I think this is wonderful. She refuses to accept judgmental answers, instead pressing for clear behavioral descriptions. She pushes for change but also finds an opportunity to provide validation. And she deals with willfulness effectively.
@@Holsgolightly It is an actor, don't make statements you know nothing about, this is a series called the Symfora tapes made in the Netherlands in 1970 by a group of Dutch psychiatrists who wanted to demonstrate different therapy modalities for BPD, this is Linehan's tape and that guy is a paid actor.
Just for people stumbling upon this video, the "patient" is indeed portrayed by an actor ..quote "In this initial session, Linehan works with a fascinating and difficult client, brilliantly portrayed by Dutch actor Henk Grashuis." from the link under the video.
Ok, so if your therapist is thinking "tough shit", which is what my BPD and SUD mother shoved at me, things like.... Irrelavant, we've already discussed it, and tough shit. I understand the context but after being in DBT nearly a year, still not the tone I expected from the author and it bothered me a lot. I understand her own background, and that she forced her way, to find her own way out and that is amazing. And as evidence based, saved a lot of lives! She is a mental scientist and always kept looking for patterns and improvements. Very intelligent. ....Yet I also notice very critical comments from people in treatment on other videos. Sometimes because they are being called out and are reacting on own projections and are still so blanketly angry and messed up they just are not close yet. ....I think, (depending on the client which can be nearly impossible to gauge) that this tough love or tough shit element is so fundamental to the early trauma and to hear it repeated in that light, I just don't understand. Even my therapist portrays accectance to change, but if has thoughts like that in that language, and with specifically that attitude (although there is truth in what Marsha said here) yeah not good for me. I am not well enough by far, if my therapist said that directly to me, I'd prolly quit. And to hear it may well the the case, is disturbing. Yes Borderlines are emotional burn victim babies, we overreact as an understatement, and I'm better... but that language really flashed me back to my mother I cut all contact with. She would have been *much* harsher though, tough luck and stop making excuses. I understand this video to be staged, *and I do get the point (to a point)*, but that seems like an anti-dialetical thought process best kept inside the therapists own mind. What do they think would happen if that was expressed directly to a client? (If should be a common and appropriate response?) ....So compassion as a tactic? That could lead one to ponder. DBT saves a lot of lives so kind of "whatever works" ....Found it highly interesting and very distressing the conflict of abortion and differences between latent physical abuse and active were contrasted in such a way. I watched a very long video earlier today on DID and trauma oriented disorders as well. They say the DSM would be reduced to a phamplet if it acknowledged the ripple effects of trauma. .... To summarize I'm pretty sure a therapist is supposed to be more tactful about expressing "tough shit" "get over it" style responses, but if it is common and not as balanced as the whole therapy presents it... well no one is perfect. Advice from a patient: **Just don't put it that way, pretend to tone it down and we clients will never know the difference and will get better, or even well, just don't say it like that.... explain why the tough is necessary cause not many of us are far along enough to hear that without feeling like splitting. For some the opposite has helped a bit, but to me seemed broadly counter-intuitive and made me question a lot.
Two important things....firstly, I agree. We have to watch our own defense mechanisms with patients. Secondly, the second half of this video that is filled with her commentary was recorded after and not something that she said directly to the patient. It was commentary for the students watching the session. She did not go into detail explaining to him why he should want to change when he asked that question. Students may have wondered why she didn't go into detail there. To me this is just verbalized to students that you may be thinking and feeling these thoughts to those questions. In that way its a great way to identify our own defense mechanisms and countertransference.
I have seen clinicians of all types (nurses, doctors, etc) make the mistake of speaking to persons suffering with BPD the same way they would speak to someone without such conditions, even when the persons were in crisis. Statements like "you can't just have (desired item) as a luxury" etc. I think every clinician may have feelings of frustration at times but it is inexcusable to speak to someone that way. Perhaps a better way is to simultaneously convey the reality that that is how life is and express empathy for how difficult that must be for the person to accept and adapt to.
I think this is an instructional video..she's illustrating her process and not an actual patient-clinician therapy. (the "patient" is indeed portrayed by an actor ..quote "In this initial session, Linehan works with a fascinating and difficult client, brilliantly portrayed by Dutch actor Henk Grashuis." from the link under the video)
I was not on board with her either, I mean if someone says their going to kill your kid I think that opens that individual up for whatever they get no matter who they are. I don't think he can go without some therapy but I don't think he should be looked at as the monster in this situation. As someone threatened to be killed by their mother on multiple occasions I wish my father was there or anyone to defend me from these verbal threats (psychological) threats.
@@justinholzman4346 Yeah. As seminal as Linehan's work has been, much of her thinking also raises irrationality to symphonic and operatic levels. In this case, when the patient asks "Why should I have to change?", one has to wonder what keeps a shrink from simply leveling with him: "You don't have to do anything. Probabilities are high though that if you continue to strike out physically whenever someone says something mean to you, you're going to either go through life being in and out of the criminal justice system, or you'll one day strike someone who'll to react by putting you in the hospital or the morgue. If you're cool with those options, we needn't continue. If you want to enjoy a rich, fulfilling life, rather than being in and out of jail, the hospital, or ending up manslaughter....well, I can point you in a viable direction"
It's interesting to note the client's microexpressions of disgust while narrating how he physically maltreated his wife (?). It is noteworthy on the other hand how difficult it is as therapist not to feel angry with an abuser such as this client. This was evident on a microexpression of contempt that the therapist 'leaked' when the client bluntly said he "hit her." Fredrick Boholst
She is a remarkable woman. This small snippet from a longer video does not do her justice whatsoever. Her teachings and her wise guidance are akin to a spiritual teacher. Sure she is a great therapist, but she is a genius teacher. She's the real thing. Her teaching radically helped turn my life around, and through an intensive year long DBT course, helped drag me back from the brink of complete self destruction. Recovery is a long slow road and I am still on it and will be for the rest of my life, but Marsha Linehan was the first person to give me a glimmer of hope when I was living in a world where I thought hope didn't exist.
