New York Times correspondent Matt Richtel has spent the last two years doing a deep dive into the youth mental health crisis that has escalated to the point that in December 2021, US Surgeon General Dr. Vivek Murphy issued a Surgeon General’s Advisory
In 2010 I went through a 90 day intensive residential treatment that focused solely on 24/7 DBT. You lived it, breathed it, and ate it. Out of all the different treatments I have gone through in 35 years since my first suicide attempt at age 11 it was the most successful. Not perfect mind you but infinitely superior to everything else. It’s what helps get me through the days when I want to give up and just do what my daughter wants, to accept her and treat her as my son. It helps me remember that to do so would cause me to spiral down into the depths of the debilitating depression that comes when I have severe cognitive dissonance. I truly believe that what is being called a “mental health crises” is in fact mental illness manufacturing. Psychologists, therapists, counselors, teachers, doctors and parents are creating bipolar and BPD in kids by reinforcing undisciplined thinking and supporting/encouraging the uncontrolled reactions to intense emotions. The more kids are taught to think about and talk about how they are feeling the more intense and overwhelming those feelings become. Then it’s made even worse by teaching them that any and all reactions to their emotions are acceptable no matter how inappropriate. The best thing schools and even daycares could do would be to have DBT be taught and incorporated throughout their day at school. Not classes that teach it specifically but just a regular and normal everyday part of school. Coping skills not taught as “coping skills” but as the logical means of handling difficulties and distresses from a disagreement on the playground to the disappointment of failing a test. Teaching kids, adolescents and young adult how to interact calmly and rationally in the objective reality everyone exists in instead of trying to wrangle some kind of order from the chaos created when everyone exists in their own subjective reality.
AAP, APA, HHS, CDC, FDA, these agencies are all captured. They do not work for Kids, Families, Parents, Americans, People, or Society. They work for Global Multinational Pharmaceutical & Tech Companies. They don’t care if they drive your kid to suicide or if your kid is harmed by hormones, sex change operations, or grotesque medical malfeasance.
DBT is for Borderline PD. It doesn’t really work well enough for the most severe Borderlines who were seriously abused by their parents & ended up in Foster Care as Adolescents because those kids have way too much Dissociation. Whenever these kids get stressed, they have thousands of mini milli-second blackouts a day. You can start any kid with DBT as treatment but many kids are gonna need a lot more; things like Neurofeedback. And they are going to need the parent to understand attachment disruption.
Borderline results from Developmental Trauma/Disorganized Attachment/ Life Threat in Infancy. The infant is forced to use what Selma Fraiberg called, “Infant Pathological Defenses” right from birth. Borderlines have mothers with Borderline. They have aunts, uncles, grandparents with Cluster B Personality Disorders. These are families with High ACE Scores.
If I wanted to help my kid, I would 1. Get every PubMed article by Susan Coates and read them, put them in a File. Share them with your kid’s doctors. 2. Get rid of the hand held Propaganda Box. 3. Read Allan Schore’s “Affect Regulation and Development of Self.” 4. Read Brown and Elliot’s “Attachment Disturbances in Adults” 5. Find a Really good therapist who knows how to do NFB for Borderline/Developmental Trauma/RAD 6. Get Dean Ornis’s Book “Undo It” and follow his lifestyle recs.
That’s where I would start. And I would do as much as I could to stay away from Allopathic Medicine.
Only in an Insane world would anyone suggest or worse believe, that you could take a Borderline or a Schizotypal/Borderline kid and give him/her cross sex hormones and a Sex Change Operation & call that treatment. This isn’t treatment. It’s Predation.
I think so too. It’s the Nazis that were taken out of Germany in Paperclip and peppered in all major US Colleges and Universities. They were doing MK work there on Kids and they were doing these Sex Change Operations on kids in the Camps. We’re dealing with Transhumanist demons who are Bent on the Singularity & Immortality & to get there, they are gonna experiment on the kids.
Coates 1: The Complexity of Early Trauma: Representation and Transformation
SUSAN W. COATES, Ph.D. MARY SUE MOORE, Ph.D.
