Reddit reviews Skills Training Manual for Treating Borderline Personality Disorder

I'm a DBT therapist working for the LA County Department of Mental Health. I would recommend purchasing the DBT skills manual http://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341 and reading through Dr. Linehan's conceptualization of the disorder, as well as her evidenced based rationale for engaging in both skills group (more like a class) and individual treatment. It is important to note that if you aren't doing BOTH skills group and individual treatment, you are not engaged in DBT - to the best of my knowledge, the research demonstrating efficacy has been conducted using BOTH skills group and individual treatment. DBT is an intensive and complex treatment, but it has been demonstrated to be very effective targeting and reducing impulsive, maladaptive, self harm and suicidal behavior. Essentially, treatment involves balancing change with acceptance and a non-pejorative view of current behavior, and replacing emotion regulation behavior that results in undesired consequences (i.e. self harm, substance use/abuse) with skillful behavior that promotes desired outcomes.

Mindfulness provides the basic framework for both change and acceptance strategies - very briefly, mindfulness (in the DBT context) refers to observation and description of internal processes in order to build in space between urge/impulse and action/behavior. This space allows for consideration of alternative behaviors, acceptance and tolerance of distressing cognitions/emotions, and use of skills based coping behavior.

The question you posed is perfectly valid and totally allowed to be posted here. :) The rest of the community may also have some great ideas to help you, here are some of my suggestions.

You could ask your therapist if she was comfortable reviewing some of the exercises with you. (Some therapists will not go this route though if they are uncomfortable with it.. but it can't hurt to ask.) Purchase one of the DBT books, Skills Training Manual for Treating Borderline Personality Disorder (this is the first edition but has handouts at the back of the book, and is less costly than the 2nd edition which is split into two books) or The Dialectical Behavior Therapy Skills Workbook. Use them it a guide, and do the exercises. This may give you a bit more accountability in keeping with them.

Another way that some people have suggested is to print out a 'cheat sheet' (example 1, example 2 example 3) of the skills and keep it in a highly visible place in their home (bathroom/bedroom/kitchen).

You could also try doing a diary card every day to get into the habit of 'checking in' Either on paper or there are apps that also do this (although I don't know how great they are)

Try to not get discouraged going it on your own. I've had personal accounts from people who are in the same or similar situations as yourself who have had success with self study.

First, you can start DBT by yourself right away by buying Marsha Linehan's workbook. The workbook is very powerful all by itself and if taken seriously and practiced diligently, it will help right away. You can find additional books by Linehan on Amazon.

I don't think there's a cure for BPD but there is a lot you can do to ensure that it interferes as little as possible with your life. I think Buddhism is the best practice because it is a see for yourself guide to happiness. Above all else, it helps by teaching mindfulness. Mindfulness will be your greatest ally throughout life. It will help to mitigate strong negative reactions to triggering events. Most importantly, it will make it possible for you to know yourself and to be compassionate towards yourself, greatly reducing self-hate.

My sister has been struggling with BPD most of her life. A couple days ago, we were talking about an incident that took place a while ago during which she attacked me viciously and kicked me out of her home. I told her how I remembered the incident and why I left and she told me she remembered it entirely differently claiming that I was the one who got angry and left of my own accord.

Now I'm left wondering if people with BPD occasionally have psychotic episodes during which they are not in touch with reality in any way. I have never suspected her of being psychotic but this would explain many terrible events in our past. My question is, do people with BPD experience psychosis under great stress so that they can have completely different memories of past events. [forgive me for asking a question instead of offering more help, but I really need input on this. I tried posting this question yesterday but my post wasn't made public for whatever reasons reddit has for doing this sort of thing.]

Someone mentioned CBT, which is similar to DBT, which is what I came here to recommend. DBT is an AMAZING resource, and you should be able to find a weekly group to get her in NOW, and it will be more affordable. I'm positive there are at least a couple DBT groups running here. All Souls might be able to direct you to one, or maybe even Mission knows who you should contact. Without insurance, it'll probably be around $100/week, but you could ask about a cash discount perhaps.

Also, order the DBT workbook and read some of it each night with her. It's a wonderful resource and the information is SO helpful, that I personally think the curriculum should be taught in schools to the general population.

Workbook

Editing to add: Doing a daily mindfulness exercise is very helpful, too. It calms the nervous system and really helps to reset things. Some meditations include tensing and relaxing your body in order from top to bottom or from bottom to top, watching the flame of a candle for a few minutes while letting thoughts leave your mind as quickly as they come in, doing a sound meditation where you close your eyes and hyper-focus on sounds around you, counting your breaths until you get to 10 then starting over again, and envisioning a warm disc of light glowing in your chest and warming you with calm light.

