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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by terrics on June 15, 2004, at 18:36:46
I miss my old therapist so much I feel like calling her tonight. This DBT therapist makes me feel horrible, absolutely horrible. She wanted to know about my mother, so I told her my mother was a bitch. She said that I was being judgmental, as if I did not know it was a judgmental statement. She is condescending too. (She has a doctorate in SW.) She contradicates whatI say. This is not exactly what she said, but similar: When did you start hating men, I thought you slept with a many. One, really has nothing to do with the other in my opinion. I was almost in tears during this session. I really don't think she likes me. I asked her if she had a hard time working with me. She said no, that I have a hard time working with her. I am not used to being treated rudely. I know DBT therapists are supposed to keep patients off balance, but is rudeness the way to do it.I like the group though. Right now I am trying to use skills to keep from cutting because I am depressed and angry. It is so hard for me to take not being liked.
The very first time I self injured (cutting) I was 9 yrs old and very depressed. Cutting must be an instinct. It is certainly not something you learn by age 9. It might be an attention seeking behavior when you get older, but I doubt it is at 9. So if this women thinks I cut to get attention she is wrong. I am supposed to call her if I think I am going to cut, but I do not want to talk to her. Do you think my old T might talk to me? She always made me feel better. I am just very hurt and angry and trying not to cut.
terrics
Posted by Aphrodite on June 15, 2004, at 19:24:12
In reply to Need help with DBT therapist, posted by terrics on June 15, 2004, at 18:36:46
Terrics, this does not sound good at all. I know nothing about DBT, but my instincts tell me this is horrible for you.
You feel like you're going to hurt yourself -- in DBT, aren't you supposed to call her? If I recall correctly, the last time she didn't return your call, and she had been cancelling excessively. Did that ever get cleared up? Would you feel comfortable calling her, or does that feel unsafe?
Please don't let this person have power over you to the point that you hurt yourself. I am sorry she is acting this way, but it's not your fault. Is there someone else close to you to call and have them help you through the urge to hurt yourself? Even if you can't say it, is there someone you can talk with for temporary distraction? If not, consider taking a walk, rearranging the kitchen cabinets -- whatever it takes to distract you until that horrible feeling passes.
Have you considered finding someone new? I know that would be a lot of change, but it's better than letting this person make you feel so badly when all you want is to be better.
(((Terrics)))
Posted by Dinah on June 15, 2004, at 20:56:16
In reply to Need help with DBT therapist, posted by terrics on June 15, 2004, at 18:36:46
"I was almost in tears during this session. I really don't think she likes me. I asked her if she had a hard time working with me. She said no, that I have a hard time working with her."
Eeeeek! Horrible flashback to biofeedback guy. He said something similar to me. I told him that I was detecting some hostility towards me from his end and did he think he could work with me, and he said he was just reacting to my hostility and could I work with him? I mumbled an affirmative, made an appointment, and went to the car and cancelled forever.
So I congratulate you on having the stamina to see it through with this therapist. But sometimes you have to wonder what on earth they're thinking?
Posted by pegasus on June 15, 2004, at 22:25:22
In reply to Need help with DBT therapist, posted by terrics on June 15, 2004, at 18:36:46
terrics, this is very sad! You shouldn't have to put up with this incompetent therapist. I just hate to think of you stuck there. Do the other people in your group see other DBT therapists? Is there any way that you could request a switch?
If not, then can you address with this person the things that she is doing that are creating such problems for you? Or else it would probably be really hard to get anywhere in therapy.
I thought DBT was supposed to keep you off balance by being irreverent, not rude. Can you tell her that some of the things she has said seem rude to you, and that you are having a hard time with the idea of your therapist being rude to you? And then give her the examples you gave us? Maybe she's trying to be irreverent, and doesn't realize that she's coming off as rude. I really hope that things get better for you. You deserve so much better.
pegasus
Posted by terrics on June 16, 2004, at 16:02:15
In reply to Re: Need help with DBT therapist, posted by pegasus on June 15, 2004, at 22:25:22
Thank you all so much. If any of you had DBT, do you know what irreverant means in this context? Is it related to rude? This is scaring me because I do not want to stay with her if she is going to make me worse. I met my old T in the library today and was very glad to see her. She thinks I should stick it out. I told her what is going on. She suggested I call DBT therapist. I have a call into her now. Heavens knows if she will call back this time. terrics
Posted by pegasus on June 16, 2004, at 16:37:09
In reply to Re: Need help with DBT t Aphrodite,Dinah,Pegasus, posted by terrics on June 16, 2004, at 16:02:15
Well, I did some looking around, because I thought you had a very good question about what exactly they mean when they say irreverent wrt DBT. On this web site (http://www.borderlinepersonality.ca/dbtoverview2.htm) I found this quote:
"The therapist relates to the patient in two dialectically opposed styles. The primary style of relationship and communication is referred to as 'reciprocal communication', a style involving responsiveness, warmth and genuineness on the part of the therapist. Appropriate self-disclosure is encouraged but always with the interests of the patient in mind.
