Forum Admin

Thank you Guys ~Lindsay

Dialectical Behavior Therapy (DBT) @ Good Therapy.com Dialectical behavior therapy (DBT) is a comprehensive cognitive behavioral treatment. It aims to treat people who see little or no improvement with other therapy models. This treatment focuses on problem solving and acceptance-based strategies. It operates within a framework of dialectical methods. The term dialectical refers to the processes that bring opposite concepts together such as change and acceptance. Certified practitioners of DBT offer acceptance and support to people in therapy. Many of the people they work with have conditions described as "difficult to treat." They work to develop techniques for achieving goals, improving well-being, and effecting lasting positive change. WHAT IS DIALECTICAL BEHAVIOR THERAPY? Currently, DBT is used to treat people with chronic or severe mental health issues. Issues DBT treats include self-harm, eating and food issues, addiction, and posttraumatic stress, as well as borderline personality. DBT was originally designed to treat people who had chronic suicidal thoughts as a symptom of borderline personality. DBT can be used in a variety of mental health settings. It incorporates the following five components: Capability enhancement. DBT provides opportunities for the development of existing skills. In treatment, four basic skill sets are taught. These are emotion regulation, mindfulness, interpersonal effectiveness, and distress tolerance. Generalization. DBT therapists use various techniques to encourage the transfer of learned skills across all settings. People in therapy may learn to apply what they have learned at home, at school, at work, and in the community. For example, a therapist might ask the person in treatment to talk with a partner about a conflict. The person may use emotion regulation skills before and after the discussion. Motivational enhancement. DBT uses individualized behavioral treatment plans to reduce problematic behaviors that might negatively affect quality of life. For example, therapists might use self-monitoring tracking sheets so sessions can be adapted to address the most severe issues first. Capability and motivational enhancement of therapists. Because DBT is often provided to people who experience chronic, severe, and intense mental health issues, therapists receive a great deal of supervision and support to prevent things like vicarious traumatization or burnout. For example, treatment-team meetings are held frequently to give therapists a space to provide and receive support, training, and clinical guidance. Structuring of the environment. A goal of therapy is often to ensure positive, adaptive behaviors are reinforced across all environmental settings. For example, if someone participates in multiple treatment programs within one agency, the therapist might make sure each program was set up to reinforce all the positive skills and behaviors learned. The standard form of DBT consists of individual therapy, skills training group, phone coaching, and a therapist consultation team. Those in standard DBT attend therapy and a skills training group weekly. The groups are designed to help those in treatment develop behavioral skills through group work and homework assignments. These assignments allow people to practice learned skills in day-to-day life. Phone coaching is also an important part of DBT. It helps people in treatment reach out to their therapist for support when a challenging situation comes up between sessions. The issues faced by many who participate in DBT can be complex and severe. Due to this, a consultation team is considered essential for DBT providers. The team is made up of group leaders and individual therapists. It can offer support, motivation, and therapy to the therapists working with difficult issues. DEVELOPMENT AND HISTORY DBT was developed by Marsha Linehan in the 1970s. She developed DBT through her work with two mental health populations: people with chronic thoughts of suicide and people diagnosed with borderline personality disorder. Linehan was intrigued by the building reputation of cognitive behavioral therapy (CBT). She decided to utilize standard CBT in her practice. Linehan and her colleagues experienced difficulties after conducting research relative to the effectiveness of CBT in her chosen population. They discovered three major problems with the application of standard CBT: Participants experienced the change-focused interventions as invalidating. These feelings often resulted in withdrawal from therapy, aggression toward therapists, or a fluctuation of both extremes. Participants and therapists recreated a pattern of reinforcement in which good work was stalled and avoidance and redirection was encouraged. When therapists pushed for change, participants reacted in anger. When therapists allowed a subject change, participants