Also, for immediate "distress tolerance", taking a bath can help, walking a dog or snuggling with a cat, distracting her with TV or a movie, putting lotion on your arms or legs, writing your worries/thoughts in a journal, even screaming into a pillow.

I'll be keeping you in my thoughts tonight, and PLEASE PM me if you need any more info or support.

Here is some basic info about DBT. It is such a wonderful approach.

Much love and light to both of you tonight.

(sorry, I don't know how to create links with descriptions)

1. http://www.amazon.co.uk/Training-Treating-Borderline-Personality-Disorder/dp/0898620341 (Skills Training Manual for Treating Borderline Personality Disorder)
   
   
2. Talking to others with BPD, to reinforce the fact that this isn't my own freakish, crazy problem.
   
   
3. Mindfulness!
   
   Edit: 4. https://www.youtube.com/watch?v=fhOotNCqg2E

No, but I have been through the DBT program a few rounds, mostly back in 1998-2002.

The textbook for the program I was in, was Marsha M. Linehan's Skills Training Manual for Treating Borderline Personality Disorder.

That in itself is a useful book to be able to review from time to time, but as I said, it's kind of annoying to get to since I tend to keep most of my similarly sized books in storage.

I haven't read the eBook on offer in this thread, but I'm familiar with DBT. I just wanted to make sure people understood that DBT was 'real mental health stuff'.

http://www.amazon.co.uk/Training-Treating-Borderline-Personality-Disorder/dp/0898620341/ref=pd_sim_b_2

I did a year of group dbt therapy (also with individual therapist), in the uk, and really we just worked our way through the book above, so have a wee look and see what you think. Best of luck.

The original

There are ones tailored to specific things now, though. That one is BPD-focused. There are ones geared more towards bipolar, anxiety, etc. that might be more appropriate for you.

dbtselfhelp.com has all the materials to look at/use free as well.

I spent a while with the label of Borderline Personality Disorder, and trust me, you don't want that. Here's the story:

I talked to my doctor about taking an antidepressant because I was feeling kind of depressed. I'd had treatment for ADHD in the past, but hadn't taken anything in a few years. He started me on Prozac.

I then got more depressed and began have suicidal thoughts. His answer was to up the dose of Prozac, and then I got more depressed and became actively suicidal. I ended up in a psych hospital for a week where they did nothing other than keep me away from sharp things. (The food was good, though.)

When I got home, I got to see a psychiatrist who diagnosed me with bipolar disorder. And added a med at night so I could sleep, and Neurontin. And upped the Prozac dose. I refer to this time of my life as "when I went nuts."

I began to self harm, and then they labelled me as Borderline Personality Disorder. Suddenly, I was the pariah of every person who saw my chart. People wouldn't make eye contact. They were afraid to make jokes with me. I wasn't a real person anymore.

The only good that came of this was I got to participate in a skills group for Dialectical Behavioral Therapy. It turns out, this helped me with what I now think is a simple case of Rejection Sensitive Dysphoria, (common with ADHD.)

To cut to the chase, I got fed up so I moved to a new town, and managed to get state health insurance. I got off the meds, (and the suicidal ideation and self-harm stopped,) and went back to finish my university degree. I got re-diagnosed with ADHD, and started taking Wellbutrin and Concerta. Didn't go nuts. Well, not completely nuts, anyway. Did finish my degree.

Bottom line is - a diagnosis isn't a magic cure. Listen to yourself. If a treatment isn't working, try something else. DBT is great for a lot of conditions, but don't pursue getting a certain diagnosis, unless you have to to get the treatment you need.

Hang in there. It gets better. And remember, only people who are truly insane don't worry about being insane. They're blissful in their insanity. If you worry about it, then you're not crazy.

If you can't find a DBT skills group to participate in, there's a lot you can actually do on your own: https://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341

I AM NOT A THERAPIST! DO WHAT YOU WANT, AT YOUR OWN RISK!

Feel free to pm me if you want more info.

http://www.amazon.com/gp/product/0898620341?keywords=the%20skills%20training%20manual%20for%20treating&qid=1458305187&ref_=sr_1_1&sr=8-1

BUY THIS BOOK ASAP!

Even if it's a bit expensive, it is worth all the money you spend on it. Order it today and start using it right away. It will change your life radically right from the time you start using it. DBT combined with talk therapy is most effective treatment. Consult a psychiatrist. You may benefit greatly from medication if you are able to use it responsibly.

Woah buddy you have a lot going on! First off, deep breath!!!! You have taken the biggest step - asking for help. If I were you (and I kinda was, at 25 (29 now) I was diagnosed as Bipolar II, Generalized anxiet, and BPD traits), I'd make sure I was seeing that psychologist as much as possible, I'd be looking at seeing a psychiatrist for medication, and on top of all else, looking for a strong DBT program.

