FAQ

*This page is still a work is progress

What is this?

 

I wanted a place to blog about Dialectical Behavior Therapy and Borderline Personality Disorder anonymously. I hope to organize some of my favorite resources and might even create a private forum for DBT nerds to provide each other peer support.

What is DBT?

 

Dialectical Behavior Therapy was created by Marsha Linehan to treat suicidal patients.

 

Fun fact: there's a common misconception that it was created specifically for people suffering from Borderline Personality Disorder - but it's not true! To qualify for studies early in the development of this therapy, Dr. Linehan had to pick a diagnosis; she chose Borderline Personality Disorder because of the high suicide rates. I don't say this to discredit the amazing impact that DBT has had on those of us suffering from BPD... I say this because I want people to understand that DBT is for everyone, especially folks with suicidal thoughts!

DBT builds on typical Cognitive Behavior Therapy tools, but is loaded with tons of validation and mindfulness. The dialectic in Dialectical Behavior Therapy is that you are learning to accept yourself as you are now, but also accepting that you need to change. It sounds a little funny at first, but, yes, BOTH of those things can be true at the same time. 

There are 4 major skill sets in DBT:

  1. Mindfulness

  2. Distress Tolerance

  3. Emotion Regulation

  4. Interpersonal Effectiveness

​What is BPD?

Borderline Personality Disorder is one of the most misunderstood, stereotyped, and stigmatized diagnoses out there - by patients, the public, and, sadly, many mental health practitioners. 

Dr. Linehan developed a bio-social theory of how BPD develops that really resonates with me and validated my own experience with the symptoms. The bio part: some people are just biologically wired to be more emotionally sensitive than others. The social part: because most people are not wired with this biologically predisposition to emotional sensitivity, many people invalidate the experiences of sensitive folks. This invalidation has several effects and maladaptions, but almost all of them can fit pretty neatly into the criteria for a diagnosis of Borderline Personality Disorder. In order to receive a diagnosis, you must meet 5 of 9 criteria. They are:

(1) frantic efforts to avoid real or imagined abandonment. 

Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 

(3) identity disturbance: markedly and persistently unstable self-image or sense of self 

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). 

Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) 

(7) chronic feelings of emptiness 

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Who am I?

 

Hi! My name is Nina. I live in the Pacific Northwest with a rescue dog. I use she/her pronouns, and I also identify as genderqueer, greysexual, and heteroromantic if you want to get real specific about it. I have experienced symptoms of BPD since what feels like forever to me, but appears like since my teenage years to everyone else. I have been in therapy on and off since I was 14. When I was 28 I started a year long DBT program after complaining to my trauma therapist that I didn't have any distress tolerance skills. I was 2 months away from finishing that DBT program when my dad died by suicide. I strongly believe that being in this program when I was absolutely saved my life. I can't imagine getting through my father's death without DBT skills. It's why I am so passionate about it!

(I used to run this site and the corresponding twitter account anonymously, but have since outed myself. For more, visit northwestnina.com).

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