Dialectical Behavior Therapy (DBT) Works if You Want it To
OK, maybe it seems like I’m being a bit hard on commenters. I swear I’m not. I like people who comment and express their opinion, but sometimes their opinion spurs one of my own. This is one such comment:
I’m bipolar, and I think we ALL should have to take a Dialectal Behavior Therapy course. The DBT course helps with coping skills, year class, and helps . . . these skills work if you want them too.
Here’s someone singing the praises of dialectical behavior therapy (DBT). She would certainly not be alone as many people find DBT to be helpful. The problem I have with this comment is the last bit, “these skills work if you want them too [sic].”
So, this means that if the skills learned in DBT don’t work for someone it’s because they didn’t want them to?
I don’t think so.
There are many therapies that have been shown to help with bipolar disorder (DBT, by the way, has only a tiny bit of recent evidence behind it.) and I believe these therapies can help people. Cognitive behavioral therapy (CBT) and, even more convincingly, interpersonal and social rhythm therapy (IPSRT) can be very beneficial.
But like all bipolar treatments, therapies only help some people. While there is evidence that IPSRT helps people with bipolar disorder stay well, it does not support the notion that therapy can help everyone that uses it. Therapy is like any treatment – it helps some and not others.
Dialectical Behavior Therapy (DBT)
DBT was actually designed for the treatment of borderline personality disorder (and there is evidence it works for this), but there is interest in using it to treat other disorders such as bipolar and depression too. DBT combines mindfulness, psychoeducation, CBT, stress tolerance and other skills together into a therapeutic package. DBT is normally adapted slightly for use with other disorders such as bipolar.
DBT Works if You Want it To
Now, there is no doubt that therapy takes work and you have to do this work in order for it to be effective. Thus, you do have to “want” DBT to work in order for it to be effective.
However, simply “wanting” it to work, or, indeed, doing the work of therapy guarantees the success of DBT. The problem with saying that “it works if you want it to” is that it suggests that if it fails, it’s the patient’s fault. They didn’t want it enough. They didn’t do the work enough. The therapy was fine; the patients were the ones who were deficient.
And I don’t think this is a message we should be giving patients. Patients feel bad enough about being sick without being told it’s their fault that they didn’t get better.
So yes, I say give DBT and other bipolar therapies a try, but if you work at them and, for some reason, they are not effective, it’s not that you didn’t “want” it enough; it’s just that they didn’t work for you.
Tracy, N. (2013, February 6). Dialectical Behavior Therapy (DBT) Works if You Want it To, HealthyPlace. Retrieved on 2019, September 19 from https://www.healthyplace.com/blogs/breakingbipolar/2013/02/dialectical-behavior-therapy-dbt-works-want-it
Author: Natasha Tracy
Unfortunatly, your post have been writing long time ago, and there is less chances that you read this answer. If too, I just want to say that your son presented some symptoms in his early age that made thinking at asperger's syndrome (routines and socks that bother him...) Asperger may make difficult to find and maintain a job as an adult and the social difficulties can lead to distress or depression. Maybe he can benefit from an assessment with an autism specialist. (Sorry for my english, it's not my usual language).
THIS IS HOW MY X TO BE DEALS MY PROBLEMS ARE THE REASON ..BLAH BLAH BLAH I HAVE TRIED TO GO and be the better try to get him excited about changes ect...leave his house more often...I am done I do not want to live with someone who cannot be happier and have less fears of every day life. I deal with p t s d I don't have to own it each day ....I love humor this man has NEVER busted a gut laughing ever but there is nothing wrong with him we are like oil vinager got to go and separate it is not healthy to expect someone else to make us happy we will be denied .I like me finally I like me I have a lot to work on sure who doesn't but I don't like being dragged around like this .........any more..
Different treatments work for different people. I tried so hard with DBT, just as I had with CBT and both made me so much worse. I know it works for most people - I see it in my own professional life - but I am not one of them.
I was told over and over again that I didn't want it hard enough. How I felt was exactly as you described it. I couldn't and can't say it though. Saying things like that to mental health professionals would get me written down as "non-complaint" or seen as anti-psychiatry. That enables people even more to treat me as if I have no self awareness and make them assume that I am trying to stir some kind of trouble. It's like walking on eggshells around them but I am glad someone finally said it. I feel a bit better that there is a voice.
There is a support group right here at HealthyPlace :) Just click on "Forums" above.
I've also listed some others here: http://bipolar.answers.com/remedies/the-best-forums-for-those-living-with-bipolar
I was diagnosed bipolar when I started to go back into therapy my Freshmen year of college. The diagnoses came from my psychiatrist. When I has another session with my therapist I told her what I was diagnosed with. She doesn't believe that I have bi-polar disorder cause I haven't have a manic episode. I was in therapy in my college for 2 years and when it ended I was unsure if I wanted to continue seeing a therapist.
1 week after graduation I meant with a new therapist. After sharing my background she diagnosed me with Borderline Personality Disorder. I was upset to hear that I have another mental illness. I was told that in order to solve the problem I need to do DBT. As the program continued I was later told that part of the therapy is a skills group. I have a huge fear of being around people because I know that I will be judged. After contacting one support group I had no luck getting in. I wouldn't be able to continue the program without doing the group. When I wasn't able to find any possible groups my therapist came up with me just doing Skills Training with another therapist instead of a group I would be by myself.
I have been doing skills training for a little over a month. I find it at times beneficial but have been getting more and more depressed when the skills don't work how they are suppose too.
I feel like I am alone because I am not able to talk about my disorders with my parents or any family member. Does anyone know a support group I could join online?
I don't think that your opinion and Natasha's are really at odds with each other. You're both effectively saying the same thing: "try out any and all therapies until you figure out what works for you."
A person without a will to beat the illness won't try different therapies, and that's what both of you are saying. Natasha was just adding that if something doesn't work, it doesn't NECESSARILY mean that it's your fault. It could be, if you didn't do the work, but it doesn't otherwise have to be.
Yay for all of us, who obviously want to beat our collective bipolar!
I just googled and found this site. Thanks Natasha for having it.
I only had one real manic episode too and it was after my first week of Prozac but I have depression, anxiety, tons of fear, obsession, and an addiction I'm working on. I have been told by like 4 psychologists and my psychatrist dbt would help me but I'm concerned not to throw away my money on a bad one. I'm 42 and had mostly bad therapy. On the positive side I am feeling good right now.
There are brave souls who care. If you're reading this you have found one in the blogger who battles our uncertainty. Have faith.
I get this type of comment all the time about medications. People say folks with bipolar are selfish, dangerous, in denial if they won't take these drugs that supposedly would work if the patient took them properly or just kept trying things.
For me, an eclectic approach has worked best too. I dunno what type bipolar I supposedly have. My therapist says bipolar 1. I think the only full blown mania was on antidepressants, though.
in the dark ...no reading glasses and in my phone.
We become what we think if we don't find a way to counter/control/change negative thought patterns. DPT and other therapies help with this. Praying and using positive mantras regularly helps too.
It is never because someone doesn't want to get better is it....??
Can't have too many tools in our get healthy tool box!!
It's not your fault. You have suffered a lot, and are deserving of compassion. Your writing gives a lot to many people. Well done!
We are all different and we may need to try a number of approaches before finding one that works for us and it is counterproductive to blame the patient.