Anthony Monaghan, thank you so much for sharing. I have not had a proper diagnosis of BPD. It was only after my 5th suicide attempt that the hospital therapist gave me papers on Borderline & I felt as if i had all of the traits that were explained in the literature. My childhood was extremely toxic & i have endured many horrific trauma's from suicide of close family members to severe sexual abuse. Im feeling so helpless & depressed at the moment & im trying to find anything on the condition that may help me. Suicide is my only other option if i cannot find the help to atleast give my head a break from constant thoughts of not being good enough. Not good enough as a mother, partner, daughter & ESPECIALLY as an older sister, losing my younger sister to suicide approx 3 months ago. We were so close growing up & most of our lives, till we became estranged for atleast 5 yrs. She since took her life, ignoring my messages to reconcile our situation. We both self medicate with IV opiods and methamphetamines. Im actually labeled terminal due to getting endocarditis (a massive infection of the heart) Reading your comment was very uplifting & gave me the opportunity to vent & share. Thanks again Anthony & I hope your kicking goals, are safe, healthy & happy? With much heart, love, light, laughter & LIFE.....Simone Vandermeulen. This profile pic is not of me, its my mother.
Having BPD at 42, I've learned one thing: I'm damaged, and I'm damaged for life. I will never have a full life. I'd like to thank my f*cked up mother for using me as a punching bag for the first 17 years of my life until she learned the hard way enough was enough. I'll be lucky at this point to make it through a degree and build some kind of career. By the time I finish graduate school I'll be pushing 50 years old. Thanks Mom. Once I graduate, I may have a good 16 productive years before mandatory retirement. The first 20 years after high school graduation was spent walking around in a fog. And the idea of disclosing my disorder to a potential life partner scares the hell out of me because I know anyone operating with a full deck would never get involved with someone with BPD. I have the disorder and I'd think twice before getting involved with someone with this disorder. And anyone who's willing to take on a challenge like this either has a saviour complex or has no idea of what they're getting themselves into. I'm sorry if this sounds harsh but facts are facts. Let's face it, they're called your formative years for a reason; once those thinking patterns are established, they're established. The most challenging part in all of this is gradually come to terms with the idea that I just may end up alone.
I read your comment. BPD is a very serious mental health issue but its treatable ! You can learn to transform and transcend your BPD and live a full and productive life. You just need to learn how. Neuroscience is slowly making progress with understanding different forms of mental health disorders. At your age of 42, your brain can still develop new pathways, a process called neuroplasticity. The brain can heal with developing these new pathways, therefore, new consciousness. Consciousness is created and then managing it with those psychological skills (i.e. DBT skills) becomes your next challenge. Often people find it helpful to work with a variety of therapeutic modalities such as, talking therapies, exercise, meditation, practicing good sleep hygiene, proper nutrition, engage in new activities that stimulate your brain to think and feel in new ways i.e. art, dance, music, martial arts, putting together puzzles, learning how to code,etc. Getting hung up with your childhood issues is tough and not easy to overcome. But, if you can forgive your mother for being shitty, that would be a great first step. Yes, its hard but very important to your own mental health. Next, develop your self-improvement plan for your mental health. Sometimes, working with a therapist is great way to do this kind of work. I think DBT is an excellent therapeutic tool for people who struggle with BPD. I hope you continue to work on your issues and if you are struggling and feeling stuck, find some help and get unstuck. God Bless and take care, A Friend from Colorado
@@AnnaSzabo First, I've changed my UA-cam name. This was posted quite some time ago...I was misdiagnosed. I have Aspergers. I'm amazed at what I wrote here, and how mixed up was back then. I've returned to school and completed an Engineering degree and have stopped projecting my problems onto my poor parents. They must truly love me for having put up with all the craziness...I don't even recognize the person in my previous comment. It's spooky.
Also what I hate about DBT and mental health survices in general is they tend to treat those with depression or personality disorders as if we are babies or even dumb. As if I have never tried to stop negative thoughts by being mindful and often times mindfulness can actually make depression worse because u have to be mindful of current thoughts and emotions, feeling them more deeply. Feeling the impulsive urges more intense.
I don't know if you will read this, but I am sorry that DBT never worked for you. Although certain therapy modalities were developed for certain disorders, this doesn't always mean that it's beneficial for everyone. Many people (like you) fall into the cracks. Have you looked into getting tested for Asperger's/Autism? I have noticed that many clients with treatment-resistant BPD tend to also have Asperger's/Autism traits. It can be harder to treat these individuals because therapies like DBT and CBT are less effective for those with more concrete thought processes (which might also explain why you feel like some of these techniques feel babyish and dumb). Most providers don't know how to recognize/diagnose Asperger's/Autism, so patients these traits often fall into the gaps. It might be beneficial for you to go get formally tested, and the results could help to direct your towards therapies that WOULD be more beneficial for your needs. Good luck and take care.
I believe I may be mild BPD...im also scared of wasting a year of my life in DBT, when I could be doing something else that maybe really helps. I don't find CBT to really get to the core of my issues. I've done better with addressing my attachment injuries. The brain has plasticity and should have some room for real change. There is a lot of evidence in recent years that healing attachment wounds, and using therapies that address where the body hibernated it's trauma, to be more effective. I'm not opposed to DBT, but because authe to city us so critical of an issue for me, if it's topical or a band aid, my inner self will recognize that. It needs to truly work and siphon some of the inner pain out. If it doesn't, it w ont last as a true help.
Its different for everyone. Everyone goes through it differently and copes with DBT differently. I find understanding the modules can be confusing as fuck and we probably aren't awaere of which we are using. Best to look up and review so fuck it
Tried. This therapy is Not for people with PTSD nor anyone who was abused. The very people who have cPTSD are recommended for this therapy and yet it completely gaslights you and invalidates how you’ve been living your life
DBT may very well help with anxiety, panic attacks, maybe even OCD but not BPD even though thats the main, pathetic excuse for treatment offered to them. The reason it dont help is because there is not actually much difference between impulsiveness and mindfulness. Because what is impulsivness? Its in the moment. Its embracing your urges and thoughts now. Very much like mindfulness. Therefore its more of a hindrance than a help.