INTHIS PAPER we will describe the case of Colin, a 3'/2-year old boy who suffered significant trauma of a nonsexual nature, which occurred in the context of his primary attachment relationship. The case was the subject of an extended previous communication devoted to a psychodynamic understanding of gender identity disorder of childhood (Coates, Friedman, and Wolfe, 1991). Here we present the case, not with special reference to issues of gender, but as seen through the particular lens of trauma. Colin's traumatization can be conceptualized as having two different components, one entailing the precipitous loss of the emotional availability of his primary caretaker
and the other entailing physical confrontations, experienced as poten- tially life-threatening, when he tried to reestablish contact with her. Beyond this, the case also touches on the issue of the cross-genera-' tional transfer of trauma.
To be noted at the outset is that neither what has been documented of Colin's traumatization nor the cross-generational issues involved in it were sexual in nature. Why present such a case in a special issue devoted to the topic of sexual abuse?
Coates 2: Mothers of Boys with Gender Identity Disorder: A Comparison of Matched Controls
SONIA MARANTZ, PH.D., AND SUSAN COATES, PH.D.
Abstract. This pilot study compared mothers of boys with gender identity disorder (GID) with mothers of normal boys to determine whether differences in psychopathology and child-rearing attitudes and practices could be identified. Results of the Diagnostic Interview for Borderlines and the Beck Depression Inventory revealed that mothers of boys with GID had more symptoms of depression and more often met the criteria for Borderline Personality Disorder than the controls. Fifty-three percent of the mothers of boys with GID compared with only 6% of controls met the diagnosis for Borderline Personality Disorder on the Diagnostic Interview for Borderlines or had symptoms of depression on the Beck Depression Inventory. Results of the Summers and Walsh Symbiosis Scale suggested that mothers of probands had child-rearing attitudes and practices that encouraged symbiosis and discouraged the development of autonomy. J . Am. Acad. Child Adolesc. Psychiatry, 1991, 30, 2:310-315. Key Words: gender identity disorder, maternal psychopathology, Beck Depression Inventory, Diagnostic Interview for Borderlines, symbiosis, autonomy, child-rearing practices.
Recent years have seen a burgeoning interest in gender identity disorders (GID) in children. Boys and girls with GID are distressed about their gender, wish to be of the opposite gender, and manifest a predominant interest in behavior and activities that are typical of the opposite gen- der. Boys with GID prefer female stereotypical activities, such as dressing up in girls’ clothes, playing with dolls, and playing the role of a female in fantasy activities. Symptoms of GID in boys usually emerge between the ages of 2 to 4 in the form of an intense interest in dressing up in female clothes (Stoller, 1968; Green, 1974; Coates, 1985; Meyer and Dupkin, 1985). Although most homosexuals have not had a childhood history of GID (Saghir and Robins, 1973; Friedman, 1988), follow-up studies have found that at least three-quarters of boys with GID become homosexual as adults (Money and Russo, 1979; Zuger, 1984; Green, 1985). The role of biological influences on the development of GID is not understood to date. No differences have been found between boys with and without GID in either morphology of external genitalia or in karyotyping of sex chromosomes (Green, 1974; Rekers et al., 1979). Despite these results, there is indirect evidence from animal studies and from spontaneously occurring endocrinological disorders that suggests that prenatal hormones may influence certain as- pectsoftemperament,suchasenergyexpenditureandrough and tumble play (Ehrhardt and Meyer-Bahlburg, 1981; Hines, 1982; Friedman, 1988).
"Are doctors and therapists—and the US Department of Health and Human Services—really choosing the best, most effective, most evidence-based path for gender dysphoric teens, or are they choosing the path that doesn’t challenge them with difficult questions?"
The beautiful lie or the painful truth?
Sexual liberation, to include extra-marital sex, contraception, transgenderism and same-sex "sex" are all part of a broader eugenics program.
Bye bye bloodlines!
The chosen ones know exactly what is best for our "transgendered" youth. They will tell us what is best. They will drug our children if that is best for the collective. Isn't this the world you all want? Right?
