Dialectical Behavior Therapy (DBT): Where We Were, Where We Are and Where Are We Going
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- Опубликовано: 11 июн 2024
- Dialectical Behavior Therapy (DBT) is a trans-diagnostic modular behavioral intervention that integrates principles of behavioral science with those of Zen mindfulness practice to provide a synthesis of change and acceptance. UW Professor Marsha Linehan discusses how this behavioral intervention is one of the few treatments that has been replicated as effective for reducing risk of suicide and what to expect from the future of DBT.
Marsha M. Linehan, Ph.D., ABPP, professor, Department of Psychology, director, Behavioral Research and Therapy Clinics, University of Washington
04/20/16
www.psych.uw.edu/
uwtv.org
I love how she admits she struggles to work with patients. She even makes it clear she needed to get a LOT of feedback from her patients to even know where to begin addressing people's problems.
Too many therapists get a big ego about how much they understand the human mind. I've had several therapists who take a huge amount of hubris in their insight.
One of the hardest lessons in life is that the human mind isn't as logical as its owner likes to beleive... Even my mind is like that.
This woman is God's gift to Borderline people.
Yes, she absolutely is. 🙏🏻
@@claire_eve8531 nope she is the god!!
No, she made things worse for survivors of abuse. She further stigmatized us. We should not be sending survivors of childhood trauma to this treatment.
@@rebeccadonaldson5197 in what way? Is there any data to support this assertion?
You’re just trolling. Scram.
I find the comfort of a mother's love, to the best of my imagination, watching and listening to Marsha. She is warm, funny, honest, smart, humble and loving.
I get that vibe. Wish she was my dr
I do too~!
Andro mache I feel so sorry for you. You deserve a better mom.
agreed
@michelle sheerin she told her patients not to tell the ER/hospital that they were BPD. My daughter was rejected for suicidal ideation last week because they know that she was diagnosed with BPD and they “can’t help her”. So now she thinks she has to prove it and she cut herself for the fist time. Still not admitted.
Marsha I was that person in the closet with no way out. Thank you for going into hell with people like me, DBT saved my life.
Can you please share how? Thank you
When I found Marshall I found hope And I felt loved And understood And I do think she is Gods gift to so many isolated and alone people. Thank you so much ML
What a brilliant lady! What a blessing to have someone with such intelligence, creativity and compassion! God bless you.
Finally, somebody knows what she is doing....You find the most knowledgable about an issue is the one who say i donot have all the answers........... Good lecture
I'm loving your information. I am thinking, as you speak, that much of your "therapy" is about both the therapist and the client accepting reality and staying in the moment. It's a good foundation to live life and to have peace of mind and at some point, even happiness!
Wonderful and encouraging. Thank you for making this publicly available.
So I’ve been struggling with PTSD, depression, and various anxiety disorders. I’ve been in CBT since 2013 with slow to very little progression. I heard about DBT, and I looked it up and got the manual for it. I started reading through the manual about a year ago, and it felt like it was written for me and my problems. In other words, it just clicked so much with me, more than CBT. So I’ve been struggling to get into one of the DBT groups in my area. They aren’t very good at returning calls. They’re fairly new, so maybe that’s why. It’s very hard to find a DBT therapist in my area that takes Medicaid. In the meantime, my current therapist has been working on some DBT basics with me. She’s not trained and doesn’t own a manual. She made it clear that she doesn’t feel comfortable delving deep into it with me. She just pointed me in the direction of a university that does DBT, but I have to find out if they take my coverage.
Ruthann A - I hope you are well :)
Can you please share with me the u r l where to purchase that very manual?
Oh god I LOVE this woman!
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This woman helped me a lot too
amor fati, acceptance was the key to moving forward....dealing with it in a realistic, rational, reasonable, and respectful approach
Hey, it's on you if you like to continue eating life's shit sandwich and poop salad but don't expect everyone to share your enthusiasm eating shit.
really appreciate her conflicts of interest slide!!!
Thank you Marsha, for saving my life with DBT!
Relieved I'm not alone in this
I have Quiet BPD, MDD, CPTSD, have had several psychosis with some grand delusions. The mind can only take so much before it fractures. The thing I am doing is allowing God to heal me and show me what I need to heal.
1) Self-acceptance using guided meditation to consolidate my own energy.
2) Treating each co-occurring diagnosis separately.
3) Magic mushrooms (yes I realize it’s dangerous for those like us with tendencies for delusions and psychosis). But it has helped incredibly for the depression, and also a catalyst for reviewing and healing the trauma.
