I'm not understanding DBT therapist

[Always27]

We are pretty new to DBT and had a pretty big blow up with our 14 year old this weekend.  Today was her DBT and when I read the conversations on her phone (which has to be monitored very closely by me), I'm shocked to see some things.  My daughter stating she just wants to be out of here, away from me.  Therapist says I would to. 

Am I missing something?  I feel thrown under the bus because much of what she feeds the DBT therapist is her grossly distorted thinking and lies.

Hoping someone can shed some light on this comraderie.

Thanks!

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[devastatedmom]

Hi Always 27 ... .welcome to the rabbit hole.  I don't know if I am supposed to Reply prior to a moderator welcoming you, but I saw your post and I knew I had to.  I am in the exact same position with a therapist who is treating my DD24.  My first post on here was last month and was about the exact same issue.  I have to say, I am surprised that the therapist would say to your daughter that "she would too" (want to get out), because it is not ethical for a therapist to encourage a patient to blame family or friends - they are supposed to encourage patients to take responsibility for their challenges and issues. 

The problem we have though is that we do not know what is said in a session - it's kind of a he said, she said, and we also don't know what context things are said in when we get small "snippets" of things.  However, that doesn't stop the hurt on our end when we know that comments and judgments have been made about us, especially when we didn't do the things that our child says we did.

My daughter is 24 now and she has been accusing my husband and I (mainly me) of "abusing" her since she was about 14.  It is a hallmark of BPD, and there are many explanations for it, and in truth, it is not your daughter's fault that she does it, it is her faulty brain.  I try to keep that in my mind so that I remember not to take it personally.  I've had 10 years practice though, so it's a bit easier now.  In the beginning my husband and I were furious at the things our daughter said, but now we have developed a "same old, same old" attitude about it.

It is very frustrating when therapists don't see past the lies, but my husband and I have our own psych who we go to occasionally to help us wade through some of this, and she said to me that a therapist has to take the things that a patient says at face value, because they don't know any different.  My concern though is that if the therapist allows the patient to be a victim, they will never learn to take responsibility for their circumstances and that is the situation I feel I am in with my daughter.

Maybe you should try talking to the therapist and making him or her aware that much of what your daughter says is made up.  You are in a somewhat better position than I am because your daughter is still a minor, so they may be receptive to you. (In my case, they just tell me it is none of my business or it is a "conflict of interest" for them to speak to me - even though I don't want to know anything confidential).

Anyway, don't want to make this too long, just wanted you to know that you are not alone, and I hope you are able to find support here.  I have already and it's only been a month.

[livednlearned]

Is the therapist validating the feelings? If so, that would be very standard for DBT.

I would imagine that any T working with DBT patients would understand they are getting a version of the BPD person, because there is a lack of real self -- mostly what we see is the false self via defensive mechanisms like lying, projection, disassociation, etc.

Do you feel comfortable talking to the therapist about your concerns?

[Always27]

 Hi!  Its me again.  Thank you for your comments.  I'm struggling again.  I was told yesterday by the therapist that she's struggling with judgement where I'm concerned and that is causing therapy interfering behavior on her part.  I had texted her with my perspective of why my daughter had had a meltdown.  I did that because there was a rage/meltdown that I did not discuss with her even though I had read my daughter's text to her and knew she was being fed a big line of horse pucky.  It got brought up later and I said I didn't tell her what my truth was because I'm not supposed to be involved in therapy.  She said some things I'll need to know.  Soo, I tell her what I think she is talking about... .a need to know thing... .and I get hit with this.  All I could do was cry and say, I don't know what I'm supposed to be doing! 

I've read texts she send to my daughter when they are communicating that are definitely me being thrown under the bus and that's fine because that happens with BPD all the time, but not from the therapist who is supposed to be making her think dialectically... .

I just don't know what to do.  I'm still emotional about it today.

[livednlearned]

Ouch! That would be so hard, to feel that the goal posts are moving, or the rules of engagement are not clear. Plus, on top of it, we feel so worried about our kids and the anxiety can mushroom and make it so hard to see a way forward.