So, another option to therapy is to go straight to the source and practice meditation & listen to dharma talks. This will strengthen self-control, emotional regulation, and the ability to be calm and loving (even while your child is off-balance).
The tradition of Thich Nhat Hanh is extremely engaging and has numerous online lectures on Youtube.
I hate to hear that DBT is yet another thing being corrupted by this cult, and rendered possibly harmful or at least significantly less benign. I have found the DBT tools and philosophy so very helpful in my life. I base my LGB activism on promoting the DBT concept of "radical acceptance," which I also try to practice in my own life.
If acceptance of anything in life is conditional it is not "radical (to the root) acceptance," and thus is not DBT.
I spent a lot of $ on DBT for my child. It was helpful for coping with moving through depression and difficulty functioning. But I had the same frustrations With the pronoun game I had with another therapist. When I complained I was told DMSO no longer classify gender dysphoria as a mental illness so it’s not treated as such.
Then tell them to treat the depression and distress by not deviating from the objective reality of your child’s biological sex while interacting with your child because to do otherwise creates cognitive dissonance for your child.
Yes! I agree! Great piece. I have a few thoughts to add.
DBT ought to be the "first stop" (though NOT "affirming" DBT -- regular DBT). Pretending the distressing thing (being female) isn't true because "G Identity is male" would be the *opposite* of DBT. "Radical acceptance" is the heart of it. Learning to tolerate upsetting realities.
The DBT program was designed by a therapist, Marcia Linehan, who herself struggled with Borderline Personality Disorder as a young woman and devised this program to address what her incapacities and needs were.
In my area, they offer *Group* DBT. I know it is offered to adults-- and I think also teens-- in the group setting. This could be one way to get DBT to more people. There's a workbook with weekly themes and homework/ practice of new skills. I think it's about a 10 or 12 session course. I know someone w BPD who took it, and she said it made her life much better and gave her effective skills to cope.
DBT is all about "distress tolerance": learning how to modulate one's emotions/ reactivity and have a better capacity to 'hold' distressful feelings or thoughts without going into a panic state, rage state, dissociated shut down, or other overwhelmed state.
There is a developmental period in early life when we normally learn distress tolerance and "emotional self regulation"... 0-3. The way we learn it is (ideally) we have a parent who is able to comfort our distress and calm us down when we get upset; amuse and engage us when bored... etc.
The frequent repetition of these actions, by which we are soothed and co-regulated, teaches us how to intuitively soothe and regulate ourselves. This skill is modeled and absorbed over time.
There's an implication that teens are still not mature, and this is why some teens need DBT. Not exactly. It isn't normal for a teen to have totally missed out on self-regulation learning altogether-- though it IS normal for racing emotions and hormones of teen years to challenge and re-test our ability to self regulate and demand we hone better skills. Teens recapitulate toddlerhood in many ways. Kids who can't self regulate at all MISSED OUT on learning the skill and that has affected subsequent learning because the developmental sequence builds on prior skills. It's a functional deficit.
DBT is a kind of CBT. These methods use the Cognitive (Left/ linguistic-rational) brain. Here, DBT skills and strategies invoked by Left brain ("I can take a hot shower") are used to calm the Right (emotional) brain down.
Of course the EASIEST way to learn emotional self regulation is when it is learned intuitively by our right brains in toddlerhood, the appropriate time frame-- or if we learn it later, learned through right brain experiences (attachment to the therapist, being co-regulated by the therapist, feeling trust and self trust, etc).
Neurofeedback is one RIGHT-brain focused therapy that can greatly improve overall regulation ("Neuroptimal"). Somatic psychotherapy or Neuro Affective Relational Model (NARM) are other right-brain focused therapeutic approaches. They are mostly wordless, body-and-sensation focused approaches (a bit like babies get when we rock them and say shhhh).
Emotions are felt bodily and these kids need to learn how to tolerate and 'surf' their body's cues and sensations rather than block/avoid/suppress-- or be carried away.
