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
poster:gardenergirl
thread:357023
URL: http://www.dr-bob.org/babble/psycho/20040614/msgs/358209.html