, not eating, medication changes, biological factors, past trauma, etc. Things that make us feel less than our best. Then there is the "prompting event #1" (the exact situation that happened to trigger the emotion), followed by the "interpretation of the event" (how we think, feel, perceived the prompting event #1). Then come the brain and body changes (how our body is affected by the event and the interpretation. These are in the inside changes, the ones someone else can't see like temperature raising, muscle tension, etc), and then our "facial and body language" (what our face and body is doing--external, shaking, grinding teeth, etc). Then we can "name the emotion" (what emotion is actually being felt) and finally, we have the "after effects" (what happens after the emotion is named). The cycle can repeat itself again with a new emotion that creeps up after the original one is named.
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| My work: Naming and Describing Emotions |
The whole point of this is to know that something happens, then we interpret this event in a way that triggers a biological, mental and emotional response. By knowing what is happening in your body, you'll be able to figure out the emotion you're feeling and be able to process things accordingly. This is especially important because the body starts reacting to the emotion way before we actually process through what the emotion is.
So this weekend was a bit of a stressful weekend (not necessarily in a bad way). On Thursday I got together with some friends for a hangout, Friday saw more friends and worked on a project, and today I've been able to decompress.
Thursday was awesome, I got to see some friends, discuss some good literature, and hang out. Was a good start to the weekend.
Friday, however, was a bit rocky. An incident occurred that has to do with my immediate, blood family (and blood family is harder, generally, to deal with than friends who have become family). I was driving up to North Jersey once again, to meet up with some friends and work on a project. I was looking forward to it, they make up a large portion of my "crew" and our project was helping others, which is always a good thing. So I was feeling a lot of joy as I was making my way up North.
However, as I was driving, I became aware of an incident that involved me, my step-mom, and other people in our family. I don't want to throw any of my family members under the bus, so I'm painting the incident in broad strokes. Words were said that bothered me, because I absolutely love my stepmom and the other members of my family, so the incident was quite unnerving to me.
Immediately, I started feeling my body tense, my hands clench around the steering wheel, I grew hot and my thoughts started to race. This was not going to be good, so I knew I needed to stop the spiral before I exploded, and fully ruined familial relations. I knew, as soon as I felt it in my body, I was angry. And because I recognized the anger so quickly, I had options before I exploded and it got out of hand. The first, I could fully engage and let it explode. The second, I could ride the wave and sit. The third, I could use a TIPP (another DBT tool for another blog post) coping skill, cut off the emotion and analyze later.
Since I was driving up the Garden State Parkway doing around 75 MPH (I speed when I'm mad), I chose the latter. I went into my TIPP toolbox and started doing some "paced breathing" in through my nose and out of my mouth on the count of 5. This helped me relax, and even be able to listen to what the other person was saying, without the veil of anger clouding my brain
When the conversation ended, I said "okay," and didn't engage any further with that information. I had interpreted it as "I'm a problem" and knew I needed to analyze more deeply. However, I had breathed through the anger, was still driving safely, and was going to see my friends. The crisis, for the moment, had passed.
However, there were aftereffects, but for the first time in my life, I understood what was happening and was able to act appropriately. As my friends and I got together and started work on our project, I found myself feeling irritated, and no one there did anything wrong. The physical work was hard, but I enjoy intense physical labor, and yet I found myself getting annoyed for no reason. I did a quick check in with myself, and realized I wasn't feeling anger towards my friends, but rather was still angry at the situation that had happened earlier. Once I realized I was feeling what my mom used to call, "misplaced anger," I was able to literally check myself before I totally wrecked myself and most of my friendships. I used a 
This morning, I realized I was still not feeling right--the anger was still there--so I called my step-mom and the other people involved. All is good, and I'm now working through the annoyance I'm feeling that the situation even happened in the first place.
I know it might not seem like a big deal, but my behavior this weekend was such a huge improvement from where I was. Without the DBT skills, I would have lost very important friendships on Friday, because I would have been lashing out at people who did nothing wrong, simply because I couldn't understand my own emotions. I never would have known that the anger I felt with my friends was anger left over from the situation earlier, and I certainly wouldn't have known how to deal with it safely. In addition to saving my friendships, DBT skills also gave me the power to call my dad and step-mom, tell them exactly how I was feeling, and explain the situation.
I don't often give myself credit, but I'm very proud of how I successfully implemented coping skills from DBT to save myself, my friendships, and my relationship with my family. Now that I know that they work, I am looking forward to learning more DBT skills, and continue to grow and learn in my ability to manage my mental illness. Things are starting to look up.
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