I’m Withdrawing From DBT and This Problematic Language Is Why

Dear Dialectical Behavior Therapist,

I’m not sure how to respond to your request for me to be more open-minded. I think I’ve voiced my concerns respectfully and  while I don’t agree all the time, it doesn’t mean I’m not being open-minded. I am engaging in all the exercises and discussions and taking turns speaking. I think I am balanced in voicing my concerns and also validating dialectical behavior therapy (DBT). I think it is important to question the language being used and really ask what we are trying to do with DBT for the population labeled as having “borderline personality disorder” (BPD) who often has a history of child abuse and neglect.

Some of the language and the examples so far have really hurt me, and it’s upsetting that questioning this is somehow viewed as possibly not being open-minded. I do not believe we should be open-minded about harmful language being used to describe people and their experiences. We aren’t working with pigeons. Rather, in DBT, we are most often working with trauma survivors.

Some of your words have honestly had me going home crying. I know it is not your intention and that you are only teaching a program that was taught to you, but phrases and sentences like “problem behaviors, therapy-interfering behaviors, swallowing the Kool-Aid” and saying a child crying about Bambi’s mom dying was what caused a negative reaction from the parents rather than acknowledging the parents responded poorly, are difficult to hear. I do not feel DBT does a good enough job of discussing the systems that have harmed these children, and while it claims to be dialectal, it really doesn’t feel to be to me.

Its goal is behavioral change and it uses, as Marsha Linehan expressed in her seminars, “validation as sugar-coating so that the distasteful medicine of cognitive behavioral strategies go down.” I’m not sorry I have a problem with this language and that I’m not open-minded about it. I’m a positive developmental psychology student, and I had hoped DBT would look through this lens. It doesn’t feel that way, though. It continues to feel that the environment these individuals are raised in is an afterthought and the feelings these individuals have about their experiences are only seen as “therapy-interfering behaviors.”

Is it my fault I hurt because my father abused me and my mother is a meth addict? Should I not talk about this in therapy because it makes me upset and is just a therapy-interfering behavior? I honestly do not know where these ideas in DBT come from. They are outdated and not from a systems lens at all, in my opinion. Yes, drinking hot things, taking a cold shower, and practicing mindfulness have all been wonderfully helpful. What hasn’t been helpful to me is this silencing of my own lived experiences that goes on in DBT because you label it as “therapy-interfering behaviors.” It’s traumatic. It feels as if you are taping my mouth shut, and I do not like it. I do not know all the stories of those given this label, but I can tell you every person I have ever met with this label was seriously abused.

I really think it’s time we start talking about the environments we are told not to talk about in DBT. Our histories are not “interfering behaviors.” Our words are insights into the real problem. The personalities of these individuals are not disordered. Their environments are. There is nothing wrong with a sensitive baby. I believe there is something wrong with a parent becoming angry at a child who is crying.

I have decided to withdraw from your DBT course, as it does not align with my values. I wish you and the rest of those in DBT the best. While I know many promote DBT as the “gold standard,” following an examination of its Kool-Aid, I have decided I will not be drinking it.

Warmly,

Rebecca