Thank you, AH, I love it! I love acronyms--guess I'm kind of weird that way--I create my own sometimes, similar to these. I'll see if I can find the one I used to use a lot tomorrow.

I think DBT skills are so helpful. I use many of them on a regular basis and would recommend them to anyone who sometimes has trouble with strong feelings.

Thank you AH for taking the time to share this with us. It's rather timely for me because my T just left for ten days and I will miss two sessions. To say that I'm struggling with strong feelings is an understatement. I'm not sure that anything can help me right now.

TN

(((TN)))I'm sorry



I have a quick question about dbt if anyone can answer -
does this work for people that hate themselves - like to the core of their being, extreme self loathing?
My T has mentioned looking into other treatments to try to break through that little self esteem issue I have - and it all seems so self nurturing and soothing. And if it's dbt she considering I don't see myself being very compliant.

Thanks for posting these. One my biggest issues has been learning to tolerate my own distress. I've not done any DBT - it's not so common over here, at least in private settings, and I would never meet the criteria for being seen in an NHS setting.

Right now I'm at a point where I don't need to do a DBT programme but I can see some aspects could have been really very helpful when I was drowning in my own feelings and just muddling my way through.

How prescriptive is it, out of curiosity? There are some things on that list I'd probably never choose to do, or outright reject because of my personal values and philosophy, while others are a staple part of my routine. Are DBT trained Ts open to clients using them how they want to?

I think I am better at some of these things than others. I think I have adopted a sort of piecemeal set of techniques that work for me; some of them are on the list - and I'm definitely better at some than others!

Distracting is difficult for me, as I tend to really hyper-focus on the issue at hand when I'm distressed with varying degrees of success; I can sometimes think my way out of a distressing state of mind but other times it's utterly pointless and I would be better trying to distract, wait until I'm not in that really hyper-aroused state and my thinking brain has returned. I forget that my ability to think rationally is impaired when I'm distressed. When I come back to 'myself' I'm often quite surprised by my black and white thinking when I'm in that state and wish I was better at recognising it!!

Thanks again AH, interesting reading!

(((exploring))) I'm excited to see your acronym you created! I love them too, my brain holds onto acronyms and metaphors far longer than information presented in any other form. It makes it 'stick'

(((BLT))) I agree that they are very useful and I feel like they just have a way of shifting thinking into a more self nurturing state of mind. I never would have chosen DBT if my T hadn't become certified in it between the first time I worked with her and when I we got back together, but I'm thankful she did.

(((TN))) I'm so sorry you are in such pain TN Breaks are incredibly difficult and do hurt. I hope you will be able to reach out here and let us support you through it, and go gently in coping each day. I am thinking of you and sending big hugs your way


(((lucy))) I am in the same boat with you lucy Since I am still new to DBT, I can't say from experience if it helps self loathing, but I feel the skills DBT teaches will elevate my self esteem. For me, I benefit from having a bit of structure and feeling as though I'm learning each week. The four main skills taught are

Distress Tolerance learning to cope with overwhelming emotions in healthier ways by means of distracting or self-soothing. Distraction is meant to give you time to settle your emotions before reacting to a situation, and is different from avoidance because it's designed to settle emotions until you can deal with a distressing situation in the future, if there is something you can do to change the situation (The idea of the serenity prayer- having the strength to change what you can, peace to accept what you can't, wisdom to know the difference) Distraction is especially used in the context of self destructive behaviors. Self-soothing is meant to bring you peace and relief, and learn to have compassion for yourself. Especially if you were never taught to do this in childhood. Also part of distress tolerance is the idea of radical acceptance involves learning to look at a situation objectively, without judgement or criticism. It doesn't mean you condone or agree with it, but you refocus your attention on the facts of what you can do about it, or what you simply have to accept as reality.