I've always thought of the difference between mindfulness and impulsiveness in terms of the difference between thoughts and actions. Impulsiveness is about acting on your emotions. Mindfulness is about being aware of them.
I appreciate DBT as it appears to be a calm but realistic conversational approach. I'm trying to extract the therapy approach and technique used in DBT. It seems to be similar to a psycho-therapeutic style. However, as we know, realization of the problem and change in destructive behavior is necessary. Obviously, if a person isn't willing, any therapy is a futile process.
Another thing is mindfulness is completely unrealistic. I know because in my darkest hours, I tried it. When I couldnt sleep and desperately wanted to shut off my thoughts, I tried so hard to be mindful of other sensations but it simply could not work very long. Its a nice theory but humans are meant to actively think, not passively think. They are meant to remember, they are meant to emotionally react... they are meant to grieve.
You need to practice the mindfulness when you're not upset first. Practice meditating 20 mins per day every day, I promise after a few weeks (or even days) of practice, you'll notice a huge difference. At first I could only focus for a few seconds, but it builds up with practice and time, like exercising your mind. Now I can focus much longer, and when I'm having panic attacks I can focus my attention on my breath and it calms everything down, it's incredible really because I never thought that would be possible. usually panic attacks or 'rage attacks' feel like static brain overload to me where I can't think at ALL or control my actions at all, but this really helps a lot. I use the app Headspace, it is really simple guided meditations, and not all hokey and "spiritual" lol
NoMoreMissNiceGirl correct, actively think. Your thoughts are not that. Yours are mindless chatter only. They mean nothing. 99% of all thoughts actually mean nothing. You must realize this. It’s just background noise. You are paying attention to them, but most people don’t. Everyone has those endless thoughts 24 hours a day. It’s only you who is paying attention to them. Trust me, your statement is nothing new. I hear it every day. It’s nothing to be worried about, and nothing you need to pay attention to. Let them be and go on with life. It really is that easy.
BPD is very hard to treat and DBT does NOTHING to stop feelings of emptiness. It also does nothing to help over-sensitivity. It tries to give you coping skills to deal with the sensitivity like being mindful but you still feel the overwhelming pain. If anything, you feel your pain even more when you are mindful of it. You become consumed by the darkness and then all you get to deal with it is more mindfulness. The only thing that helps is Wise Mind but it only helps prevent things getting WORSE.
+angelladycna I dont do DBT online. I go to DBT sessions twice every week, one session is one to one and the other is in a group. I am nearly done a year and it does not work. Its not anything I am doing wrong, it is just not good enough for severe depression and creating a sense of self. Yes some of the things they teach are good like wise mind or radical acceptance but it does not male a significant difference. It will definately not heal BPD or even make much difference.
I agree just by seeing this video. She is inviting client into pain without even saying he wont stay with this pain and alone. The best way to sabotage borderline patient. She does not discuss what kind of pain, so the mind of wounded person is inevitably subconciously will search retreat instead of opening up. Very thin line.
I agree. It’s not an even playing field and not fair. It invalidates how someone with cPTSD has been living their life. And yet it claims to help those very people. It just gaslights all over again. Only useful stuff is meditation which has been in Qi Gong for thousands of yearsz
Isn't it more likely that the patient will be more motivated to go through with the treatment if they internally agree with the reasons. Why didn't she get into a discussion of why changing would be beneficial? If she could have convinced him wouldn't it stand to say that his treatment would be more successful? I, for one, wouldn't just agree to do something because someone was just asking me to do it. That's like signing a contract without reading it. Just because he has a disorder doesn't mean you shouldn't try to treat him with respect and consideration. I understand his decision making process might be hindered, but at least an attempt should be made.
Once you see youre being bullied in a relationship.its time to leave. Bullies never change. Its in their personality. Its who they are. Its how they operate.
Should we be mindful of our food and embrace little things like that more that we take for granted? Sure. We should do one thing at a time and slow down more but to try pass mindfulness of as some cure for a crippling mental illness is ridiculous. Mindfulness doesnt even come close to touching the issue of personality disorders because its too broad and too general. Its about paced breathing, relaxing (may help reduce anxiety) but does not even come close to undoing the complex thinking of BPD
The reason why most attempts to heal depression are vain is because it is often caused by our views on life which is so much deeper and complicated than just black and white thinking. And often times our views are valid ones so shouldnt be changed. DBT also doesnt help with self-esteem from bullying etc. or the desperate need to feel loved which is a big driving force behind the behavior of BPD.
DBT is super misleading. Marsha runs around saying it’s the only “strong evidence based therapy” for borderline personality disorder. However the APA states clearly on their website of evidence based practices that DBT is only evidence based during their 1st stage of safety planning, stabilizing, and “skills training.” The actual talk therapy portion of DBT does not have strong empirical validation, and performs moderately successful. In many studies too, people who utilized DBT reported that their quality of life was still very poor and they were just as depressed as they were prior to utilization. They still hated their lives. However all they could now do was use their deep breathing and other skills when they were feeling impulsive. Many clinical trials find transference focused therapy and mentalization to be far more successful in regards to an increase in reported quality of life.
I don't know if I have bpd 100% or not but I had a horrific childhood which left me completely disabled in my teenage years and very suicidal from flashbacks and intrusive thoughts, I couldn't form a bond with anyone etc . . I did EMDR therapy and it changed me , I was able to work full time and function, I still suffer from anxiety but it's not disabling so I'm sure there are definitely other therapies that could help besides DBT
It is proven to reduce suicidality. It saves lives. That’s a big deal in todays world. It is also widely available. No one does transference focused therapy.
