Category Archives: therapy

First NPD-Focused DBT Group: Real World DBT

I’ve become a big fan of Facebook groups recently. It’s where all of my Cluster B support groups are.

I’ve been looking for a while for a good Facebook group for DBT. Unfortunately it wasn’t as easy as expected. The problem:

Trigger Warnings 

Trigger warnings have taken over. In one group I’m a part of, the arguments over who was and wasn’t using trigger warnings and when, got so out of control they had to shut down new posts. Seriously, people?

I find this to be baffling. The point of learning DBT is to better regulate our own emotions and change unhealthy behaviors. Expecting everyone to anticipate what will trigger us and act accordingly seems counter to the purpose of learning DBT.

In my opinion, it’s just more asking others to walk on eggshells. I’m trying to get rid of my personality disorder, not continue expecting others to work around it.

Learning DBT helps us do that – with mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. So we should be using the skills we are learning when we feel triggered. After all there is no way we are going to avoid all our triggers out in the real world.

Narcissist Bashing

Let’s face it, the majority (if not all) of DBT groups cater to those with Borderline Personality Disorder. There are a lot of similarities between NPD and BPD and in my real life DBT class, I honestly don’t even think they realize I’m not one of them, our experiences are so similar.

But online people feel a lot freer to attack others, especially when they don’t realize there are people with NPD in the group. The idea that narcissists can’t become self aware is still pervasive.

In the end I find myself being triggered without empathy, by the same people who have a 200+ long list of trigger warnings they need for themselves.  Not cool.

Real World DBT

So, I started my own group, Real World DBT, for learning, practicing, sharing tips or resources, and seeking advice on DBT skills.

While anyone is welcome to join, the emphasis is on those with NPD, CPTSD, anxiety and dissociation. And there are no trigger warnings required. 

To my knowledge it’s the only group of its kind.

The structure of the group is laid back. You can be as active as you’d like. Every week we will highlight a new skill, and at the end of the week anyone who wants to share their diary cards, progress or challenges can.

Throughout the week we will support each other, offer resources, and give/ask for skills advice.

Group Info

Real World DBT is a group for those with trauma-based disorders to learn, practice, share tips and resources, and seek skills advice, on Dialectical Behavioral Therapy (DBT), including mindfulness and grounding techniques for dissociation.

Who: Emphasis on those with/suspect NPD, C-PTSD, Dissociative Disorders, Anxiety Disorders and other personality disorders. However, all interested in learning DBT are welcome.

In this group there are no trigger warnings required. We can’t always avoid our triggers. It’s up to us to learn how to cope with our emotions in a healthy way. Learning DBT helps us do that – with mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness.

Want in? Join us!

Research: Can You Change Your Personality?

The client’s reason for entering therapy did impact the level of personality change, though. Those who sought therapy for anxiety or personality disorders (such as borderline personality disorder or narcissistic personality disorder) changed the most, while those with substance abuse and eating disorders changed the least. It’s not clear why that is, especially since personality disorders are considered as difficult to treat as substance abuse. But it does suggest that not everyone is able to change to the same degree and that more research is needed to uncover why.

Can You Change Your Personality? | The Huffington Post

A Narcissist Does Group Therapy

For the last few months, I’ve been doing DBT kind of on my own. I bought the green book, The Dialectical Behavior Therapy Skills Workbook, which I’ve been working from. Also, my therapist and I dedicate the last 10 minutes of every session to DBT, mostly practicing “wise mind.”

But I wanted to accelerate my learning, so I asked my therapist to suggest a DBT group for me. She came back with a group led by a woman who focuses on DBT through “art therapy.” Last night was the first meeting and I was so excited that I even arrived on time.

It’s a small, all-women group of four, plus Marsha, the therapist. As we sat there waiting for the group to start, we began introducing ourselves and saying what we do for a living. I quickly got up to speed on who everyone is and why they were there.

First up was Suzanne, who lives with extreme anxiety. Her whole body seemed to shiver with nervousness every time she talked. Even her voice quivered. When she held up a piece of paper, it shook uncontrollably.

Next was Sam. Sam initially seemed to be OK, speaking amongst just us participants, but when the group started and Marsha asked her to introduce herself, she completely shut down. Her eyes looked down in avoidance and she gave clipped one-word answers. She looked like a child being scolded after getting caught with her hand in the cookie jar. The sudden shift was jarring and awkward.

Introducing Teresa

computer hackerThen, there’s Teresa. My guess is Teresa is Borderline. I may have even considered her for a covert narc, but I already got the scoop from Marsha that I’m the only NPD in the group. (I’d expect nothing less.)