I'd also talk to your gf, be fully honest with her. Let her know this is a process and the prognosis is good if you fight (which it seems like you want to) but you need her help and understanding. It may be best to consider taking a break to shield her until you work through some of this treatment - I know that option sounds shitty, but trust me, had I listened to that advice when I was 25, my life would have been drastically different.

If you can't get into a DBT group quickly, pick up a book such as this one - This was the book I used in group. It makes WAY more sense with a group, but reading it yourself may help. The author actually created the DBT model.

More than anything else, remember the single best part of being bipolar: you may be one mood now, but that mood always passes.

You can PM me if you want to chat too. I promise, it can get better.

I would recommend two books, and highly recommend to look for a few more.

This book has changed my life and several friends, all with varying disorders. Saved my best friend from bulimia, helped my husband greatly with BDP, and my brother come out of meth addiction.
Man's Search for Meaning https://www.amazon.com/dp/0807014273/ref=cm_sw_r_cp_api_i_RcS3CbEF3R10K

This is to work through BPD and I know it’ll help you define if that’s what’s going on:
Skills Training Manual for Treating Borderline Personality Disorder https://www.amazon.com/dp/0898620341/ref=cm_sw_r_cp_api_i_pbS3Cb2EDVHH8

You should definitely seek out a therapist. Be empowered to call places locally. It’s so great to figure out what’s going on, especially early.

Oh yes there was, though I received photocopied dittos. http://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341

Here is a good recap of the skills: http://www.dbtselfhelp.com/html/dbt_skills_list.html

I also read the manual that they give to therapists wanting to administer DBT. It helped. Made me see myself through the therapist's eyes.

This is a sample o f a diary card: http://www.dbtselfhelp.com/html/diary_card_1.html

http://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341

I recommend this book highly. Borderlines have to basically relearn how to react to things. We are extremely emotional. Stay strong and remind yourself you are not your illness

If you have a good rapport with your current therapist, maybe she would be open to getting a workbook that the two of you could work through together. I've used this workbook. I haven't used this but that is a reputable publisher (New Harbinger) and looks good.


DBT is a very "manualized" treatment; meaning it's standardized and books and workbooks are used. There is a clear structure and process for DBT. All DBT includes the same basic principles. It's pretty standard stuff for a therapist.

DBT was originally conceived by Marcia Linehan as a group therapy model, but it's been adapted to individual therapy. There are specialized training courses in DBT, but as far as I know, any licensed therapist can use the basics of DBT as long as they've done some reading and understand it. You can read more about it on Dr. Linehan's website.


Even if you're not totally convinced of the BPD diagnosis, the skills in DBT are really excellent for emotion regulation, tolerating distress, and relating better to the other people around you.


I would talk to your current therapist and see what she says. She may be willing to do this with you, but she may not. Ultimately, you'll have to rely on her to be the judge of whether or not she feels comfortable working with DBT with you.

I bought as many books as I could on DBT and ACT not all at once only when I could afford it.

I started by reading http://www.amazon.com/Cognitive-Behavioral-Treatment-Borderline-Personality-Disorder/dp/0898621836/ref=sr_1_2?ie=UTF8&qid=1408057792&sr=8-2&keywords=cognitive+behavioral+therapy+for+bpd

&

http://www.amazon.com/Doing-Dialectical-Behavior-Therapy-Individualized/dp/1462502326/ref=sr_1_sc_1?ie=UTF8&qid=1408057888&sr=8-1-spell&keywords=doing+dialectical+behavioural+therapy

to get a better understanding of BPD and DBT. and right now I am working with these workbooks:

http://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341/ref=sr_1_3?ie=UTF8&qid=1408057792&sr=8-3&keywords=cognitive+behavioral+therapy+for+bpd

and


http://www.amazon.com/Expanded-Dialectical-Behavior-Therapy-Training/dp/1936128128/ref=pd_sim_b_6?ie=UTF8&refRID=1H69WV6FGR18FCSQ5TSQ


and I have just ordered this one.

http://www.amazon.com/Dialectical-Behavior-Therapy-Skills-Workbook/dp/1572245131/ref=sr_1_1?ie=UTF8&qid=1408057792&sr=8-1&keywords=cognitive+behavioral+therapy+for+bpd

the Acceptance and Commitment Therapy book I got is (I have yet to start this one):

http://www.amazon.com/Acceptance-Commitment-Therapy-Second-Practice/dp/1609189620/ref=sr_1_1?s=books&ie=UTF8&qid=1408058093&sr=1-1&keywords=acceptance+and+commitment+therapy


I do what is on the workbooks and I also do further research on the skills online so I can understand it better and see what works and what doesn't for me and I test them out forcing myself to do exposure sessions ( or try to get used to using them in the moment they are needed or helpful) and I write down everything so I don't forget and kind of monitor myself and my progress.