validation from therapist in DBT

[Winniethepoo]

Hi,

I am not understanding the way I am to respond to comments my daughter makes after she has been seen by her DBT therapist.  My daughter will tell her therapist about some " incident" that happens and in with her distorted thinking, always spins the situation to make sure she is "right" and we, her parents, are "wrong". She will go on to say, or scream.. " even my therapist agrees you're wrong and f..ed up". Of course, the therapist is only hearing one side of the story and is validating her emotions but at what cost to our family dynamic???? How does this help our relationship if my daughter can continue to think that her way of responding is appropriate and we are always in the wrong. I feel like it doesn't help my daughter understand the opposite opinion if all they do in sessions is validate emotions which can be toxic. This is a common theme in our fights and I'm wondering if the therapist understands the distortion. Why do I feel like I always need to defend myself? Or be the cause of her disorder?

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

[kells76]

Hi Winniethepoo  

Oof, that must be beyond frustrating to hear what someone else's therapist "said" about you... especially when it's not like you're hearing it balanced with "my therapist thinks you're amazing!"

Two things I'd keep in mind when I hear something like that.

One is that you're not hearing from the therapist directly, you're hearing your D's recounting. If your D is in DBT, then the therapist will absolutely know about BPD dynamics. I strongly doubt that the therapist is saying "oh yes, nothing is your fault, and your parents are horrible people who wrecked your life -- you're correct".

The therapist is likely building buy-in from your daughter. If your D doesn't commit to the process, she won't stick around to get help. Therapists routinely establish buy-in with clients, and it may take longer with pwBPD. The T may be focusing on how your D feels, yes, and may be doing some skilled validation: "Wow, that would be so shocking if a parent did XYZ" (not agreeing that it did or didn't happen, just focusing on the feeling). Your D may have an emotional reason that she converts that into "even my therapist was shocked that you did XYZ" when that isn't what the T was saying.

So, I'd take anything your D says "my therapist told me about you" with a big grain of salt. Understand that you're not there, the T is likely skilled if it's DBT, and your D is expressing these things to meet an emotional need.

The other thing I'm thinking is that you get to decide how long you'll participate in listening to your D's statements. You might choose to engage skillfully with them for a bit, and then, when you feel like you don't have more tools in the toolbelt, you're allowed to take a break. Y

pwBPD are very impaired when it comes to accurate emotional expression. For example, a pwBPD might feel happy that she feels like her therapist understands her. A non-impaired person with skills might say "I really appreciate my therapist, I feel like she 'gets me' and understands why I feel the intense ways I feel". However, a pwBPD, even when expressing something positive/joyful, may still be impaired in accurate expression, and the feelings of joy or relief might come out as: "my therapist is sooooo much better than you, she totally gets me, and you never do". It sounds like blame and negativity when in fact the pwBPD is struggling with accurate expression (this does get worked on in DBT from what I've heard).

All that to say --

I wonder what real feeling is behind your D saying these things?

What I'm getting at is -- if you set aside the words for a minute, she's trying to engage with you about what's going on in her life (though she's very unskillful about it, and it comes across as blame).

If you had a therapist, and you were sharing your feelings about your family with your therapist, and your T responded in a really supportive way, how would you feel? Would you feel: relieved, understood, good, great, relaxed...?

What do you think would happen if, the next time your D said "My T said I'm right and you're wrong", you were able to say "that must feel really good, to have someone in your life who understands you" and left it at that (without trying to correct her thinking -- which only she can do with her T)?

...

We all feel that need to defend ourselves against the distorted pictures of us that the pwBPD in our lives seem to create  

What if we practiced letting go of that need, by working on our own sense of ourselves? Maybe we are OK enough, and the funhouse-mirror lenses that others see us through, don't define us.

Like DBT says -- we are always doing the best we can, and we can work to do better next time.

Doesn't make the distortions easy to hear... it's hard stuff.

