In this Episode of Family Psych Consumer:
Understanding Dialectical Behavior Therapy . . . and How It Changes the Lives of the Most Stigmatized Persons in the World of Treatment
In this episode, Tom delivers another national expert in his Shrink Rap series. This time, it’s Dr Anne Wake, a national expert on dialectical behavior therapy (DBT) and longtime colleague and collaborator with DBT’s originator Dr Marsha Linehan. Like all Tom’s picks, Anne is a soothing but exacting reporter on how to understand the person suffering in their chaotic world AND this uniquely functional and successful behavior therapy. And how families can count on it for real change.
In the mental healthcare treatment world, families struggle to understand what types of therapy are out there out and then figure out which therapy is best for their loved one. Most therapy types can serve a variety of trauma, anxiety and mood-related disorders. But a select few are designed to help uniquely disabled persons. And dialectical behavior therapy is one of them - and it is specifically successful for persons with borderline traits or Borderline Personality Disorder.
I don’t know another therapy style that simultaneously validates and confronts the emotional state of the client; that both understands its power over the client and helps the client to see it for what it is – an overpowering state of mind to be defused. DBT therapists don’t talk about what’s going on with your loved one, they confront what’s going on. And what’s always going on with DBT clients is their emotional overwhelm. Dialectical Behavior Therapy cuts through emotional dysregulation and creates the head space to rationally engage one’s life. Dr. Wake delivers what every parent and family wants to hear – love cloaked in relentless challenge to create real change for your loved one.
Full Episode Transcript
Hey everyone, welcome to our next episode of Family Psych Consumer.
Today, we are talking to another national expert in our Shrink Rap series about a very special topic. It's not special because it's extraordinary; it's special because it's a very successful functional treatment for a unique but highly misunderstood condition. The topic is dialectical behavior therapy, or “DBT”, and the condition is borderline personality disorder. My very special guest is Dr. Anne Wake, a long time colleague and one of our national experts on the topic. She is also a longtime associate of DBT’s originator Dr. Marsha Linehan.
Now I'm always telling you that our Shrink Rap experts are selected to give you a solid overview on an important mental health topic, to stimulate your thinking, and give you the critical thinking to select quality healthcare providers. Listen to how Dr. Wake describes the distress and chaos in the person who seeks out and benefits from dialectical behavior therapy AND how the DBT therapist plies their craft to get someone out of the prison of feelings and into the world of rational thinking and behaving.
This discussion is in two segments. Now, Dr. Wake.
[Interview with Dr Wake Part 1]
Listening to Dr. Wake, I felt a deeper appreciation of how quality DBT therapists are always working, sometimes grinding, to move a life forward toward its more healthy future. The therapist’s heavy lifting is helping your loved one gain insight into his or her destructive coping behaviors- leaning into the thing that they would otherwise run away from; all the while managing the emotional overload.
A few days after our talk, Dr. Wake called me to say she forgot the most important thing that families should do when selecting a good DBT therapist. So I gave her a call and here's that last nugget:
[Interview with Dr Wake Part 2]
I’d like to say something about the baggage, in my mind, that further traumatizes your loved one when the mental healthcare world diagnoses him or her with borderline traits or borderline personality disorder. And that baggage is this: that her or his behaviors collectively constitute a mental illness. The extreme reactivity, the over-the-top emotional responses, the skin cutting or drug use to alleviate emotional pain – are all their own personal hell. These persons suffer greatly each day and most go through life alone; most are unable to form meaningful relationships, unable to feel like they have a sense of self, or fit into the world around them.
So the diagnosis itself is a double-edged sword– the pathologizing of personality – amps the person’s distress. The diagnosis of a personality disorder implies that who you are, in your totality, is disordered or broken. Now that being said, the persons who are able to normalize the diagnosis (versus resist it), understand it for what it is – the mental healthcare world’s attempt to help the patient make sense of their chaos and suffering. But those that stay distracted or distressed by the diagnosis consider a damning label and struggle more and longer.
I'm thankful that neuroscience has been able to isolate the amygdalas in the brain that regulate emotion . . . so we can say to the adolescent with borderline traits “you know you've got this part of your brain that doesn't work quite right and you experience emotions much more intensely than the other kids”; being able to say this allows your loved one to normalize that the person they know themselves to be, or are becoming, can be distinct from their compromised brains.
So a skills-based therapy like DBT provides some sense of control over how they experience life even though the quality of that life may be very compromised. So there's a lot to say - and learn - about this topic both DBT as a treatment modality and the dys-regulated brain and all the chaotic personality traits that go along with it. So again, we're not here to be the experts on everything; we will always be wrong about something.
But we are here to help parents and caregivers begin to understand the basics of these primary treatments in the mental health care marketplace and how to bring relief and dignity to these highly chaotic lives.
Until next time take care.