reacted with warmth and positive feedback. This loop seemed to trick both therapist and participant into thinking they were on the right track, when in retrospect, they were not. Due to the intensity of crisis-related situations, therapists spent a good deal of time addressing safety concerns, such as suicidal thoughts or gestures, hostility and threats toward the therapist, or self-injurious behavior. Often, little time was left to teach coping skills or address behavioral functioning. After analyzing these problems, Linehan devised several adaptations to CBT. These directly addressed the needs of the population. Acceptance-based techniques were included to ensure participants felt supported and validated before they were asked to focus on change. In addition, dialectics were incorporated to allow therapists and participants in treatment to focus on the synthesis of polar opposites, such as acceptance and change. This helped them to avoid becoming trapped in patterns of extreme position-taking. These and other adaptations were added to the practice of CBT. In 1993, Linehan published the first official treatment manual, Cognitive Behavioral Treatment of Borderline Personality Disorder. Since then, the practice of DBT has grown in popularity. Over the last several decades, a great deal of research has supported the efficacy of DBT. This form of therapy is now practiced in dozens of countries around the world. It is also listed in SAMHSA's Registry of Evidence-Based Programs and Practices. This page contains at least one affiliate link for the Amazon Services LLC Associates Program, which means GoodTherapy.org receives financial compensation if you make a purchase using an Amazon link. DBT THEORY Three major theoretical frameworks combine to form the basis for DBT. These are a behavioral science biosocial model of the development of chronic mental health issues, the mindfulness practice of Zen Buddhism, and the philosophy of dialectics. The biosocial theory attempts to explain how issues related to borderline personality develop. The theory posits that some people are born with a predisposition toward emotional vulnerability. Environments that lack solid structure and stability can intensify a person's negative emotional responses. They can also influence patterns of interaction that become destructive. These patterns can harm relationships and functioning across all settings. They may often result in suicidal behavior and/or a diagnosis of borderline personality. DBT draws mindfulness techniques from Zen Buddhism to use here-and-now presence of mind. This may help people in therapy objectively and calmly assess situations. Mindfulness training allows people to take stock of their current experience, evaluate the facts, and focus on one thing at a time. Dialectics are used to support both the therapist and person in treatment. They pull from both extremes of an issue. Therapists use dialectics to help people accept the parts of themselves they do not like. They also use dialectics to provide motivation and encouragement to address the change of those parts. Synthesizing polar opposites can reduce tension and help keep therapy moving forward. STAGES AND GOALS IN DBT This form of therapy is designed to systematically and comprehensively treat issues in order of severity. Because DBT was initially intended for people with suicidal tendencies and extreme emotional issues, treatment happens in stages. This ensures all concerns are eventually addressed. DBT involves the following four stages: Findings from multiple studies reflect the efficacy of DBT, especially for the treatment of borderline personality issues, posttraumatic stress, self-harm, and suicidality. Stage 1. The focus of this stage is stabilization. People in therapy may be dealing with things like suicidal thoughts, self-harm, or addiction. They often report feeling like they are at an all-time low point in their lives. Therapy is centered on safety and crisis intervention. The goal of this stage is to help people achieve some control over problematic behaviors. Stage 2. In this stage, behaviors are more stable, but mental health issues may still be present. Emotional pain is typically brought to the surface. Traumatic experiences are safely explored. The goal of this stage is for people in treatment to experience their emotional pain instead of silencing or burying it. Stage 3. This stage focuses on enhancing quality of life through maintenance of progress and reasonable goal-setting. The goal of this stage is to promote happiness and stability. Stage 4. During this stage, therapists support people in advancing their lives to the next level. In therapy, people may improve upon learned skills or work toward spiritual fulfillment. The goal of this stage is to help people achieve and maintain an ongoing capacity for happiness and success. Copyright © 2007 - 2022 GoodTherapy, LLC

