A request-What is DBT?

One of my loyal followers  🙂   (I actually have some!) asked me to talk about DBT therapy.  Sure thing!

DBT stands for Dialectical Behavioral Therapy. It involves both individual and group meetings. The main idea behind DBT is to learn how to deal with life’s little crapshoots in a manner that is healthier for your mind and body. This is done through conversation (Dialectical) and through 4 modules (Behavioral) that are covered in an 8 week cycle. No, it is not a miracle program that cures you in 8 weeks! It is ongoing, and it works.

I will share my story with you and perhaps you will see how DBT has truly had a major impact in my life.

As I indicated in my 100 post, all my life I have been dealing with depression but didn’t know it. I was depressed as a child, but it was never diagnosed. My pediatrician told my mom I was just a bit anxious and it would go away.

Right after I had my son (24 years ago), I kind of flipped out. It wasn’t post-partum blues; it was more like a humungous anxiety attack over spiders! I accidently touched a dead spider while I was cleaning and completely lost it. Crying, heart pounding, out of control. Ding-dong…hello in there…something is very wrong here! So, I called my physician and asked for a psychologist to go see. I got the name of a reputable guy and went to see him. After a day of tests he diagnosed me as having a generalized response disorder and needed to learn how to relax. So, I went to him for several months, learned how to self hypnotize and learned how to relax.

I finished up my doctoral program (self hypnotizing myself to death for relaxation purposes) with what I considered a normal amount of occasional blues.  After about 7-8 years, I started getting other symptoms…I couldn’t make my leg work to drive. I would sit in my car at work, and it was like my leg went numb..I could not drive. This happened about a half dozen times and I called my doctor; he checked me out and said nothing physical was wrong so maybe I needed to see the psychologist again.

THis time, it was anxiety. It seemed to be work related more than anything else, so once again, I was back in for weekly sessions and learning the progressive relaxation strategies in addition to the self hypnosis. A few months, good as gold.  Almost.

I started to fall back into a funk and knew it for once. Crying a lot, eating too much, etc. So, I decided to try to become part of a depression study that was going on at the University of Pittsburgh. I went in for all the tests, etc and that was the first time anyone difinitively said to me, you have been depressed since you were a child! They mapped it and the cycle was crystal clear. That actually made me feel like I could maybe understand what was going on. But, I couldn’t be part of the study because I wasn’t depressed enough! Love that one! They said if I started to feel myself going back into a deeper depression, give them a call. Very therapeutic! So, I just dealt with it the best I could.

Then, I wasn’t feeling particularly terrific on one of my visits to OB-GYN (whom I will adore forever, even though he is retired now) and he just asked how I was and I burst into tears in his office. I sat there and sobbed for almost a half hour just pouring my heart out to him about anything and everything. When I stopped, he said, “You are depressed…you are very depressed. Has anyone talked to you about any medications?” Well, I am not one for taking pills. I hate taking pills. But, when he suggested that I should maybe think about taking a small dose of Prozac, I was willing to do it because I realy needed to feel better.

So, I started on a small dose of Prozac and it did help for a while. It really did level me off.  That was until a series of crises happened. My mother got a particularly bad form of lung cancer and died exactly one year from her diagnosis; within months her older brother was suddenly diagnosed with cancer and died in just a few months; then her sister (who had battled and beat lung cancer for 20 years) and was now battling recurring lung cancers and then died. Three of them in less than 18 months and my dad and I did just about all of the hospice care for my mom and aunt. I was still working full time and my husband had just lost his job that he had for 31 years. Both of my children were in college and having some of their own issues. And I was the Executrix on my uncle’s and aunt’s wills.  I lost it. I did nothing but cry. I could not get out of bed, but I could not sleep. I ate nothing but sugar and chocolate. And I started wishing that I was dead. I envisioned myself driving as fast as I could into a tree or off the side of the road (didn’t want to kill anyone but myself).  I took a medical leave for part of a semester to try to get myself back together and increased the Prozac.

Then, my house caught fire and nearly burned down. So now we had to live in an apartment until the house was rebuilt. I cried a lot in the shower, in the car, in my office at school; anywhere I could cry except at home in front of people.

