Author Topic: Dialectical behavioral therapy for gender dysphoria, depression and anxiety  (Read 364 times)

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Offline KennedDoll

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Are there any people here who practice DBT, or want to practice DBT?

I would, but don't know of a group except for one that requires you to live in Australia and another that is for money and on facebook.

Essentially, I would like to practice DBT with other transgender people. For example, we would use one of the books that has exercises and email or post what exercises we plan to do, share what we wrote for the exercises, and share more open ended conversation about the practice and our mental health.

Having the group consist of transgender people would make it much more comfortable for me.


Offline Chloe

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Having the group consist of transgender people would make it much more comfortable for me.

     Kendall I had to startpage "Dialectical behavioral therapy" to get an idea what this entails. Then I added "transgender" to the search and came up with many webpages . . .

Quote from: from one
        With attempted suicide rates greater than 40% in the transgender community, it's important for clinicians to be aware of the issues gender nonconforming clients bring to therapy, and to be knowledgeable about how best to support them.

I've never had any real destructive behavioral issues around life or being trans but feel free to PM me if you'd like to discuss this more . . .

"But it's no use now," thought poor Alice, "to pretend be two people!
"Why, there's hardly enough of me left to make one respectable person!"

Offline KennedDoll

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Thank you. A short description of what DBT can involve (I'm going to make assertions, but I really mean "in my opinion" or "as far as I understand it" or "the part that interests me is", everywhere):

Behavioral therapy is focused on working with behavior as opposed to psychoanalysis where people talk about their thought process and their feelings. The hope of psychotherapy is to have a realization about things one was previously confused about. Behavioral therapy is like teaching a dog to sit and stay.

Rather than seeking a cure for depression/anxiety, an approach like DBT aims to build frustration tolerance. It is like how physical exercise slowly builds strength and stamina in the body. Instead of physical stamina, one builds mental stability and stamina, not because there is some fact that you learn, but because you are conditioned to tolerate disappointments.

The importance of this needs to be experienced.

DBT exercises can be put into 2 big categories. One is disputing irrational beliefs and the other is distraction.

For example, an exercise can involve noting details of an event that was distressing. What was the event that lead one to become upset? What was your reaction to the event? What belief did you have about the event? Was the belief rational? What ideas could dispute the belief that you had?

The idea of distraction is that some events are too distressing to think about in much detail, without upsetting oneself. When one finds they are upsetting themselves too much about some event, you back off and find a way to distract yourself.

A similar approach is REBT (rational emotive behavioral therapy). My experience has been that the community around REBT is more rigid about what one is supposed to do. It used to be that REBT in SMART promoted the idea that thoughts always precede emotions and you can "control" your emotions through thought. That is a pretty harmful belief, in my opinion.

If that sounds interesting to anyone, let me know. I should be attending SMART online meetings, but most of the people involved are dealing with substance abuse or gambling addiction. Neither of those are of concern to me.

An important aspect of DBT and REBT is that there isn't really a role for someone who is an expert who teaches you something. So, it is harder for a hierarchy to be formed within the group. This makes them perfect for group therapy and welcomed by rather anti-authoritarian people, such as myself.

Offline AutumnGlory

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It's an interesting topic, and as pointed out, with such a high suicide rate, important.

I used to coach, not TG / TS, but in the fetish world where many with gender issues find solace and support as well as those struggling with fetish.  My coaching was loosely based on NLP.

In particular, I dealt with people facing their fears and putting themselves in the situations they feared, to work on 'being uninjured'.  However unsuccessful they were in their feared situation (such as a would-be fetishist going to a munch or club) they should congratulate themselves on having got there and placing themselves in the situation.  By not beating themselves up over lack of performance, pressure is taken off, and they can begin to work on their fears rather than be overwhelmed by their reactions. 

This, it seems, is similar to some of the approach described by the OP, chance to develop some frustration tolerance and chance to examine in detail what is happening.

Distraction is a new idea to me, and a good one.  Ten years down the line and I find myself once more facing my fears, rusty at working through them and rather overwhelmed.  I'm wondering what form distraction would take, and thinking maybe by scheduling short time intervals working on the scary stuff interweaved with scheduled work on more comfortable subjects might be my way forward.

Sorry that this doesn't address directly the OP's post, but it is an interesting topic.