The following is a synopsis of a weekly Dialectical Behavior Therapy (DBT) group lesson, based on the work of Marsha Linehan out of the University of Washington. This week’s lesson is actually outside of the normal DBT content, it is solely based on the codependency literature, specifically the work of a wonderful fellowship called CODA.

New Disclaimer: I LOVE doing this, I think it is desperately needed, and I WANT to do it. However, I have zero time to do it so, while I am committed to giving it my all, I may fall behind or skip a week or two. I apologize in advance for that, and for the fact that I will not be spell checking, fixing formatting, or doing a read through before I post. No offense, but I gotta draw the line somewhere!

Interpersonal Skills Module: Ending Toxic, and Finding New Relationships

So this week was different for each group due to snow last week, we normally would be discussing finding new relationships and Intimacy, but Tuesday skipped the Intimacy lesson to catch up with FAST and GIVE and Wednesday did more with Intimacy. In reviewing reviewed the two newer sheets on ending unhealthy relationships, and finding new ones, almost every single group member is concerned about having “no friends”, having friends who are not healthy, and/or about being anxious around new people. That’s why, although I’m not crazy about a lot of the newer worksheets in the updated manual, I think these 2 are particularly important.

Ending Relationships: One of the symptoms of BPD is “a pattern of intense, unstable interpersonal relationships”. For youth or young adults, this is sometimes hard to assess, as they haven’t yet had a long-standing pattern of much in their lives. However, most kids that I work with have a history of keeping friends that are mean, dangerous, unhealthy, etc. Alternatively, they may have a history of failing to attach to others, often having multiple therapists, ex-friends, etc.; which is in line with the fears of abandonment that individuals with BPD struggle with.

For group members, and individual clients, many of them struggle with intimacy issues, wondering if they are settling by being with their boy/girlfriend, or if they are running from intimacy by breaking up with him/her. In addition, most of us struggle with toxic family members, either immediate or extended, and need to consider when and if to end those relationships. While I am a huge proponent of keeping people in our lives rather than cutting them out, we also must consider what type of challenging relationship it is:

Destructive Relationships: Destroys or completely spoiling either the quality of the relationship, or aspects of yourself. such as physical body and safety, self-esteem, sense of integrity, happiness or peace of mind, or caring for the other person (Linehan, 2015, Interpersonal Effectiveness Handout #13)

        Interfering Relationships: Block or make difficult pursuing goals that are important, ability to enjoy life, to do things we like doing, our relationship with other persons or the welfare of others that we love (Linehan, 2015, Interpersonal Effectiveness Handout #13)

Clearly, if a relationship is destructive we are likely feeling better about ending it, however interfering relationships may need to be ended, particularly if they escalate to be destructive. The steps to ending a relationship are:

  1. Decide to end relationships in Wise Mind, never in reasonable mind or emotion mind
  2. If the relationship is import and and NOT destructive, and there is reason to hope it can be improved, try to problem solve rather than end the relationship
  3. Cope ahead to troubleshoot and practice ending the relationship ahead of time
  4. Be direct: Use the DEAR MAN, GIVE and/or FAST as appropriate
  5. Practice opposite action for love if needed (ex. if you are in love with a friend who has a girlfriend, so you only hang out with him in big crowds, and you try to avoid talking with him alone, taking about intimate things, etc.)
  6. Last but not least, seek support from others if in an abusive or life-threatening relationship through the Domestic Violence Hotline 1-800-799-7233.

Finding and Getting People to Like You

Another problem related to difficulty ending relationships, we need to be able to find relationships and pursue friendships. The steps to this are:

  1. Remember that ALL human beings are lovable! If we are afraid of someone, they seem prickly, angry or unhappy, be mindful of the fact that humans are social creatures. We by nature, want to connect to people, and to love and be loved.
  2. Proximity helps. Remember that people who are close by you, frequently around and visible, are easier to connect with and to stay connected to.
  3. Look for people who are similar to you. Finding people who like the things that we like gives us some things to talk about.
  4. Work on conversation skills. Making small talk, asking and answering questions (with more information than asked for to keep the flow going), keeping self disclosure similar to that of the other person, being careful to avoid interrupting or talking to soon after someone talks, and learning about current and historical events will help us with our social skills. So for all of you out there who think that school is dumb and you are NEVER going to use this information, remember that the more we know, the more we can talk about, and we just may be able to use the information in conversation one day.
  5. Express liking for people. Without being obvious or phony, compliment others, do favors, and be kind.
  6. Join an ongoing group conversation. Rather than waiting for others to approach us, we need to be willing to join in a conversation in a group that appears to be open.
Open Groups Closed Groups
People are standing apart People are standing close together
People occasionally glance around the room People attend exclusively to each other
There are gaps in the conversation There is a very animated conversation with few gaps
Members are talking about a topic of general interest (ex. The walking dead) People seem to be pairing off

If a group seems open, sit close to it in hopes of being pulled in to a conversation, ask to join in, try to make eye contact with someone and react to them, or listen for gaps in the conversation and give an opinion or ask a question.

Some of these things may seem corny, or scary, but if we dont practice taking risks socially, we will find ourselves lonelier and lonelier. People are worth the risk.

The information below has to do with intimacy which is not a part of the DBT lesson, but is just cut and pasted in from a website I researched (with very limited time), because I liked some of the things they had to say about what barriers to intimacy are and how do we reduce them. This is really good to reflect on, as we often don’t realize the fear of intimacy that many of us have, especially those of us with fears of abandonment. Especially in recent times with the emergence of all different forms of sexuality, I have become increasingly concerned with what this means for people’s ability to give and receive healthy love, as sex and sexuality is very confusing, and very important. The website is:

http://www.michaelsamsel.com/Content/Couples/barriers_to_intimacy.html