4) Learning to trust yourself - I do believe having a daily routine of self care is essential. And adding small things that make you feel purposeful.
5) I make a daily video diary. I felt a huge instinct to make a video every day and discuss my process. But felt I need to keep it private. Soooooo huge! I see someone else commented this on this video and it is true. It is critical for you to hear your thoughts out loud and back, and send love to your replay person. Because you are healing that.
That’s all I got for now folks. The VA doesn’t have DBT near me. So, I have to treat myself for now.
I have found DBT to be the most effective therapeutic intervention, and possibly the only effective one. It's been many years since I was so fortunately placed in that outpatient DBT group, and I'd love to revisit the literature and maybe buy some of Dr. Linehan's books.
Perfumaphilia please share it !
Where did you go? How can I get access to therapy and a fair diagnostic?
Love ur comment…it’s saving my life too, DBT/ cbt that is…here’s my story…. Up to Date, August 22..A lot of my knowledge has come through living it (TERROR/ below HELL- from the depression/ meth/ paranoia at a very high level according to my multiple doctors (I’m N:Ow sober from Alcohol and Crystal Meth for over 14 months and 17 days at this moment… Thanks to the moment/ moment help of CBT and DBT skills!! ALL of you that have been there for me throughout this whole crazy journey….(MENTAL ILLNESS/ Wellness (if your lucky and do the Work) Kaiser Facilities> I’ve visited, stayed at some of the following >Woodland Hills, downtown Los Angeles (51/50 stay), Simi Valley, Lancaster (multiple I.O.P’s= Intensive outpatient program), and that doesn’t count the olive view hospital in Sylmar ER/ 72 hour hold) I went to before I had Kaiser insurance) I’ve seen throughout my battle/ past 3.5 years) and not just reading a book on “how” it tells, which I do respect, but I’m uncommon amongst the common now, my goal is to be “uncommon amongst the Uncommon”- D Goggins, so I know ALL about true suffering and true PAIN/ Addiction/ Mental illness, because I live it on a moment to moment basis...but I also now know on the other side of true pain and suffering is this glorious life I N:Ow have (and will N:oW die for) and am becoming….(How Can I be of Service ?)💚
I suffer from suicide and bordline personal disorder thank u for helping people like us
59F. I am in therapy using The Dialectical Behavioral Therapy Skills Workbook. After 4 attempts in 3 months, I am a month without an attempt.
Thank you for everything you do
Thank you for posting
While Dr. Burn’s work with CBT is awesome; i think he and his Team can learn a lot about sharing vulnerability instead of talking about the times when things got solved in 30 mins with all handsome beautiful talented people giving people false expectation.
*dont have issue with the people, but their communication style’s side effects
A phenomenal Master Class by Prof Dr. Linehan. This lecture would make any professional develop core insight into the core of DBT journey. V.helpful. Thanks a ton Ma'am 🙏🌻✨
Thank you! For everything.❣️
Love u marshaaaa. U helped save my life
I've just been diagnosed it is relieving and very very scary to know it's not jyst a phase or my circumstances
awesome scarf...
Dbt has helped me so much
Still fabulous.
The most maddening part to all of this is is that they will not diagnose people properly if there's no need for medication. For years I did not understand how I was not borderline, I'm very self aware, I'm very solution driven, and nobody would help me. They could, they chose not to, because of the stigma and the very very broken old system that most medical people in the US still go by. I have more diagnosis than fingers on one hand.... ok. Let that be MY problem so I don't make it other people's problem. Please.
I needed help understanding "this" but they would not even honestly let me know what "this" was.. They kept saying that I did not want to be borderline because it could not be medicated. How freak'n convienient for THEM.
But very inconvenient for somebody who wanto be better.. I want peace for crying out loud which means I want peace for the people around me as well. I wish I could go back and start over for all the years were they refused to help me... Well I wish I'd never had this at all I wish I didn't have the drama I wish I didn't have the memories I didn't live in a culture where people want to be mentally ill for likes..... But at the very least I wish that they would have been honest with me... I had to run screaming with my kid--- at at the risk of them seeking protection services after me--- God knows what kind of crazy treatments they would have forced her and do like they did me for so many years--- Forced epileptic medication that I did not need, forced sterilization medications that gave me permanent migrained disorders--- I had to run and completely be willing to lose all services so that I could save us both because I knew they were sinking as deeper and deeper and deeper into mental illness without giving us any resource to spiral out of it.