Looking at the co-occurring issues of the trans ID population, it is obviously an early childhood regulation/attachment-challenged group: ASD affects interpersonal/relational skills and learning, so that impairs acquiring self regulation. PTSD, or Trauma history/abuse/bullying, deeply affects acquiring these self calming/ self-accepting skills. Most foster youth are surrendered under age three and have been abused or neglected in this window. Adoptees, with 4x the TG ideation, are another group who have had shock trauma in early babyhood-- even if later experiences were very loved and safe. If a baby has PTSD and is in "freeze," it is hard to learn anything.
Last, what babies would consider traumatic is not what we necessarily think of as "Trauma" and might be accidental on the part of the parent. For a baby, Mom being hospitalized for two weeks (nobody's fault) could be VERY traumatic, like a death or an abandonment. Or a depressed mom, a financially stressed household, lack of mirroring/attention.
There is a thing out in the therapy world too about DBT. I don’t know how many therapists believe it, but they think DBT is harmful. I’m sorry I don’t know more about this--have just run into it in online therapists groups.
What an excellent article! Even though it poses more questions than answers, the questions are thoughtful and extremely important. I am pleased to have a name (DBT) for the type of approach that I favor for beginning to unravel the origin of peoples' gender identity issues. I will eagerly seek more information on this and pray that we get more traction on this without involving politics.
Hi Randy, I agree that there are certain areas where a person's statements indeed need to be treated as unassailable fact, specifically, when that person asserts how they feel about something. You should accept that as fact - unless that person is an accomplished liar as many addicts are.
However, in the realm of the exceptions that you might grant are some cases of interest. For example, a 70 year old man may claim, as he risks his life savings and his house, that he does not have a "gambling problem." One would be right to be skeptical. Another case, a young man with body integrity identity disorder might insist that his right arm does not exist and therefore this thing attached to his shoulder must be cut off. Any surgeon confronted with this belief and requested to "saw it off" should demur.
Finally, if a young lady with less than 1% body fat proclaims that she IS FAT, that does not mean she is. And those that affirm her belief and help her act on that belief, thereby causing her death are doing her no favor. Anorexia, which is often spread by a social contagion, is strongly held - but objectively incorrect.
To deny someone the ability to chemically castrate himself/herself or surgically mutilate himself/herself because you see a serious disconnect between that person's stated belief and objective reality may indeed be a productive strategy. When the social contagion has run its course and reason and sanity return, that person may well thank you. But this is not guaranteed. They may still hate you - but they may hate you with their fertility and ability to achieve orgasm intact.
I don’t have to be inside another person’s head to know that whatever they are feeling their feelings are not the feelings that are felt by only or mostly by people who identify as a certain gender. Those feelings are the feelings of that person and that person alone. No one can feel exactly what they are feeling because no one else is exactly that person, only they are. So with that it means that they are feeling the feelings that they were made to feel. They aren’t feeling emotions and thinking thoughts meant for another body. If they were they would have been born in a different body but they weren’t. That is what is meant by radical acceptance. The first thing someone has to do is accept those things that will always be absolute. If you gift wrap a soccer ball the soccer ball will remain a soccer ball no matter what the wrapping paper looks like. If you pop the soccer ball it doesn’t become a placemat, it still remains a soccer ball. If you slash that soccer ball into strips and throw the strips around the room it is still a soccer ball. Albeit a soccer ball in multiple pieces but the soccer ball didn’t magically become shrimp shush kabobs because you made it into multiple pieces.