Mindfulness This is the ability to be aware of your thoughts, emotions, physical sensations and actions in the present moment, without judging or criticizing yourself or your experience. By focusing on the present moment instead of the past or future, you can better control and soothe overwhelming feelings. It helps you identify judgmental thoughts and separate them from your experience, and develop wise mind. Wise mind is the ability to draw from both logic and emotion equally, it is similar to intuition, or gut feelings that resonate with your deepest values as well as the facts of the situation you are facing.

Emotion Regulation This involves learning to cope with your emotions in more effective ways, remembering that we can't always control what we feel, but reacting differently to the feelings) This combines practices from distress tolerance and mindfulness. Learning to recognize, identify and label what emotion you're experiencing, how you view them, and what behaviors are prompted by those thoughts. You practice the concept of 'reducing vulnerability to emotional overwhelm' by eating healthy nourishing food, avoiding drugs & alcohol, regular exercise, sound sleep schedule & addressing any physical illnesses that need treatment. Also identifying triggers in the form of thoughts or situations. The eventual goal is to be able to face emotions calmly with acceptance instead of fear & avoid them.

Interpersonal Effectiveness learning social skills, like interacting with others in a healthy assertive way instead of being passive or aggressive. It teaches you how to ask for what you want, say no, and negotiate conflicts without damaging the relationship. Knowing how to observe and understand another person's feelings and reactions, and be mindful of the state of your relationship, without projecting your fears and insecurities onto them. Shifting away from a passive style of communication which causes you resentment, or aggressiveness which pushes the other person away. Identifying toxic relationships that are better off ending, and learning to better handle toxic people you can't avoid.

So that's the idea of what I'm learning.
I will say this, the largest amount of progress I've made in addressing my self hatred has come from a book I posted recently about C-PTSD (on book forum) I've gained an enormous amount of insight into why I feel that way about myself and how to overcome it, and I feel like I've been making progress in reducing self-loathing. If you decide to look into it, I must say to be aware it is very raw and emotional material, some of it was difficult to read. I cried a lot and had to stop and start, but once getting through it I'm really glad I did.

(((mallard))) No problem, I'm glad you found it helpful As I understand it, DBT was originally designed for treatment of BPD, but has since become used for anyone who has overwhelming emotions. (I asked my T if doing DBT automatically meant she was diagnosing me with BPD and she said no)

If you feel interested in learning the skills without doing a program, there is a self help work book called 'The Dialectical Behavior Therapy Skills Workbook' by Matthew McKay, Jeffrey C. Wood & Jeffrey Brantley.

I am unsure of how T's in general are trained to use DBT, but I can speak for my T that she never has pushed me to use all of the techniques. One thing I love about her is she is open minded and sort of eclectic in her approach to therapy. She holds the view of each skill being like a tool, and I'm building a 'toolbox' of my choosing, whichever skills are most effective for me. (And there are some I have also rejected because of my beliefs and personal values) She has been respectful of my choices in this, and presents things in a 'take it or leave it' way, which I appreciate.

The CPTSD book I mentioned to lucy also addressed the idea of the nervous system getting locked into flight mode, and had an interesting section on 'right brain' vs 'left brain' dissociation. The idea being that we can dissociate with activities or over thinking and analysis, but either method becomes addictive if used to escape feelings altogether. I had to really have T explain to me the difference between distraction and avoidance, because it confused me a lot at first.

I also read that the logic area of the brain 'goes offline' when the amygdala takes over in what it perceives as a threatening situation and activates 'fight or flight' mode. I always think of the way someone who is really in emotional distress will revert to their 1st language if they are bilingual, and I think there's something to that.

's to all

AH I am always impressed by your insight and resourcefulness and determination. I think you and your T are a good match. My oldT once out of the blue told me that I should do DBT (that was after telling me to do EMDR... he seemed to like the alphabet ) Of course he knew little to nothing about either one of them. It was his way of trying to push me out to any other T. When he told me about the DBT I had a terrible meltdown because I felt he was telling me I was BPD. I felt so betrayed and devastated and he had no f'ing clue what he was talking about. So now I have a bias against the whole idea of doing any of the DBT stuff although it could perhaps be helpful. I am glad your T was so straightforward when you asked her about your diagnosis. I have an issue with the whole "acceptance" theme. I just struggle to accept anything about my past or about me. My brain seems to equate acceptance with submissiveness. And I rebel.

