Do I need to rethink my feelings about DBT?
Posted by talesofacrazypsychmajor on June 23, 2011
I don’t usually post links to other articles here. That’s generally not my style. And judging from the content of this one, it’s probably going to get posted many other places.
I just have to share some of my reactions somewhere.
Here is the article
You may need to make a free NYT account to be able to read it.
tldr version: Marsha Linehan reveals her personal history of self-injury
DBT was not helpful for me. With other therapy types that have not helped I never really felt anger towards the big names that created it. I don’t have strong feelings towards Aaron Beck as a person even though there are some complex emotions going on for me about CBT. Things have been different with Linehan though.
Her name has been all over my experience of the therapy. When I was in DBT I worked in her workbook, which I pursed a copy of. In hospitals when DBT was shoved down my throat I used xeroxes of the same workbook.
After I quit DBT my (non DBT) therapist pressured me to take home DVDs of Linehan’s to watch. If I refused to continue the DBT therapy, she thought maybe the DVDs would help. They just made me angrier. I have pages of typed notes picking apart every detail of those DVDs. Some of them were obnoxious and irrelevant such as my criticisms of the lighting quality. Mostly I just felt that Linehan just didn’t get it. Combined with later viewings of youtube clips of her and videos of her I saw in school, I’ve developed a view of her as cold, mean and out of touch. The cultish language of DBT did nothing either to endear her towards me either. That she could possibly have a personal history of these problems was not something that ever would have occurred to me.
A lot of my anger towards this therapy, that was repeatedly forced upon me, became directed at her. She created this overhyped therapy that no one will believe is ineffective for me.
This article really turns a lot of my feelings upsidedown. I guess she’s not quite as out of touch as I thought. Some of these comments she made that seemed cruel make me think more now that she’s using humor as a way to deal with some fo these things.
I am not going to become a hardcore DBT advocate, but it does make me feel its worth a little more examination. Not so much as a treatment for myself (I’ve long ago ruled out the possibility of it being effective for me and strongly believe anyone who treats any therapy as a panacea is delusional), but in terms of general professional knowledge it could be useful. I still have theoretical objections and think DBT is backwards (behaviors should not be the first issue address with in a therapy, IMHO), but this gives it a little more credibility.
This news is certainly going to take over my therapy session today.
I’m still processing my thoughts about this. I don’t usually like to post here without digesting thoughts more, but I wanted to share while it was still fresh news. Feel free to add your thoughts on the matter.
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Edit:
I walked into therapy and said “Hey, did you read the NYT today?”
S.M. replied “I haven’t finished reading it yet, but I bet you want to talk about the Linehan article”
He’s got me figured out.
sanityisknocking said
I had a bit of the same reaction. I softened a tad to her revelation….
However. I’ll never forget one of her videos when she said she wanted to help the people no one else wanted and how “easy” these suicidal people were to find. The audience laughed. She laughed. Even if she has a history, making fun or laughing at people’s struggles is incomprehensible to me.
I can’t help be a skeptic as to why she’s decided to share NOW. The article made it sound like there was proof she was in the hospital as a teen, which I won’t dispute, but I guess I am just wary of being bamboozled.
I agree 100% about the thought that DBT is a cure-all….especially outside of BPD.
talesofacrazypsychmajor said
I think I was thinking of the same video while I was writing this. I think she has issues with empathy for sure, but this does make it a little easier for me to feel empathetic towards her, knowing that at least its misguided attempts at humor and not the complete misunderstanding and disconnect that I’d thought.
talesofacrazypsychmajor said
Also I think I can understand why now. She’s a leader in the field. I’m sure she has tenure. At the place she’s at she can do almsot anything aside from research or professional misconduct and still maintain her position. I imagine she’s realized she has a level of security that she dosn’t have to hide anymore. Maybe she also has retirement plans coming up.
K8 said
Interestingly, I read this article just now and came here to share it with you… and lo and behold, you beat me to it!
I know there are stigmas against mental illness, know very well- you’ll just have to take my word on this, I don’t share other people’s business without their consent, but let’s just say some very close loved ones have dealt with the stigmas.
I think about your situation sometimes though, and this may seem completely random and unrelated- but I was an obese person who lost a lot of weight and now I am finding that this gives me credibility with other obese people that people who have never been obese can’t ever attain. I even remember thinking “what could a thin person who has never been overweight possibly know about what I’m dealing with?” So now this has become my passion, to help other people with this issue.
My loved one often says things like “therapists don’t understand me. they are just out to make money. they don’t really care to help anyone.” I have to wonder if he might feel differently if there was someone he could talk to who would actually understand some of what he is going through.
When you read the article, you rethought your position on this type of therapy (which I have never heard of because it’s out of my realm.) When I read the article, I thought about your status of living with this “in the closet” and wondered if maybe there is good argument for re-thinking that.
Hope that didn’t come off as intrusive. Obviously nobody knows how to live your life better than you, but there certainly is something to be said for being a person who’s “been there/done that” when it comes to credibility.
talesofacrazypsychmajor said
Linehan and I are in very different situations. There’s not really a shortage of people with my type of history trying to get into this field. I’ve very explicitly heard people comment about people trying to get in this field for the “wrong reasons” and heard talk to grads schools making efforts to filter people like that out. The thing about mental health issues is that if you have a high enough status you can come out and it isn’t as big a deal, because your position in life is secure. U of Wash isn’t going to fire one of their top tenured academics over this or give her any kind of trouble at all. If nothing else this reminds the public that this high profile person works there.
The thing is very few people ever reach that sort of postion where they have that levels of status safety. It’s unlikely that I will ever reach that kind of place. The best I can hope for is getting enough security to be able to open up to a handful of close people. Maybe far enough along in my career some of those close people might even be people I work with.