Yes, DBT is about stabilization. Stage 2 is sometimes referred to as the "quiet desperation" phase, where problem behaviors are under control. This session is clearly a "pre-treatment" session, where the client describes and commits to changing the problem behaviors. No, the stages beyond 1 (behavioral stabilization) and 2 (processing trauma without resorting to probem behaviors) are not well developed. I don't see the Keibler with that. There are a multitude of other effective, well researched treatment approaches for meeting life goals (stage 3) and finding meaning in life (4). There are none as effective and well-researched as DBT for extinguishing problem behaviors.
This is false. The studies show that it takes one round of DBT to stabilize and stop people from killing themselves. Yes they are still miserable at this point but stable. Then you’re supposed to go through it a second time to work on building a life worth living, which takes much longer.
Great video. I'm in grad school for counseling - question - if someone says something like he did, such as "Why should I change?" - does that indicate personality disorder? There aren't many details about the personality disorder in the description but I thought his question was a very interesting one. Growth minded people want to change.
No absolutely not, most people do not like change and will avoid it. If i tell you that you need to change how does that sit with you? I doubt you are entirely welcoming of that comment.
@@BK-hp6fv thanks for the reply! I actually love changing the parts of me that need to be changed and healed so for me growth is a good thing for sure! I crave change for the better 😊
@@LesliWebandMediaSvcsonUA-cam as its a year since you asked that question I'd guess you don't me to answer it for you but in short my answer would be no. Change is hard, I'd guess you did alot of inner work to be so welcoming.
Is she a Clinical Psychologist? I believe her Phd was in Personality Psychology which is similar but completely different as it does not involve clinical training in anyway. Is she licensed to work with clients?
Yes, she is one of the most famous psychologists in the world. She developed Dialectical Behavioral Therapy (DBT) specifically for people suffering from Borderline Personality Disorder (BPD).
Ok does she still work with clients. Is she a licensed Psychologists. I know she's a professor and created DBT but has she practiced with clients one on one?
I really like that she is so non-judgemental.. I mean here is a guy disclosing he has hit a woman to the point of breaking her finger and instead of raging on him Marsha sees the illness in him .. the reason for his behaviour.. she doesn’t blame him but guides him so that he himself realises his mistake. And even as he realises his mistake Marsha has this calm assuring voice explaining to him without words that she feels his pain and is not judging him..
Take note of the therapist's facial micro expression at 1 minute and 42 seconds. That was an expression of contempt, probably the feeling she had toward the client. Paul Ekman's method points to a unilateral (one-sided) ''contraction' of the muscle on one side of the face; like a smirk.
I wouldn't expect any less. And the bored expression, head hanging to the side, as if she felt so powerful she didn't even have to pretend she's interested and respectful.
I mean the guy is an actor and she's a psychology researcher. It's a demo video, not a real session. So he comes across as real. She's probably trying to remember her lines.
@@delphinelouise838 I was quite shocked yes irregardless of the value of DBT, which I spent 2 years in... that did sound quite cold and did have a trigger effect on me as well. Mary Z on borderliner notes has several videos than examines beyond DBT which I found encouraging.
WOW....in denial........"her finger got broken by accident? This woman is using her wise mind. Why waste time if the the person does not agreed to change..........
Congrats to this man for telling her not to kill their baby!! Never have I heard of a man actually standing up for himself regarding unborn children!! Courage comes in a DBT Therapy session!!
I would dump this woman so fast. Notice her judgmental tone and tilted head as he speaks. This is your therapist? Who literally thinks "tough shit"? Instead of phrasing her words as if she understands and empathizes but still focuses on his change, she automatically challenges the validity of his thoughts....and this is the first session. Rediculous. I hope she sticks to counseling women
I don't have experience as a therapist, but I agree. I would have trouble trusting someone who treated something I said like that. If she'd actually gone over the reasons, I could maybe see getting away with it, but if the client is already agreeing that "anything would be better than this" then it should have been easy to tie that in. Her attitude is more punitive than caring. Her empathy with the client is lacking and glossed over while. Her validation of his pain sounds half hearted to me. He's a good actor - I FELT sad for his pain over the unborn baby even though I am pro-choice. I felt sad for him feeling helpless about the child he cares about. It sounds like she's brushing it aside in a hurry. I'm a little surprised this could even work. Maybe she's different in a real life situation and shortened it for educational purposes.
Barry Soetoro I feel the same way. When her totally bored looking face came on the screen I was like “Oh my GOD!! BODY LANGUAGE WOMAN!! Show a little assertion for the price he’s paying you for therapy!!” Jeesh! You might think she’s not getting PAID to be there!!
I think this is wonderful. She refuses to accept judgmental answers, instead pressing for clear behavioral descriptions. She pushes for change but also finds an opportunity to provide validation. And she deals with willfulness effectively.
we watched this video in a Masters psychology class. This man is an actor & not a real client! She is awesome
Damn, that's a really good actor!
That’s not an actor
He is amazing, understood the character or the relationship and played it excellently
@@Holsgolightly It is an actor, don't make statements you know nothing about, this is a series called the Symfora tapes made in the Netherlands in 1970 by a group of Dutch psychiatrists who wanted to demonstrate different therapy modalities for BPD, this is Linehan's tape and that guy is a paid actor.
Such a freaking brilliant mind. Could anyone else start off as a patient and end creating up a treatment plan for an entire disorder.
yes, me
@Brainjoy01 bring it on! Enlighten us?
Just for people stumbling upon this video, the "patient" is indeed portrayed by an actor ..quote "In this initial session, Linehan works with a fascinating and difficult client, brilliantly portrayed by Dutch actor Henk Grashuis." from the link under the video.
