DBT!!

 I have always been interested in learning more about DBT. I often use or refer to DBT skills so it was helpful to get a better picture of the mechanism of change and other components of DBT. I found the Crowell article to be especially interesting. The authors point out BPD can look significantly different in different individuals, making it difficult to study in addition to the general complexity of the disorder. One thought I had while reading about Linehan's biosocial theory was about the invalidating environment. Crowell and authors define an invalidating environment as one that is "[intolerant] toward the expression of private emotional experiences." Who defines if the environment is invalidating? It goes back to the idea of ontology- do the parents or does the environment have to be a certain way or can the child interpret the environment as invalidating? I know the two usually go hand in hand, but I just wondered if the environment has to be consistently invalidating or if the child can generalize feeling invalidated based on a couple events. I also thought it was interesting the family that  Linehan proposed contributed to BPD- disorganized, perfect, and normal. Is that not all families? I guess it gives light to the biological component of BPD given that a dysfunctional or normal environment may lead to the same outcome, I just thought it was interesting to say that these types of families increase the risk for BPD. I also found it interesting that the authors connected BPD with conduct disorder and Antisocial Personality. I may have talked about it in class, but Shannon Curry (the Jonny Depp psychologist) discussed that ASPD in women often presents or is interpreted as BPD. There seem to be similar etiological components between ASPD and BPD, but the two drastically differ on the emotional components. BPD is often understood to be overemotional, whereas ASPD is underemotional. I wonder if emotionality is manipulated by females with ASPD, causing the individual to appear as if they have extreme dysregulation of emotions. Considering that I plan to research and work with justice-involved females, I imagine this is a line of research and clientele I will soon encounter. 

I know that DBT is often used in correctional settings, given the high prevalence rate of BPD. I am not sure about the intensity of DBT programs in prison though. I would imagine setting boundaries as a psychologist would be difficult considering that you are working where your clients live. the full DBT approach already includes many treatment modalities that are beyond the boundaries of other therapies, but I wonder how much that is challenged in correctional settings. Depending on the security of the facility, the client may have consistent access to you. I would imagine that clients may engage in more self-injurious behaviors in order to gain your attention. I also would be curious to know if the mandated treatment has different effects than if the client had a choice. I would be interested to see the similarities or differences between DBT in hospitals vs correctional settings. 

I like the theory behind DBT and the balance it brings between change and acceptance. As one article pointed out, there are some general components to DBT, but I like how they are understood through DBT. I also like the unique components of the theory. I don't know if I will ever implement full DBT, but I can definitely see myself using DBT skills, DBT groups, and other components in my work to target emotional regulation, interpersonal effectiveness, mindfulness, and distress tolerance. 

24/25