Tag Archives: Dialectical Behavior 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!

Learning to become the mother I wish I’d had

I have a six year old son, Andrew. I first started noticing a shift in his behavior in Kindergarten. He started acting out at school, but it didn’t become a huge problem until he started first grade this year.

For the first few months of the school year, I was getting daily calls from the teacher telling me that Andrew was a problem. He lashed out at other kids. He was hyper-sensitive to any perceived slight – if someone stepped on his toe, for example, it wasn’t an accident in his eyes. They clearly meant to hurt him. And he had to react and get back at them. He had to defend himself.

It was at the point I was worried he would get kicked out of school.

At home, he would throw temper tantrums and a couple times, he physically lashed out at me.

His friendships were dwindling. His best friend moved away, and he had trouble making and maintaining friendships. When he was invited to something, he was crippled by anxiety and reverted to acting out, or acting like a clown—trying to make others laugh, because he didn’t know how to connect with them any other way.

I see so much of myself as a child in him. I too had rage. I too acted out. I too felt alone and unloved.

I look back and realize these were all cries for help. Instead, my parents blamed me for my poor behavior, told me what a terrible child I was, heaped positive attention on my more docile sister, and offered no other help.

One of my biggest fears is raising a child that has the same emotional problems I have. I know how hurt I was by my parents and I don’t want my son to feel hurt by me in that way.

I know what it’s like to live with the low self-esteem, to have no control over my emotions, to have fleeting volatile relationships. Never able to believe anyone gives a shit about me at all. It’s lonely. I’ve lived a life full of rage.

I looked at Andrew, and realized he was becoming me. Most of what I’ve read says narcissism is established in children before age five. Fuck.

Well, I can’t go back in time and change my earlier mistakes, but I can change what I’m doing now and going forward. Furthermore, if I can change pathological behaviors in myself at 36, he has a much better shot at age 6. Focus on the positive. 

My goal became to turn things around before his behaviors become so engrained in his personality that it takes root as a full-fledged personality disorder. Early intervention.

So far, it seems to be working. This week his report card came home and for behavior, he got a B. Huge improvement.

Also, he was invited over to a neighbor’s house to play and I think it went well. Evidence he’s starting to be more socially accepted and learning to get along better with others.

Maybe he won’t be stuck with these issues for the rest of his life after all. Fingers crossed.

Here’s some of what we’ve been trying:

Labeled Praise

I enrolled Andrew in behavioral therapy. I had mixed feelings about it, because I was afraid the emotional issues would be ignored for behaviors. But we had to get his behaviors under control ASAP or he was going to get kicked out of school. 

For our three sessions, we walked away with one real piece of advice: offer labeled praise when he does something good, ignore bad behavior.

The labeled praise should be given liberally while he’s doing the positive thing. For example, “I like how quietly you’re playing.”

Seems too simple, but it started to immediately turn his behavior around at home and at school. That was the crucial first step.

Being mindful when I’m with him

I would often be checked out when I was with my son. Time spent with him was necessary to get the job done (bathing him, getting his homework done, feeding him, etc.). I could be dissociating or thinking about my own issues or checking my phone. Most of the time, my mind was elsewhere and I was running an internal countdown clock to his bedtime when I could finally get some uninterrupted “me time.”

I wasn’t there with him, didn’t enjoy spending time with him, and he knew it. One day, he asked me if I love him. Like, really asked. My heart sank.  

Now I make a concerted effort to be in the moment when I’m with him. Sometimes I will leave my phone in another room. We have phone-free family time now too.

The more I practice being one-mindful with him the more naturally it comes.

Engaging him

I didn’t know how to talk to my own son. I didn’t know how to relate to him. When I first started engaging him more in conversation, it was incredibly awkward. He would say something or ask me a question and I had no idea how to respond.

I couldn’t be myself with him and he couldn’t be himself with me. It’s like I was babysitting someone else’s child. At six, he already wasn’t sharing major details of his life with me. He already felt he had to handle everything on his own.

I had to build trust with him, by talking to him a lot and really listening to what he has to say – and then showing him that I was willing and eager to help with his problems – and prove that I’m his advocate.

Empathizing with him and teaching him empathy for others

I have to teach him empathy, while I’m still learning it myself. Essentially, we are learning together.

I make a regular effort to put myself in his shoes. I ask myself often, how might this make Andrew feel? I try to remember how it felt to be a child.

I talk it through with him. I explain how I think he feels and ask if I have it right. I tell him I understand why he would feel that way. I relate to him by talking about how I may feel in a similar situation or how I felt in similar situations in the past.

I encourage him to think about how others may feel in a given situation, or how he would feel if it was him.

When he feels slighted by someone and wants to defend himself, we talk through what actually happened (the facts). We talk about how the other person may feel. Discuss other possibilities for their actions, rather than assuming they are out to intentionally hurt him.

I praise and encourage him when he shows empathy for others, for animals, for his baby brother. 

Last week, he took it upon himself to get the cat water and I praised him for thinking about her needs and being kind to her.

Kindness

Being kind to him. Being understanding when he makes a mistake. Being forgiving. Encouraging him to be kind to himself and not to engage in negative self-talk. Encouraging and praising him for being kind to others.

Focusing on the positive

I remember to praise him for the good things he does. When we talk about the negative, I try to frame it in a way that emphasizes healthier reactions. I make sure to let him know bad behavior doesn’t mean he’s a bad person, it means we have some stuff to work on.  