Thank you thank you for this lady. It's rough for me as an adult trying to untangle this nonsense 💜
Knowledge is power. One helpful tip for me, and I was considered 1 of these hopeless types, is have a private video journal. Please for your own sake do not make it public. This is just for you. Spend a year looking at yourself. You can use RUclips as a platform to upload your stuff as long as you do it locked 🔒 so nobody can see it. Pretend like you're making videos for the public but for god's sake do not make them public. I cannot stress this enough. If you want to make it public in a few years after you've had time to get to know yourself and understand what the hell is really going on, you always have the opportunity later. But you can't go back and undo it if you change your mind later after you've grown leaps and bounds.
I didn't even really understand how much I was mixing my words up, I would be convinced I said something but then from recording myself & editing, this put a mirror in front of me that I was completely mixing up words- like I would say "mailbox" instead of "microwave". I had no clue I was doing this.... but then I caught myself doing it on camera and I was like "oh my God I have so many amends to make". I also caught myself in a rage meltdown.. Now granted these are things that honestly believe I had no control of until I saw myself do it and compared it to how I've seen other people do it and I was like "Oh hell no I don't want to be like this..."
Not to mention how many people in the world really really do fake mental illness so they can get attention on the Internet, But they don't realize that they really really are mentally ill and they don't have to fake anything. So then how is this helpful? How are people going to get real help when they're so far out that they have to pretend to be mentally ill.. When they already are!?!?!? They do this because they try to get help and there is really hardly any help out there to be had.... Which proves that the people that are training to be helpers have their own mental illnesses that they refuse to address...
😼🐀😼🐀😼🐀😼🐀😼🐀😼🐀😼🐀
We need more people like this wonderful lady. I'm the kind of brain that wants homework every time I go to the therapist. If you see me again and I haven't done my homework, sit with me and do it right then and there because I don't know how to do the homework. I want to do the homework but I don't know how. So I need somebody to do it with me a few times so I can fly solo.
Borderline is that weird thing where you don't want it but knowing you have it is helpful but only if you have the resources or you've had a lot of time to already work on yourself and get to know yourself. Please do not let it be a death sentence. Don't let it be a forever since. It's not medicated. It's an inside job. For me that means ME.
By the way, For anybody struggling with this and you're surrounded by people that refuse to listen but just give you impossible advice 🧐..... if somebody tells you, "If I was you I would do this…" You can kindly remind them that no you wouldn't because that is not what "ME" means.
🙏🙏🙏 Stay Golden
I absolutely love this woman, and I am so thankful for all the work she has done in this field. Thank you, Marsha; you are helping me so much.
❤🩹
Thank you for this presentation, but how in the world are there only 20 comments... and less then 500 likes
Brilliant
Despite its strong empirical support, DBT obviously does
not have positive outcomes for all individuals. It is critical that cases of DBT nonresponse be analyzed so that further treatment development efforts can be made to enhance treatment outcomes for all individuals in DBT.
I wonder if the nonresponse is in situations where true DBT is not being practiced? A lot of therapists say they do DBT, but it's DBT lite without a consultation team, skills training or phone coaching which are the 3 central components.
Wish I could access someone of your ilk. I'm so tired of chasing my tail. I'm beginning to think DBT is a myth in Australia, to the poor. How many people with BPD can hold down a job? I can't for long. I imagine those that can afford the prices of the places I've been referred have good family support.
Absolutely agree with you. It's even worse in Latin America, where I live. It's almost a myth and don't even get me started on the prices
@@xshikitty that's no good at all
I don’t know what state you are in but in WA I’ve just started a 17 week pre-comprehensive followed by a 12 month course through the community mental health system so no out of pocket expense all Government funded. Hope that helps
Yeh you really have to keep fighting for the right help in Australia. It's very tiring but keep pushing! Don't put up with help that's just ok
I'd like to participate in research, and be observed as well, can this be done remotely?
I wish I wasn’t acutely suffering from ptsd when I was @ UW
Does anyone know where this entire conference can be viewed I see where she mentioned a Dr by the name Martin ?? whom is the worlds expert on BPD ... Does anyone know this individuals full name ? she mentioned him at 24:12 in the video
JON DAVID , Dr. Martin Bohus
ruclips.net/video/d1CFlF57eNo/видео.html
The close captions are miss-timed. Too advance.
