MCAD, Thoughts & Exploration

Thoughts on DBT Therapy – Healing Tool & Systemic Tool of Oppression?

Lately I’ve been deep into a reading called The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel Van Der Kolk, M.D. This book so far, among several other factors in recent weeks have both reaffirmed some of the techniques and developing habits from my investment in Dialectical Behavioral Therapy (DBT), while also re-evaluating this time as I try to funnel my experiences into art and pursue activism.

Re-shaping the Brain
Agency / Empowerment

DBT is a program that was recommended by my therapist to move forward with my life after being sexually assaulted over a decade ago. It is both group therapy and individual therapy, focused on establishing / relying on taught skills to cope with bad circumstances and re-train the brain to be in the present, be aware of the body and its sensations, and work toward an acceptance of your particular reality. To do this, we essentially force ourselves to pay attention to our surroundings, try to listen to our bodies, and practice mindfulness techniques. We keep weekly sheets to track our skill-use, impulses, and harmful behaviors.

Without a doubt, in the four months I have been in DBT, it has made an enormous difference, as is reaffirmed in The Body Keeps the Score.

“…many psychological problems involve difficulties with sleep, appetite, touch, digestion, and arousal. Any effective treatment for trauma has to address these basic housekeeping functions of the body.” (56) + In DBT, these are the PLEASE skills.

“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives. Numerous studies of disaster response around the globe have shown that social support is the most powerful protection against becoming overwhelmed by stress and trauma. Social support is not the same as merely being in the presence of others. The critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart. For our physiology to calm down, heal, and grow we need a visceral feeling of safety.” (81) + Group setting, Interpersonal Skills, Individual therapy, “safe spaces”

“by helping my patients to first notice and then describe the feelings in their bodies – not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on.” (103) + Mindfulness exercises, Observing, Noticing

“Self-regulation depends on having a friendly relationship with your body. Without it you have to rely on external regulation – from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others.” (99) + PLEASE skills, tracking impulses, etc.  (I know this one a little too well)

All of these make sense personally, and have helped me really see some of my own habits and behaviors, which is the first step to changing them.

However, creeping at the back of my mind as I continue to do research in graduate school and live in systems of oppression, whereby I have been conditioned as a woman to be quiet, to think always of others before myself, and not to see my own value, therapy mirrors the system in ways that I would like to confront through my art work as a mediator. Especially as I am involved in activist groups with mainly women and women of color trying to change the culture of sexual violence and gender violence, I no longer want to simply follow an “easy” path toward a status quo I simply do not agree with or tolerate.

In order to heal, I’ve put many things aside, including my own self interest and beliefs at times, because I believe that at some point I will be able to function “normally”. While this is no doubt important, that normalcy must not continue to ignore race and sexuality.

I also can’t shake the underlying message of the goal of retraining our brains, that we are broken and wrong, and need to change in order to deal with our circumstances. Normal people cope and move on with their lives after bad events, while we are still trapped in the past.

“We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. …. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character -they are caused by actual changes in the brain.” (2-3)

Even in understanding how DBT can be an effective healing tool and with the support of Van Der Kolk’s research and experience in his book, I am still a “subject” that needs to be fixed. For me, this does not help to promote agency or empowerment, help me to speak up for myself, or feel comfortable in daily life.

I’m not suggesting that it is therapy’s job to change the structure of our society, however because it perpetuates the same systems that have in many ways created circumstances of trauma and suggests a mimicking of supposed agency within these limits, how much can this form of therapy truly help me feel empowered? How much will this form of agency perpetuate the same behaviors at the end of the day that contribute to my mental illnesses?

“Sexuality must not be thought of as a kind of natural given which power tries to hold in check, or as an obscure domain which knowledge tries gradually to uncover. It is the name that can be given to a historical construct: not a furtive reality that is difficult to grasp, but a great surface network in which the stimulation of bodies, the intensification of pleasures, the incitement to discourse, the formation of special knowledges, the strengthening of controls and resistances, are linked to one another, in accordance with a few major strategies of knowledge and power.” Foucault, History of Sexuality: Volume I, An Introduction (105-106)