I’m teaching my six year old DBT

My husband and I are both working on learning DBT ourselves, and we don’t hide it from our son — we invite him to participate.

So far, we’ve showed him opposite action, distraction, mindfulness, radical acceptance, fact checking and a few other skills.

The other day he was upset about not getting home until late, because he wouldn’t get to watch Pokémon XYZ, which had just come out on Netflix. It was a great opportunity to learn radical acceptance

I validated his feelings, acknowledging how upset he was and explained that I could totally understand why he felt the way he did.

Then we talked about how this particular situation was something we couldn’t change, and that continuing to be upset about it would only make him more upset. Instead, I helped him distract himself from the negative emotions by playing a game with him in the car.

Encourage him to explore his feelings

Anger is a secondary emotion that other harder to face emotions hide behind. When he’s angry, I encourage him to take some time to think about exactly why he felt so angry. I try to talk through it with him to help him explore the root feelings. 

Showing fairness between him and his brother

Growing up I was the scapegoat, my sister was the golden child. When my sister was born, I was essentially ignored and told I was the bad one, she was the good one. We were pitted against each other and because of that, I was almost in my 30s before we had a relationship. I don’t want that for my kids.

I honestly see how this could have happened. 

Last year, I gave birth to my second son, Ethan. With all my attention going to the baby, I would get easily frustrated with Andrew, who was feeling ignored and seeking attention by acting out. 

He also is loud and wakes up the baby. He is much bigger and doesn’t realize the baby is more fragile, so he can be too rough sometimes, etc. etc. etc. Normal kid stuff, but it was already beginning to turn into me focusing on all the annoying things Andrew did, while heaping all my kindness and attention on innocent little Ethan. That had to stop.

I now praise him for any kindness he shows to the baby and tell him often what a great big brother he is. I ask for his help with small tasks and praise him for being so thoughtful and showing empathy toward Ethan.

I make every effort to point out when the baby shows affection to his big brother by smiling, wanting to play with him, etc. I tell him how much his baby brother loves him and looks up to him.

I try not to compare them. We do sometimes talk about differences in their personalities, but non-judgmentally. I try to point out each of them have their own unique personalities, and highlight the good in each of them.

I also make time for just Andrew. Last weekend we went to the movies, shopping, out to dinner, just the two of us and I was able to stay in the moment for most of it.

Highlighting my own flaws and discussing them with him

I let Andrew know now that we (me and his father) are not perfect either and that we need help managing our emotions too.

I’m still learning and sometimes I mess up. Sometimes I blow up,  mentally check out or am just plain negative. I’m a work in progress.

But I’m trying to do better and take responsibility when I mess up. I apologize when appropriate or necessary.  I do my best to explain that it’s not his fault. I talk about what I could have done better — then really try to do better next time. Ask him how he feels. Try to show him I’m trying and that things are consistently improving. 

I also try to use these situations as teachable moments. I relate to Andrew and the trouble he’s had with his behavior, explaining that I have the same problems and I’m also working on it, just like he is.

I ask for his empathy, by reminding him how he feels when he loses control of his emotions and ask if he can understand how I may have been feeling in a similar way.

We talk about better ways to handle those situations. I make every effort to handle it that way going forward. I encourage him to point out to me if he feels I’m acting a certain way and I take a pause if he tells me I am.

I do my best to talk through my own efforts at emotional regulation so that he can see and learn what’s healthy and what works (and what doesn’t). It’s important to me he knows how hard I’m working on it. My emotions are mine to control and not his fault. Sometimes I will tell him, mommy is feeling angry – you didn’t do anything wrong and I’m not mad at you– but I need a few minutes alone to cool off. He gets it and will sometimes tell me the same. If he does, I back off and come back in a half hour to see if he might like to talk about it now.

I also ask him every so often: what can I do to be a better mom to you? 

Bonding with my son

Last week, Andrew got in trouble at school. This is much less frequent these days, but still happens sometimes. I wanted to talk to him about it.

He had noticed the field in back of our house was filled with small flowers and had been wanting to show it to me for a few days — he kept bringing it up, but it was never a good time. He asked if we could talk about school in the field. It was one of the first nice spring days. We sat in the shade of a tree, just me and him in the field of flowers.

He told me what happened. He was honest, I was kind. It was a good talk.

After we’d talked it through, he told me: I want to focus on positive thoughts now.  That made me smile. 

We played hide and seek and I stayed in the moment with him.

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.

Distraction: Using Music and Counting to Self Soothe

I love music. I have always kind of naturally used it for emotional regulation. Happy music to expand happy feelings, or to pull me out of a funk. Sad music to mirror my feelings.

In Dialectical Behavior Therapy (DBT), music is suggested as a tool to distract you from intense emotions, and to calm and soothe yourself when stressed and overwhelmed.

When I need a distraction — like when I am getting upset and want to avoid a fight with my husband — I like to use music, combined with counting, another DBT distraction technique.

For distraction, I tend to prefer something with a heavy beat or baseline. I lay down, put on headphones, close my eyes and count the beats. To help my mind not drift as much, I like to picture big bright numbers flashing one after the other. Usually by the end of a song or two I’m feeling much calmer.

Do you use music for emotional regulation, self soothing or DBT? What are you listening to these days?