Dialectical Behavior Therapy

I came across the letters DBT in an adoption discussion group and as I had no idea what it stood for, I do what I often do in such cases, google it. It started with this comment by an adoptive parent –

“I just had it click in a deeper way yesterday that I put a lot of thought and effort and will into trying to heal my kids. As if I’m a savior. As if I can. But in DBT, it talks about creating a change ready environment for your kids. By the way, if you can find a child DBT therapist, do it! Its expensive and it involves individual and parent and group sessions, and its work and learning, but its SUPER effective. All kinds of stuff prove its effective. Back to my point, if I’m trying to create a change ready environment, a calm and consistent environment where mean words can roll off my back, and I’m working on me setting the example that self care is important and I’m working on me so that I can hold all the pain they send my way, that’s where I make the most beneficial impact for all of the family and that’s where I love my kids the best.”

DBT stands for Dialectical Behavior Therapy. Dialectical behavior therapy is an evidence-based psychotherapy that began with efforts to treat borderline personality disorder. There is evidence that DBT can be useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm and substance abuse. Many of these issues are aspects experienced by adoptees due to the trauma of separation from their original mothers.

One woman commented – “DBT absolutely SAVED MY LIFE. The skills helped me stop with SI and I then went on to lose 140 pounds.” I had to google SI too. Introverted sensing (or Si for short) is one of the most misunderstood cognitive functions in the personality community. Introverted sensing is a perceiving (information-gathering) function. It focuses on the subjective, internal world of personal experience and compares and contrasts new experiences to past experiences and memories. Si-users tend to notice patterns repeating themselves and are quick to spot changes or inconsistencies in their environment. They trust personal experience and subjectively explore the impact of current events, choices, and consequences.

So back to DBT . . . .

Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. DBT can help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors (eating disorders and substance use disorders). DBT is sometimes used to treat post-traumatic stress disorder (PTSD).

DBT incorporates a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when there is a “dialogue” between opposing forces. The process makes three basic assumptions:

All things are interconnected.
Change is constant and inevitable.
Opposites can be integrated to form a closer approximation.

Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain. The strategy can also help you stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior. BTW, I am a BIG believer in mindfulness.

Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook. There are 4 techniques – distraction, improving the moment, self-soothing and thinking of the pros and cons of not tolerating distress.

Emotion regulation lets you navigate powerful feelings in a more effective way. The skills you learn will help you to identify, name, and change your emotions. When you are able to recognize and cope with intense negative emotions (for example, anger), it reduces your emotional vulnerability and helps you have more positive emotional experiences.

Interpersonal effectiveness helps you to become more assertive in a relationship (for example, expressing your needs and be able to say “no”) while still keeping a relationship positive and healthy. You will learn to listen and communicate more effectively, deal with challenging people, and respect yourself and others.

A Lie Or Pretend

Someone in my all things adoption group wrote – I think it’s important to recognize that adoption for all parties is literally living a lie or playing pretend. I know my mom who was adopted felt this. She had her DNA tested at Ancestry and was in the middle of creating family trees when it really hit her. Both my mom and my dad were adopted and she realized none of it was real. I now know who the real grandparents are and I do intend to complete each of my parents’ family trees, I just haven’t gotten around to it yet.

One woman responded – When people get so hung up on I’m real and start lecturing their kid on it I want to laugh. They look like the fool…yeah you’re real but you aren’t “the mother”. Yeah I’m the mother but I’m not raising my kid. Reality, people.

Another woman shared – It is both at different times, yes. It’s also filled with excuses and justifications for the truth. Why can’t we JUST be real about it. Addressing that I really wasn’t “chosen” by my adoptive parents didn’t send me in a tailspin. I was next on the list that fit their criteria. That’s just fact. Could have easily been some other blonde, blue-eyed toddler they ended up raising. I don’t see why anyone would think that’s hurtful. Do adoptive parents really think we don’t know we were given away and them being our parents is a crapshoot? It’s kind of obvious, yet they go through all kinds of gyrations to fluff up the simple facts.

People act like adoptees are oblivious or incapable of handling the truth. Adoptees crave the truth, it’s all they ever want. Honesty. That’s it. Of course, adoptees already know the truth and adoptive parents just need to acknowledge what the adoptee already knows.

Acknowledge and validate. The two most important things to remember.