There’s a prayer that is well known in certain circles of people who have been driven to a point of absolute rock bottom where other than accepting the death that will come by continuing on in subjective fantasy the only thing they can do is accept absolute reality
“God, grant me the sincerity to accept the things I cannot change;
In 2010 I went through a 90 day intensive residential treatment that focused solely on 24/7 DBT. You lived it, breathed it, and ate it. Out of all the different treatments I have gone through in 35 years since my first suicide attempt at age 11 it was the most successful. Not perfect mind you but infinitely superior to everything else. It’s what helps get me through the days when I want to give up and just do what my daughter wants, to accept her and treat her as my son. It helps me remember that to do so would cause me to spiral down into the depths of the debilitating depression that comes when I have severe cognitive dissonance. I truly believe that what is being called a “mental health crises” is in fact mental illness manufacturing. Psychologists, therapists, counselors, teachers, doctors and parents are creating bipolar and BPD in kids by reinforcing undisciplined thinking and supporting/encouraging the uncontrolled reactions to intense emotions. The more kids are taught to think about and talk about how they are feeling the more intense and overwhelming those feelings become. Then it’s made even worse by teaching them that any and all reactions to their emotions are acceptable no matter how inappropriate. The best thing schools and even daycares could do would be to have DBT be taught and incorporated throughout their day at school. Not classes that teach it specifically but just a regular and normal everyday part of school. Coping skills not taught as “coping skills” but as the logical means of handling difficulties and distresses from a disagreement on the playground to the disappointment of failing a test. Teaching kids, adolescents and young adult how to interact calmly and rationally in the objective reality everyone exists in instead of trying to wrangle some kind of order from the chaos created when everyone exists in their own subjective reality.
100% agree-- DBT is best evidence-based treatment for BPD / severe emotional dysregulation.
Be aware that it can be given in group settings. They offer group DBT in my community.
"Radical Acceptance" is part of DBT.
AAP, APA, HHS, CDC, FDA, these agencies are all captured. They do not work for Kids, Families, Parents, Americans, People, or Society. They work for Global Multinational Pharmaceutical & Tech Companies. They don’t care if they drive your kid to suicide or if your kid is harmed by hormones, sex change operations, or grotesque medical malfeasance.
DBT is for Borderline PD. It doesn’t really work well enough for the most severe Borderlines who were seriously abused by their parents & ended up in Foster Care as Adolescents because those kids have way too much Dissociation. Whenever these kids get stressed, they have thousands of mini milli-second blackouts a day. You can start any kid with DBT as treatment but many kids are gonna need a lot more; things like Neurofeedback. And they are going to need the parent to understand attachment disruption.
Borderline results from Developmental Trauma/Disorganized Attachment/ Life Threat in Infancy. The infant is forced to use what Selma Fraiberg called, “Infant Pathological Defenses” right from birth. Borderlines have mothers with Borderline. They have aunts, uncles, grandparents with Cluster B Personality Disorders. These are families with High ACE Scores.
If I wanted to help my kid, I would 1. Get every PubMed article by Susan Coates and read them, put them in a File. Share them with your kid’s doctors. 2. Get rid of the hand held Propaganda Box. 3. Read Allan Schore’s “Affect Regulation and Development of Self.” 4. Read Brown and Elliot’s “Attachment Disturbances in Adults” 5. Find a Really good therapist who knows how to do NFB for Borderline/Developmental Trauma/RAD 6. Get Dean Ornis’s Book “Undo It” and follow his lifestyle recs.
That’s where I would start. And I would do as much as I could to stay away from Allopathic Medicine.
I would also learn about Structural Dissociation and read Otto van der Hart’s Book.
Only in an Insane world would anyone suggest or worse believe, that you could take a Borderline or a Schizotypal/Borderline kid and give him/her cross sex hormones and a Sex Change Operation & call that treatment. This isn’t treatment. It’s Predation.
I think it's eugenics.
I think so too. It’s the Nazis that were taken out of Germany in Paperclip and peppered in all major US Colleges and Universities. They were doing MK work there on Kids and they were doing these Sex Change Operations on kids in the Camps. We’re dealing with Transhumanist demons who are Bent on the Singularity & Immortality & to get there, they are gonna experiment on the kids.
Coates 1: The Complexity of Early Trauma: Representation and Transformation
SUSAN W. COATES, Ph.D. MARY SUE MOORE, Ph.D.