I've been reading the book you posted about and am only half way through. It has been triggering to me and I tried to talk to T about it but he was focused on other stuff and then he was leaving and maybe that is why he avoided getting into it. I like the author and have read his stuff for a number of years. But I think you are doing much better with it than I am because I cannot seem to do anything he suggests. It just seems that a lot of it has to do with acceptance and maybe I need to focus on that with T.

Thank you for posting all of this. It's good to think about and talk to T about. How do you view the whole acceptance vs. submissiveness issue I'm having?

Hugs
TN

True North -

would it be appropriate to copy the descriptions of the four main skills as well as the tips from the first post and make it a "featured post" in the general discussion boards.

I think it would be a really good "go to" when people are having a hard time.

just a thot
-RT

Hi RT.... I'm not sure what you mean by a featured post. Do you mean having it as a "sticky" so it does not get lost in the forum threads?

I'm not sure as a co-mod if I have the ability to do that. I can suggest it to Shrinklady if members would like that to be done.

TN

yes, a sticky

(((RT))) I love that idea! I think a go to section would be amazing to have on the boards. I put the tips from the first post on an index card to carry around with me when I find myself in distress and just can't pull out of it or remember how to.

I also made a travel book of sorts and put 5 plastic zip lock bags in it, one for each of the senses. I carry it in my purse to go to if I need to do some grounding and I'm away from home. The vision bag has pictures i find soothing, quotes that calm me or uplift me. The hearing section has a cd of my favorite songs in case I'm in my car, or headphones to use with my playlist on my phone. Smell has a fabric softener sheet and I'm planning to add some of the perfume insert samples from magazines. The taste bag has my favorite candy. And touch has a couple of those fuzzy gloves you put lotion in and wear overnight.

I attached all of the ziplock bags together and put a scrapbook cover around it so it's like a book. And then I got all crafty and decorated the cover

(((TN))) You are so kind, thank you I am feeling much more connected and comfortable with T now, she has really come to understand how traumatizing ex-T was and actually last session said she is very sorry she did not respond in a more validating way when I told her about it. It was soothing to hear that, and helped me trust her.

I understand very much what you mean about being afraid DBT comes with a diagnosis automatically. I am glad I asked, because I actually assumed for a couple weeks, then finally asked and was glad we could clear the air as to whether she was diagnosing me without telling me. (your alphabet reference made me giggle btw )

I also TOTALLY TOTALLY COMPLETELY resonate with your feelings about acceptance. T told me that the idea of 'radical acceptance' is the hardest thing she ever works through with clients, and generally the last skill mastered, but one of the most crucial ones. I think the biggest issue that comes up is 1. how acceptance is defined, and 2. the feelings attached to that definition.

My issue lies in the idea of what I was taught acceptance to mean. I grew up believing it was synonymous with approval of wrong, condoning of mistreatment, giving up trying to change things, or being powerless. I have a big issue with all of those ideas. Also I still hold onto a childlike fantasy of 'if I dwell on this enough, I can change the other person, I can control the outcome, etc'

So my first task has been to redefine what acceptance truly means. What I've learned so far is that it is simply a different way of looking at things, and instead of creating powerlessness, it actually give you far more power. Being consumed in distress over a situation doesn't change the outcome, and takes away from our ability to see it as it really is, deal with it the best way possible, and then as a result find alleviation from suffering by the fact that we were able to focus on what we could change, instead of what we couldn't.

So another thing that helped me was clearing up what exactly I was accepting- not mistreatment, not bad behavior from others, not a future destined to misery- accepting that I can not alter the past, I can not control the future, but I can choose how I deal with the present. And that realization frees up a lot of space and resources to do so.

A key concept of DBT is acceptance and change, not acceptance or change.