Wow I never thought that he might be an actor. Amazing acting!
absolutely brilliant acting
Ok, so if your therapist is thinking "tough shit", which is what my BPD and SUD mother shoved at me, things like.... Irrelavant, we've already discussed it, and tough shit. I understand the context but after being in DBT nearly a year, still not the tone I expected from the author and it bothered me a lot. I understand her own background, and that she forced her way, to find her own way out and that is amazing. And as evidence based, saved a lot of lives! She is a mental scientist and always kept looking for patterns and improvements. Very intelligent. ....Yet I also notice very critical comments from people in treatment on other videos. Sometimes because they are being called out and are reacting on own projections and are still so blanketly angry and messed up they just are not close yet. ....I think, (depending on the client which can be nearly impossible to gauge) that this tough love or tough shit element is so fundamental to the early trauma and to hear it repeated in that light, I just don't understand. Even my therapist portrays accectance to change, but if has thoughts like that in that language, and with specifically that attitude (although there is truth in what Marsha said here) yeah not good for me. I am not well enough by far, if my therapist said that directly to me, I'd prolly quit. And to hear it may well the the case, is disturbing. Yes Borderlines are emotional burn victim babies, we overreact as an understatement, and I'm better... but that language really flashed me back to my mother I cut all contact with. She would have been *much* harsher though, tough luck and stop making excuses. I understand this video to be staged, *and I do get the point (to a point)*, but that seems like an anti-dialetical thought process best kept inside the therapists own mind. What do they think would happen if that was expressed directly to a client? (If should be a common and appropriate response?) ....So compassion as a tactic? That could lead one to ponder. DBT saves a lot of lives so kind of "whatever works" ....Found it highly interesting and very distressing the conflict of abortion and differences between latent physical abuse and active were contrasted in such a way. I watched a very long video earlier today on DID and trauma oriented disorders as well. They say the DSM would be reduced to a phamplet if it acknowledged the ripple effects of trauma.
.... To summarize I'm pretty sure a therapist is supposed to be more tactful about expressing "tough shit" "get over it" style responses, but if it is common and not as balanced as the whole therapy presents it... well no one is perfect. Advice from a patient: **Just don't put it that way, pretend to tone it down and we clients will never know the difference and will get better, or even well, just don't say it like that.... explain why the tough is necessary cause not many of us are far along enough to hear that without feeling like splitting. For some the opposite has helped a bit, but to me seemed broadly counter-intuitive and made me question a lot.
Two important things....firstly, I agree. We have to watch our own defense mechanisms with patients.
Secondly, the second half of this video that is filled with her commentary was recorded after and not something that she said directly to the patient. It was commentary for the students watching the session. She did not go into detail explaining to him why he should want to change when he asked that question. Students may have wondered why she didn't go into detail there. To me this is just verbalized to students that you may be thinking and feeling these thoughts to those questions. In that way its a great way to identify our own defense mechanisms and countertransference.
I have seen clinicians of all types (nurses, doctors, etc) make the mistake of speaking to persons suffering with BPD the same way they would speak to someone without such conditions, even when the persons were in crisis. Statements like "you can't just have (desired item) as a luxury" etc. I think every clinician may have feelings of frustration at times but it is inexcusable to speak to someone that way. Perhaps a better way is to simultaneously convey the reality that that is how life is and express empathy for how difficult that must be for the person to accept and adapt to.
I think this is an instructional video..she's illustrating her process and not an actual patient-clinician therapy. (the "patient" is indeed portrayed by an actor ..quote "In this initial session, Linehan works with a fascinating and difficult client, brilliantly portrayed by Dutch actor Henk Grashuis." from the link under the video)
I was not on board with her either, I mean if someone says their going to kill your kid I think that opens that individual up for whatever they get no matter who they are. I don't think he can go without some therapy but I don't think he should be looked at as the monster in this situation. As someone threatened to be killed by their mother on multiple occasions I wish my father was there or anyone to defend me from these verbal threats (psychological) threats.
@@justinholzman4346 Yeah. As seminal as Linehan's work has been, much of her thinking also raises irrationality to symphonic and operatic levels. In this case, when the patient asks "Why should I have to change?", one has to wonder what keeps a shrink from simply leveling with him: "You don't have to do anything. Probabilities are high though that if you continue to strike out physically whenever someone says something mean to you, you're going to either go through life being in and out of the criminal justice system, or you'll one day strike someone who'll to react by putting you in the hospital or the morgue. If you're cool with those options, we needn't continue. If you want to enjoy a rich, fulfilling life, rather than being in and out of jail, the hospital, or ending up manslaughter....well, I can point you in a viable direction"
It's interesting to note the client's microexpressions of disgust while narrating how he physically maltreated his wife (?). It is noteworthy on the other hand how difficult it is as therapist not to feel angry with an abuser such as this client. This was evident on a microexpression of contempt that the therapist 'leaked' when the client bluntly said he "hit her."
Fredrick Boholst
Thank you for sharing! I wish more therapists had the skill of Marsha Linehan. I've grown very weary of those who don't.
She is a remarkable woman. This small snippet from a longer video does not do her justice whatsoever. Her teachings and her wise guidance are akin to a spiritual teacher. Sure she is a great therapist, but she is a genius teacher. She's the real thing. Her teaching radically helped turn my life around, and through an intensive year long DBT course, helped drag me back from the brink of complete self destruction. Recovery is a long slow road and I am still on it and will be for the rest of my life, but Marsha Linehan was the first person to give me a glimmer of hope when I was living in a world where I thought hope didn't exist.
+Anthony Monaghan Wow, welcome back :)
Thank you for posting this because when I watched this snippet for class it did not give me a great impression of the therapist. Good luck to you!
Anthony Monaghan, thank you so much for sharing. I have not had a proper diagnosis of BPD. It was only after my 5th suicide attempt that the hospital therapist gave me papers on Borderline & I felt as if i had all of the traits that were explained in the literature. My childhood was extremely toxic & i have endured many horrific trauma's from suicide of close family members to severe sexual abuse. Im feeling so helpless & depressed at the moment & im trying to find anything on the condition that may help me. Suicide is my only other option if i cannot find the help to atleast give my head a break from constant thoughts of not being good enough. Not good enough as a mother, partner, daughter & ESPECIALLY as an older sister, losing my younger sister to suicide approx 3 months ago. We were so close growing up & most of our lives, till we became estranged for atleast 5 yrs. She since took her life, ignoring my messages to reconcile our situation. We both self medicate with IV opiods and methamphetamines. Im actually labeled terminal due to getting endocarditis (a massive infection of the heart) Reading your comment was very uplifting & gave me the opportunity to vent & share. Thanks again Anthony & I hope your kicking goals, are safe, healthy & happy? With much heart, love, light, laughter
& LIFE.....Simone Vandermeulen. This profile pic is not of me, its my mother.