INTHIS PAPER we will describe the case of Colin, a 3'/2-year old boy who suffered significant trauma of a nonsexual nature, which occurred in the context of his primary attachment relationship. The case was the subject of an extended previous communication devoted to a psychodynamic understanding of gender identity disorder of childhood (Coates, Friedman, and Wolfe, 1991). Here we present the case, not with special reference to issues of gender, but as seen through the particular lens of trauma. Colin's traumatization can be conceptualized as having two different components, one entailing the precipitous loss of the emotional availability of his primary caretaker
and the other entailing physical confrontations, experienced as poten- tially life-threatening, when he tried to reestablish contact with her. Beyond this, the case also touches on the issue of the cross-genera-' tional transfer of trauma.
To be noted at the outset is that neither what has been documented of Colin's traumatization nor the cross-generational issues involved in it were sexual in nature. Why present such a case in a special issue devoted to the topic of sexual abuse?
Coates 2: Mothers of Boys with Gender Identity Disorder: A Comparison of Matched Controls
SONIA MARANTZ, PH.D., AND SUSAN COATES, PH.D.
Abstract. This pilot study compared mothers of boys with gender identity disorder (GID) with mothers of normal boys to determine whether differences in psychopathology and child-rearing attitudes and practices could be identified. Results of the Diagnostic Interview for Borderlines and the Beck Depression Inventory revealed that mothers of boys with GID had more symptoms of depression and more often met the criteria for Borderline Personality Disorder than the controls. Fifty-three percent of the mothers of boys with GID compared with only 6% of controls met the diagnosis for Borderline Personality Disorder on the Diagnostic Interview for Borderlines or had symptoms of depression on the Beck Depression Inventory. Results of the Summers and Walsh Symbiosis Scale suggested that mothers of probands had child-rearing attitudes and practices that encouraged symbiosis and discouraged the development of autonomy. J . Am. Acad. Child Adolesc. Psychiatry, 1991, 30, 2:310-315. Key Words: gender identity disorder, maternal psychopathology, Beck Depression Inventory, Diagnostic Interview for Borderlines, symbiosis, autonomy, child-rearing practices.
Recent years have seen a burgeoning interest in gender identity disorders (GID) in children. Boys and girls with GID are distressed about their gender, wish to be of the opposite gender, and manifest a predominant interest in behavior and activities that are typical of the opposite gen- der. Boys with GID prefer female stereotypical activities, such as dressing up in girls’ clothes, playing with dolls, and playing the role of a female in fantasy activities. Symptoms of GID in boys usually emerge between the ages of 2 to 4 in the form of an intense interest in dressing up in female clothes (Stoller, 1968; Green, 1974; Coates, 1985; Meyer and Dupkin, 1985). Although most homosexuals have not had a childhood history of GID (Saghir and Robins, 1973; Friedman, 1988), follow-up studies have found that at least three-quarters of boys with GID become homosexual as adults (Money and Russo, 1979; Zuger, 1984; Green, 1985). The role of biological influences on the development of GID is not understood to date. No differences have been found between boys with and without GID in either morphology of external genitalia or in karyotyping of sex chromosomes (Green, 1974; Rekers et al., 1979). Despite these results, there is indirect evidence from animal studies and from spontaneously occurring endocrinological disorders that suggests that prenatal hormones may influence certain as- pectsoftemperament,suchasenergyexpenditureandrough and tumble play (Ehrhardt and Meyer-Bahlburg, 1981; Hines, 1982; Friedman, 1988).
"Are doctors and therapists—and the US Department of Health and Human Services—really choosing the best, most effective, most evidence-based path for gender dysphoric teens, or are they choosing the path that doesn’t challenge them with difficult questions?"
The beautiful lie or the painful truth?
Sexual liberation, to include extra-marital sex, contraception, transgenderism and same-sex "sex" are all part of a broader eugenics program.
Bye bye bloodlines!
The chosen ones know exactly what is best for our "transgendered" youth. They will tell us what is best. They will drug our children if that is best for the collective. Isn't this the world you all want? Right?
"It takes a village"...right?
I’ve read DBT is often used with PTSD, and that does seem to be a frequent comorbidity with membership in the gender cult 😕
DBT is derived from Buddhism.
So, another option to therapy is to go straight to the source and practice meditation & listen to dharma talks. This will strengthen self-control, emotional regulation, and the ability to be calm and loving (even while your child is off-balance).