[Winniethepoo]

kells 76,

All I can say is thank you for that response. It is a fun house mirror and you are right, I do not need to beat myself up for some perceived reaction from a therapist. I know that professional healthcare workers do search for a buy in and that comment helps me to think of it a different way. I think I'm just tired today and just sick of always putting my emotions on hold or in check and validating, validating validating... I haven't lived a normal life for years and some days just feel like my life has been hijacked and I'm in a bad movie. I know everyone on these boards will say we are good parents and have tried our best but do you realize how rare it is to hear those comments from a therapist? Maybe, just maybe, therapists can remind their patients that they have people/family who care and who would do anything in their power to try to help.

[kells76]

I do not need to beat myself up for some perceived reaction from a therapist. 

   

I think I'm just tired today and just sick of always putting my emotions on hold or in check and validating, validating validating...

I wonder if it would help to remember that just like not every tool in the toolbox is for every job (we don't saw wood with a hammer), not every BPD tool is for every moment?

Validation has its time and place -- and it is not for every single situation ever. If you find yourself unable to genuinely validate, then it's probably not a moment for validation.

If you check in with yourself and find yourself exhausted, with low energy, near the end of your rope, ready to snap, or without bandwidth... that might be a sign to do self care first, or to use what the Family Connections class terms the "STOP skill", where you literally stop, allow yourself not to say anything, pause, take a moment, and ponder the most skillful way to continue.

Sometimes not doing anything is still a skill 

I haven't lived a normal life for years and some days just feel like my life has been hijacked and I'm in a bad movie. I know everyone on these boards will say we are good parents and have tried our best but do you realize how rare it is to hear those comments from a therapist? Maybe, just maybe, therapists can remind their patients that they have people/family who care and who would do anything in their power to try to help.

Repairing broken family bonds would be a true gift to the world, and I share your hope 

[BPDstinks]

i do not know enough about DBT therapy, however, I will say, RIGHT after my pwBPD began seeing hers, is when the disturbing comments started, i.e. "she needs to remove herself from stressful situations (she quit her job & is working at a daycare (STRESS!!!) (I do not see what world one lives in to have ZERO stress) and said she cannot come to our "family" home (she has an apartment) because she remembers her childhood trauma (on my life, I cannot recall any trauma (ANY) (was there regular family living (disagreements, etc,?) yes, however, nothing I would think of as traumatic (my other daughter agrees, no trauma) and, finally, she needed "space to figure things out, because I enable her (I probably DID, because she gave me very specific instructions to "help" her (I, too, would like to call her out on things, however, am petrified I will be the cause of a "spiral"

[CC43]

Hi Winnie,

First off, I'm glad your daughter is getting DBT therapy.  That's the recommended treatment for BPD, and it has a track record of working, as long as the patient is committed to the process.  So my reflection is that when your daughter talks about her therapy session, you might congratulate yourself for supporting her in getting therapy!  You can take it as good news, not only that she didn't skip the session, but that she's talking about it with YOU.  That she is even talking with you is a very good sign, because the mother-daughter relationship is probably the most important relationship she will ever have.  Secondly, in a way, she might be reinforcing some of the lessons the therapist has been talking about, by re-living the session with you.  You might say, "I'm so glad that you've committed to therapy.  It's great that you found a therapist who you trust and seems to understand you really well."  That would be validating, wouldn't it?

Now one thing I've learned about BPD is that a victim mentality is prevalent.  Rather than take responsibility for poor choices or bad behavior, which is too painful for her to bear, the tendency is to blame others, especially parents.  Does that narrative sound familiar?  The victim attitude can be so prevalent that it becomes a core part of their "identity."  Shedding that identity could seem traumatic, because if they aren't a victim, who are they, and how will they relate to the family and friends?  I think identity is extremely fragile for pwBPD.  So I bet that blaming you is likely to continue for a long time.  However, I think it is possible for her to get a better handle on managing negative emotions--by learning better emotional control, distress tolerance, reducing impulsivity, etc., which doesn't require shedding the victim mentality as a prerequisite.  I think she probably needs to progress in baby steps first, before she starts to formulate a new, healthier identity.

