Intensive DBT

Went to an appointment at the drug & alcohol service today. My case manager spoke to me and suggested that I enter into an "intensive DBT" (dialectical behaviour therapy) program, where I'd be obliged to attend a group meeting and a one-on-one meeting with a counsellor every week for a year. Then once that year is over, I'll have to continue the weekly appointments with the counsellor throughout the following year. That's two fucking years! Plus daily homework and all that shit. Apparently it's designed to treat my borderline personality disorder and drug addictions simultaneously, but it's gonna be so emotionally demanding on me. My first thought... fuck that.

 

Yeah, why put any effort into improving yourself? Giving up is much easier.

Seriously P, you're being handed a golden opportunity on a silver platter, and you're turning your nose up at it because it might entail a bit of effort? I... I just don't understand that.

 

DBT is intense but it's sooooo worth it. It can be super intimidating at first when you find out about the commitment that it takes but it's done wonders for me and I'm sure it will help you as well.

 

According to my file I'm "resistant to treatment". In the past I've had little or no success with therapy, which has made me kinda disillusioned with it all. I don't want to pour my heart out to somebody I barely know, regardless of their qualifications.

 

P

I don't want to be a downer, but have you ever thought your drug problems are a result of BPD? Or a means to cope with having BPD?

I can understand if it's not for you. It most certainly was for me (with ADHD) and heroin and I didn't realize it until roughly 16 to 17 months after I quit using heroin all together. When I quit using heroin, the rebound effect on my ADHD was too great, and Suboxone only helped to a certain degree. I was sleeping in more than half and sometimes up to 2/3rds of the day (occasionally a whole 24 hour day slept away too), before I got on sleeping (and now) ADHD meds. Suboxone wasn't cutting it for my ADHD issues that only became worse after I abused H.

However you have a different DOC and a different diagnosis than me, so I can't even have an inkling whether or not your use is connected. The likelihood is great due to the association with all/most personality disorders and increased likelihood of drug use (/abuse) but overall it may just be a coincidence who knows?

I think DBT might be a good chance for you to work on your BPD but I don't know much about DBT, but I have been reading the wiki page for DBT. It sounds very promising! I would recommend it for the people I know IRL with BPD but they don't care about getting better, so it would be a waste of my time.

It's great that you DO want to get better! That says a lot about you and your possibilities of success.

I'll be rooting for you if you go the DBT route, and if not or if you want to hold off for now, I wouldn't blame you either. It's not always getting help that works, it's more like getting help at the right time for you.

If someone isn't ready for whatever reason (there are probably more reasons than I can think of) then it may not do anything for them, may be of little benefit, or may actually do harm.

So think deeply about what you want/need, what your goals are, etc, and make an informed decision. Do some more research beyond the wiki page if you need to.

Good luck!

also, thanks for telling me about DBT! I haven't ever heard of it before, and I love learning about new therapies.

 

^ Yes, I think my drug problems are definitely linked to my BPD. I remember reading somewhere that up to 75% of people diagnosed with BPD also have drug and/or alcohol problems.

I'm still angry at the service for refusing to prescribe me prescription amphetamines, and I'm now seriously considering pulling out of the service completely. I actually don't want their help any more... not that they've ever been all that helpful.

 

But Sweet P, you can't really tell someone how to help you. If they are offering, what do you have to lose?

Give it an honest go at it and see what happens. Couldn't hurt.

 

^ I don't think I can be helped. At least not through therapy. That's the problem.

 

A lot of good advice has been given here Sweet P.
I appreciate that I am relatively new here and that relationships have formed so I’m not about to give advice all I will say is that it’s important to know what you want, what you really want. Yes it’s difficult to open up in therapy to a complete stranger but that’s the joy of therapy going in and dumping it all for them to sort out and work through it with you.
Having been in therapy for years I love it, it’s sad, uplifting, empowering, I cry, I laugh, and I heal… That’s my journey.

“I don't think I can be helped. At least not through therapy. That's the problem”, you won’t know unless you try…
By the way I love the name ‘Sweet P’
Take care.

 

^ Thing is, I've been doing one-one-one CBT therapy for years (I first entered the mental health service at the age of 12 or 13). It hasn't made much of a difference in my life at all. I've also done some DBT work with a psychologist in the past (again one-on-one stuff) and I found it extremely difficult to put all the techniques into practice.

 

I think with DBT in a group setting it will be easier to practice the techniques because you can hear how others in the group use them and they can give you advice on how you can. It's a great support network to have!

 

I don't think I can be helped. At least not through therapy. That's the problem.

You are right, most people with BPD have drug issues. The person I know IRL with BPD, they were severely addicted to Adderall (d,l-amphetamine) and benzos.

They may be skeptical of giving you amphetamines since that is related to your DOC. I do think you could use them responsibly though, especially with someone else helping you hold onto them, or if you do weekly/daily pick ups, etc.

I think though that therapy and medication is a good combination for success. I don't think just DBT would be ideal for you, nor would just medication be. However, you could start with one or the other, and use the other if you need it.

I don't blame you for wanting to pull out of their service. But maybe you should try the DBT. If it doesn't work or it doesn't work as well as you'd like, maybe you can ask for prescription amphetamine again, saying going through DBT gave you a much more positive outlook, etc, or do you think it wouldn't help your chances out at all?

I am sorry about the difficulties you're experiencing P, I wish you the best of luck trying to get through all of this.

I guess I'll sum up the way I am thinking about it like this: I do think your best odds would be to begin amphetamine maintenance with supervision (either daily/weekly pickups, or a script being held by a trusted friend/family member/etc), with or without therapy. However, since they are only offering you DBT, let me ask you this. Could it hurt? Has CBT made your issues worse or set you back at all?

If you begin DBT can you not say "I want to quit" or would they hold you to it?

If you can quit any time you want, I don't see why doing just DBT could hurt at all, just my 2 cents. If there are some obligations or if it could set you back, I understand why you are skeptical.

Make sure you think about the opportunities you have, and think about the possible outcomes. I think you're doing a good job so far weighing your option (I would say options but it's like they're only offering you therapy, and that's just one option - if you are like "CBT vs DBT" then you could count those as two options).

Do you think maybe there are some fellow BL'ers who have tried DBT you could talk to? Is there a thread in TDS about DBT therapy? If not maybe you could make it?

I am planning on telling the wife and mother of two BPD people (her father and son have BPD) about DBT, in hopes she may be able to get her family members the help they need. I think it's great news for them since nothing has worked for them thus far.

 

^ My main gripe with the therapy is that I'll be obligated to drive into the city twice a week and discuss deeply personal issues with people I don't even know. That's one of the main reasons therapy hasn't been successful for me in the past - I don't like opening up to strangers. Even if they are qualified therapists, and everything I say is confidential.

Also, the program runs for 2 years. I don't even know what my situation will be like in 6 months from now! Hell, I might not even be living in the same city! I really do believe d-amps will help me, but I'm told that isn't an option. I assured them I won't abuse them and I'd be happy to do a weekly or daily dispense, but that didn't change their minds.

In a nutshell, therapy on its own doesn't work for me. Medication (d-amps) will help to wean me off methamphetamine over time, and I'm sure a combination of medication and therapy would be helpful. But not DBT on it's own - while I'm still using meth on an almost daily basis.