I immediately sized Teresa up as the most likely person in the group for me to be friends with. First of all, when I mentioned what I do, she was familiar with my work, she had seen it before and even cited some back to me. Brownie points for Teresa!

She seemed about my age, attractive, well spoken, and smart. Socially we seemed to hit it off pretty quickly during small talk. So Teresa already had my attention. Finally, it was Teresa’s turn to share what she does for a living. Turns out Teresa is… a forensic hacker! [Record screeches to a stop]

Holy shit, a hacker? Teresa’s stock with me just skyrocketed. How badass! I feel myself immediately warming to Teresa. I resize-up her outfit, her hair, the way she talks, and I’m thinking… yeah, me and Teresa could totally be friends!

Let the (art) healing begin

Marsha starts us off with some mindfulness, then she asks us to begin painting. While we are painting, she tells us to be mindful of the thoughts in our heads.

I smile, but internally I’m rolling my eyes. Quite honestly I feel a little silly doing this – a bunch of grown women with emotional problems sitting around a table doing art like we’re five – but I’m trying to go with the flow. Do something new and out of the box for me. I follow Marsha’s advice and acknowledge my feelings without judgement, gently bringing my attention back to the experience of painting.

It takes me a minute to get started. I need to rock this painting – really establish myself as the leader of the pack here. Everything I do should really be a masterpiece. But I don’t have any idea of what I want to draw. I let my eyes glance over…Sam and Suzanne are no competition. Seriously, are you guys even trying?

I look over at Teresa’s. Her painting is…good! Probably still not going to be as good as mine, but she’s hanging tough. Respect, Teresa. Your cool points with me keep accumulating.

Guess I’ll take the lead…

group therapyEvery time Marsha asks a question and looks around the room, no one wants to answer. So, it appears to be up to me, the narcissist, to get the ball rolling. Of course.

Once or twice is cool, but I really hope this isn’t my “role” now. The emerging pattern is that I go first, Teresa chimes in after – usually with something totally relatable to me – followed by Suzanne. Sam must be coaxed by Marsha to contribute.

Marsha asks us to talk about what emotions we felt while painting. What thoughts did we acknowledge? True to form, the table is quiet. Ok… guess I’ll go first. Again.

“I really wanted my painting to be the best. I had trouble just being in the moment because I was too focused on the final product, not the act of creating the art.” Marsha is happy with my contribution. Teresa laughs in a friendly, we totally relate, kind of way. Sam looks at me awkwardly and tells me she likes my hair. Ummm, thanks!

The elephant in the room

elephant in the room

We begin reviewing the list of things we will touch upon in the class. One reads, “Addressing the elephant in the room.” Oh shit…there’s going to be some elephant in the room situations? This could get interesting! I have one: why can’t Sam talk when called upon, but when we are supposed to mindfully be doing art, she can’t be quiet?

Does anyone have trouble with that, Marsha asks. The others nod an enthusiastic yes. I chime in, “Oh, I have no problem addressing the elephant in the room. My problem is how I address it.” More kudos from Marsha for my stellar contributions. So far, I’m winning at group therapy.

The thought crosses my mind: what’s the elephant in the room when it comes to me? But I really don’t like that thought, so I quickly dismiss it and mindfully get back to my work. Funny how I ruminate over everything else though, isn’t it?

Take-aways from my first group session

I’ll tell you one thing I immediately took from the group – however socially awkward I felt before, I really need to stop being so down on myself about it. Seeing Suzanne and Sam in action let me know I really am not that socially awkward. At all. In fact, I’m basically a rock star.

Although this thought initially feels very narc-y it’s actually a DBT principle – comparing yourself to others who are less fortunate. So, I remind myself not to feel bad about it. It certainly helped me put some things into perspective.

In fact, in other good news: Outgoing Yara is back! I haven’t seen her in damn near a year, and boy did I miss her. Outgoing Yara is one of my “selves.” Instead of looking at them now as “false selves,” I have decided to look at them as different facets of my core personality. None of them necessarily “false,” all of them part of the real Yara.

But while some personalities – like Cluster B Girl – I really hope to get rid of or drastically diminish, Outgoing Yara is one of my faves. She’s pretty, smart, well-put together, confident, friendly, competent. The whole package. I definitely want to keep her around.

I did have to remind myself to have empathy with Suzanne and Sam, while listening to them talk and watching them interact. It was a conscious effort, but one I’m glad I put in. I give props to all the women there, for stepping outside their comfort zone and trying to improve.

Although I am concerned about the art, I will say I started to get into it. It may be good for me to learn to create for fun, instead of competing constantly with others. The exercises really drew to my attention how competitive I am at all times, even when not appropriate or helpful.