Similarly, people with BPD are very "sensitive," "primed" or "triggered" to feel insulted or disrespected very easily, even if insults and disrespect weren't ever intended.  Thus I think it's normal to for her to accuse you of all sorts of transgressions, as you are the most important person in her life.  I bet she resents you for feeling so dependent on you.  Does that ring true?  When she's triggered, her brain is all emotion, and her logical thinking goes by the wayside.  She's just wired to see negativity where you or I wouldn't detect any negativity.  Furthermore, her emotions are super-sized, making everything disproportionate, and her reactions over-the-top.  This is something she can work on in therapy.  But for now, she probably still feels the full force of these negative feelings.  She hasn't yet learned how to fact check (Am I just hungry or tired?  Was Mom just hungry or tired?  Surely she doesn't think I'm a loser/ungrateful/a slob all the time?  Surely she loves me, she's just trying to help, and she has high expectations for me because she believes in me?  I was a little obnoxious, but I'm not that way all the time, and she could cut me a little slack.  She doesn't know what I'm dealing with, but how could she, because I didn't tell her?  Anyway, this incident isn't the end of the world, it will be quickly forgotten, I shouldn't get so upset about it).  Maybe she hasn't learned to have more compassionate self-talk yet (my life isn't all that horrible, I had a bad day, but tomorrow will be better.  Just because I didn't get what I wanted, it doesn't mean I'm a loser and hopeless and that nothing will go my way ever again).

It's very possible that the therapist is asking your daughter to describe situations where she felt wronged, so that she can learn to cope better.  Rather than denying the feelings or disputing the facts, the current focus might be on learning to sit with the negative feelings, process them and ultimately handle them.  Maybe part of "processing" the feelings could be writing them down or even talking about them.  In my opinion, if your daughter were able to handle FEELING being disrespected/disappointed/infantilized/wronged by you, but avoid a total melt-down and come back to baseline quicker, that could be a major advancement.  Maybe you focus on that, rather than JADE (Justify, Argue, Defend or Explain) your position.  Even if she's completely wrong about the fact patterns, learning to sit with the feelings, which are real and super-sized to her, could be an important milestone for your daughter.  Maybe you say something like, "It sounds like therapy is helping you handle tough situations" or "It sounds like your therapist is really helping you get a handle on your feelings."  Either way, it sounds like she's making some progress.  Building resilience and getting back to the emotional baseline are fundamental skills for your daughter to learn.  It might take some time, but it sounds to me like she's moving in the right direction, which is the way to be going.  And DBT has been shown to work in lessening BPD symptoms.

Look, my stepdaughter was diagnosed with BPD, and she did all sorts of therapies, including DBT.  Thankfully, her moodiness has lessened.  She still has some inappropriate outbursts, but the frequency, intensity and duration have diminished.  Her daily functioning is much improved, and she's finally on track to complete college and work some.  She's sharing an apartment with roommates and hasn't had any blow-ups/evictions/roommate crises for a year.  She's developed a new friend group.  She can now stop by our house and join us for dinner, and engage in a "normal," two-way conversation, something that would have seemed impossible around 18 months ago.  Nevertheless, she still retains much of the victim mentality, which seems based on self-fabricated traumas whose fact patterns are highly distorted, if not completely false.  As I mentioned, she still clings to the victim mentality.  But I suspect that, as she graduates and gets a real job, she might be ready to shed this identity for a new one--a working college graduate.  There were some attempts at shedding the identity in the past, but they failed.  For example, she recently failed at reconciling with her sister, because her sister didn't want to admit to the purported past "abuses" she was accused of.  But the family accepted that it was OK for the sisters to remain estranged.  The sisters just "weren't ready" to reconcile.  I'm not sure when this day will come, but I suspect it won't come until the sister with BPD has adopted her new "identity" of a successful, independent adult.  Only then will she be on "equal footing" and might be able to let go of the victim narrative.  I know I'm doing a lot of mind reading here, but by the same token, I've seen a lot transpire over the last decade, and I feel like I have a decent sense of what is going on.  I hope this story might give you some insights and hope.

All my best to you.