Marsha M. Linehan works with seriously suicidal people, having faced the same struggles when she was younger.

 

Expert on Mental Illness Reveals Her Own Fight

By BENEDICT CAREY

Published: June 23, 2011

Marsha M. Linehan works with seriously suicidal people, having faced the same struggles when she was younger.

http://www.nytimes.com/2011/06/23/health/23lives.html

 

may 14 2009

 

 

Mental Health Awareness Ribbon
Mental Health Awareness Ribbon (Photo credit: Wikipedia)

 

Hello. I just figured since everytime I come to therapy with you I have difficulties talking I would atleast write to you and maybe that will be a start for our session in the morning which you probably won’t get this till before I see you anyways and it will be fresh in your mind. Well anyways DBT group I felt went well for the most part although I realize I did get annoying. It is difficult for me to sit through the whole thing normally I guess and I get unfocused. I am ready to stop going to group but I am not ready to go to Continuing care DBT group as I know what the skills are and am very able to help and explain them to others and I am also able to give examples for the most part and help others learn and try to understand them but I am using them regularly and have a hard time seeing when I am using them the way they are supposed to be used as opposed to manipulating the skills in a way that justifies my wants, needs, and desires. I actually like helping out with others who want to learn the skills but then also feel that I am hipercritical and have no right to tell people how to use them when I can not use them effectively. I think what it all boils down to in my head is I do not have a life worth living when I use them or when I do not use them and I analyze too many things to an extent in which I am able to find the loopholes and manipulate them to use negavtively more than positively. I also know that I am using the word manipulate alot in this letter because it seems that you feel I manipulate everything and everyone so it appears to fit here more than in any context you have tried to use it with with me. yes I do manipulate skills and things I do in my life to justify my behavoirs and lack of happiness and shit like that but I do not purposely manipulate people and that is where I get offended and build my walls up. I also know that I need to start working on things with you because to me it appears I am just coming there and nothing is changing but yet everything seems to be going away and the professionals such as yourself are the ones feeling I do not need the services but yet I do not see much has changed and really my life appears to be a chaotic mess. I also know that I am the one who allows my life to be this way but how do I stop it? You have stuck with me through thick and thin these past few years and really has not been as long as you think or feel considering the time I have been in treament for mental health but I realize maybe it has been too long for you. Maybe you feel overwelmed and burnt out a bit with me. I do not know but not really sure where we are not really working on anything that I should be working on talking about and learning to let go of maybe we should begin the process of ending treatment altogether. Maybe I can see you tommorrow and 1 more time this month and start out done with DBT and therapy. Maybe it is just time to fly free out of the nest away from comfort and all I really know. I did it before until I was forced by social services to have treatment again. Maybe we can try it and see how it goes? Maybe like say we will schedule an appointment in September which is right after the fall semester begins and I have hopefully found myself a place in Lynchburg and wont need it at all. What do you think? You probably are thinking it is not a great idea but why put yourself through the burnout and stress of seeing me and talking to me when I am not really doing any work with you as I should. I am having a hard time talking bout stuff that happens and that I have been through and that is being triggered by things occurring currently and by myself placing myself in that situation so then it just feels so lonely and as if I will never be able to unburden myself and let this stuff and let it go or get over so then why continue to use your time in an unproductive manner when others in the area really need help and you could be helping them. You could be showing them a better way of life rather than me taking the time I have and not using it th e way it is meant to be used. Well I guess this should be alot to discus more than enough and probably alot to digest at once and figure out analyze and comprehend so I will leave it at this and maybe these are the things that should be talked about tomorrow at the beginning of our session as they are important and time should be spent on them. I will see you at 10am. probably be there before then depends on the taxi if you need to see me earlier. Take care. Have good night if you get this before the morning.

 

 

Radical Acceptance

 

Radical Acceptance has always been a very hard concept forme to grasp and maybe not even grasp but implement and accept for myself. As I am able for the most part to help others in understanding it somehwat but not really implementing it.

According to The Dialectical Behavior Therapy Skills Workbook by McKay,Wood, and Brantley “The word dialectic (in dialectical behavior therapy)means to balance and caompare two things that appear very different or even contradictory. In dialectical behavior therapy, the balance is between change and acceptance (Linehan, 1993a). You need to change the behaviors in your life that are creating more suffering for yourself and others while simultaneously also accepting yourself the way you are.

Radical Acceptance is one of the hardest skills to master because it will require you to look at yourself and the world in a different way. However, it’s also one of the most important skills in dialectical behavior therapy (linehan, 1993a). Radical acceptance means that you accept something completely, without judging it. for example, radically accepting the presant moment means that you dont fight it, get angry at it, or try to change it into something that it’s not. To radically accept the present moment means that you acknowledge that the presant moment is what it is due to a long chain of events and decisions made by you and other people in the past. The presant moment never spontaneously leaps into existancewithout being causedby events that have already taken place.”