The alternative style is referred to as 'irreverent communication'. This is a more confrontational and challenging style aimed at bringing the patient up with a jolt in order to deal with situations where therapy seems to be stuck or moving in an unhelpful direction. It will be observed that these two communication styles form the opposite ends of another dialectic and should be used in a balanced way as therapy proceeds. "
It sounds like your DBT therapist is using the alternative more than the main style. But according to this description, irreverent may be related to rude in the DBT context. That's too bad.
I still vote for you explaining that some of her comments have seemed rude to you, and that you're finding that difficult. Maybe you could also explain that you understand irreverence is part of DBT, and ask her to explain the point of her style that seemed rude, in the context of how it could help you. I know this is a tall order. But maybe in a perfect world, talking about it all up front would be helpful.
Good luck, and let us know how your conversation goes (if she calls you back). And that's another thing. If you can't count on her calling you back when you call her, then the point of that part of DBT is not going to be satisfied. In your place, I'd try to renegotiate the calling rule, if she doesn't call you back this time.
pegasus
Posted by Dinah on June 16, 2004, at 21:20:35
In reply to Re: Need help with DBT t Aphrodite,Dinah,Pegasus, posted by pegasus on June 16, 2004, at 16:37:09
Perhaps she just isn't very skilled with that part of DBT. I would imagine that if it weren't applied with a very light hand, it can come across as mean. And your therapist is using a trowel.
On the other hand, I couldn't tolerate that part of the dialectic at all, and would probably quit therapy faster than they could contact my insurance company. I'm not saying that's a good thing, or anything.
My therapist laughs at me sometimes, but I'm just fine with that. In fact, I generally feel most cared about when he teases me. That's how my daddy showed affection.
I imagine that's how it's supposed to work with DBT, when ideally applied. But as I told Tabitha, I don't tolerate that sort of thing well. I'd probably tell her I had too much self respect to be spoken to that way, and until she could speak to me politely, she shouldn't speak to me at all.
Have I ever told you that I run through mental health professionals like water? They all can't stand me. My relationship with my current therapist is an amazing aberration.
So please don't listen to a thing I say I'd do, because while I definitely would do it, it hasn't been a style that's worked well for me.
Posted by Dinah on June 16, 2004, at 21:22:24
In reply to Re: Need help with DBT t Aphrodite,Dinah,Pegasus, posted by pegasus on June 16, 2004, at 16:37:09
That was something I really hadn't picked up on while reading Linehan, and on the off chance anyone ever offers DBT around here, it's something I should keep in mind. I wouldn't tolerate it well.
Posted by terrics on June 19, 2004, at 14:49:43
In reply to Re: Need help with DBT t Aphrodite,Dinah,Pegasus, posted by pegasus on June 16, 2004, at 16:37:09
Hi, I read most of Linehan's book before I started DBT. I wish I had read it in more depth. I truly cannot find a purpose in belittling patients. It is very painful. If I wanted attack I could go to my mother. Anyway, I am now reading it in depth and still cannot find the point. Maybe she just does not have the personality for this kind of therapy or maybe DBT is not all it is supposed to be. The irreverance is supposed to be balanced with validation so the pt. does not drown in self hate I guess.
ps She did call back late at night because she could not hear my phone number. Anyway I did not do any cutting. The time had passed. thanks again. terrics [I'll let you know if this DBT is worth while or a waste of time ].
Posted by gardenergirl on June 19, 2004, at 21:54:19
In reply to Re: Need help with DBT t Aphrodite,Dinah,Pegasus, posted by terrics on June 19, 2004, at 14:49:43
terrics,
DBT does require a certain amount of skill on the part of the therapist to pull off the irreverance part. And irreverance is not supposed to be a huge chunk of DBT, or it loses its power. Instead, the therapist must balance acceptance of the client for who they are and where they are with challenging the client to change. Irreverance does not have to be a part of every interaction. And irreverance can come across as condescending or false if not done well.An example of this balance might be like this: Let's say a client throws out all of her boyfriend's clothes and runs over them with the car after the boyfriend refuses to go with her to a wedding. Now the therapist might do a chain analysis to look at all the factors in this event, which could include lack of sleep, alcohol, increased work stress, etc. After looking at all of the factors, the therapist might say something like this: "I can see why you wanted his things out of the house. You were really angry at him and felt unsupported. His things likely reminded you of this." This is supposed to be a validating statement. It should convey to the client that the feelings and actions make sense in some way, and that the therapist can understand the action from the client's world. But then the therapist might add something like this: "what if you had been able to get more sleep the night before?" and/or "what else could you have done to express your anger and vent some?" This is the change part, trying to get the client to problem-solve and think of other behaviors. The two need to go together, with the validating first in most cases, for the change part to be effective and to not have the client feel criticized or picked on.