I agree that there is a benefit for people to know some of the humanity behind therapists, but I don’t think I’m going to be the person to lead the breaking down of that barrier. Instead I hope that my experience can help inform my research investigations to ask questions that others without this experience might not think of. So I can help in my own way without oversharing.
talesofacrazypsychmajor said
I also don’t want all my actions to be viewed through the lens of my disorders. I’m already seeing some of thing happening on forums discussing this article. Saying that this explains some of her judgmentalness etc.
When I talk about disorders that I have in professional situations, I want my academic speech to be viewed as academic, if I am open there will always be an uncomfortable double layer of meaning to worry about. I’ve seen academic situations where people start oversharing and it makes things uncomfortable and derails the conversation. I want to be able to talk about psychology without blatantly talking about myself. If people know too much they start reading things into it.
Campbell B. said
I’ve never had DBT, but it’s seriously mentioned to me everyday that I go to partial or a therapy session. I can relate to it being shoved down my throat. My gf even bought me a workbook because HER therapist said it’s something I should be doing. I thought some of the ideas listed for alternatives to cutting were really stupid. Draw on my skin with a red marker? Seriously? I’m supposed to start this DBT program in August that requires me to sign a year long contract with someone I never met. That’s just something I not willing to do and seems a little much. I don’t know very much about DBT other than what I can find online and the stuff I’ve skimmed through in that workbook but honestly all of that stuff just confuses me. After everything I’ve read, I still don’t get what it is. My therapy program has CBT but I don’t go to that group anymore because I think CBT is a little too unrealistic and idealistic. Then I feel like maybe this therapy just doesn’t work for someone with my issues or maybe I’m just too stupid to get it. I hate the mantra the CBT therapist says and writes all over the board. “Feeling is inevitable, suffering is optional.” Every time he says it out loud I cringe inside. I’m not sure what it is about the phrase that bothers me so much. I literally left one CBT group in tears because I was asked to share my opinion of this article he made us read together. It was all about finding the positive in a negative situation. It sounds good I guess, but I just don’t think that’s realistic. I said that I honestly thought it was a little simplistic and can’t be applied to every situation. He seemed offended and wanted me to explain. I said, “Well, what exactly am I supposed to find positive about never being adopted? Or living in 42 foster homes? What can you find positive about things like rape or death or cancer?” That’s when everyone in the group decided they needed to persuade me that the positive thing about not being adopted is that I get to look forward to creating my own family by having children. Needless to say I exploded into tears and ran out of the group. I’m kind of just rambling now. Basically I’m trying to say that I loathe CBT and I’m confused by and terrified of DBT.
talesofacrazypsychmajor said
Somethings are negative and trying to put a happy spin on them in really a insult to the individuals pain.
I hate the things they list instead of SI. No holding an ice cube is not going to help anything.
If you want to do it don’t worry about the 1 year contact thing. Don’t let that be what holding you back. It’s not legally binding. Just bullshit. It means nothing. If you want to try it for a week and bail you have every right to.
Anonymous said
No, you don’t have to rethink your ideas around DBT. Linehan has cornered a market and is making a fortune out of rolling out this pernicious, judgemental, silencing nonsense. She has the need to be accepted and validated and unfortunately she has done this by going out of her way to become part of an establishment that brutalised her and one in which she would have felt extremely frightened and misunderstood. Good little Martha, she’s so regulated now. It’s actually very sad in a way.
The very fact that she has built a life and a career out of validating pejorative, unscientific smear labels like BPD is in and of itself slightly grotesque.
As Dana Becker says “the distress is real, the diagnosis is fiction.”
Radical Acceptance and Mindfulness were chosen by her to include in her ‘therapy’ as they were the up and coming thing in the field at the time. Survivors often find DBT horrifically invalidating and offensive. It’s often delivered in a highly controlled and power differentialed environment. It’s the ultimate insult to anyone who’s suffering. The ultimate “we know better by virtue of the fact that we’re not in the distreSs you currently are.”
I think it has the capacity to radically damage people and train them into a self policing state of constant monitoring and checking. Welcome to the Borg!
Trust your gut, DBT may sound on first look like a light fluffy warm thing, but scratch the surface and it’s very obviously a system in which non compliance is punished and ‘boundaries’ are enforced which actually mean rejecting, manipulating and controlling peoples behavior and how they express themselves, particularly in distress.
It has been labelled ‘doing bollocks therapy’ or ‘diabolical behaviour therapy’ by survivor activist Louise Pembroke. It compunds the idea that there’s something inherently wrong with the person thats receiving it and that they need to be taught how to be diferent.
It may be wrapped up in a nice shiny bow but its used to bully, coerice and hoard people into programmes that prevent them from clogging up the mental health system with distress that is legitimate but that they dont want to hear about.
Spent a liftime being told there was something wrong with you? DBT will confirm this subtly but powerfully by being complicit in the notion that you are ‘dysregulated’ and need to learn new ‘skills’.Yuck. It’ll be something else in 20 years time.
People need to fight back, this is not a therapy, it demands ‘behavioural modification’ but won’t do anything to address the very real distress that many people feel and that deserves a respectful space in which the person can be accepted and supported without coercion.
Linehan’s outing was not necessarily of her own choosing. It makes it even more tragic that she would inflict this on others having suffered herself. I believe that she really does think she’s helping and if it works for you go for it.
However if it doesn’t help or you simply arent’ interested and want choices in the help or support you receive then it’s simply not good enough that this is force fed to people who are often feeling much too vulnerable to refuse it even thought it’s not what they want. Sound familiar? Don’t drink the cool aid. Say no to the nun.