NAMI is working to reimagine the way mental health crises are handled in the United States. Learn about 988, the nationwide 3-digit number for mental health & suicide crises, and what services need to be available in every community to help anyone in crisis and reduce law enforcement involvement. Visit nami.org/988 to learn more and get involved. If you or a loved one is seeking mental health treatment or additional information on mental health, visit our website at NAMI.org. Call our HelpLine at 1-800-950-NAMI (6264) - open Mon-Fri from 10 a.m. to 10 p.m. ET Text “NAMI” to 741-741 - Available 24/7 Visit us online at nami.org. Find your local NAMI at nami.org/findsupport NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

Welcome, Ms. Dryemptywell to our Depressionforums family😍 We are here for you, albeit you must be a tad more in talking about what is troubling you in different forums? We have many to forums choose from and I am certain that you have many questions which our members are very happy to answer for you🥰 You do not have to be so specific in describing your problems, but members need to know what your problems are like in order to help. We want to help in your road to recovery aid and make you feel more comfortable talking to people. Please do not hesitate to get back to us with questions Hugs, Lindsay, Forum Administrator

No pictures in topics or posts that is why we have gallery for members or Blogs to share your pictures ❣️ then you can put a link to your blog or your gallery❗️ Best, Forum Admin

Hello John, What a great post! I do hope many of our members read your story. Please talk about it more. I am in total agreement with you. It does work. Going on a keto diet does work. A Low Carbohydrate diet for life works on DEPRESSION as well as weight loss. It is a well known fact. I thank you for posting about how excess carbs can really destroy a personality and a body. Take care and keep up your low carb journey! 🤩 -Lindsay

If you feel lost or have suicidal Ideation and cannot find a Forum to talk to your peers: Find Your Local NAMI https://www.nami.org/findsupport There are more than 600 NAMI State Organizations and Affiliates across the country. Many NAMI affiliates offer an array of free support and education programs. Contact your NAMI Affiliate to find out what types of programs and supports they offer. To find the NAMI closest to you click on a state on the map or enter your ZIP code below. We care and we are here for you to help you find your way ~Lindsay, Administrator

Welcome Luciano❣️ There are so many forums that you can post to and share your experiences about depression and how you came about overcoming! Please no links! Read our terms of service (TOS) as you may find a plethora of mental health issues you might not have not known about yourself❗️ take very good care of you🙏 -Lindsay, forums administrator, owner

Happy Birthday cherryapplez2020🥰 ~Lindsay, Forum Admin

Welcome to our new Members!😍 As I posted in this Forum back in 2009 and beyond, I will repeat, please read and make the best of these forums as there are so many. Post your feelings and post to our "seasoned" members who will also give you some sage advice. We also have BLOGS for you to start your own after 5 posts that you can make❣️ Depression Forums is a wonderful place to start to open up and relieve yourself of all the pressure you have stored up. I have also described it as somewhat of a stepping stone to move on with your life. Take your time and look around. If you need anything click on our staff (pinned above) and PM them. Hugs and best wishes & #StaySafe You may hng out all you want and you will learn quite a bit. Also, do not mind "the Dust" as we are redoing a lot since we have been here since 2004! Glad that you found us! With all my best wishes to you, ~Lindsay, Forum Administrator, Owner

