The first time I encountered DBT, I did not have a good experience with it. I think there were really 3 reasons. First, and perhaps most importantly, I was not in the right place for it- I was too deeply depressed, I was too suicidal- I wasn't sure I wanted to live. My questions were existential- did I want to live? And here DBT was trying to teach me how to get through the moment. I didn't know if I wanted to get through the moment.
Secondly, I think the program wasn't very good, and wasn't explained very well to me. The second time around, 12 years later, it was a very good program. These people lived and breathed DBT! And it made a lot more sense to me.
But thirdly, the second time I was willing, and the first time I was willful. I can only say that in hindsight, because I didn't know those terms at the time. But I had a different attitude. My first time with the program, I did the exercises expecting them not to help, almost to prove to myself that they wouldn't help.
After my latest hospitalization, I was referred to an IOP program that was DBT based. I had very low expectations, because the groups in the hospital were so terrible. I told myself that I would give it a couple of weeks- and if the groups were equally terrible, I would quit. But I would try it. And if they were good, I would stay the whole 6 weeks. And just that willingness to be open, to give it that 2 weeks, and to really work it- that was enough.
I was in a different place that second time. I had decided that, at least for the moment, I wasn't going to kill myself. I had a job to go back to. I was not feeling as desperate.
DBT was designed for people with borderline personality disorder, although now it is being used for a lot of other things. It is designed for handling mood swings. I think that it can fall short for dealing with severe, prolonged, depression. But maybe I am just not doing it right.
As time passes since I was in the program, I think I am using some of the concrete skills less and less- but some of the big concepts just as much. Mindfulness. Radical Acceptance. Wise Mind. Willingness vs. Willfulness. And appreciating the dialectics in life.
The skill I continue to practice is Opposite to Emotion Action. Part of me says, well, of course. If you have spent much of your life depressed, you have spent much of your life doing opposite to emotion action if you have any kind of life. But the difference is to do it more mindfully, and with an acknowledgement of the emotions that you are experiencing, so that it does not feel like such a denial of self to carry on.