A Little About DBT

Dialectical Behaviour Therapy, or DBT, is currently the most effective treatment being used today to treat those suffering with Borderline Personality Disorder, or BPD. DBT can be used with trained professionals in an extended program, typically it should last a year but can be modified or adapted for shorter terms, or you can do the DBT skills on your own. There are a number of Workbooks that people can use as well as the DBT Manual by Marsha Linehan itself. I’ll give a list of Workbooks currently available at the end of this post. I will say that the DBT Manual is typically for professionals, and believe me it reads as such, but anyone can order it online (for Canadians Chapters/Indigo www.chapters.ca carries it as does Caversham Booksellers www.cavershambooksellers.com). I’ll warn you as well that the manual is not cheap so I highly suggest checking out in the library before purchasing it because the book can get pretty academic at times but it also can be a huge help in filling in some of the blanks that you may get from other workbooks or shorter term DBT programs. For those in the GTA, the Toronto Public Library has a copy at the Reference Location but unfortunately it can’t be checked out.

DBT has been a tremendously effective treatment for those suffering with BPD that it has been adapted to work with several other disorders as well, including but not limited to Bipolar Disorder, Binge Eating Disorder, and Bulimia.

DBT was developed by psychologist Marsha Linehan, PhD, ABPP. The original edition of the DBT Skills Training Manual was published in 1993, and the most current edition was published in 2015.

DBT was originally used to treat chronically suicidal patients with Borderline Personality Disorder. Initially one of the main problems that patients and therapists alike faced when attempting to treat the Borderline Personality Disorder was that the patients would make frequent suicide attempts. Since the suicide attempts would, of course, be the most urgent matter to contend with, the other struggles that BPD patients suffered with would be overlooked, or would not be given the due attention that they required. As the BPD patient would suffer from frequent suicide ideation and attempts this led to great frustration for the therapists who would become overwhelmed and even drained by the demands of their BPD patients and they would feel the need to end their therapy. The BPD sufferer would also feel frustrated as their other day-to-day struggles, aside from the suicide ideation and attempts, and would feel that they just can’t be helped, and so they would leave therapy. The development of DBT, and the core skills it covers, proved successful over and over in helping patients overcome the difficulties they struggled with in addition to the suicide ideation and attempts.

Each module offers its own unique perspective in ways to manage emotions and relationships, keeping mindful throughout their day, and managing distress. The modules on their own can offer so much with the worksheets and handouts to walk through the skills and implement them into your day, and life. But the modules work best when they’re implemented as a whole.

As someone who is just starting to really dig into DBT, I can say that it’s nice to be able to explore and work with the worksheets and handouts respectively on their own and see how one just builds on the last.

In the interest of full disclosure, I was hospitalized in August of last year, where I was diagnosed with BPD, and the After Care Program that I was fortunate enough to be a part of was like a gamechanger for me. It was only 8 weeks long for twice a week and covered DBT, so it was very abridged version but it still managed to really make an impact for me, and laid the groundwork for me to really dig my heels in and get to know and use the skills of DBT in the year-long program I’m currently in.

So I’m going to take right now as an opportunity to actually thank CAMH, and the TCP After Care Program I was in. I don’t want to name names in case it’s not allowed, but the facilitator who ran the program, I’ll call her “Carrie”, who developed the program (abridging DBT modules is no easy task let me tell you but she did it), she was my hero. She is truly a superstar who really helped me to get back on my feet and face forward so I could move forward. There were a number of times I questioned how these skills would help me, or if they could at all, and I don’t know how she managed to do it but she did. And I have such respect and admiration for her and all she has done for the program and for me. She will always be a superstar to me, and I truly thank her for everything she’s done.

While I don’t recommend hospitalization, if you do find yourself at the end of your rope, and feeling truly desperate, and on the brink of doing very bad things (you borderliners will know what I mean),if you live in the GTA, I highly suggest going to CAMH emergency for help. There are 2 locations you can go to, Queen and Ossington, and College and Spadina. I am not totally sure about the Queen/Ossington location being 24 hours but I know the College/Spadina one is. It’s there, it’s open, use it.

Sorry for the segue there…back to DBT…

So the modules…they are in no particular order:

  • Mindfulness
  • Emotion Regulation
  • Distress Tolerance
  • Interpersonal Effectiveness

Midnfulness is basically self-explanatory. It covers ways to be mindful through Wise Mind, and practicing loving-kindness.

Emotion Regulation helps to identify, understand, and manage your emotions.

Distress Tolerance covers ways to cope in high situations.

Interpersonal Effectiveness is all about being more effective in your relationships, with others as well as with yourself.

So this is just a condensed overview of everything the modules are and what they offer.

Over the next fifty-two weeks I’ll be going through the modules in detail, and working to implement the skills into my life. I admit I have some skepticism despite all I’ve learned so far but I am hopeful. I really hope that this will help me and with any luck my BPD will be less taking over my life.

I guess only time will tell, so here goes…

Books on DBT:
DBT Skills Training Manual
Author: Marsha M. Linehan
Guilford Press, 2014

DBT Skills Training: Handouts and Worksheets
Author: Marsha M. Linehan
Guilford Press, 2014

The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance
Authors: Matthew McKay, Jeffrey Wood, Jeffrey Brantley
New Harbinger Publications, 2007

The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD & Other Anxiety Symptoms
Author: Alexander L. Chapman, Kim L. Gratz, Matthew T Tull
New Harbinger Publications, 2011

The Dialectical Behavior Therapy Skills Workbook for Bulimia: Using DBT to Break the Cycle and Regain Control of Your Life
Author: Ellen Astrachan-fletcher, Michael Maslar
New Harbinger Publications, 2009

The Dialectical Behavior Therapy Skills Workbook for Anger: Using DBT Mindfulness & Emotion Regulation Skills to Manage Anger
Author: Alexander L. Chapman PhD, Kim L. Gratz PhD
New Harbinger Publications, 2015

The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life
Author: Sheri Van Dijk, MSW
New Harbinger Publications, 2009

DBT Made Simple: A Step-by-Step Guide to Dialectical Behaviour Therapy
Author: Sheri Van Dijk, MSW
New Harbinger Publications, 2012

The Borderline Personality Disorder Survival Guide: Everything You Need to Know About Living with BPD
Author: Alexander L. Chapman, PhD, Kim L. Gratz, PhD

New Harbinger Publications, 2007