Philadelphia Dialectical Behavioral Therapy: Can you fail in DBT?

Life has definitely been challenging for you. Your relationships are in the toilet, you can’t stop worrying, your moods have been out of control, and you’re on the verge of losing your job.

You feel like the universe has dealt you a crappy hand and you certainly haven’t coped very well. When you get hurt, your emotions just take over. Now, you’re left feeling embarrassed and ashamed of your behavior. You wonder if you’re doomed to fail at everything in life. Things keep going wrong and you really, really want to give up and just say “f*ck it”.

Why Philadelphia DBT Therapy is different.

I’ve talked about how DBT is different than other forms of therapy. Therapists who use Dialectical Behavior Therapy to treat their clients hold a number of beliefs (assumptions) about their clients with Borderline Personality Disorder (BPD) and DBT. These assumptions help guide DBT therapists in treatment with their Borderline clients.

My prior posts discussed the first 6 DBT assumptions. If you missed them, you can read about DBT Assumption #1, “Clients are doing the best they can”, here. Click here to read about the 2nd and 3rd DBT Assumptions, “Clients want to improve”, and “Clients need to do better, try harder, and be more motivated to change”. To learn more about DBT Assumption #4, “Clients may not have caused all of their own problems, but they have to solve them anyway” and DBT Assumption #5, “The lives of suicidal, Borderline individuals are unbearable as they are currently being lived”, click here. My most recent blog post about the 6th DBT Assumption, “Clients must learn new behaviors in all relevant contexts” can be found here.

This newest post in this series will focus on the 7th DBT Assumption.

Dialectical Behavior Therapy: The 7th Assumption 

Clients cannot fail in therapy.

As a DBT therapist, I hold the belief that if a client doesn’t make progress or drops out of therapy, it means that the therapy, the therapist, or both have failed.

Hmmm… What?!? How can this be?!?

This belief can be difficult for therapists and clients alike. As a DBT therapist, I can understand how therapists, in general, find this assumption a difficult pill to swallow. Many therapists and counselors will often make the incorrect assumption that when a client drops out of therapy prematurely or doesn’t make progress in therapy, it can be attributed to that client’s lack of motivation or something the client failed to do. This can be seen with regard to assumptions made about Borderline clients and specifically about Borderline clients’ motivation to improve and efforts to make a change.

As I’ve already written about before, people with BPD have often been told over the course of their lives, that they are the reason for their continued suffering and are often blamed for not trying hard enough. Borderline individuals will often succumb to this reasoning and even say it themselves. It makes sense to me why clients with BPD will often come to the conclusion that it must be their own fault for failing to make progress.

Here’s the thing-

Therapy can fail. As I’ve written about many times before, not all therapy works for all clients. The same goes for the therapist. Not all therapists are the same.

Further, not all therapists are the best fit for all clients.

When looking at why therapy failed, it isn’t about finding blame.  

Think about it this way.

Here’s a metaphor that is commonly used to help explain this assumption.

A person diagnosed with cancer will be prescribed a treatment that has evidence supporting its efficacy in helping other people with the same diagnosis. The same holds true for people with BPD. DBT has been shown effective in treating Borderline Personality Disorder. If the individual with cancer does not improve, people won’t typically say that that person failed cancer treatment.

So, why would it be different with Borderline individuals in Dialectical Behavior Therapy?

DBT Therapist in Philadelphia

Tired of being blamed for not progressing in therapy?

I know you’re doing the best you can. I know you’re trying really, really hard to make improvements in your life. As a DBT therapist in Philadelphia, I totally get it.

As a Philadelphia DBT therapist, I specialize in Borderline Personality Disorder Treatment and therapy for anxiety. Reach out today.

I offer free 15-minute consultations for DBT therapy in Philadelphia. You can schedule your own DBT consultation HERE.