Someone else needed to add more complex context.

There are children being raised by extended relatives or adopted after a Termination of Parental Rights (assuming good reason). Do you tell these children they are living a lie? Or do you tell them that this is not the first choice, but it is what we have and we can try to make it work. Denying the trauma is living a lie, but I don’t think the family formed afterwards necessarily is. I don’t think every family formed outside of biological relationships is living a lie or pretending.

And sadly, not every family is good for the children born into it. Here’s one such story – I was raised by a very narcissistic mother and a very hands off father except when my mother manipulated him into abusing my brother and I (including putting me in foster care for being suicidal and self harming). I don’t feel towards them the way a child should parents. I lost the woman I actually considered a mom at 12. I personally feel like being a parent is more than giving birth and doing the bare necessities for a child. My parents may have given me everything I could have needed and let me play sports and go to camps, but they severely neglected my emotionally and mentally. I found my family elsewhere in other people. Them not being blood doesn’t invalidate my experience. I personally don’t agree with infant adoption or foster to adopt, but some people who give birth, really should just not be parents.

Responses to Reunion Trapped

This is a follow on blog to yesterday’s “Opportunistic Dependency” blog. Some responses to the young woman’s plight.

From one response – Do you know where she is located ? When she says these threats I would call the police or 911 to do a wellness check explain the situation and your concerns. If she is using it as leverage, she will hopefully not want that burden. If she is truthfully mentally not doing well, then you could really be helping her. Even if she is using it as leverage and has to get psychological help, maybe it could get her head in the right place.

While this answer seems harsh, I had to make a similar decision – to cut ties with a toxic sibling for my own mental health. Here’s what the commenter said – There is only so much your own mental health can take, and my view is that this seems to be all about her, not about you. She is your mother, not the other way around. Your relationship should be about you, or at the very least about both of you, not about what you have to offer her. Until she can get to a place where she can have that relationship with you… It’s on her. Disconnect for your own health. If you choose not to follow this advice, I totally understand. It took years of abuse/neglect for my siblings to come around to this way of thinking. Sending hugs. This is so hard. I get it.

I found this to be a direct and reasonable response – She sounds like she is suffering from a serious addiction. This is not who she really is. That being said the burden isn’t yours to carry. She needs a professional to help her.

And maybe spending time with others facing similar challenges would be helpful, as this woman suggests – None of this is on you. She’s sick in addiction. And appears that abuse and manipulation are her tools. All I can recommend is an Alanon meeting and know that whatever she chooses to do to herself is her choice – not on you at all.

Another one shared – Similar to my story although she was older at 18 and is an alcoholic/depressive which she told me was my fault! I tried but like you she wasn’t actually interested in me…it’s tough and I do think of her but for my own sanity or what I have left its easier to have no relationship and it looks like I never will. Please don’t feel bad in anyway about saying no. Life is so difficult sometimes.

Another woman shared – It took me many years and thousands in therapy to understand that I am not my mothers mother. I had to get to the point where my mental health, family and self came before her. I’m so sorry that you are dealing with this. My mom was a teen mom too. She suffers from active addiction and I “raised” her my entire life. It is completely acceptable to cut toxic people from your life. It can be heartbreaking but at the end of the day you and your family (significant other, kids) need to come first. I personally learned how to compartmentalize the relationship and to politely but firmly say no. It’s hard when threats of suicide and self harm are thrown at you but you cannot be held responsible for her actions. She has a lot of issues that she needs to work out for herself.

And just one last sharing with perhaps a ray of hope –

Birth mom and recovered addict with an adopted daughter in reunion, Addicts are sick and many behave very differently to how they are sober. Not excusing her behavior. I never asked any one for a dime when I was an addict but that was mainly because I chose escorting to fund it, rather than stealing or bleeding family dry. I like to think that shows my character – that I’d rather choose a path harmful to myself than to others. Your mother has to answer for that, My advice would be keep your distance until she’s sober. Don’t close the door forever. She was so young and its tough. She may well be a sweetheart like you – when sober – but definitely don’t give her money and ignore the threats. Mostly anyone who’s going to kill themselves doesn’t barter it for money. I’d say it’s all hot air to manipulate. Ultimately, it’s up to you to decide if you want the “addict mom” drama. But do hope she cleans up her act. It took me 12 years! But I’ve been sober now for 13. It can be done.