How to approach a loved one about the possible need for DBT or another form of psychotherapy?

Here are a few thoughts and suggestions for family members and friends.

First, everyone is unique. What helps one person talk to a loved one is not going to necessarily work for someone else. How we communicate is often more important that what we say.

·    Can you communicate with a full expression of caring and compassion using your GIVE (gentle, interested, validating, with easy manner) skills? Without this, a loved one might perceive judgment or yet another demand. Many of us will “shut down” when we perceive someone judging us.

·    Can you ask your loved one if you can discuss something important, yet possibly awkward? Many of us don't open up when we are about to be told what we should do, especially when we haven't asked for advice or suggestions. Asking them if they are willing to discuss an important matter gives them a chance to agree or not. And if they agree, they may be more receptive to your hearing your concern for them.

No matter how much we love the person and have to offer them, we don't get to be in control of anyone but ourselves. For instance, the time when we are eager to share our knowledge is not necessarily the timing that will work for our loved one. Can we humbly accept these facts? 

·    Do you need to consult with wise friends or professionals on how to most effectively approach your loved one?

Sometimes we can encourage our loved one's willingness by...

·    Using our Validation skills to affirm their experience, thoughts and feelings

·    Letting them know that emotional sensitivity is not their fault

·    Letting them know they are not "the problem' and that we are learning, benefiting from practicing skills, and working to be a better parent/sibling/relative/friend with them.

Sometimes loved ones will listen to our concerns and suggestions.

Sometimes loved ones will read useful, relevant information, such as articles or chapters by DBT therapists, like Marsha Linehan, Perry Hoffman, Alan Fruzzetti and Shari Manning.

Sometimes loved ones will watch an informative video, such as can be found at the websites of NAMI or NEABPD www.borderlinepersonalitydisorder.com.

Sometimes loved ones will read a page on a website like the above or at dbtselfhelp.org.

It can help to know if your loved one has wondered if therapy might help. How can you support that curiosity? What have they tried? What happened? It’s quite possible that they had a poor experience in a previous therapy or counseling session. They may need reassurance that this need not happen again. They may need help identifying a knowledgeable therapist or even to have a family member join them for the first session.

What else has made them reluctant? Are there fears that can be validated? Do they know that severe emotion dysregulation (BPD) can be successfully treated? Do they know that most people see significant improvement in 2 years? Having a good match with a DBT or other skilled therapist is essential. 

Caution. If you believe your loved one is engaged or about to engage in life threatening behaviors, then an immediate response is called for. You can take them to their doctor or the Emergency Department. If they are in immediate danger and unwilling to seek help, the doctor or you can complete commitment papers with the magistrate so that law enforcement officers will transport your loved one for an evaluation and treatment.

In closing, knowledge about skills is truly wonderful. The good intentions of sharing this knowledge can be balanced with compassionate understanding and empathy of your loved one. In DBT, we are reminded again and again that effective change involves effective validation. It may take an initial focus on validation before a loved one is ready and willing to risk the prospects of change. And when in doubt, we can always pause, breathe and listen to our "wise mind" for some mindful, nonjudgmental and effective guidance on how to proceed.

May our families, friends and loved ones experience less suffering and more understanding,
John

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John Mader, MA, LMFT  |  AAMFT Approved Supervisor  |  AAMFT Clinical Fellow  |  Co-Director, TADBiT
919.968.0231 x. 2  |  jmaderlmft@gmail.com  |  www.dbtfamilyskills.com  |  triangleareadbt.com

This work is licensed under a Creative Commons Attribution 4.0 International License.