Posted by fallsfall on June 1, 2004, at 7:30:48
In reply to the frustration continues, posted by crushedout on May 31, 2004, at 20:33:48
The diary cards are hard to fill out. It is hard to remember to do it. It is hard to be honest on paper. You are just learning the skills, so of course you are a bit confused about them. If you knew all the skills and did them all the time, you wouldn't need DBT. But you don't know all of them. Give it time.
"Standard" DBT includes one individual session (45-50 minutes) and one group skills session (1 1/2 hours). Please do talk to your therapist about the time - this does seem to be an issue for you.
Since you are doing this individually, she should be able to pace it so that you feel more comfortable. Can you divide up the diary cards, and only fill out part of them for now (i.e. the part you understand)? Then you can add more in as you feel comfortable with it.
Don't minimize the difficultly of being honest on paper. It is really hard to look at yourself objectively. It is really hard to write down when you have "failed". But it also does really feel good when you can write down a success. I found that it was really valuable to have notes from each day. My memory is terrible. This allowed me to have a record of how the days were, and I put a short (4 sentances) summary of what went on that day in, too. It let me have a way to look back and see the patterns, and see the progress, and see when I was slipping.
The diary cards were as much for me as they were for her. Sometimes they were a good way to introduce a topic that I knew we needed to talk about, but I didn't want to bring up ("Gee, I was feeling suicidal this week - look at those numbers! Usually it isn't this bad" - and recognize that things DID change, and to be aware of how they were changing). It gave me a better understanding of my own ebbs and flows.
OK. I just went to get my Skills Training Manual to look at the diary cards. There are two sides: the front talks about alcohol, meds, suicidal ideation, misery, self harm. The back talks about the skills.
Since you have just started, of course you don't know what the skills are - that is what you will be learning over the next 6 months. Have you talked about Wise mind yet (P.S. this was the HARDEST skill for me - still is)? After you talk about wise mind, and have a chance to do the homework on that, then that one skill should start to be clearer for you. You can't say whether you have done a skill if you don't know what it is. So, you shouldn't fill out the skill section for skills that you haven't learned yet. Maybe at this point you don't even understand wise mind (I don't...). So, maybe you aren't ready to fill out the second side - or maybe you can only tell if you have worked on one skill, or two (because that's all you have learned). You can just leave the rest blank. You'll use it later.
You should be able to fill out the front. This is not pleasant to do - and that makes it hard. But this is where you can see what is going on in your life and identify things you want to work on. For instance, you might decide that you want to reduce self harm. You won't succeed every day, perhaps. But you will be able to see your progress by watching either the "urges" rating go down, or by seeing that even though you have the urges that you are not acting on them. This is why I included a short part on what went on that day. It helped me to recognize what kinds of things were triggering the urges etc.
Maybe even the front of the card is looking hard to you. But the drugs and alcohol columns should be OK to fill out (see filling these out as a reward for your hard work). Maybe you need to add the other columns more gradually.
So maybe, right now, the front of the card is (more than) enough to be filling out (and you can even forget the last column, since you don't know the skills yet, so it is really hard to use them). Or the front, plus one or two skills that you understand. The idea of the cards is to make the things that are happening in your life more obvious to you and to your therapist. The idea of the cards is NOT to frustrate you.
There has often been talk on Babble about doing DBT here as a group. Maybe you will be the catalyst for that! If you tell us about the skills you are trying to learn, we can talk about it here, and maybe things will get clearer for both you and the rest of us! Many of these skills are REALLY hard - requiring you to change the way you see the world or the way you deal with it. Don't expect it to be easy. It would be good for me to review all of this - because I certainly didn't get it all the first time around.
So I look forward to the new continuing "DBT Saga" thread!
poster:fallsfall
thread:351645
URL: http://www.dr-bob.org/babble/psycho/20040522/msgs/352659.html