Presenting DBT + DBT PE

Two weeks ago I had the opportunity to do intensive training in DBT PE-prolonged DBT exposure protocol for posttraumatic stress disorder (PTSD), with Melanie Harned and Annie McCall. Melanie was the creator, researcher and creator of this method of trauma treatment with dialectical behavioral therapy. Protocol this focused on patients with high risk and multiple diagnostics, such as suicidality, self -injury, substance dependence, compulsive eating, bipolar personality disorders, depression, dissociation and others. Adapted from prolonged exposure therapy for PTSD (FOA et al 2019), occurring simultaneously with standard DBT and being conducted by individual DBT therapist.

My goal here is to draw attention to this reality and this type of treatment, still recent, but with a lot of scientific evidence. According to Harned (2023), many DBT patients have many traumatic stories for long periods, with the NPPT a common result, which generates intense suffering, paralyzing consequences and large experiential dodge. Involving in high risk and self-destructive behaviors, restricting, disconnecting and limiting their lives.

According to Harned (2023) it is important to offer a psychoeducation about posttraumatic stress disorder, pretreatment if possible or at any stage of DBT. In general this is a very informative and validating conversation, helping them understand that many of their problems are related to past trauma and are not personal failures or weaknesses.

In the pretreatment step it can be very useful to introduce the term traumatic invalidation to patients that the subject seems to be relevant. Invalidating behaviors usually attack the sense of oneself and the validity of the person. The messages received is that they are bad, wrong, inferior, inadequate, no matter, they do not deserve care, are incompetent and unacceptable. And often the responses to these invalidating behaviors are also invalidated, which increases suffering. Reinforcing beliefs that they are bad, useless and unworthy people of being loved, presenting intense feelings of shame and anger at themselves.

According to Harned (2023), it is less risky to treat the PTSD than not to treat it, no matter how challenging it may be. It is unlikely to be remission if it is not treated during the DBT, and it is likely to make other problems worse. According to research data, the integration of DBT PE in DBT seemed safe and effective for the treatment of these serious comorbidities.

The most beautiful was to hear, at the end of the training, melanie thrilled thanking the therapists there for the courage to be willing to work with such sensitive and difficult themes, but they will surely turn lives. It was really a gift to learn from them.

Want to know more? Call me! It will be a pleasure to talk about it.

About me? Enthusiastic and motivated to continue studying and working with DBT P.

references:

Harned Melanie S. Treating trauma with dialectical behavioral therapy: prolonged exposure protocol in DBT . Technical Translation by Stove Nicoletti and Vinícius Guimarães Dornelles - Novo Hamburgo: Sinopsys Editora, 2023.