What a Dialectical Behavior Therapy (DBT) Session Looks Like

Summary

In this insightful session, Dr. Judy Hope demonstrates Dialectical Behavior Therapy (DBT) with a patient named Kyle, who struggles with depression and feelings of hopelessness. The session focuses on managing depressive symptoms and preventing future episodes through self-soothing techniques and the concept of 'wise mind,' which balances emotional and logical responses. Dr. Hope introduces practical strategies like engaging in pleasant activities daily and accepting the current experience to foster resilience and navigate through depressive episodes.

Takeaways

• 😀 The session demonstrates an example of Dialectical Behavior Therapy (DBT) with Dr. Judy Hope and a patient named Kyle.
• 🤔 Kyle is dealing with depression, feelings of hopelessness and helplessness, and is seeking help to manage these symptoms using DBT.
• 💊 Kyle is on antidepressants and has a history of depressive episodes but has stopped therapy due to a move and is looking for a new therapist.
• 🔄 Kyle discusses the cyclical nature of his depressive symptoms and the impact of his work and pride on his mental state.
• 🧘 Kyle has tried various methods to cope with his feelings, including overeating, exercising, and focusing on a clean, organized environment.
• 🌱 Dr. Hope introduces the concept of self-soothing using the five senses as a quick method to manage distress and prevent escalation into a depressive episode.
• 💡 The importance of not rushing to prevent depressive episodes but accepting their occurrence and having the skills to handle them is emphasized.
• 🧘‍♂️ Kyle is encouraged to engage his 'wise mind,' a state of mind that combines emotional and logical thinking to make balanced decisions.
• 📝 Dr. Hope provides a list of pleasant activities as a preventive measure and for building an emergency toolkit for Kyle to use when feeling hopeless.
• 🔑 The session highlights the DBT principle of finding balance and not being overly rigid in thinking, which is key to managing depressive symptoms.
• 🌟 Kyle's biggest takeaway is the realization that he needs to work with both his emotional and logical sides, rather than fighting or negotiating with them.

Q & A

What is the main purpose of the session between Dr. Judy Hope and Kyle?

The main purpose of the session is to explore how Dialectical Behavior Therapy (DBT) can help Kyle manage his depressive symptoms and develop strategies to prevent or cope with depressive episodes.

What is Kyle's current mental health status according to the transcript?

Kyle mentions that he is currently not experiencing severe symptoms, but he still has feelings of hopelessness, helplessness, and self-doubt about his worth and impact, especially in relation to his work.

What does Kyle believe about the origin of his feelings of hopelessness and helplessness?

Kyle believes that these feelings are hardwired in his brain, possibly due to heredity, similar to how he has Crohn's disease, and not due to lifestyle factors or lack of social interaction.

What strategies has Kyle tried in the past to combat his depressive symptoms?

Kyle has tried overeating, exercising, and sleeping as subconscious methods to mask his feelings. He also mentioned using medication and therapy as part of his coping mechanisms.

What is the concept of 'wise mind' in DBT as discussed in the session?

The 'wise mind' in DBT refers to a state of mind that integrates both the emotional and logical aspects of a person, transcending them to make better decisions and find deeper meaning in experiences.

What is the significance of the 'roller coaster' and 'play' analogies used by Dr. Judy Hope?

The analogies are used to illustrate the different levels of self-awareness and emotional distance one can have from their experiences. It helps to understand that there is a part of oneself that remains intact and can observe and survive even the most painful episodes.

What is the role of 'radical acceptance' in managing depressive episodes as per DBT?

Radical acceptance is a technique used in DBT to accept the current experience without judgment or resistance, acknowledging that there is a part of oneself that will always survive the episode, which can help in reducing fear and distress.

What is the 'pleasant activities list' and how is it supposed to help Kyle?

The 'pleasant activities list' contains 250 activities designed to improve positive emotions. Kyle is encouraged to pick one activity from the list to do every day as a preventive measure and to manage depressive symptoms when they arise.

How does Dr. Judy Hope suggest Kyle should approach the inevitable feelings of hopelessness and helplessness?

Dr. Judy Hope suggests that Kyle should not rush to prevent these feelings but instead practice acceptance and use strategies like self-soothing with the five senses, engaging the wise mind, and doing pleasant activities to manage the moments when these feelings arise.

What is the homework assignment given by Dr. Judy Hope to Kyle at the end of the session?

The homework assignment is for Kyle to look at the pleasant activities list, pick one activity to practice every day, and circle the ones that work best for him as he experiments with them, with the goal of building an emergency tool kit for when he starts to feel hopeless and helpless again.