Radically accepting it does not mean that you like it or approve of it. It just means you accept it as it is. It means it is what it is and you have realized their is nothing that you can do to change it. You accept it for what it is no more no less.

 

Confusion regarding DBT and Trauma Recovery

 

DBT Is based a lot about living in the moment and to a big degree, I totally agree with it. We cannot change our past. We can only control what is happening in the present. We can only control our own actions and reactions to things that are happening in the moment.

Here is where I am confused or unsure of regarding DBT and what I believe. DBT can be very helpful for people who have experienced trauma and sometimes DBT is all a trauma survivor needs to use to be able to cope and eventually live a productive life worth living. My confusion is when someone such as myself has been through DBT and used DBT but still feels a void and a need to open the Pandora’s box that has been closed for so long and face the secrets inside themselves using the skills taught by DBT to cope with the uncomfortable feelings these secrets bring up while opening the box and letting them out and sharing them.

Yes DBT says we cannot do anything about the past but our past is what has shaped us to be who we are now and will shape our future unless we deal with it and change how we think about it. DBT Talks about Radical Acceptance which is still probably the hardest DBT skill I have tried to practice and cannot honestly say that I understand it to the extent I need to but I believe I have a better understanding of it than I did back in 1998 when I attended my first DBT Skills Training group when I was 19 years old.

I no longer attend DBT skills training groups but I still see a therapist who runs one and trained in DBT. And at time she has asked me about the skills as a reminder to her regarding what a skill or two is and how best to describe to someone to practice it since she only did the training back in 2007 after I had been seeing her for about a year already and had been in and out of DBT for almost 10 years back in Massachusetts and here in Virginia they were just starting to implement it into the central Virginia area not long before I came here. So I actually take pride in knowing that my knowledge of DBT is needed here even if I it is just here and there. I hope to someday to be able to start and run a peer led DBT group.

They just opened a Peer run recovery walk-in center close by through the local community mental health center but it is run by 2 peer specialist one of who are in one of my human services classes at the local community colleges and I have been building conversation and repertoire with her and hope to bring it up to her someday possibly in the fall.

 

DBT Skills List

 

DBT Skills List: “Using Objectiveness effectiveness: (Dear Man)
D Describe
E Express
A Assert
R Reinforce
M Mindful
A Appear Confident
N Negotiate

Using Relationship Effectiveness: (Give)
G Gentle
I Interested
V Validate
E Easy Manner

Self-respect effectiveness: (Fast)
F Fair
A Apologies (no Apologies)
S Stick to value
T Truthful”

 

DBT Skills List

 

DBT Skills List: “Using the What Skills:
Observe
Describe
Participate

Using the How Skills:
Non-judgmentally
One-mindfully
Effectively”

 

DBT Skills List

 

DBT Skills List: “Using Reduce Vulnerability: (Please)
P & L Treat Physical Illness
E eating
A Altering Drugs (no drugs unless it is medication to be taken as prescribed by your doctor)
S Sleep
E Exercise

Using Build Mastery

Build Positive experiences

Be mindful of current emotion

Opposite to emotion action”

 

DBT Skills List

 

DBT Skills List: “Using Crisis Survival: Distraction with Wise Mind Accepts
A Activities
C Contributing
C Comparisons
E Emotions – use opposite
P Pushing Away
T Thoughts
S Sensations

Using Self Soothe with five senses:
Taste
Smell
See
Hear
Touch

Using Improve the moment:
I Imagery
M Meaning
P Prayer
R Relaxation
O One thing at a time
V Vacation
E Encouragement

Using Pros and Cons

Using Accepting Reality:

Willingness

Turning your mind

Radical Acceptance”

 

IE Handout 10

 

IE Handout 10: “1. Be Fair
This means being fair to yourself and the other person in your attempts to meet your objectives. The idea here is that it is hard to like yourself in the long haul if you consistently take advantage of the other person.

2. No Apologies
Apologize when apologies are warranted. No overly apologetic behavior. No apologizing for being alive. No apologizing for making the request. No apologizing for having an opinion. No apologizing for disagreeing.
Apologizing implies that you are in the wrong…Apologizing when you do not believe you are in the wrong will reduce your sense of effectiveness over time. Being able to apologize is a very important skill, and is important for maintaining relationships, however, it gets on people’s nerves and can reduce relationships effectiveness

3. Stick to Values
Don’t sell out your values or integrity, just to get what you want or keep the other person liking you. Be clear on what, in your opinion, is the moral or valued way of thinking and acting. However, in dire situations, or where lives are at stake, people may decide to give up their values.

4. Be Truthful
Don’t lie or act helpless when you are not. Don’t exaggerate.
A pattern of dishonesty over time erodes your self respect. One instance of dishonesty may not hurt, but dishonesty as your usual pattern over time erodes your self-respect. Acting helpless is the opposite of building mastery. Sometimes being honest may actually reduce relationship effectiveness. The little white lie was invented for this reason. However, if you are going to lie it should be done mindfully, rather that habitually.
Important notes about self respect effectiveness.”