Have you read the book Buddha and the Borderline? It's a true story about a woman with BPD who did DBT. She had both bad and, finally, a good experience. I wonder if it could help clarify for you whether this DBT therapist is effective?

I know what you mean about second-guessing the T and questioning your own role. We are expected to put a lot of faith and trust in someone who is dealing with the most intimate and private aspects of our lives, except it's being transmitted through kids that cognitively distort and have trouble with reality testing!

One thing I realized. I am not on trial. My story is my own, and there is only me doing the best I can, while recognizing I can always do better (dialectical thinking  )

I ended up discharging my angst into reading what I could about BPD. It's been a few years journey trying to make sense of what, exactly, is happening, and how I can change what I do (only thing I have control over) to prevent things from getting worse.

I once had a conversation with my son's psychiatrist (they do talk therapy in addition to medication), and told him about an episode in my son's toddler years that confirmed for me he was genetically predisposed to suffer extreme abandonment depression. I wanted him to know this for some reason, I guess to say that this perhaps showed up very early and that I did not always handle this skillfully.

The psychiatrist said, "That takes a lot of courage to say, and I know it has to be so painful." For some reason, his recognition of my own feelings hit me like a wave and I was suddenly in tears on the phone, feeling things I was so surprised even existed, they were so buried and hidden.

I'm not sure what I'm trying to say, exactly... .maybe just that we have our own feelings and needs and fears, when it comes down to it. Be sure to take care of yourself in all of this, and get support for how your D's therapy and her work affects you.

 

LnL

[Always27]

Thank you!  That was very helpful.  I'm going to get that book!

[RunningWithScissors]

I know there are bad therapist out there.  And good ones.  And ones who aren't adept at addressing BPD behaviours.  So, I don't know which category this one falls into.

I'm speculating that when the therapist affirmed that she would 'want to leave as well', she was trying to validate the feeling.  I've read most of the books out there on DBT including clinician's manuals and workbooks, and the process of therapy often follows an evolution such as:

1) acknowledgement of the BPD person's feeling (i.e. 'If I were feeling 'X', I would want to do 'Y' too'.
2) step 1 feeling + exploration of how one's emotions are separate from a situation (If someone does 'X', what are some ways you could react?  Can you choose your reaction or how you feel?)
3) Ongoing work to help the BPD person gain mastery over feelings and reactions.

[Gorges]

My daughter would tell me things her therapist said it was definitely NOT HELPFUL and threw me under the bus.  This started when my daughter was 13 and continued till she was 17 and with two different therapist.  I felt that I had to continue to take my daughter to therapy because her behavior was extreme and I thought it would be negligent not to.  It is interesting that the therapists texts because I never knew if my daughter was lying or not about what the therapists said.  I did confront the first therapist and she said that my daughter was lying but did not want to confront my daughter about the lying so I did not know who was telling the truth.   With the second therapist I would email her and my daughter quoting what my daughter said.  My message to my daughter was that it is mean and deceitful to lie about the therapist.  My message to the therapist was that if she really said these things that it undermines the message of holding my daughter accountable.   I was paying and driving my daughter to therapy to get better not to become further entrenched in unhealthy patterns that led to unhealthy relationships.   

I think the fact that the therapist validates the teenager (and I understand that is a big thing to do) can sound to the kid like they are agreeing.  One thing that I have read is "validate the valid not the invalid".  But, I guess the therapist doesn't really know what is invalid.

If you can find a DBT group that might be better because it is more like a class where they learn skills.  The hard part is that they have to want to learn the skills.

I would also recommend that you have face to fact honest conversations with the therapist about the text and the message you feel it is sending your daughter.  I also think that you might want to evaluate if therapy is really helping your daughter and switch if you don't like the therapist or the results. 

I don't envy you as this is a long journey.  I will say that since my last post about 3 weeks ago my daughter is working, living independently and pretty happy and kind to us.  She decided against therapy but comes instead to yoga with me.  We had to set some very firm boundaries with her though and she is over 18.   She wants a relationship with me even though she was telling me about 2 years ago that her therapist was encouraging her to leave home and never speak to me again after she turns 18.    It is very, very difficult to detach when they are under 18 and you are trying to protect them.