Dialectical Behavior Disorder: Ask the Therapist

In Dialectical Behavior Therapy but Still Suffering

Question: I have loyally attended a dialectical behavior therapy (DBT) group for over a year now. While it has helped me a great deal not to be in emotional pain 24/7, I still have at least an hour or two most days when basically I just practice distress tolerance because I am miserable. I worry that I am already as good as I can expect to be- which isn't a great comforting thought. My therapist says that the pain I feel now is due to the dramatic changes that I am in the process of making in my life. Can this be true even if I don't "see" the changes or "feel" them? My life frustrates me.

Answer: It sounds like your therapist is on the right track. As someone who's been working with you and witnessing your progress, s/he is in a unique position to offer you this piece of objective observation. This kind of intense personal work - in itself - creates some level of change that you might necessarily be able to always "feel." The best way to tackle things in your life that you don't like is the same way you probably go about other tasks: one thing at a time.

If you were once in "emotional pain 24/7", and are now down to 1-2 hours per day, that's great! You should celebrate and enjoy your achievements, which have no doubt come as a result of very hard work. You've seen how the skills you've learned have helped you, and should continue to practice. As you hone them and they become more refined, you should continue to see some progress.

Finally, take some comfort in knowing that you are not alone when you feel as if life is frustrating! To expect that it will never be so is being unrealistic and unfair to yourself. Life will continue to be frustrating and difficult at various points and you can only do the best you can to assure that you're meeting its challenges in the best way you know how. It sounds like you're doing a great job.