The tradition of Thich Nhat Hanh is extremely engaging and has numerous online lectures on Youtube.
One example among many: https://www.youtube.com/watch?v=yHetqgMB8SM
Great points.
I hate to hear that DBT is yet another thing being corrupted by this cult, and rendered possibly harmful or at least significantly less benign. I have found the DBT tools and philosophy so very helpful in my life. I base my LGB activism on promoting the DBT concept of "radical acceptance," which I also try to practice in my own life.
If acceptance of anything in life is conditional it is not "radical (to the root) acceptance," and thus is not DBT.
Thank you for this. It is the best written article I have read on the subject, and I appreciate your perspective.
I spent a lot of $ on DBT for my child. It was helpful for coping with moving through depression and difficulty functioning. But I had the same frustrations With the pronoun game I had with another therapist. When I complained I was told DMSO no longer classify gender dysphoria as a mental illness so it’s not treated as such.
Then tell them to treat the depression and distress by not deviating from the objective reality of your child’s biological sex while interacting with your child because to do otherwise creates cognitive dissonance for your child.
That’s alarming info on DSM. It’s the left moving goalposts and terminology again.
🔥🔥🔥
Yes! I agree! Great piece. I have a few thoughts to add.
DBT ought to be the "first stop" (though NOT "affirming" DBT -- regular DBT). Pretending the distressing thing (being female) isn't true because "G Identity is male" would be the *opposite* of DBT. "Radical acceptance" is the heart of it. Learning to tolerate upsetting realities.
The DBT program was designed by a therapist, Marcia Linehan, who herself struggled with Borderline Personality Disorder as a young woman and devised this program to address what her incapacities and needs were.
In my area, they offer *Group* DBT. I know it is offered to adults-- and I think also teens-- in the group setting. This could be one way to get DBT to more people. There's a workbook with weekly themes and homework/ practice of new skills. I think it's about a 10 or 12 session course. I know someone w BPD who took it, and she said it made her life much better and gave her effective skills to cope.
DBT is all about "distress tolerance": learning how to modulate one's emotions/ reactivity and have a better capacity to 'hold' distressful feelings or thoughts without going into a panic state, rage state, dissociated shut down, or other overwhelmed state.
There is a developmental period in early life when we normally learn distress tolerance and "emotional self regulation"... 0-3. The way we learn it is (ideally) we have a parent who is able to comfort our distress and calm us down when we get upset; amuse and engage us when bored... etc.
The frequent repetition of these actions, by which we are soothed and co-regulated, teaches us how to intuitively soothe and regulate ourselves. This skill is modeled and absorbed over time.
There's an implication that teens are still not mature, and this is why some teens need DBT. Not exactly. It isn't normal for a teen to have totally missed out on self-regulation learning altogether-- though it IS normal for racing emotions and hormones of teen years to challenge and re-test our ability to self regulate and demand we hone better skills. Teens recapitulate toddlerhood in many ways. Kids who can't self regulate at all MISSED OUT on learning the skill and that has affected subsequent learning because the developmental sequence builds on prior skills. It's a functional deficit.
DBT is a kind of CBT. These methods use the Cognitive (Left/ linguistic-rational) brain. Here, DBT skills and strategies invoked by Left brain ("I can take a hot shower") are used to calm the Right (emotional) brain down.
Of course the EASIEST way to learn emotional self regulation is when it is learned intuitively by our right brains in toddlerhood, the appropriate time frame-- or if we learn it later, learned through right brain experiences (attachment to the therapist, being co-regulated by the therapist, feeling trust and self trust, etc).
Neurofeedback is one RIGHT-brain focused therapy that can greatly improve overall regulation ("Neuroptimal"). Somatic psychotherapy or Neuro Affective Relational Model (NARM) are other right-brain focused therapeutic approaches. They are mostly wordless, body-and-sensation focused approaches (a bit like babies get when we rock them and say shhhh).
