Friday, January 28, 2011


DBT (dialectical behavioral therapy) is a widely used therapy program that was developed by Marsha Linehan for use with patients with borderline personality disorder. It is now used with mood disorders, abuse survivors, and substance abuse issues. The mood and anxiety program I'm in as my outpatient treatment program post-hospitalization is solely DBT-focused. At first, the worrier in me wondered if the fact that I knew DBT worked well for me meant that I had BPD (a diagnosis I really fear)... but using my wise mind (a DBT skill!), I know that correlation does not imply causation and that I should not worry about that.

Basically, DBT is awesome. It has four modules (mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness). Today, as skill practice, we played a game called Moods in which you choose a card with a mood on it and a card with a totally random saying or phrase, and you say the phrase in the specified mood. The moods aren't all easy ones, either... they include bashful, indignant, and hopeful. Try saying "there's gold in them there hills" indignantly. Go ahead. It's not easy!

Think about how much these skills can help a person with ASD. Distress tolerance? Emotion regulation? Interpersonal effectiveness? Mindfulness? I mean, come on, this is huge. Why aren't people using this for people on the spectrum?! The study I'm in uses a cognitive therapy, CET (originally developed for schizophrenia), to treat ASD, and it's not even as helpful as DBT is for me. These skills are also hugely helpful for someone with an ED, I might add. We focus a lot on disrupting the cycle of emotion dysregulation which leads to engaging in problem behaviors (for me, that's restricting calories and overexercising).

I'm so excited to finally be in a program that might actually WORK. That would be new. In a good way.


  1. Sounds like an interesting program - I have not heard of it before. I am glad to hear that it is helpful to you and that you are able to find it useful despite your initial fears.

    I'll definitely be looking into this for more information - so thank you for sharing!

  2. and you get to do it living at home with Elsie P :o)

  3. This is sounding very hopeful Lydia. I really do pray that it is really helpful for you.

    Mrs. E

  4. Thought of you today--the coffee shop I hang out in on my days off has this badass calico cat named Trixie, who will sometimes come and sit with me (and lick whipped cream out of my cup) if there aren't too many other people around. I'll try to get a picture for you next time I'm there.

    I've heard of DBT before and thought that it sounded like it might be better for people with ASD's than CBT (how's that for an alphabet soup of a sentence?). I had CBT a couple of times and it sucked. Anyways, glad to hear you're feeling better!

  5. The psychologist who diagnosed me used DBT for AS. Now I kind of wish I stuck with him, evn though I hated his personality. I have always thought thos] skills would b VERY useful for me and AS. Hmmmmmmmmmmm.

  6. I'm sure you could find a psychologist you like who also uses DBT. No reason to stick with one you don't like. I've had... 6? and I've only liked one of them, so I've been with her for 3 years. She doesn't really use any method but just talking to me. I feel like we've spent 3 years building rapport, but you know, I REALLY needed that. I didn't trust them worth beans when I started with her, so she's taken a really long time just to get to know me, throwing in suggestions and ideas when I need them. Basically, you have to find the right fit for you :)

  7. I am happy to have read your post. My therapist suggested DBT for me and I was wondering how effective or would be. I was also concerned about the BPD label. You are correct in saying correlation does not imply causation. I believe I will give it a shot. Thanks for sharing!

  8. Hello,
    Lydia, the book you provide a link to does not lead to the book. Is it still available?
    I agree that DBT provides a useful set of skills for emotional regulation, distress tolerance, and self-soothing, etc. What do you find is the most helpful skill for you? Have you seen any areas in which DBT comes up short or does not address an area in which ASD causes a challenge functioning in a neurotypical world? I am really interested in people's experiences with this.

  9. Hi! I am an Intensively trained DBT therapist. I am currently teaching these skill sets to Autistic children and their parents on an individual, case by case basis. We ARE out there! -Tina

  10. Hi Lydia, it has been 4 years since this post and I am so so curious on whether DBT continued to have an amazing impact on your ability to manage emotional and situational challenges. My curiosity comes from the place of being a mother to 6yr old boy with HF ASD as well as being a therapist & peak performance coach. I really would love to hear your response. you can call me at 949-424-3298 or email me your contact info and I will give you a call. Thank you so much!

    1. oops my email is