Dialectical behavioral therapy was founded by American psychologist Marsha Linehan, who developed the practice while working with sexually assaulted female refugees who showed symptoms of borderline personality disorder. Combining cognitive behavioral therapy and contemplative habits from eastern religious practices, Linehan produced four modules - interpersonal effectiveness, mindfulness, distress tolerance and emotion regulation - which could be completed and learned through a five month-long period.
Linehan also recommended, however, that patients go through the process twice, the first time to become familiar with the skills associated with DBT, and the second time to implement the habits learned. That totals ten months in the program.
Which brings me to my current predicament. I finished DBT last week - yahoo! - and I attach a real sense of pride to this. Having finished one of the elements so crucial to my psychotherapy makes me feel productive, and more optimistic about the future.
But my current coordinator - strangely they changed me from H. to A. without ever consulting/informing me - thinks that after last weekend, I should return to DBT and stay for a second dose of the program. I find it unnecessary - when I first heard the news, it was like being informed I'd taken a course and performed well, but I'd now have to repeat it.
A. was gently adamant about it all, saying she was only trying to be a good coordinator, and the incident proved I needed more time for the material to sink in. I was adamant, though not gently, that I didn't need it. For I've truly benefited from DBT. I find its non-judgmental attitude comforting, and the writing exercises we were assigned for homework a great exploration into what really goes on in a moment of distress. I joined DBT with some great people, all of whom I miss. But the module I entered the group in was distress tolerance, probably the most instructive part of DB therapy, and it taught me different ways to deal with separation anxiety, to act opposite when I felt depressed, and to radically accept certain facts about my life, especially my treatment. For example, for years, I'd walk down the street comparing myself, negatively, to every tall, elegantly dressed woman in heels. Empowered by DBT, I quietly say to myself, paused in the street if need be, "It doesn't matter. Just keep going." If it sounds cliche, it probably is - in my opinion, psychotherapy is a lot of trite phrases and practices cobbled together, in the best possible way, to project a more optimistic glow as a whole.
And I continue to benefit from psychotherapy as a whole. Morning group is doing me genuine wonders. I find myself surprised to read these words, as I was filled with naught but resentment upon first returning to the 10 - 12:30 sessions. But the people in that small, dimly lit room are pure gold. We are all slightly selfish, very self-deprecatory, depressed and anxious, but together we are one hell of a comfort to one another. And I've discovered similarities with my fellow patients that leave me gobsmacked - from tiny things, like E. and I share a psychiatrist (we talk about how helpful he is all the time now), to whole childhoods comprised of similar experiences, like with H. (patient, not coordinator) and C. And if there was ever a gem of a person, it's H. She and I have bonded so quickly, and are even considering living together when we head back to school in the fall. M. remains hilarious as ever, and group coordinator J. is the only doctor at the program unafraid to question our motives, sarcastically call us out and crack jokes.
To paraphrase Virginia Woolf, "The meanest patient, yes, even the very lowest is allowed some say in the matter of her own prescription. Thereby she defines her humanity." It's this theory that guides me to my answer in response to DBT: no, thanks. I'm one of two people who admit to benefiting from DBT in ways which daily affect their lives. Combined with practicing yoga, it leaves one in a peaceful place, free of surmounting psychological obstacles. (It even has me refusing to judge people on the subway! The subway!)
So A. put me on an exit schedule. April 11 is to be my last day in the program, and guys, it will be good. I plan to celebrate. In the meantime, mornings when I eat breakfast, walk to the station in the crisp sunshine alongside the East River, and sit in a room with my peers, trying to mine ourselves for answers, prove to be little victories of their own.
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