Taking a look at a contentious topic loaded with societal shame by Peg Streep Tech Support Source: Photograph by Jody Hong Films. Copyright free. Unsplash Recently, I reposted an article I'd written about estrangement—or “No Contact” as it’s informally called on Facebook—and got pushback from mothers who were estranged from their adult children and who did not initiate the cut-off. What they had to say was achingly familiar—it’s what I and other daughters who’ve made this painful but sometimes necessary decision have heard from our mothers, family members, people we know, and strangers alike. It was a consistent narrative composed of declared innocence (“I was a good mother"; “She was loved and cared for”), defensiveness and rationalization (“She didn’t like being held as a baby”; “She resisted any effort to discipline her”; “Everyone agreed she was a problem”), and downright blaming (“She has always been difficult”; “She is extremely abusive and everyone sees it”; “Abusive, ungrateful, and a bad person”). This isn’t to say that a daughter or son cannot be abusive, especially if there is an undiagnosed mental illness or addiction involved. But I have a horse in this race and I know for sure that most adult children don’t self-orphan—and, yes, most of the time the loss is never just the mother—because it’s a spur-of-the-moment angry or thoughtless decision. As I have written before, most daughters mull the decision over for years, if not decades. And, if they go no contact, they are prone to reverse themselves once or twice, because their need for connection and maternal love has not abated, despite their recognition that they probably won’t get either from the mother they have. Research confirms that estrangement can go through a predictable cycle—of going no contact and then reinstating connection— so it’s not just my experience or those reported by women I’ve interviewed. The reality is that these mothers—who claim to be abandoned by ungrateful, impetuous, and difficult adult children, who never informed them of either their complaints or their plans—are more likely to get a fair hearing by our culture, to get sympathy and support when they wage war against the so-called ungrateful adult child, and to be embraced by their communities for their actions. That’s precisely what a study by Christine Rittenour, Stephen Kromka, and others found when they looked at stereotypes and attitudes toward adult child-parent estrangement. The Cultural Onus of the Adult Child’s Estrangement It has the weight of a stone tablet—yes, a Commandment—and it’s “Honor Thy Mother and Father.” I have had a number of different pastors explain the injunction in context and they all agree it does not include accepting being emotionally abused, marginalized, or ignored. But, in the court of public opinion, the Commandment is hard to beat. The mythology of motherhood, I think, has just as much clout and maybe more for the culture. Despite the science that makes it clear that motherhood in the human species is learned behavior, the culture is content to pretend that we are more like elephants for whom mothering is pure instinct. As a group, we cling to the myths that all women are maternal and nurturing, that mothering is instinctual, and that maternal love is always unconditional; not one of those three statements is true. But that doesn’t explain why the adult child-parental estrangement is the elephant in our cultural living room. Mind you, when the parent initiates estrangement—ridding the family of the bad seed, the intransigent one, the odd-one-out—the culture clucks with sympathy because everyone knows that parenting is hard. The mother myths carry weight here, too, testifying to the myth that no one divorces a child without compelling reasons every sane person would agree with. But are we getting the whole picture on why we’re so quick to judge the adult child? Why do we, as the study by Ritenour and others found, revert to stereotypes calling the adult child “childish, immature, and ungrateful” for initiating estrangement? Looking at the Big Picture Here are some pieces of the puzzle revealed by research that are worth considering when we talk about familial estrangement. 1. There may be an evolutionary reason for the taboo. That’s exactly what psychologist Glenn Geher (a blogger on this site) and his colleagues suggested when they examined the evolutionary psychology of social estrangements. Remember that humans began as tribal folk—try surviving as a hunter or gatherer on your own—and social bonds were primary. Thus, estrangement was not exactly a strategy for survival. Seen through this lens—that of evolution—forgiveness is a step forward while saying that someone is “dead” to you is a step back. The research team wanted to test whether the number of estrangements in a person’s life would be predictive of adverse psychological outcomes and whether there were psychological factors that could predict estrangement over the more conciliatory act of forgiveness. (In case you’re interested, the more estrangements a person had in life, the more likely they were to exhibit narcissism and other not-so-wonderful traits. That’s not surprising—but here, we’re looking at a specific kind of estrangement that tends not to be part of a larger pattern). So, perhaps, the problem we have with estrangements, especially of close others, may have to do with our human history. 2. It’s not really rare (and, no, blood isn't always thicker than water). There isn’t a reliable number on how common estrangement is but it’s clear that it’s neither as rare nor as unexpected as cultural taboos and mythologies would have us believe. One 2015 study by Richard Conti which was conducted with a sample of college and graduate students found that 43.5 percent had been estranged at some point and that 26.6 percent reported extended estrangement. His study also confirmed that anecdotal evidence makes clear: that estrangement from a parent always involves estrangement from other family members. He concluded that estrangement “is perhaps as common as divorce in certain segments of society.” That sounds pretty dire—but another study, this one conducted by Lucy Blake in Great Britain, found even higher percentages; out of the 807 people interviewed, 455 were estranged from their mothers. As someone who was estranged from her one surviving parent on and off and then finally, I can tell you from experience that given the cultural onus, few people come forth and speak out. So, the truth is that for every incident of adult child estrangement you hear about, there’s probably one or two that is kept under wraps. That’s not a scientific statement but an educated guess, which happens to be bolstered by the following research study. 