Emotions are felt bodily and these kids need to learn how to tolerate and 'surf' their body's cues and sensations rather than block/avoid/suppress-- or be carried away.
Looking at the co-occurring issues of the trans ID population, it is obviously an early childhood regulation/attachment-challenged group: ASD affects interpersonal/relational skills and learning, so that impairs acquiring self regulation. PTSD, or Trauma history/abuse/bullying, deeply affects acquiring these self calming/ self-accepting skills. Most foster youth are surrendered under age three and have been abused or neglected in this window. Adoptees, with 4x the TG ideation, are another group who have had shock trauma in early babyhood-- even if later experiences were very loved and safe. If a baby has PTSD and is in "freeze," it is hard to learn anything.
Last, what babies would consider traumatic is not what we necessarily think of as "Trauma" and might be accidental on the part of the parent. For a baby, Mom being hospitalized for two weeks (nobody's fault) could be VERY traumatic, like a death or an abandonment. Or a depressed mom, a financially stressed household, lack of mirroring/attention.
Wow. "Affirming-type DBT" (as opposed to "Regular DBT"). So, like if there were two AAs: one that served alcohol at meetings; and one that didn't.
😂👍🏻
There is a thing out in the therapy world too about DBT. I don’t know how many therapists believe it, but they think DBT is harmful. I’m sorry I don’t know more about this--have just run into it in online therapists groups.
What an excellent article! Even though it poses more questions than answers, the questions are thoughtful and extremely important. I am pleased to have a name (DBT) for the type of approach that I favor for beginning to unravel the origin of peoples' gender identity issues. I will eagerly seek more information on this and pray that we get more traction on this without involving politics.
Hi Randy, I agree that there are certain areas where a person's statements indeed need to be treated as unassailable fact, specifically, when that person asserts how they feel about something. You should accept that as fact - unless that person is an accomplished liar as many addicts are.
However, in the realm of the exceptions that you might grant are some cases of interest. For example, a 70 year old man may claim, as he risks his life savings and his house, that he does not have a "gambling problem." One would be right to be skeptical. Another case, a young man with body integrity identity disorder might insist that his right arm does not exist and therefore this thing attached to his shoulder must be cut off. Any surgeon confronted with this belief and requested to "saw it off" should demur.
Finally, if a young lady with less than 1% body fat proclaims that she IS FAT, that does not mean she is. And those that affirm her belief and help her act on that belief, thereby causing her death are doing her no favor. Anorexia, which is often spread by a social contagion, is strongly held - but objectively incorrect.
To deny someone the ability to chemically castrate himself/herself or surgically mutilate himself/herself because you see a serious disconnect between that person's stated belief and objective reality may indeed be a productive strategy. When the social contagion has run its course and reason and sanity return, that person may well thank you. But this is not guaranteed. They may still hate you - but they may hate you with their fertility and ability to achieve orgasm intact.
I don’t have to be inside another person’s head to know that whatever they are feeling their feelings are not the feelings that are felt by only or mostly by people who identify as a certain gender. Those feelings are the feelings of that person and that person alone. No one can feel exactly what they are feeling because no one else is exactly that person, only they are. So with that it means that they are feeling the feelings that they were made to feel. They aren’t feeling emotions and thinking thoughts meant for another body. If they were they would have been born in a different body but they weren’t. That is what is meant by radical acceptance. The first thing someone has to do is accept those things that will always be absolute. If you gift wrap a soccer ball the soccer ball will remain a soccer ball no matter what the wrapping paper looks like. If you pop the soccer ball it doesn’t become a placemat, it still remains a soccer ball. If you slash that soccer ball into strips and throw the strips around the room it is still a soccer ball. Albeit a soccer ball in multiple pieces but the soccer ball didn’t magically become shrimp shush kabobs because you made it into multiple pieces.
There’s a prayer that is well known in certain circles of people who have been driven to a point of absolute rock bottom where other than accepting the death that will come by continuing on in subjective fantasy the only thing they can do is accept absolute reality
“God, grant me the sincerity to accept the things I cannot change;
The courage to change the things I can;
And the wisdom to know the difference.”