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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by LiLi80 on March 15, 2002, at 2:31:22
I cant give her up. SHe is the only life line i have. I dont trust anyone else with my life stories. I dont get why the DBT person is doing this. She said my insurance wont cover 2 therapists. She is wrong cause they said they would, then she told me it was her personal decision not to take me as a DBT patient if I had a therapist already. Group DBT is not an option, because its an intensive 40 hr a wk program, i need individual DBT with one therapist, but i dont think i should have to give up my first therapist because this bitch says so. Oh did I mention I have called all DBT specialist in the New England area? Its this lady or her colleague. and he favors group and will probably take her side. Why I bother trying to get help is beyond me.
Posted by trouble on March 15, 2002, at 6:05:39
In reply to I was told to get DBT I must give up my therapist, posted by LiLi80 on March 15, 2002, at 2:31:22
> I cant give her up. SHe is the only life line i have. I dont trust anyone else with my life stories. I dont get why the DBT person is doing this. She said my insurance wont cover 2 therapists. She is wrong cause they said they would, then she told me it was her personal decision not to take me as a DBT patient if I had a therapist already. Group DBT is not an option, because its an intensive 40 hr a wk program, i need individual DBT with one therapist, but i dont think i should have to give up my first therapist because this bitch says so. Oh did I mention I have called all DBT specialist in the New England area? Its this lady or her colleague. and he favors group and will probably take her side. Why I bother trying to get help is beyond me.
Oh my, Lilli, this is very strange. It's my understanding that DBT protocal requires group participants to have a personal therapist, b/c DBT is not a "process" therapy. I believe this rule is clearly spelled out in the DBT manual, written by the founder Marcia Linehan. Let's ask other participants, in the event I'm mistaken about this, but I clearly remember in my DBT group we could only be admitted if we had a therapist, and we had to provide proof of it to boot.
I haven't heard of DBT being done on an individual basis, but that's not saying there's anything "wrong" w/doing it this way. Perhaps you'll have opportunity for both process and cognitive therapy in such a setting, and this could be a more complete and holistic experience for you, something to consider before dismissing it out of hand.
My concern is that ANY of your mental health resources would be eliminated right now, as you are in a crises mode, and need all the support you can get. She says your insurance won't cover it, then when shown that your insurance will cover it, she tells you regardless, she doesn't want you seeing anyone but her period. Does that sound like an honest person to you or am I being paranoid? Why didn't she just tell you upfront she wanted you to quit your therapist, if that's what she wanted all along, which it appears she did? It's disconcerting.
I'd ask my therapist about all this, and see if she thinks it's okay for you to take a break from her during the DBT training, and take it from there. I'm also interested to learn if DBTis now being practiced one-on-one, or if you stumbled upon a maverick of some sort.
You ARE facing obstacles in your recovery, and are meeting them w/ considerable self-assertion, I wish you could see your own courage in all this mess. I still think the part of you that wants to be well is fighting for primacy in your life, she will not be crushed dagnabbit, and I applaud her spirit. You're gonna be so strong from the work you're doing during this baptism of fire, and you may not think the world needs you right now, but I believe you're going to find people one day who are going to need a specific kind of help that they can only get from you. You've already gotten a few messages thru my own thick skull, and can't believe I've become a defender of orthodoxy all of a sudden! But I can see now that it's appropriate, and no amount of arguing w/ my handlers could sway me on this, it took your experience to help me see the light.But for now, the immediate issue is getting that DBT therapy the way it's supposed to be delivered, if other posters agree that Linehan's protocols include group therapy, and a personal therapist for clients, the next step is to write down those words from the manual, present them to the practitioner (if you still want to work w/her) and ask if it's ok w/ her if you at least abide by the personal therapy rule, as that has been a studied and proven technique. Someone out there must have access to the current methods, if not there's always the library. One step at a time my friend.. I don't see why this should be an issue w/her one way or another, but these are the terms she's given you, and we might as well proceed from there.
til tomorrow,
trouble
Posted by NikkiT2 on March 15, 2002, at 7:30:25
In reply to posters, any info on DBT protocol? help!, posted by trouble on March 15, 2002, at 6:05:39
I'm on a 15 month waiting list for DBT (hey, you should try the UK.. you' think you were getting great treatment then!!)
I had to choose between DBT and normal therapy too.. I have chosen DBT... Only 12 more months to wait.. *sighs*
I was told I woul have a one to one session AN a group session each week.. hmmm
nikki
Posted by fachad on March 15, 2002, at 8:31:15
In reply to I was told to get DBT I must give up my therapist, posted by LiLi80 on March 15, 2002, at 2:31:22
What is "DBT"
Posted by LiLi80 on March 15, 2002, at 8:32:53
In reply to posters, any info on DBT protocol? help!, posted by trouble on March 15, 2002, at 6:05:39
My friend said that the lady was just trying to get paid twice by my insurance, once for DBT and once for as a therapist. Though she wont have time to talk to me about my regular problems during the "its so not enough time hour" that is given.
I believe you're going to find people one day who are going to need a specific kind of help that they can only get from you. You've already gotten a few messages thru my own thick skull, and can't believe I've become a defender of orthodoxy all of a sudden! But I can see now that it's appropriate, and no amount of arguing w/ my handlers could sway me on this, it took your experience to help me see the light.Just out of curiousity what do you mean? and how did I help you ?