Also, the fact that I feel silly doing the art makes me think I should keep going, because I need to focus less on how silly I think I “look” or how others may perceive what I’m doing.

Finally, the point of doing the art is to remain mindful during, which I really need lots of practice in, as the mindfulness is key to addressing my almost constant dissociating. So, maybe it’s not so dumb after all.

Soulmates in another lifetime

best friends.jpg

Finally, Teresa’s OK in my book. We related on basically everything, like twin flames. Marsha told us at the start we can’t be friends though—at least not until the group ends. She said it can interfere with group dynamics, which makes total sense.

I can tell you though, just two years ago had I been in this situation, me and Teresa would have been immediate best friends. Inseparable within weeks. This is it folks: the beginning stages of idealization.

In the past, I’d be unwittingly love-bombing her as my new BFF. Highlighting everything I like about her, while ignoring anything that didn’t fit with the image I created for her in my head.

It’s probably a good thing that Marsha laid down the law. Disappointing though, because it’s not very often at all that I find someone I can relate to so well – and Teresa was hitting on all cylinders.

But for now I’ll just mindfully acknowledge that feeling and bring my attention back to focus on the therapy. I’ll get to know Teresa better, and if, by the end of the group we are still cool, maybe then we can become friends.

How to Make Yourself Fall Out of Love

Ever been in love with someone you knew was bad for you, but couldn’t help yourself?

Cluster B’s have a tendency to idealize and devalue others. When I have idealized someone they can virtually do no wrong.

Even, and sometimes especially, if they are treating me poorly, it can be hard for me to let go. I see only the good in them, and have a tendency to internalize their bad or hurtful behavior as some fault of my own. I am defective. Unlovable. That’s why they are treating me so poorly.

At times like these my old friend, Devalue, would be really handy to have around. But I can’t control the devaluation process. Devaluing for me, is like falling out of love — it just happens.

Worse, I have a tendency to devalue those who treat me well, and exalt those who mistreat me. I think, if they love me, there must be something wrong with them.

Or, they are trying to manipulate me.

A couple of weeks ago, someone in one of my Cluster B groups mentioned the DBT Peer Connections series on YouTube. I finally got around to checking it out and found it helpful.

The series consists of 23 episodes, ranging in length from 3 minutes to 2 hours. So, it’s a time investment. But from what I’ve seen so far, it’s worth it.

In this video (below), she talks about using the DBT skill, “Opposite Action” for emotional regulation, and goes through a series of emotions including jealousy, anger, shame, guilt and even love. DBT Opposite Action Love.png

This was the first time I had seen love covered as an unhealthy emotion that requires regulation. But for a lot of us, it is.

When love doesn’t fit the facts, when the person doesn’t deserve our love or admiration, there are things we can do to change our feelings — we don’t have to be slaves to unhealthy emotions.

She gets to love at 18:00, but the entire video is worth a watch. I identified with needing help on all of the emotions, especially anger.

DBT Peer Connections Ep 4c – Emotion Regulation Opposite Action

14 Psychologists Describe What It’s Like To Treat A Narcissistic Patient

Wow. Reading stuff like this makes me feel like I’ve won the lottery by waking up.

It’s also incredibly depressing what the world thinks of us, and how quickly and easily they write us off as inherently damaged and unfixable. It’s eerily similar to the messages my mother gave me as a child, which is how I got the disorder in the first place. Irony or nah?

On the flip side, I am coming to see narcissists are much more open to awareness and change than previously thought. It took me 9 months in therapy to wake up.

It’s just I don’t think the world — including the psychiatric world — has caught up yet.  When my husband told his therapist that I was diagnosed with NPD and was working on changing, she didn’t believe him at first. And she’s a professional. Sheesh.

I should note, not all professionals agree with these pessimistic outlooks on NPD. In this podcast, the therapists agree the narcissists are the fun ones to treat, while the codependents are really frustrating. Others, like Craig Malkin, author of Rethinking Narcissism, also take a more positive approach. And personally, my therapist is very supportive, positive and empathetic toward me and my recovery.

I think it’s important to find a therapist that really enjoys working with personality disorders — they are the ones leading in this field and making the biggest strides toward effective treatment, whereas others are quick to write us off.

I’ve heard too many stories of NPDers seeking treatment, only to be dropped without explanation by therapists who never even gave them a chance. In my opinion, that’s incredibly irresponsible, damaging to the patient, and should come with some sort of professional consquence.

Despite some of the pessimism, it’s interesting to see what professionals treating NPDers are thinking. You can read the article, 14 Psychologists Describe What It’s Like To Treat A Narcissistic Patient here.