Having BPD at 42, I've learned one thing: I'm damaged, and I'm damaged for life. I will never have a full life. I'd like to thank my f*cked up mother for using me as a punching bag for the first 17 years of my life until she learned the hard way enough was enough. I'll be lucky at this point to make it through a degree and build some kind of career. By the time I finish graduate school I'll be pushing 50 years old. Thanks Mom. Once I graduate, I may have a good 16 productive years before mandatory retirement. The first 20 years after high school graduation was spent walking around in a fog. And the idea of disclosing my disorder to a potential life partner scares the hell out of me because I know anyone operating with a full deck would never get involved with someone with BPD. I have the disorder and I'd think twice before getting involved with someone with this disorder. And anyone who's willing to take on a challenge like this either has a saviour complex or has no idea of what they're getting themselves into. I'm sorry if this sounds harsh but facts are facts. Let's face it, they're called your formative years for a reason; once those thinking patterns are established, they're established. The most challenging part in all of this is gradually come to terms with the idea that I just may end up alone.
I read your comment. BPD is a very serious mental health issue but its treatable ! You can learn to transform and transcend your BPD and live a full and productive life. You just need to learn how. Neuroscience is slowly making progress with understanding different forms of mental health disorders. At your age of 42, your brain can still develop new pathways, a process called neuroplasticity. The brain can heal with developing these new pathways, therefore, new consciousness. Consciousness is created and then managing it with those psychological skills (i.e. DBT skills) becomes your next challenge. Often people find it helpful to work with a variety of therapeutic modalities such as, talking therapies, exercise, meditation, practicing good sleep hygiene, proper nutrition, engage in new activities that stimulate your brain to think and feel in new ways i.e. art, dance, music, martial arts, putting together puzzles, learning how to code,etc.
Getting hung up with your childhood issues is tough and not easy to overcome. But, if you can forgive your mother for being shitty, that would be a great first step. Yes, its hard but very important to your own mental health. Next, develop your self-improvement plan for your mental health. Sometimes, working with a therapist is great way to do this kind of work.
I think DBT is an excellent therapeutic tool for people who struggle with BPD. I hope you continue to work on your issues and if you are struggling and feeling stuck, find some help and get unstuck.
God Bless and take care,
A Friend from Colorado
Thanks mom lol you are pathetic
How are you doing now?
@@AnnaSzabo First, I've changed my UA-cam name. This was posted quite some time ago...I was misdiagnosed. I have Aspergers. I'm amazed at what I wrote here, and how mixed up was back then. I've returned to school and completed an Engineering degree and have stopped projecting my problems onto my poor parents. They must truly love me for having put up with all the craziness...I don't even recognize the person in my previous comment. It's spooky.
@@thomasreese5653 Thomas, you sound like you’ve grown so much. My heart is rejoicing for you. Thank you for sharing your story with me.
Oh, my. The angle of her head was SO LOUD! I am curious if that non-verbal communication tactic was conscious and deliberate. Fascinating.
Also what I hate about DBT and mental health survices in general is they tend to treat those with depression or personality disorders as if we are babies or even dumb. As if I have never tried to stop negative thoughts by being mindful and often times mindfulness can actually make depression worse because u have to be mindful of current thoughts and emotions, feeling them more deeply. Feeling the impulsive urges more intense.
I don't know if you will read this, but I am sorry that DBT never worked for you. Although certain therapy modalities were developed for certain disorders, this doesn't always mean that it's beneficial for everyone. Many people (like you) fall into the cracks. Have you looked into getting tested for Asperger's/Autism? I have noticed that many clients with treatment-resistant BPD tend to also have Asperger's/Autism traits. It can be harder to treat these individuals because therapies like DBT and CBT are less effective for those with more concrete thought processes (which might also explain why you feel like some of these techniques feel babyish and dumb). Most providers don't know how to recognize/diagnose Asperger's/Autism, so patients these traits often fall into the gaps. It might be beneficial for you to go get formally tested, and the results could help to direct your towards therapies that WOULD be more beneficial for your needs. Good luck and take care.
I believe I may be mild BPD...im also scared of wasting a year of my life in DBT, when I could be doing something else that maybe really helps. I don't find CBT to really get to the core of my issues. I've done better with addressing my attachment injuries. The brain has plasticity and should have some room for real change. There is a lot of evidence in recent years that healing attachment wounds, and using therapies that address where the body hibernated it's trauma, to be more effective. I'm not opposed to DBT, but because authe to city us so critical of an issue for me, if it's topical or a band aid, my inner self will recognize that. It needs to truly work and siphon some of the inner pain out. If it doesn't, it w ont last as a true help.
Its different for everyone. Everyone goes through it differently and copes with DBT differently. I find understanding the modules can be confusing as fuck and we probably aren't awaere of which we are using. Best to look up and review so fuck it
Tried. This therapy is Not for people with PTSD nor anyone who was abused. The very people who have cPTSD are recommended for this therapy and yet it completely gaslights you and invalidates how you’ve been living your life
@@NB99999-eit’s certainly not for people with assault trauma or abuse trauma.
DBT may very well help with anxiety, panic attacks, maybe even OCD but not BPD even though thats the main, pathetic excuse for treatment offered to them. The reason it dont help is because there is not actually much difference between impulsiveness and mindfulness. Because what is impulsivness? Its in the moment. Its embracing your urges and thoughts now. Very much like mindfulness. Therefore its more of a hindrance than a help.
I've always thought of the difference between mindfulness and impulsiveness in terms of the difference between thoughts and actions. Impulsiveness is about acting on your emotions. Mindfulness is about being aware of them.
Mindfulness has nothing to do with behavioral output.
When you are impulsive you react when you are mindful you respond
I appreciate DBT as it appears to be a calm but realistic conversational approach. I'm trying to extract the therapy approach and technique used in DBT. It seems to be similar to a psycho-therapeutic style.
