DBT – 1 Year On

TW: Some mentions of self harm and suicidal ideation.

*If you aren’t familiar with Dialectical Behaviour Therapy, please read My DBT Experience blog post first!

A life update

It has been a year since I graduated from a 2 year intensive DBT programme. A lot of time has passed, so what’s changed?

Unfortunately I haven’t been able to progress with the trauma therapy I was all geared up to do, owing to my therapist unexpectedly and abruptly needing to take some time off for a cancer surgery. This will now hopefully be able happen next year (COVID and his health permitting).

Overall, I feel I have had quite a stable year, save for cyclical PMDD episodes for which I have now received a formal diagnosis. While getting a diagnosis for a chronic condition is not exactly good news, it is helping me access some help, and the validation of my problems is in itself making it feel less ‘doom and gloom’.

Has DBT helped at all?

Put it this way, there isn’t a day that goes by where I don’t use, or at least think about using, a skill I learned from the programme.

DBT skills I still use

Some of this might not make sense unless you are familiar with DBT – there are loooaads of silly (and sometimes a tad forced) acronyms for things which are supposed to help you remember the different components to a specific skill.

For example, an emotion regulation skill I use every day is PLEASE. The PLEASE skill encourages you to “look after your mind by looking after your body” which helps to reduce your vulnerability to difficult emotions and using unhelpful coping methods (which for me is self harm).

  • P L = Treat PhysicaL Illness (yeah, I did say some of these acronyms push it a bit, haha)
  • E = Balance Eating
  • = Avoid Mood-Altering Substances
  • = Balance Sleep
  • = Get Exercise

So when I “do PLEASE” I: Take my medications correctly and on time, try to eat three meals a day, avoid drinking alcohol alone (I don’t smoke or use drugs), try to get a good night’s sleep (difficult with my chronic PTSD nightmares), and attempt some form of exercise or activity that raises my heart rate (insert wanking joke here).

A distress tolerance skill I use quite often is STOP.

  • = Stop! Don’t react, stay in control
  • = Take a step back. Take a break. Take a deep breath.
  • = Observe. Notice what’s going on – inside and outside of you.
  • = Proceed mindfully.

STOP is supposed to help access your Wise Mind to see things more clearly, or how they really are, and react mindfully rather than impulsively. This has definitely helped managing problematic urges, from suicidal feelings to just making a shitty unnecessary remark to my partner for no reason other than I’m feeling irritable.

Oh yeah, Wise Mind – I literally got it tattooed on me! Before DBT I thought I had mindfulness down, but having to really engage with the concepts and do lots of practice in group has improved my abilities massively. I use mindfulness and grounding techniques when I notice I have been dissociating.

Other skills I come back to are Problem Solving, Opposite Action and Cope Ahead.

Radical Acceptance is still something I struggle with which I think is normal. It’s a hard concept for a lot of people – illustrated nicely by the decidedly visceral responses others in the group had. Those sessions were always… an experience!

The journey onwards…

I said it in my other post and I’ll say it again.

DBT is a game changer has been so, so beneficial for me. Completing the programme was totally worth the effort as I feel very equipped to tackle trauma therapy next. Incidents resulting in self harm have definitely become less frequent. I can also apply the DBT way of thinking to my PMDD symptoms (particularly depression and suicidal thoughts) and feel I manage those a lot better as a result.

I am still in contact with four other members of my original group which is really sweet. It’s nice seeing them share their ups and downs too, and that the hard work appears to have helped them function better as well.

Hopefully this time next year I will have another positive update to share!

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