Most people are used to the stereotype of a therapist being – an expert, an all-knowing being, a director of conversation, a blank slate. In contrast, a Dialectical Behaviour Therapy (DBT) therapist is a human being sitting in a room with another human being. A person (in the therapist) who is ready to be the coach, offering support from the sidelines, while the player (or client) runs and ultimately scores, each time putting life points on the board. This is what I love about my work.
I have worked with people living with borderline personality disorder (BPD) since 2013, using a DBT approach. I remember when I started my career, there was significant stigma held amongst clinical staff. Most thought any treatment would be unsuccessful and any attempts I made in therapy, would fail to achieve meaningful change for the client. My clinical experience over the course of my career has shown the opposite. Clients were recovering, creating meaning in their lives, returning to work, rebuilding relationships, and using helpful ways of coping.
Why DBT?
What I enjoy most about practicing from a DBT approach is the large emphasis on the relationship. A real relationship between equals. I might know more about the treatment protocol; however, the person knows more about themselves and together, we work as a team. This means that I’m part of that team, I am also accountable– even when I’ve forgotten to send that email or forget to review the home practice, I had set the week before. I know my clients will kindly remind me of this.
Given it is a real relationship, it’s unsurprising that conflict within the relationship will at times arise. Given the relationship is built on trust and equality, when conflict inevitably arises, a repair will soon follow. In my experience, the act of repairing the relationship ultimately strengthens the alliance. What I respect and admire about working with people with BPD is their honesty, I can recount several instances where clients shared what it is that I had said or done that caused the rupture. In DBT we hold the belief that therapists are fallible. Sometimes we will make mistakes, we are only human right? Given it’s a strong relationship, we work through the issue together, we are held accountable for our actions (therapist included) and away we go. Just like you would in any other relationship.
While some may see DBT as a structured and strict treatment approach, it allows for tailoring to the individual. It has meant that I can support someone and assist them to score life points regardless of their age, gender, or ethnicity. At its core it’s a treatment focused on people, delivered in a trauma-informed way.
DBT also allows me to be radically genuine, it allows me to show up as me. It means that
while we are often unpacking very difficult and confronting aspects of people’s lives, we can
also find the light – we can laugh together and have fun together. It has been a real privilege to work in this field over the past nine years. So, to those clients who I have worked with and those I will work with in the future, thank you. Thank you for trusting me and allowing me to walk with you on your journey, I see the gain in you, and I see the gain in me too.
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