Does this make sense? Is this anything like what your T is doing? It *may* be that you are sensitive to the change part, and that feels like belittling. Or, your T may not be doing enough validating, or may not be "getting" you for you to feel secure in exploring change.
Regardless, I hope that things get better for you. I admire you for hanging in there. Have you been able to talk to your T about how DBT is coming across to you? I wonder if perhaps she may not realize how you are perceiving her interventions? I don't know, but I wish it was feeling better for you.
Take care,
gg
Posted by terrics on June 20, 2004, at 11:10:35
In reply to help with DBT...jumping in here, posted by gardenergirl on June 19, 2004, at 21:54:19
Hi gg, I am very sensitive to criticsm. I think this T. is into criticism. I cannot think of one time she validated anything. ( been there 8X). You learn anger from anger, happiness from happiness, criticsm from criticsm. Her M.O. is very much like my mother's. I don't want to feel bad the rest of my life, that is why I'm trying this. This SW has a doctorate and I feel she comes off as arrogant. I realize this can be my perspective or perhaps something is going on in her life.
I just finished Linehan's book. In parts of it the therapist goes into a rage.
I wasn't even sure I borderline when I started this as I have had many dxs. She read me some stuff and asked if it was me...Yes. We are not all alike, us borderlines. I started getting better when I got this dx because I realized through lots of tears that I did have many bpd traits. If therapy continues like this I will have to quit. thank you for pointing the validation thing out. When do you graduate? Maybe I'll come to you. lol terrics
Posted by gardenergirl on June 20, 2004, at 12:23:47
In reply to Re: help with DBT...jumping in here » gardenergirl, posted by terrics on June 20, 2004, at 11:10:35
terrics,
You are very sweet. Unfortunately, even with my internship year this year, I have to do 1-2 years post doc before I can be independently licensed. Your T may be a doctorate in SW, but if she has not had special training in DBT, it's not really something you can learn just be reading the book. Good supervision is essential, even for experienced professionals. It is built into the DBT model for "therapy" for the T, too.Gosh, I can so relate to what you said about being sensitive to criticism and feeling like it's just like your Mom. In my case, it's more my Dad, I think, but still. No matter what you do, it's never good enough it seems. DBT can help you realize that you have value as an individual. That helps increase your sense of self, which then allows you to work on change. I'm sorry the validation element seems to be missing in your therapy. I believe it is key. It's a huge part of what I use, whether I am specifically doing DBT or not (probably because of my own lack of validation when I was young.)Because I think all of my clients have value just as they are now. That doesn't mean they can't change or feel better, but they are valued. And you are too!
I'm sorry it doesn't feel that way right now.
gg
Posted by fallsfall on June 21, 2004, at 8:31:32
In reply to Re: help with DBT...jumping in here, posted by gardenergirl on June 20, 2004, at 12:23:47
>Gosh, I can so relate to what you said about being sensitive to criticism and feeling like it's just like your Mom. In my case, it's more my Dad, I think, but still. No matter what you do, it's never good enough it seems.
It is my dad, too. And it tears me apart.
Terrics, please talk to her about how you experience her. I'm finding that my issues (which are around this very area right now) are part transference and part reality. My therapist and I are smack in the middle of this, but if I come out of it I'll tell you how it worked in my case (I know I wrote "if" - I do have more optimism than that, I do trust my therapist, but I am so far down right now that I can't see where I need to go).
I didn't find my (not officially trained) DBT therapist to be rude. My current therapist can appear cold, heartless and combative at times. But he can also be very kind and gentle. We don't seem to always agree on when he should stop being cold, heartless and combative... And those times he really is able to force me to truly look at and see things that I never thought I would see. I think that his method is effective (even if it is painful... But NOT changing is ALSO painful for me). I couldn't tolerate the hard times if I didn't believe that he truly cared and that he was very good at what he does.
He was kind and gentle and caring on Friday, and so I have the courage to see him today.
Perhaps your DBT therapist needs to spend a little more time establishing the therapeutic alliance before you could have a similar trust in her to carry you through the painful learning.
(((((Terrics)))))
Posted by gardenergirl on June 21, 2004, at 12:19:24
In reply to Re: help with DBT...jumping in here -gg t, posted by fallsfall on June 21, 2004, at 8:31:32
Falls,
You are so right about the part transference, part reality thing. It's hard to sort them out. I wish you the best in dealing with this. It does tear one apart. And it's so frustrating to find yourself continuing to reach for or need something that won't be there reliably (at least in my case).Take care, sweetie!
gg
Posted by terrics on June 22, 2004, at 13:36:37
In reply to Re: help with DBT...jumping in here -gg t, posted by fallsfall on June 21, 2004, at 8:31:32
Hope it works out for you. I am not so sure it wll for me. Maybe I have had enough therapy??? Hope you start feeling better. terrics
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