However, as we know, realization of the problem and change in destructive behavior is necessary. Obviously, if a person isn't willing, any therapy is a futile process.
Another thing is mindfulness is completely unrealistic. I know because in my darkest hours, I tried it. When I couldnt sleep and desperately wanted to shut off my thoughts, I tried so hard to be mindful of other sensations but it simply could not work very long. Its a nice theory but humans are meant to actively think, not passively think. They are meant to remember, they are meant to emotionally react... they are meant to grieve.
You need to practice the mindfulness when you're not upset first. Practice meditating 20 mins per day every day, I promise after a few weeks (or even days) of practice, you'll notice a huge difference. At first I could only focus for a few seconds, but it builds up with practice and time, like exercising your mind. Now I can focus much longer, and when I'm having panic attacks I can focus my attention on my breath and it calms everything down, it's incredible really because I never thought that would be possible. usually panic attacks or 'rage attacks' feel like static brain overload to me where I can't think at ALL or control my actions at all, but this really helps a lot. I use the app Headspace, it is really simple guided meditations, and not all hokey and "spiritual" lol
NoMoreMissNiceGirl correct, actively think. Your thoughts are not that. Yours are mindless chatter only. They mean nothing. 99% of all thoughts actually mean nothing. You must realize this. It’s just background noise. You are paying attention to them, but most people don’t. Everyone has those endless thoughts 24 hours a day. It’s only you who is paying attention to them. Trust me, your statement is nothing new. I hear it every day. It’s nothing to be worried about, and nothing you need to pay attention to. Let them be and go on with life. It really is that easy.
@@joesmith389 your thoughts and emotions are what make you a human being.
BPD is very hard to treat and DBT does NOTHING to stop feelings of emptiness. It also does nothing to help over-sensitivity. It tries to give you coping skills to deal with the sensitivity like being mindful but you still feel the overwhelming pain. If anything, you feel your pain even more when you are mindful of it. You become consumed by the darkness and then all you get to deal with it is more mindfulness. The only thing that helps is Wise Mind but it only helps prevent things getting WORSE.
studies demonstrate all symptoms decrease with time the further you go into dbt hun. it is a gradual process soon you will FEEL better too
+Mary Rose Roche fuck, I'm fucked then.
@@bonson9156 no, it's proved that dbt could help bipolar
+angelladycna I dont do DBT online. I go to DBT sessions twice every week, one session is one to one and the other is in a group. I am nearly done a year and it does not work. Its not anything I am doing wrong, it is just not good enough for severe depression and creating a sense of self. Yes some of the things they teach are good like wise mind or radical acceptance but it does not male a significant difference. It will definately not heal BPD or even make much difference.
+Mary Rose Roche Depends on the severity of your history. Or you may be misdiagnosed..? It happens.
Depends on the dbt therapist. Most not all are rigid.
It doesn't mean it wont work with other people
I agree just by seeing this video. She is inviting client into pain without even saying he wont stay with this pain and alone. The best way to sabotage borderline patient. She does not discuss what kind of pain, so the mind of wounded person is inevitably subconciously will search retreat instead of opening up. Very thin line.
I agree. It’s not an even playing field and not fair. It invalidates how someone with cPTSD has been living their life. And yet it claims to help those very people. It just gaslights all over again. Only useful stuff is meditation which has been in Qi Gong for thousands of yearsz
I have anger issues that scares me too
me too
Good on you for recognizing it & being vulnerable enough to admit it :)
Isn't it more likely that the patient will be more motivated to go through with the treatment if they internally agree with the reasons. Why didn't she get into a discussion of why changing would be beneficial? If she could have convinced him wouldn't it stand to say that his treatment would be more successful? I, for one, wouldn't just agree to do something because someone was just asking me to do it. That's like signing a contract without reading it. Just because he has a disorder doesn't mean you shouldn't try to treat him with respect and consideration. I understand his decision making process might be hindered, but at least an attempt should be made.
Why don't you ask, Dr. Linehan?
Once you see youre being bullied in a relationship.its time to leave. Bullies never change. Its in their personality. Its who they are. Its how they operate.
The "patient" is Dutch actor Henk Grashuis.
Should we be mindful of our food and embrace little things like that more that we take for granted? Sure. We should do one thing at a time and slow down more but to try pass mindfulness of as some cure for a crippling mental illness is ridiculous. Mindfulness doesnt even come close to touching the issue of personality disorders because its too broad and too general. Its about paced breathing, relaxing (may help reduce anxiety) but does not even come close to undoing the complex thinking of BPD
The reason why most attempts to heal depression are vain is because it is often caused by our views on life which is so much deeper and complicated than just black and white thinking. And often times our views are valid ones so shouldnt be changed. DBT also doesnt help with self-esteem from bullying etc. or the desperate need to feel loved which is a big driving force behind the behavior of BPD.
DBT is super misleading. Marsha runs around saying it’s the only “strong evidence based therapy” for borderline personality disorder. However the APA states clearly on their website of evidence based practices that DBT is only evidence based during their 1st stage of safety planning, stabilizing, and “skills training.” The actual talk therapy portion of DBT does not have strong empirical validation, and performs moderately successful. In many studies too, people who utilized DBT reported that their quality of life was still very poor and they were just as depressed as they were prior to utilization. They still hated their lives. However all they could now do was use their deep breathing and other skills when they were feeling impulsive. Many clinical trials find transference focused therapy and mentalization to be far more successful in regards to an increase in reported quality of life.
I don't know if I have bpd 100% or not but I had a horrific childhood which left me completely disabled in my teenage years and very suicidal from flashbacks and intrusive thoughts, I couldn't form a bond with anyone etc . . I did EMDR therapy and it changed me , I was able to work full time and function, I still suffer from anxiety but it's not disabling so I'm sure there are definitely other therapies that could help besides DBT
It is proven to reduce suicidality. It saves lives. That’s a big deal in todays world. It is also widely available. No one does transference focused therapy.