Hi, I need your help. My vision is mysteriously decreasing after cataract surgery. I am counselor and I desire to read Marsha Linehan’s DBT Skills Training Manuel in an audiobook. Can anyone recommend a good DBT Skills Training Manual in Audio? Thank you in advance.
Where can I enroll in a Dialectical Behavior Theraphy Course and get certified?
If you find out, please let me know as well. Thank you
You just need to be convincing to people to eat shit like you do
If people were doing their job properly on in patients wards and in crisis teams they wouldn't be so many deaths, most of the staff are unskilled.
Anthi Iliopoulou Largely due to poor funding
So right.
I kind if wrote myself off as a potential mental health professional, but now that I've gotten to just about the end of my own DBT (treatment) program, I'm reconsidering a degree in expressive arts therapy. My own therapist will soon relocate to a corrections facility, which amazes me, but it's no surprise.
@@g.i.clamvirus2058 how did you find the treatment worked for you?
@@kristinpetersburg1755 you’re both wrong in different ways. It isn’t that open ended.
Dear All, I need some help. I have been diagnosed with BPD 4 months ago and started on therapy. I live in the UK but my partner needs help. I was wondering if there was a support group for partners of those with BPD. She needs someone she can talk to, who can understand and help explain or make sense of our situation. Does anyone know of anybody who offers this service?
DBT works
You can't get treatment anymore. You get referred out and DBT is not available.
Can they cause visualization effects on sone one
No, bpd does not have visual hallucinations as a symptom. It is a personality disorder, not a perception disorder. but schizophrenia can cause auditory, visual, and even taste distortions.
2:13 that is a calling. You cannot WANT that. You are made for that or you are not.
i have borderline and i cant get help. its expensive
Yes you have to do the research to prove it, it's totally individual and in my service the opinions are divided, nevertheless a crisis plan should be in place, if not with admissions, with crisis teams and engaging properly with the patient, not just go to see if they breath in oxygen, which is what they do in the UK, most of them anyway.
So you decided hospital wasn’t for you, Marsha, then you found Buddhism and so what do you decide to do but go back and force it to somehow work?
🤗
13:22
Sounds like organizing a business model.
41:31 the least engaged audience frame I have ever seen in my life.
I heard everything one with bpd shouldn't, 4 suicide attempts 2 were real then stopped thinking what will be leaving behind atleast not like this, Caged myself, at home society psycho label Stigma Is for life with me losing alot even now finding escapes, nothing more nothing less, Don't want to say to a person don't want to hear anything just get somewhere where i can breath without being like this, just normal emotionally
Inclination toward loneliness waking hollow, being free becomes a myth as so computerized dbt therapy Messed up, Masking them Fakeness All one with this wretchedness Just once Wanted to be Free, Nonetheless Life goes On, Days better worse Good , it's a Part
"most therapists are actually jerks" my imposter syndrome is cured
Dear Dr Lindham...you are correct about suicide as a result of inpatient hospitalization. It can cause trauma and is a horrible broken and abusive system...and I will never hire the woman in the audience who was crocheing nor the one sitting up while sleeping. This womans work is ground breaking.
I am so thankful for Dr.Linehan.
what a title ,, more like a tongue twister
well, PhD and still did not get the very reason for suicides...
"The wages of SIN is death."
One needs a PhD in order to beat around the bush in a verbally eloquent and sophisticated manner.
Blah blah blah! I was hoping to learn more about treating BPD with DPD!
There is no cure except death
I need to add a comment to The Forum in this video, That was the worst education given to Working psychologists, Of the hours I've spent researching available information on Mental Health
care to tell us why?
What ???? LOL
You're joking?
DBT is an abusive treatment and self-harm and attempted suicide is not the definition of the construct of BPD
Self-harm and suicidal thoughts are the first thing DBT focuces on but in no way the last. Self-harm would be natural after a therapy session talking about trauma so it has to be solved or get better (reduce frequency and such) first. Same goes to other impulsive and/or self-destructive behaviours.
It isn't a 100 percent succesful treatment but there is no treatment that would be. It also depends on the therapeutic team providing it.
What I want to say is: dbt is not an abusive treatment in my experience but rather effective.
@@TatjanaMeierxxx yes it is abusive, I've listened to enough victims of it
@@ethelgreen836 I have experieced it and I get where the 'abuse' myth can come from. It's either a bad therapist and/or group or unwillingness to change and accept that change of behavior is needed. The treatment itself is harmless.
