DBT Therapy

Today I finally saw Dr.Knowles again. I like her, she knows so much about medication and she really wants to help. I came in to tell her that my medication was becoming less and less effective. After a few questions about the depression and a few other things, she told me she wants me to try DBT therapy.

I've never heard of this before, but she is pretty sure it would be a great fit. She said I'd benefit a lot from therapy, and she thinks this type would help. The more I look at it, the more I feel like she may be right! It's mostly for people with Borderline Personality Disorder, but it's also for people who are chronically suicidal and do self-harm (check).

"A key assumption in DBT is that self-destructive behaviors are learned coping techniques for unbearably intense and negative emotions. Negative emotions like shame, guilt, sadness, fear, and anger are a normal part of life. However, it seems that some people are particularly inclined to have very intense and frequent negative emotions. Sometimes, the human brain is simply “hard-wired” to experience stronger emotions, just like an expensive stereo is “hard-wired” to produce very complex sounds. Or, it could be that severe emotional or physical trauma causes changes in the brain to make it more vulnerable to intense feeling states. Additionally, sometimes clients have mood disorders – Major Depression or Generalized Anxiety -- that are not controlled by standard medications and thus lead to emotional suffering. Any one of these factors, or any combination of them, can lead to a problem called emotional vulnerability." Basically, "A person who is emotionally vulnerable tends to have quick, intense, and difficult-to-control emotional reactions that make his or her life seem like a rollercoaster." (check). Also, everyone thinks I'm crazy.

Another large contribution to emotional vulnerability is an invalidating environment. "The “environment,” in this case, is usually other people. “Invalidating” refers to a failure to treat a person in a manner that conveys attention, respect, and understanding." Examples of an invalidating environment can range from mismatched personalities of children and parents (e.g., a shy child growing up in a family of extraverts who tease her about her shyness); to extremes of physical or emotional abuse. Check.

So the purpose of DBT, as I understand it, is to help people deal with their intense emotions and reactive episodes. That's when we do self-harm. That's when we get distraught and, at least in my experience, the most at-risk for going through with suicide.

I'm pretty excited about it except for the fact that group formats are usually recommended because they've been proven to be the most effective form of treatment. Not the best for a social phobe. Also, I don't know if I want total strangers hearing my noise. But Dr.Knowles has helped me so far, so I'm thinking she knows what she's talking about.

Edit: Oh yeah, and I'm gonna take two 100mg gabbapentins 3 times a day now. It seems to help so far.