3. Estrangement isn’t the only way adult-child relationships destruct. In an effort to clarify the various ways in which communication within families is disrupted, Katrina M. Scharp and Elizabeth Dorrance Hall posited that there were indeed three separate processes at work: Family-member marginalization, Parent-child alienation, and Parent-child estrangement. They define family member marginalization as signifying one person as the outsider or black sheep. Being the black sheep can be a function of being or looking different, having different interests or a different point of view, not conforming, or simply telling truths about the family the group prefers not to hear. According to the authors, even though they are marginalized, most so-called black sheep don’t tend to break ties with the family entirely. Parent-child alienation is their second category, which mostly occurs in the context of divorce and, according to the studies they cite, affects about 13.4 percent of parents. It seems to me that while part of the landscape, parent-child alienation is different in kind because 1) it is the result of active efforts by one parent to create a rift between the child and the other parent and 2) the child is still in a position of dependency, forced to be loyal to one side at the cost of the other. Adult child-parent estrangement is the third process; they note that research indicates that estrangement instigated by a parent is conservatively estimated at 12 percent. They note that all the research underscores that estrangement is highly stigmatized and writes, “Indeed, adult children go to great lengths to keep their estrangement experiences private or even secret.” That is a statement every daughter or son who has gone no contact can corroborate. A personal opinion: While it’s useful to see these different distancing processes, it seems as though parent-child alienation is the odd man out, even though it might ultimately be the basis for a continued adult child-parent estrangement later, since it is a function of an adult’s deliberate and tactical effort to disrupt the other parent’s connection to the child. 4. While estrangement may be cyclical, reconciliation is usually elusive. Both research and the interviews I’ve conducted with women for my books, Daughter Detox: Recovering from an Unloving Mother and Mean Mothers confirm that estrangement is usually not a single or decisive action. Daughters usually attempt to manage the relationship to their mothers or fathers first, either by attempting to set boundaries, limiting communication, or simply having fewer interactions; what’s informally called “low contact” works in some cases, especially when there’s geographic distance between the adult child and her family of origin, but not always. Sometimes, the failure of low contact simply yields to a decision to move into a full-blown estrangement. Other times, a daughter will reinstitute contact either because of hopefulness that things can change or some other reason. But, as a study by Kristen Carr, Amanda Holman, and others showed, the difference between the parent’s perspective and that of the adult child is usually enormous. In a study of 898 of unmatched parents and adult children, the researchers found that there was absolutely no agreement at all about what had caused the estrangement. While parents tended to focus on their children’s objectionable relationships or sense of entitlement, adult children honed in on toxic treatment or feeling unloved and unaccepted. Interestingly, while the adult children were able to be explicit about why they felt unloved or unsupported and connected those feelings to their parents’ behaviors, the parents showed very little self-reflection. It’s worth saying that this research supports every story I have heard from adult children over the years. Old ideas die hard, and new research on family estrangement offers a new opportunity for all of us to discuss and learn. Copyright © 2019 Peg Streep Facebook image: Thanakorn Stocker/Shutterstock References Rittenour, Christine, Stephen Kromka, Sara Pitts, Margaret Thorwart, Janelle Vickers, and Kaitlyn Whyte, “Communication Surrounding Estrangement: Stereotypes, Attitudes, and (Non) Accommodation Strategies, “Behavioral Sciences (2018), vol.8 (10), 96-112. Geher, Glenn, Vania Rolon, Richard Holler, Amanda Baroni, et, al. : You’re dead to me! The evolutionary psychology of social estrangements and social transgressions.” Current Psychology (2019). 10.1007/s12144-019-00381-z. Conti, Richard P. “Family Estrangements: Establishing a Prevalence Rate,” Journal of Psychology and Behavioral Science (2015), vol.3(2), 28-35. Blake, Lucy. Hidden Voices: Family Estrangement in Adulthood. University of Cambridge Centre for Family Research/Stand Alone. http://standalone.org.uk/wp-content/uploads/2015/12/HiddenVoices.FinalR… Scharp, Kristina M. and Elizabeth Dorrance Hall, “Family Marginalization, alienation, and estrangement: questioning the nonvoluntary status of family relationships,” Annals of the International Communications Association (2017), vol.41 (1), 28-45. Scharp, Kristina M. “You’re Not Welcome Here: A Grounded Theory of Family Distancing,” Communication Research (2017), 1-29. Agilias, Kylie. “Disconnection and Decision-making: Adult Children Explain Their Reasons for Estranging from Parents, Australian Social Work (2015) 69:1, 92-104. JAgllias, Kylie. “Missing Family: The Adult Child’s Experience of Parental Estrangement,” Journal of Social Work Practice (2018) vol. 31(1), 59-72. Carr, Kristen, Amanda Holman, Jenna Abetz, Jody Koenig Kellas, and Elizabeth Vagnoni, "Giving Voice to the Silence of Family Estrangement: Reasons of Estranged Parents and Adult Children in a Non-matched Sample, Journal of Family Communication (2015), vol. 15, issue 2, 130-140. https://www.psychologytoday.com

Even I am hurting at times, but I am not giving up on myself, Depression Forums, or it's Members!!!! No one should be left behind! DF cares about YOU, it's members. Tell us what you want to see more of!