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Re: What does DIALECTIC mean? » Janelle

Posted by helenbpd on March 16, 2002, at 1:54:39

In reply to What does DIALECTIC mean? (nm) » LiLi80, posted by Janelle on March 15, 2002, at 15:20:53

It's "dialectical", meaning back & forth, each participant responds and builds on the next. (Dialectics=school of philosphy founded by Hegel ... thesis--antithesis--synthesis and all that ;) ) Its basic premise is that no one perspective is prioritized, which was always a deterrance to a healthy therapeutic atmosphere for folks with BPD.

For LiLi, here's a cite from a write-up by the Behavioral Technology Transfer Group, the Linehan group in Seattle that does most of the DBT training for the USA (and world, actually).
The last bit of this quote should be helpful in addressing your concerns re. practice of the new therapist you're considering. I've known a number of folks who've done DBT, and it usually involved both group and individual sessions (and the individual sessions weren't always with a DBT-trained therapist, just someone who knew Cognitive Behavioral Therapy, which is pretty standard). Have you asked her point-blank where/how she was trained in DBT?

Here ya go:
"DBT grew out of a series of failed attempts to apply the standard cognitive and behavior therapy protocols of the late 1970ís to chronically suicidal patients. These difficulties included:

1. focusing on change procedures was frequently experienced as invalidating by the client and often precipitated withdrawal from therapy, attacks on the therapist, or vacillations between these two poles;
2. teaching and strengthening new skills was extraordinarily difficult to do within the context of an individual therapy session while concurrently targeting and treating the clientís motivation to die and suicidal behaviors that had occurred during the previous week;
3. individuals with BPD often unwittingly reinforced the therapist for iatrogenic treatment (e.g., a client stops attacking the therapist when the therapist changes the topic from one the client is afraid to discuss to a pleasant or neutral topic) and punished them for effective treatment strategies (e.g., a client attempts suicide when the therapist refuses to recommend hospitalization stays that reinforce suicide threats).

To overcome these difficulties, several modifications were made that formed the basis of DBT. First, strategies that reflect radical acceptance and validation of clientsí current capabilities and behavioral functioning were added to the treatment. The synthesis of acceptance and change within the treatment as a whole and within each treatment interaction led to adding the term ìdialecticalî to the name of the treatment. This dialectical emphasis brings together in DBT the ìtechnologies of changeî based on both principles of learning and crises theory and the ìtechnologies of acceptanceî (so to speak) drawn from principles of eastern Zen and western contemplative practices. Second, the therapy as a whole was split into several different components, each focusing on a specific aspect of treatment. The components in standard outpatient DBT are highly structured individual or group skills training (to enhance capability), individual psychotherapy (addressing motivation and skills strengthening), and telephone contact with the individual therapist (addressing application of coping skills). Third, a consultation/team meeting focused specifically on keeping therapists motivated and providing effective treatment was also added."
in: "DBT in a Nutshell" http://www.behavioraltech.com/basics.html

Here are more good links to DBT info:

This is an excellent description of the theory, by a woman with BPD who did DBT:
http://www.phoenixinflight.homestead.com/Linehan.html

A less intimidating description:
http://www.writtenbyme.com/content/48021

Marsha Linehan's home page:
http://faculty.washington.edu/linehan/

BTTG home page:
http://www.behavioraltech.com/index.cfm

Related:
Westermeyer's very nice 'Cognitive Therapy Pages'
http://www.habitsmart.com/cogtitle.html

hang in, hope you can resolve this without much more dithering around on the part of your "caregivers" (snort) :)

Helen
http://home.hvc.rr.com/helenbpd


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