Tags

, , , , ,

1513724713325-644868949

Act Opposite is a DBT skill.  Dialectical Behaviour Therapy (DBT) was invented by Marsha Linehan, a US therapist, primarily to treat a particular client group for whom regular Cognitive Analytic Therapy (CBT) appeared ineffective.  Her clients were mainly women diagnosed with borderline personality disorder (BPD) who frequently self harmed, often severely, made multiple suicide attempts, whose lives were chaotic and whose therapists were frequently burned out.

These were women who had grown up in invalidating environments.  Just being told they needed to change was often experienced as further invalidation.  Enter the paradox:  DBT says, yes, the current situation is untenable and you do need to make changes, but given your circumstances it is completely understandable that you feel and behave this way.  I am going to support you in making the changes you need to make but I am also going to accept you just as you are.  And however difficult I may sometimes find this to do, I am going to hold fast to the belief that you are doing your very best.

That’s quite a long explanation;  when I am in a hurry I just say DBT is like CBT with Buddhism.

There is also a very tight framework which supports the therapists in delivering high quality consistent therapy, this is important as many therapists working with this client group can’t cope and end up abandoning their clients, who have often already been abandoned by previous therapists, friends, etc.

In DBT, the client has an individual therapist who helps the client to talk through their week, focussing on the most dangerous incidents first, in a strict hierarchy, using chain analysis to see what triggered the event and where the client could have employed alternative skills and strategies.  Separately the client attends a skills training group, where they learn the skills of interpersonal effectiveness, emotion regulation and coping in crisis.  That way, even if individual sessions are dominated by chaining suicide attempts and self harm, the client is still getting protected time to learn the skills that will help them in the long term.  Oh and there’s lots of mindfulness.

I trained in DBT and learned all the skills myself.  So when on Sunday I found myself in a slump, groggy, no energy, slightly depressed, feeling kind of incapable, I knew what to do:  Act Opposite.

I wrapped the Christmas presents and actually didn’t hate it.   They look very pretty all together on a shelf in the dining room, surrounded by fairy lights, wrapped in brown paper and bright pink metallic ribbon.  I cleaned the bathroom, all of it, including the black and white lino floor.  (A word of advice, you might think a black and white checked floor will look nice, but it shows every mark, every piece of fluff, every strand of hair…)  I vacuumed everywhere.  All three of these tasks I dislike intensely, but I did them- with sensible breaks for food and smoothies and cat cuddling- and afterwards, my slump was over.  By the time evening came and I put my feet up on the sofa to read and write, I felt much, much better.

So what caused the slump?  Well, it was the weekend and at the moment that means sex:  Saturday night, early dinner, a roaring fire, the floor of the sitting room covered with rugs, blankets and cushions…

It was so good that the next morning we were hungover even though we’d only drunk tea!  In bed in the morning, we weren’t going to come, but then we did.  Afterwards we dragged ourselves out of bed and went for a hazardous walk in the ice, and about halfway back we both just felt the energy drain out of us.   Yes, it really is a thing, orgasms drain your energy.  Plus, we’ve both been slightly ill with colds.  Then at bedtime I realised my period had arrived.  I don’t follow a lot or read a lot, I manage my media and sensory input, and I don’t like much stuff.  But what I like, I really like, and I remember.  I remember this tweet from when I was on twitter about eight years ago:  ‘Do you ever get your period and think, wow, that explains a lot…’