Since I am all about metaphors, I've learned to connect acceptance with a metaphor from my life, and it helps me make sense of what I'm trying to learn. So I bought some wonderful lavender bubble bath recently, and was all excited one night to use it. I filled up the tub, but my new bubble in, and was so looking forward to a relaxing hot bath. I get in, and realize our hot water is out. It was a tub filled with icy cold water on a winter night, and my lavender bubble bath had gone to waste. I was angry, sad, disappointed, irritated and most of all... freezing. And as I sat there for a moment, I thought of the idea of acceptance T had been working with me on. And I thought to myself, this is what it is. I don't like it, but I can not change it right now. I can sit in this cold water as long as I want, but it will not get warmer. All that will do is make me colder and angrier. What I can do, is get out, see if we can fix the water heater, and try again. I can't change that it happened, but I can choose what to do from here. And I felt a sense of empowerment from that small act of viewing things in that way.

I don't know if that makes much sense, but that's the progress I've made on the subject so far...

(wanted to add one extra thing on the subject of acceptance)

I was thinking of it some more, especially in the context of a relative who recently gave me some advice to just 'let it go'- which his definition was to completely forget, dismiss, minimize the abuse I went through, and continue relationships in my family as if nothing happened.

I feel like that concept, which I don't agree with, causes further complication in trying to view acceptance in a healthy way. In the case of trauma, healing takes time to work through and requires grieving losses. So there is a balance in all of it I guess, it's hard...

I'm still sorting it all out

Thank you for the information, AH. That's been really helpful - as well as all of the posts in this thread.

I did look in the book forum. I will likely look into that book. Later. I find it kind of frightening

quote:

AH I am always impressed by your insight and resourcefulness and determination. I think you and your T are a good match.

and to the cyber powers out there:
I concur - sticky!!

Thanks Lucy!

AH--
I found it! I looked for the acronym earlier today, but could not locate that particular journal. I used to have it memorized, but haven't used it in awhile so it had become hazy. I used to use it daily, sometimes multiple times a day, when I would get overwhelming feelings or when I would begin to dissociate with no actual danger nearby.

Anyway, I wrote in my journal once, "How can I counter these feelings?" Then I turned "counter" into an acronym that walked me through analyzing what was going on with me and reconnecting me with the world. It goes like this:

C--Comfort. To comfort myself, I would try to think of at least three recent pleasant interactions--my child smiling at me, for example, or a coworker's compliment.

O--Opportunity to learn about myself. Why am I feeling sad, or why am I being triggered? Sometimes the answer is just, Because my response system is reactive, and I did not choose the experiences that made it that way. Sometimes I can identify the exact reason why I am reacting emotionally. Either way, it helps me feel more kindly toward myself.

U--Unity with loved ones. I would conjure up images of the faces of people and critters I care about.

N--Now is the time to deal with this. It might be tempting to try to push it away, but that is not possible. The only way through it is through it. Thinking this helps me retain my time orientation.

T--Treasure sensory experiences. Notice what is around me: a pretty blue sky, a comfortable pillow under my head? What is there to appreciate in the immediate surroundings?

E--Embrace reality. I mentally consolidate the observations I have been bringing to mind.

R--Reach out. This could mean smiling at someone nearby or reentering a conversation. Whatever is appropriate to the situation.

So--there it is! I hope you find it helpful, or at least that someone who reads it does. AH, thank you again for sharing your learning on the forum; what a giving soul!

Exploring - Nice! Really nice. And a brilliant idea. I need to make some acronyms of my own. I hadn't considered being original! How about starting a new thread called acronyms? You could post this one and invite others to share too...

and AH too...

BTW AH, I forgot to mention that I think your ziplock bags are fantastic...


Red Tomato
Morning Peeps

Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think. - A.A. Milne, Winnie-the-Pooh

(((exploring))) I'm so impressed with your creativity!! Wonderful, I'm going to remember that



(((RT))) Thank you!! and I agree, great idea for acronym thread