Yes, DBT is about stabilization. Stage 2 is sometimes referred to as the "quiet desperation" phase, where problem behaviors are under control. This session is clearly a "pre-treatment" session, where the client describes and commits to changing the problem behaviors. No, the stages beyond 1 (behavioral stabilization) and 2 (processing trauma without resorting to probem behaviors) are not well developed. I don't see the Keibler with that. There are a multitude of other effective, well researched treatment approaches for meeting life goals (stage 3) and finding meaning in life (4). There are none as effective and well-researched as DBT for extinguishing problem behaviors.
This is false. The studies show that it takes one round of DBT to stabilize and stop people from killing themselves. Yes they are still miserable at this point but stable. Then you’re supposed to go through it a second time to work on building a life worth living, which takes much longer.
on psychological and physical hitting, sometimes the psychological can do a LOT more damage.
Yes...and that's a major driver of a child developing BPD!
But that doesn’t mean that the way he perceives her hurting him is worse than how he hurt her.
Great video. I'm in grad school for counseling - question - if someone says something like he did, such as "Why should I change?" - does that indicate personality disorder? There aren't many details about the personality disorder in the description but I thought his question was a very interesting one. Growth minded people want to change.
No absolutely not, most people do not like change and will avoid it. If i tell you that you need to change how does that sit with you? I doubt you are entirely welcoming of that comment.
@@BK-hp6fv thanks for the reply! I actually love changing the parts of me that need to be changed and healed so for me growth is a good thing for sure! I crave change for the better 😊
@@LesliWebandMediaSvcsonUA-cam as its a year since you asked that question I'd guess you don't me to answer it for you but in short my answer would be no. Change is hard, I'd guess you did alot of inner work to be so welcoming.
1:12 I’m surprised this “husband” told this lady anything with how condescendingly she is looking at him.
Is she a Clinical Psychologist? I believe her Phd was in Personality Psychology which is similar but completely different as it does not involve clinical training in anyway. Is she licensed to work with clients?
Yes, she is one of the most famous psychologists in the world. She developed Dialectical Behavioral Therapy (DBT) specifically for people suffering from Borderline Personality Disorder (BPD).
She is a professor and what the person above me said ^
Ok does she still work with clients. Is she a licensed Psychologists. I know she's a professor and created DBT but has she practiced with clients one on one?
RajaMCool Yes, for many years. She is utterly expert.
RajaMCool Yes, she is.
Always Enjoy the wine Wednesdays sana!!!🔥🤟🏼❤️
Wait, the guy's wife was threatening to kill their baby?
That went along great
He has to change because he is obviously a physical abuser. Not many people have compassion for that.
I really like that she is so non-judgemental.. I mean here is a guy disclosing he has hit a woman to the point of breaking her finger and instead of raging on him Marsha sees the illness in him .. the reason for his behaviour.. she doesn’t blame him but guides him so that he himself realises his mistake. And even as he realises his mistake Marsha has this calm assuring voice explaining to him without words that she feels his pain and is not judging him..
Recommend you look at Mindfulness Therapy for overcoming anxiety disorders; it's available via Skype and can be very effective.
This therapist seems like a creep
Take note of the therapist's facial micro expression at 1 minute and 42 seconds. That was an expression of contempt, probably the feeling she had toward the client. Paul Ekman's method points to a unilateral (one-sided) ''contraction' of the muscle on one side of the face; like a smirk.
I wouldn't expect any less. And the bored expression, head hanging to the side, as if she felt so powerful she didn't even have to pretend she's interested and respectful.
"tough shit"
It’s a therapy that truly guilt trips you
Linehan looks like she is rather non-empathic and constipated.
I mean the guy is an actor and she's a psychology researcher. It's a demo video, not a real session. So he comes across as real. She's probably trying to remember her lines.
True. I'm borderline and i'm trigerred by this woman lol.
@@delphinelouise838 I was quite shocked yes irregardless of the value of DBT, which I spent 2 years in... that did sound quite cold and did have a trigger effect on me as well. Mary Z on borderliner notes has several videos than examines beyond DBT which I found encouraging.
WOW....in denial........"her finger got broken by accident?
This woman is using her wise mind. Why waste time if the
the person does not agreed to change..........
Congrats to this man for telling her not to kill their baby!! Never have I heard of a man actually standing up for himself regarding unborn children!! Courage comes in a DBT Therapy session!!
This man is a Dutch actor; this is part of a video series about DBT. Though I’m sure most men have love for and try to protect their children.
I would dump this woman so fast. Notice her judgmental tone and tilted head as he speaks. This is your therapist? Who literally thinks "tough shit"? Instead of phrasing her words as if she understands and empathizes but still focuses on his change, she automatically challenges the validity of his thoughts....and this is the first session. Rediculous. I hope she sticks to counseling women
Challenging his thoughts like that is necessary. She was validating but like she said, unless it's painful no change is ever going to be facilitated.
I don't have experience as a therapist, but I agree. I would have trouble trusting someone who treated something I said like that. If she'd actually gone over the reasons, I could maybe see getting away with it, but if the client is already agreeing that "anything would be better than this" then it should have been easy to tie that in. Her attitude is more punitive than caring. Her empathy with the client is lacking and glossed over while. Her validation of his pain sounds half hearted to me. He's a good actor - I FELT sad for his pain over the unborn baby even though I am pro-choice. I felt sad for him feeling helpless about the child he cares about. It sounds like she's brushing it aside in a hurry. I'm a little surprised this could even work. Maybe she's different in a real life situation and shortened it for educational purposes.
Barry Soetoro I feel the same way. When her totally bored looking face came on the screen I was like “Oh my GOD!! BODY LANGUAGE WOMAN!! Show a little assertion for the price he’s paying you for therapy!!” Jeesh! You might think she’s not getting PAID to be there!!
This woman is the person who invented DBT.
He is an abuser! Let's stop making the victim the one who always has the problem.
we watched this video in a Masters psychology class. This man is an actor & not a real client! She is awesome