My therapist knows that I read my records, and will in fact be reading some soon because I requested a batch a couple of weeks ago. So when I came into my appointment last week she went ahead and mentioned to me that the notes made by the DBT group therapist indicate that while I seem to understand the concepts, I am struggling to apply the skills to my life. She commented that she doesn’t see that, because when I share my diary cards with her there are always multiple skills on each day and they usually help at least a little. So what’s different about group?
Well, in group I try to share the one or two best examples of skill use from my week, without getting into detail about the situations that prompted use of those skills. When I went to the appointment where group was explained to me, that therapist (a different one from both my individual and group therapists) said that sharing diary cards in group was just about sharing the skills used and that sharing the life situations should be minimized. I was quite put off when I got into the group and found that people overshared in this regard, and yet undershared in that they rambled on and on with cryptic references to their lives which made me wonder if I was the only one having trouble understanding.
I also noted to my therapist that when these other group members start rambling, they are prompted to keep sharing. They are asked questions about the situations, and then when they seem to be done they are repeatedly asked if they used any other skills that week. When I share my brief example of skills? They thank me and move on. The only time I’ve been prompted to share is the week when I was made uncomfortable by the presence of a different therapist (and the fact that my skill use related to some very negative situations), and I declined to share anything. At this point I was asked, “Didn’t you use any skills?” I said, “Yes, I just have nothing to share.” The group therapist did have the decency to ask me on the break if I was okay, but she was walking with the stranger and I just muttered, “Yeah.” Hint: I was not even remotely okay that day.
I do not tend to be a very angry person, but I felt a flash of anger at learning that I was being perceived negatively for doing what it was both said and implied that I should do. I recalled the shift notes from my first inpatient stay, which repeatedly stated that I kept to myself and did not socialize with other clients. I had no idea that socializing was acceptable, let alone expected. It was a hospital setting! How can it possibly be appropriate to make small talk with other people who are there seeking treatment? I felt both shame that I once again did not understand people’s unspoken expectations, and anger that the expectations were never explained to me. Had someone come up to me at the first sign of me staying secluded and invited me to engage with the other clients, I happily would have tried to do so.
So, back to group and my apparent failure to do what was expected of me. My therapist has been encouraging me, due to my continuing hatred of group, to contact the group therapist and explain to her what is frustrating me so that I don’t end up exploding and saying something I regret. In addition to this new information about my “struggle to apply the skills”, I’ve been increasingly frustrated by how little we are taught in group. My therapist has been giving me worksheets from a book by Moonshine Consulting, which has numerous skills in each of the four categories: Distress Tolerance, Mindfulness, Emotional Regulation, and Interpersonal Effectiveness. These worksheets are very helpful, and I expected group to cover the same material. Instead, they use only handouts from Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder. There were only three total skills in the Interpersonal Effectiveness section we started with! Yet, it took us weeks to actually cover what little material was offered.
This slow pace and lack of content has had me leaving group every week feeling that I’ve just wasted another 2 hours of my life, not to mention the money I paid to attend group. Many of the group members have been in group for years, repeating the same material over and over. This is not my objective. My aim is to get through the skills and get out. So not only do I wish we’d move faster, but now that I see how little we’re being taught I question the point of trying to stick with the group through the entire cycle of skills, when I have an individual therapist who is giving me better material to work with. I went into group with the caveat that I would have to quit if I found a job that conflicted with the scheduled group time. In my first interview, for a part-time job, I actually listed group as a scheduling conflict. They asked, so it seemed plausible they could schedule around it. I didn’t get that job, and now I’m desperately wishing for a job, any job, that will force me to leave group so that I don’t have to look bad by quitting.
I did finally e-mail the group therapist today, pushed over the edge by the notion that I’m being unfairly judged. I tried to keep all my comments polite and focused on my emotions and perceptions and not on laying blame, but I’m not sure how well I succeeded. I’m still working on assertiveness, and I’m sure I frequently miss the mark. However, I feel much better now that I’ve put my thoughts out there for her to read. Either she’ll have something helpful to say, or she’ll encourage me to go ahead and leave the group, and either of those has to be better than the current situation.