@@TatjanaMeierxxx disagree, it's not solely about bad therapists it's entire premise is simply behaviour modification
@@ethelgreen836 see, as someone who went through it I can say is it is not. It is common for my fellow borderlines to feel as the victims even if they aren't and to feel like the abusers even if they aren't. A very black and white approach leading nowhere in my eyes.
This presentation is lacking in the fundamental understanding of what it means to be human. Unfortunately, DBT therapists, like Marsha, treat patients like test subjects that need to be trained and manipulated into compliance with a set format of desired behaviors. Nothing new here, just some more Skinner in a different package, but in a way that makes a lot of $$$ for Marsha and crew
Yes, a lot of $$$!
You do know Marsha struggles with bpd herself, right?
@@xshikitty Yes, I do. What point are you trying to bring out?
DBT is hot garbage.
Sounds like some black and white thinking there bud. Perhaps if you tried a dialectical approach you would understand that while it may be "hot garbage" for you, it's a life saver for others and there is no absolute truth when it comes to this stuff. DBT is not for everyone. I believe it works well for those of us who are highly intellectually curious and need to think about everything deeply. If you want a quick fix or a less rigorous approach I would agree it's going to be "hot garbage" for you :)
You are oversimplifying DBT. It is not a hot garbage. It is convincing people that life is a shit sandwich and you have to love eating shit. I am on DBT and I refuse to eat shit and accept that shit is food. Life = shit. The only true solution is to avoid triggers. And avoiding it permanently. Life is not for everyone and not everybody must eat shit. Suicide should not be considered bad. Suicide should be deliberate.
Boring boring and boring because clearly it’s all about manipulating the crowd on raising funds nothing nothing helps the narrator as you can hear is a tough narcissist just listen how she introduced herself people the more you get scared listening to this the less you are going to find peace
DBT-bullshit then, bullshit now
try something else ...get well soon!
it depends a lot on timing, if you are stable enough with other meds, if you had any other therapies before, if you have it one to one or in a group. Or another therapy might be the right one for you, e.g Schema
Dear "dbt is bull shit". Keep one critical fact in mind; MANY and I do mean many as in most Clinicians who practice DBT, are profoundly untrained to deliver DBT effectively. Sadly, unless a therapist is Linehan trained over a minimum of 5-7 years, that person is NOT able to deliver DBT w positive lasting results. So 'trying' DBT w a therapist who is highly trained with a Linehan certification proving their ability to divide it as it's meant to be provided, its highly unlikely the client will get results, in fact clients often get worse. Do your research on the therapist! A 2-day DBT training makes that therapist ready to do no DBT. And yet that typically what therapists get re: training and then advertise they do DBT. The only policing of DBT therapists is found at www.dbt-LBC.org. Anything less? One can expect a very poor outcome. I sincerely hope you're able to find what you need. If you're in FL? Go to www.fbpda.org for a list of the highest trained DBT Clinicians statewide. Be aware. And write me back if you're still suffering, or a loved is in need still of solid help w positive results. Info@cbtpinellas.com
Watch your mouth - no credibility pal
I am on DBT. I just cannot radically accept that life is a shit sandwich and I have to love eating shit.
Low frustration tolerance goes with the dx. Superego is very judgmental. Rejection sensativity! Have to be very supportive. Mindfulness will help so much. Dayhospital?
I have Bpd and attending DBT but I would rather die than be conditioned and accept eating life's shit sandwich. The only way to be cured of mental illness is to avoid and eliminate the triggers. Life is a huge trigger itself and I would prefer to finish it than swallow shit and enjoy it.
I resonate with your sentiments. I've been struggling with this beast since I can remember. I was the quiet kind borderline who just sucked it up and didn't explode until I was really pushed for a long time. I'm almost 40, can't hold a job and have lost all ability to trust anyone. So I have no close friendships anymore and I isolate. Even then, I'm always on a roller coaster, losing jobs, houses, and DIGNITY! I just want to jump off the ride sometimes but I tell myself that I need to stick it out until the end, regardless of how painful it is.
this only works for some and them that it do not work for after a shrink who based there full rep training on will diss u forever in all servises if u don't get ok with this dbt. ML'n made this on the 80's be4 any 1 knew what bpd was, how the hell are we still useing it today when not 1 study apart from hers or 1 she has sorted the results of others be real and the truth. grrrrrrrrrrrrrrrrrr.
i know i did it back then and 3 other times, to me was just more pain but was non stop told i was not helping myself so it can't work, wtf.hmmmm, would u diss some 1 with cancer when the radiotherapy didn't work ?, no, never but the most messed up heads are treated that way.