Posted by LiLi80 on March 15, 2002, at 8:34:06
In reply to What is DBT? » LiLi80, posted by fachad on March 15, 2002, at 8:31:15
Posted by NikkiT2 on March 15, 2002, at 14:40:15
In reply to I was told to get DBT I must give up my therapist, posted by LiLi80 on March 15, 2002, at 2:31:22
Posted by Janelle on March 15, 2002, at 15:20:53
In reply to I was told to get DBT I must give up my therapist, posted by LiLi80 on March 15, 2002, at 2:31:22
Posted by helenbpd on March 16, 2002, at 1:54:39
In reply to What does DIALECTIC mean? (nm) » LiLi80, posted by Janelle on March 15, 2002, at 15:20:53
It's "dialectical", meaning back & forth, each participant responds and builds on the next. (Dialectics=school of philosphy founded by Hegel ... thesis--antithesis--synthesis and all that ;) ) Its basic premise is that no one perspective is prioritized, which was always a deterrance to a healthy therapeutic atmosphere for folks with BPD.
For LiLi, here's a cite from a write-up by the Behavioral Technology Transfer Group, the Linehan group in Seattle that does most of the DBT training for the USA (and world, actually).
The last bit of this quote should be helpful in addressing your concerns re. practice of the new therapist you're considering. I've known a number of folks who've done DBT, and it usually involved both group and individual sessions (and the individual sessions weren't always with a DBT-trained therapist, just someone who knew Cognitive Behavioral Therapy, which is pretty standard). Have you asked her point-blank where/how she was trained in DBT?Here ya go:
"DBT grew out of a series of failed attempts to apply the standard cognitive and behavior therapy protocols of the late 1970ís to chronically suicidal patients. These difficulties included:1. focusing on change procedures was frequently experienced as invalidating by the client and often precipitated withdrawal from therapy, attacks on the therapist, or vacillations between these two poles;
2. teaching and strengthening new skills was extraordinarily difficult to do within the context of an individual therapy session while concurrently targeting and treating the clientís motivation to die and suicidal behaviors that had occurred during the previous week;
3. individuals with BPD often unwittingly reinforced the therapist for iatrogenic treatment (e.g., a client stops attacking the therapist when the therapist changes the topic from one the client is afraid to discuss to a pleasant or neutral topic) and punished them for effective treatment strategies (e.g., a client attempts suicide when the therapist refuses to recommend hospitalization stays that reinforce suicide threats).To overcome these difficulties, several modifications were made that formed the basis of DBT. First, strategies that reflect radical acceptance and validation of clientsí current capabilities and behavioral functioning were added to the treatment. The synthesis of acceptance and change within the treatment as a whole and within each treatment interaction led to adding the term ìdialecticalî to the name of the treatment. This dialectical emphasis brings together in DBT the ìtechnologies of changeî based on both principles of learning and crises theory and the ìtechnologies of acceptanceî (so to speak) drawn from principles of eastern Zen and western contemplative practices. Second, the therapy as a whole was split into several different components, each focusing on a specific aspect of treatment. The components in standard outpatient DBT are highly structured individual or group skills training (to enhance capability), individual psychotherapy (addressing motivation and skills strengthening), and telephone contact with the individual therapist (addressing application of coping skills). Third, a consultation/team meeting focused specifically on keeping therapists motivated and providing effective treatment was also added."
in: "DBT in a Nutshell" http://www.behavioraltech.com/basics.htmlHere are more good links to DBT info:
This is an excellent description of the theory, by a woman with BPD who did DBT:
http://www.phoenixinflight.homestead.com/Linehan.htmlA less intimidating description:
http://www.writtenbyme.com/content/48021Marsha Linehan's home page:
http://faculty.washington.edu/linehan/BTTG home page:
http://www.behavioraltech.com/index.cfmRelated:
Westermeyer's very nice 'Cognitive Therapy Pages'
http://www.habitsmart.com/cogtitle.htmlhang in, hope you can resolve this without much more dithering around on the part of your "caregivers" (snort) :)
Helen
http://home.hvc.rr.com/helenbpd
Posted by trouble on March 16, 2002, at 1:57:15
In reply to Re: posters, any info on DBT protocol? help!, posted by LiLi80 on March 15, 2002, at 8:32:53
Hi Lilli,
Your friend may have hit on something sleazy there that I, in all my cynical paranoia missed. Yikes! That's why we need multiple posters on this ole board.
The Thick skull thing has to do w/ some of my earlier posts in January re: DBT. I did it for 3 months and came away from it sneering, chiefly b/c the therapists did it right out of the manual and I'm too deep to be given formulaic therapy. But the education itself is good stuff, basically a mix of Eastern metaphysics and a Western social-cognitive approach. They gave us about 50 handouts to refer to in various emergencies, and we'd go over each one, point by point. BORE-ING!
More seriously, I saw a need for process in my group that went ignored, people were in all kinds of severe emotional states, but the therapists put the kabosh on any discusssion of feelings or issues, we were there to learn specific techniques, and that was that. Rigid, controlling and uptight, just what the doctor ordered. It was hard for me to see people walk out the door all depressed and preoccupied w/their problems. To me therapy is about going wherever the client is and staying 'til the need is met. But DBT is an educational therapy and maybe some of us weren't ready for it at the time. All us borderlines started acting like our diagnoses and after a few months I took my handouts and quit. But I do use them.
The good news is that the founder of DBT advocates a more relaxed, humorous approach, and after studying the manual myself I got the impression she would have been miffed at how bossy and severe my group-leaders were.
Maybe I'll try another group in town, since I see in you some of my own enduring problems-in-living, and IMO those simple but specific DBT techniques could come in handy, anchor us both a bit right now. And whoever teaches you them better do it right, that is, By The Book, you don't have time to mess around with mavericks right now.
Guess sometimes the old disdain for orthodoxy gets in the way of my seeing the big picture, and your courage and determination to create some order in your world has shown me there's more to life than being an enfant terrible. Hard lesson, but I'm learning, kicking and screaming all the way.keep me posted,
trouble
This is the end of the thread.
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