My best friend suggested a new counselor (oh, I tried the psychologist one more time and finally figured out what a major asshat he was) and this counselor referred me to a psychiatrist to work with me on the medications. Well, after readjusting the Prozac, changing to Cymbalta (which was the absolute worst drug in the world for me), and going back to Prozac and working with the new counselor, I seemed to be on the right track; seemed to be…

THis past March it happened again and hit me like a ton of bricks. The suicidal thoughts were back and I was soooo tired of dealing. I went for a med check and told the Psychiatrist I no longer wanted to be on any medications at all. That I had to learn how to deal with this in a more behavioral manner and that day, he removed me from my totally poisonous work environment and put me into a DBT group. I was initially receiving therapy three times a week between group and my individual counselor.

That was 7 months ago. Today, I am 100% med free and I have learned life skills that will help me recognize immediately any depression triggers and eliminate or significantly reduce my depressive responses to the triggers. I am still going to group every single week and will do so until I KNOW that I can handle anything that comes my way. I still have many skills to learn.  DBT is a SKILLS group, you learn and practice with people who absolutely understand exactly where you are and where you have come from.

What have I learned…

I have learned to live every single minute in the here and now and to be MINDFUL and focused. THis is hard people. It is so easy to look back at things and get disturbed by memories or to look forward in anticipation of things that may not even happen. IF you stay in the moment, you can use all kinds of skills to maintain your mental and physical health.  #1 skill-BREATHING, solid meditative breathing. Nothing centers you faster and makes you feel better faster, for real!

I have learned to use what DBT calls ‘Wise Mind’…equal amounts of emotion and logic…you don’t get overwhelmed when you use ‘Wise Mind’.  You can make decisions that follow your heart AND your head.

I have learned to use EMOTION REGULATION strategies. When I begin to think about something stressful, I DISTRACT myself by listening to a great song on the radio or a CD. When I feel myself becoming stressed I SELF-SOOTHE by petting my kittens, chewing a piece of cinnamon gum, listen to relaxing music. These strategies immediately reduce your heart rate and reduce anxiety and stress.

I have learned more effective INTERPERSONAL EFFECTIVENESS skills. I always thought I was pretty good at these skills, and I am. But there is always something you can learn.  DEAR-MAN is an acronym for a sequence of behaviors that are very effective in getting what you want and need out of relationships with others. NO GUILT, NO FEAR, NO EMBARASSMENT.

I have learned DISTRESS TOLERANCE skills that allow me to stay very calm in the face of activities or people who I used to allow to cause me tremendous distress. The best strategy I learned here is RADICAL ACCEPTANCE or another way of saying it is: It is what it is. For me, that meant learning how to walk away; how to say no to requests and not feel guilty about it; how to really accept that there are things that cannot or will not change and move on.

So, I am back at work, and I am saying NO to a lot of people and feeling pretty darn great about it.  I can sit in my office and when one of the previously offending parties call or come to visit, I half-smile (that’s another skill), breathe and pretty much let them babble on at which point I usually say, “Oh well!” and move on. If it is not my primary responsibility, Oh Well! If things get bungled (as they ALWAYS do at a University)..It is what it is…NOT MY PROBLEM.  I have also used the DEAR-MAN very effectively to get what I want out of my job. 

In short, I have found a wholesome natural way to really gain control of my life and my depression. Cause, depression never really goes away. You can control it and you can control it well and that is what I am doing.

Now, if I could just control these hot flashes……….


4 Responses to “A request-What is DBT?”

  1. October 5, 2008 at 8:47 am

    I’m glad you found a way that works for you Mum. I won’t even say “I told you so” about medications…I think that switch to Cymbalata gave you a good idea about why I decided to try to stay off them if it’s at all possible.
    I also think it’s good that you’ve been able to find a clear method that helps you….I never did, I was just somehow sort of able to fix myself enough to get back to normal again, but I never followed through with anything so I have no idea how I helped myself. I wish I knew cause times like now I really need a way to regulate and I’m not sure what to do.

  2. October 5, 2008 at 11:49 am

    Thank you for writing this! I think it helps a bit to see how far we’ve come, don’t you? Although I do know I need to work on emotional regulation a bit – for myself, and for my daughters. Sometimes we feel things a little too much.
    The radical acceptance is also one that I work on continually.
    Not to tell you what to do with your blog or anything, but I’d love to learn more detail about all of the skills you’ve listed here.

  3. October 5, 2008 at 12:44 pm

    Thanks SO much for sharing this! We have some similar issues in our family and it’s wonderful to learn of new therapies. I’m going to look into this further. And I’m so relieved you found something that is helping you. Huge hugs.

  4. October 7, 2008 at 12:11 pm

    Here is the thing that will control hot flashes at night.

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