Therapy doesn't stop after the session ends....
This is something I have such a hard time explaining
So I am attempting to explain it here. A common misconception that people tend to have is that after the therapy session, they go about their lives with no recognition of what was talked about in therapy. Don’t worry, I am calling out a previous version of me too.
Talk Therapy versus Skills (Acceptance versus change)
I had such a hard time understanding this conversation in grad school. We would hear “traditional talk therapy doesn’t help most people. Skills based work is what is important to focus on to lead to the best outcomes”. What did they mean when they were talking about talk therapy and why are skills so prevelant? When we talk about talk therapy, this is the therapy for people who want to speak about their problems in their lives. This is the therapy where they only talk about their troubles during the week and maybe some new perspective is offered. Think about the traditional role of therapist in media. The white guy saying “how does that make you feel” and encourages you to add a new perspective to your understanding.
What talk therapy doesn’t do is provide care based on trauma based symptoms. The traditional, “I have anxiety” person who feels anxious about some things but it isn’t related to their trauma history can benefit from talk therapy. Adding perspective can be super helpful and can change lives for a lot of people. When they can think about something differently, they can find themselves feeling lighter and applying their new perspective into multiple parts of their lives easier.
However, does a new perspective make it easier to talk to your mom who yelled at your relentlessly growing up for “making me do things for you”? Does a new perspective help you navigate harmful and unfair systems who legitimately oppress people of diverse populations? Does a new perspective make you forgive yourself after a long pattern of self-destructive behaviors? It can, but if you have found yourself in that place, skills are what can bring you back to a place where a new perspective can provide you the context necessary.
What are we asking for in DBT?
We are asking that you open yourself to be listened to and given the space needed to practice the skills that can find you a new lease on life. Life is painful. Life has so much suffering. For many of us DBT therapist, we have experienced a lot of suffering in our lives. So, we are wanting to help you find the skills to give you the best chance at this difficult life. Along the way, we ask for hard things. We ask that you remain open to critique on behavioral patterns that we think interfere with your life goals and treatment objectives. We ask that you validate yourself and notice the dialectic of acceptance and change. We ask that you try your best to take what is learned in therapy into your life to help you reduce your own suffering.
Why practice skills outside of therapy?
When we are searching for skills, we are searching for ways to make life easier. For many of us, our guardians didn’t teach out how to regulate emotions or ask for what we need in helpful ways. What a painful experience! When we are asking you to write out a DEARMAN so that you can effectively communicate your needs, we are cheering for you to take what is learned in therapy so you can reduce opportunities of suffering. When we ask you to recognize your body sensations and notice if it’s tolerable or untolerable, we are encouraging you to take care of yourself so that your progress can continue to flourish.
For those who need metaphors and analogies:
If you’re looking for muscle growth, going to the gym once a week will lead to a slow time for growth to happen. If you go to the gym once a week and do home workouts at home during the week, your muscle growth progress will happen faster.
If you’re trying to pass a test, studying once a week will make it harder for you to make sure you will pass the test. Studying multiple times a week will make your chances higher to pass.
Going to therapy once a week will give you some progress but going to therapy once a week, attending a skills class weekly, and using skills outside of session will give you a great chance to reduce your experiences of suffering.
All in All (TLDR)
I can’t promise 100% of the time that suffering will reduce with all of those things put in place. Life is hard and our mental health symptoms love to show itself in unique ways. However, doing all of those things will make your chances of feeling more relief happen. Just attending therapy and skills class with no practice is better than nothing, and practicing the skills taught outside of therapy and skills class will give you the tools necessary to conquer your mental health symptoms. Just talking about something can be helpful for many. For many with trauma histories (which is happening more often than not), talk therapy will be less likely to help than a skills based approach. A comprehensive skills usage plan will reduce your suffering. But hey! I’m a DBT and EMDR therapist. I recognize my bias and this is one thing I can fully believe in.