In my previous post, I talked about how I wanted to print off my DBT flash cards, I thought I should create a post discussing my thoughts about dialectical behaviour therapy.

CBT

When trying to improve my mental health following a decade of depression and anxiety, I had the most popular form of therapy - cognitive behavioural therapy, or CBT. But I found it to be an extremely distressing experience, and although the process began with optimism, I soon felt dread at starting a session as they would always end with me upset crying and with a sense that I was so broken I couldn’t be fixed.

This was because I was constantly told off for not doing the activities properly, and questioned if I did actually want to get better, despite me trying my absolute best. I tried so hard to do all sorts of exercises, but when I would do them honestly I gave responses they didn’t like, or I said how difficult something was and told to just keep doing it anyway until it worked. It felt like they wanted me to gaslight myself and my emotions by pretending what I was feeling wasn’t real, and that if I simply lied to myself enough, then that would be the new reality.

So, I then figured out if I simply lied and said what they wanted to hear, I was then doing it right, and praised for now being cooperative. This only made things worse because it fed more and more into that idea of being unfixable - progress couldn’t be made when I was authentic, so how could I ever become truly better?

After my sessions ended, I came away more distraught and decided to admit defeat, that there was no possibility of getting better, and to instead find a way of coping with my issues rather than treat them.

DBT

I’m not sure how I stumbled across DBT, but I liked its approach of dealing with distress by not invalidating what I’m feeling, but instead focusing on calming me down and making me feel better.

DBT is broken down into four modules:

1. Mindfulness
2. Distress Tolerance
3. Emotion Regulation
4. Interpersonal Effectiveness

There are further components within these modules, known as skills. I find browsing the dbt.tools to be a really helpful overview of these with the easy to use navigation and simple language. For example, it summarises these following skills:

How Skill: To live fully, DBT encourages us to be non-judgmental, mindful of the moment, and to focus on the desired outcome for each situation.

Radical Acceptance Skill: Radical acceptance is the complete and total acceptance of reality. This means that you accept the reality of a situation in your mind, heart, and body. You stop fighting against the reality and accept it.

Build Mastery Skill: You can build mastery by doing things you enjoy. Whether it is reading, cooking, cleaning, fixing a car, working a cross word puzzle, or playing a musical instrument. Learn as much as you can about the subject in order to be well versed. Discuss what you have learned and write about what you have learned. Practice these things to build mastery and in time, feel competent.

FAST Skill: The FAST skill is an important component for communication as it allows you to maintain your self-respect and requires you to be truthful about the problems (even if you are tactful about how you frame them) and not to sacrifice your values or integrity.

be Fair, no Apologies, stick to Values, be Truthful

I have the website on my phone as a PWA (progressive web application), so I can quickly access it when I feel the need to. But I also wanted something more physical to hold and flick through, so I also have the aforementioned flash cards, which feature similar content to the dbt.tools website. These, in combination with worksheets and audio I listen to about DBT, have helped me make progress towards better mental health. I’m not told my feelings aren’t true, or that I am doing an exercise or activity incorrectly simply because I’m not doing it the way that is expected. Instead, solutions are presented to help with immediate distress as well as steps towards feeling better in the long-term, with these done in a much more positive mindset than the negativity I felt with CBT.

Going Forward

While I still have issues with anxiety, my depression has drastically reduced in the past couple of years, and I think that is heavily connected to discovering that I am autistic, as the world and the difficulties I faced now make so much more sense, and that has led to a greater acceptance of who I am as a person. Nonetheless, I still refer back to DBT regularly, either when distressed or when in a good mindset and feel able to try improve my overall wellbeing. I think many aspects within DBT are beneficial for good wellbeing, and believe if I was taught them when growing up, I would have probably been better equipped with dealing with my emotions.

That’s not to say DBT may be a good fit for you, and similarly, you might have had a great experience with CBT. My wish is that people have greater choice when it comes to options for improving their mental health and wellbeing. It sadly feels that due to budget constraints, people are funnelled towards the cheapest option available and what is most commonly taught, rather than what may be actually most helpful.