Marsha Linehan, founder of dialectical behavioral therapy (DBT), was speaking today at The NAMI (National Alliance for the Mental Ill) national conference in San Francisco. How did I know this? Sadly it was not because I was there, it was because folks like Carl Dunn Jr. and many others were live tweeting from the event (using the hashtag #NamiCon15). I wish I was there because her talk looked incredibly thought provoking and inspiring.
She set out describe the core problems DBT set out to solve when it was founded. I “tuned in” during the part of the presentation when she discussing the role of the therapist in DBT. She was discussing two “problems” that DBT set out to solve for therapists…
#Linehan : Immediate problem to solve #4: Changing clinical presentation w/ frequent crises a problem for therapist & the therapy #NAMICon15
— Carl Dunn (@CarlDunnJr) July 6, 2015
She went on to describe the stats for how many diagnoses a client can have when presenting with suicidal ideation and how this complicates therapy. This certainly put DBT practice in perspective for me. As a therapist the “alphabet soup” diagnosis can be frustrating. What do I treat, the PTSD, the major depression, etc.? DBT provides a framework to reduce the “the soup” and treat the suicidal person in front of you.
#NAMICon15 "therapy doesn't work with dead people, you have to keep them alive" 😉 Dr. Linehan
— kristamackinnon (@kristamackinno1) July 6, 2015
Then you have an individual with multiple crises presenting to ER’s. As a therapist this whole process can be very disempowering and frustrating. Also this can be scary. I think the worst part is as therapist’s we often blame the clients and use labels like being “a “borderline”, “manipulative”, “behavioral”, and being a “frequent flyer” to the ER. As therapists we need to grasp….
#NAMICon15 Linehan: therapist emotional dysregulation leads to excessive fear and hostility. Gets in the way of successful tx.
— Sally Spencer-Thomas (@sspencerthomas) July 6, 2015
No one wants to talk to Marsha Linehan in the grocery store, for fear others will think they have BPD. #NAMICon15 #shatteringstigma
— Tara Rolstad (@taratalks2much) July 6, 2015
This is something I think we don’t talk enough when about learning to treat individuals with Borderline Personality. Again reflecting on my own use of DBT, it is a fantastic way to reconcile the fact that suicide ideation requires problem solving for the client and is a “problem” to be solved with the therapist.
#NAMICon15 Linehan: suicide is seen as a solution by client (thoughts of escape self reinforcing), suicide seen as problem by therapist
— Sally Spencer-Thomas (@sspencerthomas) July 6, 2015
#NAMICon15 "thinking about suicide actually helps people feel better, but no one talks about that" – Linehan
— kristamackinnon (@kristamackinno1) July 6, 2015
These tweets reminded me of the importance of parallel process of psychotherapy. Therapists need to be mindful of the complexities of treatment. In practicing DBT, we ask clients to be mindful of their thoughts; seems like the founder is asking practitioners to do the same. I think we need to listen to Dr. Linehan..
#Linehan Almost everyone in the suicide field has come around to the team approach. The team is treatment for the therapist. #NAMICon15
— Carl Dunn (@CarlDunnJr) July 6, 2015
Sean 🙂
For the entire “Story” told in tweets check out this Storify by Carl Dunn Jr…
https://storify.com/carldunnjr/marsha-linehan-dbt-suicide-through-failure-namicon
