I had a fairly good day at work today.I lead a group and there were some great insights that unfolded in the group. I love that. That is my pat on the back.
There are many different modalities (art forms) of therapy that I use, but there is one that dominates my style. I do a particular kind of therapy called Dialectical Behavior Therapy aka DBT. Now, DBT was created by to treat a specific mental illness, Borderline Personality Disorder aka BPD. Hang in there. It will get good. According to the DSM (bible of mental health), characteristics of BPD include, “frantic efforts to avoid real or imagined abandonment, chronic emptiness, a pattern of unstable relationships, impulsivity, recurrent suicidal attempts, inappropriate anger…” and on. If you google BPD, you may find negative descriptors, such as master manipulators, dramatic, “I hate you-don’t leave me” behavior, suicidal and self-mutilating, and on. Still with me? So why, would I choose to do DBT and to work with BPD? Because DBT has given me a remarkable skill set that has helped me become a better person, a better therapist, and enormous gratitude for being able to help people that were once considered untreatable.
We have certain assumptions as a DBT therapist. 1) We assume all clients are doing their best. I mean aren’t we all doing our best almost always. Even if it’s less than our very best, it’s the best we can do in that moment. 2) We assume all clients want to get better. Seems pretty straight forward. You’re taking time out of your day and dollars out of your pocket. It only makes sense that it is to get better. 3) We assume clients can’t fail. Hmmm… but we are human. We always fail, right? Wrong.
Now let’s take this premise and attempt to apply it in our life. I am sure we can all think of someone that pushes our buttons, behaves in ways that we don’t understand, and doesn’t jive us. Now assume that they are doing their best, they want to perform well, and they are not failing. Why is this so impossible? Why is it hard to assume the best in people, rather than the worst? How do we know that the better case scenario is less true?
We did an exercise in group today known as the Half-Smile. Try it. I’ll guide you through. Sit in a comfortable seated position with your eyes closed. Take a breath or two to help center you. Go ahead. I’ll wait. Now, imagine that you have two strings at each corner of the mouth and there is a slight tug, upwards. No inauthentic cheeses here. Just the motor skills of moving the corners of your mouth upward in a sort of Half Smile. Maybe a Mona Lisa Smile if you will. Try this for about two minutes and observe how you are feeling. Most people will notice a slight shift in their emotion. It may become lighter or softer. The physiological movement of a slight smile sends a message to your brain that you are happy. Neat, huh? But, if you didn’t get that, no worries.
Ok, so we are talking about this half smile in group and are generating ideas of various places to try this. Then the kicker comes. Try a half smile while thinking about someone you despise. The idea is to think about where they are coming from, the thoughts and behaviors that have led them to who they are, the messages that they have received in their life to act accordingly, etc. EEEEEK! OK maybe try it first on someone that just sort of bugs ya.
It would be pretty impossible for me to lead this style of group without learning something or applying the concepts to my own life. It would be like going to a hair stylist with bad hair. DBT has given me a therapeutic framework for how to live my life. So while it works great with BPD, I truly think we all need a little DBT. It was what was missing from our 10th grade curriculum. I think we would be much better off if we learned how to smile off our enemies rather than geometry. And who wouldn’t want a therapist that thinks that you are doing your best and you want to get better? Umm, no brainer. Hence, why DBT has demonstrated effectiveness for far more than BPD.
At the end of the group, everyone shared stories of how smiling while thinking of someone they despise was a bit out of their reach, but they were willing to go the distance. I definitely do not call that failure.