Alan Fruzzetti PhD on ‘Anhedonia’
Treating Emptiness, Anhedonia, Relationship Chaos and Difficult Problems
Dialectical Behaviour Therapy has been shown, in dozens of studies, to be very effective at reducing self-harm, suicide attempts, aggression, substance use problems, eating disorders, relationship chaos and distress. Training in DBT typically focuses on how to treat these “Stage 1” primary targets.
However, more diffuse problems can be more difficult to identify, assess, and target for improvement. These may include common problems in disorders such as feelings of profound emptiness, anhedonia, loneliness and relationship chaos and distress.
Alan Fruzzetti is coming to Australia in June 2017 to present series of two-day workshops in Sydney, Melbourne & Brisbane. His focus will be on the identification and assessment of these more diffuse targets, which are common not only in borderline personality disorder, but in related disorders as well.
He will focus on how to use mindfulness skills in particular to treat these sticky problems. The workshops will include lecture, demonstration, and practice opportunities for participants.
What about realistic anhedonia? If you are a climate scientist, and understand the evidence, you’ll know we are past the tipping points. Not only humanity, but most of life on this planet is headed for extinction.
This is unlikely to lead to great explosions of joy.
I am in this position myself, and so are some of my clients.
My approach is Buddhist acceptance/equanimity, so perhaps that’s not too far beyond mindfulness.
Just read your comment Bob and wanted to reply from the perspective of a person that lives with BPD, and has recovered from the disorder in the eyes of my therapist and my peers. Dialectical Behaviour Therapy is very much a Buddhist approach in that, each person who undergoes the program with a fully accredited clinician is treated with acceptance of where they are. More importantly, DBT treats each client with great respect for the accomplishment of getting to where they are now, given where they came from, and what they may/may not have dealt with prior to treatment, surviving is seen as a huge achievement. Marsha Linehan treats each of her clients with the utmost acceptance of who they are and genuinely respects their efforts to “live with the load that life has given each of them”, so to speak (these are my words, not Marsha’s per say). Marsha herself is a Zen Master so I think you may be pleasantly surprised with how similar her approach is to your own practice. I certainly know that I used to expect grand moments of happiness, success, and fulfilment from my everyday life. Since DBT, I have retrained my mind with the DBT skills to notice and appreciate the “small blessings” that exist in every moment, and in every interaction, rather than desperately waiting for a spectacular display of fireworks to happen for me each day. I feel this sits well with Buddhism.
Rose may I share your story their with my dbt skills group? I am a cofacilitator and skills coach. I also have the perspective of a husband with bpd, we have been together 17yrs. What the group said they want most as its helpful is stories of dbt that give hope things will be more manageable and life wont be such chaos and extremes. So thanks for answering and sharing that 😊
Hi Natalie, I was unaware that I had feedback left for my comment. I am truly hopeful that in the past year you have indeed shared my comment. I am most certainly happy to share my story with your DBT skills group – anything that can help another grapple with the extraordinary effort it takes to commit to DBT and successfully complete the year. As your husband would tell you, we are quite in need of human connection – I hope that you did share my story with one another, and with the DBT skills group. From one to another may we all embrace our uniqueness and learn to live by the DBT middle path. It can only bring about connection, self-love, and life purpose within us. Best wishes and thank you kindly Natalie!
Hi there Rose, when I read your comment on dbt I was taken aback because i did not feel that our group were treated with a great deal of respect, your view or the way your group was run sounds very different to my experience.
I thought the skills seemed quite well developed but didn’t quite fit for every person at every time or needed to be fleshed out and understood more which there was no time for. I am curious to know whether or not you had a therapist seeing you along side the groups to talk about the issues that arose for you during that time and whether or not this made a difference? Our group did not have this option and I believe the skills without the ability to talk through where they fit in to ones own personal setting requires the person to be their own therapist which is a lot to expect especially because issues will arise during the dbt course that need looking at with the help of someone insightful and supportive
Hi Sydney, as was the case with Natalie’s reply above, I was not aware you had replied to my comment. My sincere apologies to both yourself and Natalie – a year later! I want you to know that I have been told by many peers similar experiences of DBT. I must thus express my deep disappointment in the professionals who are not following Dr. Marsha Linehan’s DBT model as she has explicitly requested it be practiced. DBT is very clear about how it is to be delivered with clients in both private therapy, and within the full year setting of both private one on one therapy and a DBT skills peer group. Remember, that Marsha Linehan believes that the Clinician must practice DBT themselves in order to correctly teach it to clients. The sad truth is that many practitioners NOT in the public health system do not have the adequate training, nor attending follow up training regularly as a rule of good practice. This was emphasised by my personal Clinical Psychologist that was assigned to me via the full DBT program held in the public health system. I also attended 3 hours of DBT skills training. The purpose of each is PRECISELY the reason your experience of DBT was so invalidating and wholly untraditional to DBT therapy. The clients are meant to attend a Clinical Psychologist for one on one sessions regarding the issues in the ‘here and now’ whilst confronting the very deep-seated beliefs within each person. This is a weekly therapy session and assists to unpack what is working, what isn’t, and practicing DBT skills that challenge. The rule of DBT is to invite the idea of “Just trying is doing DBT, you cannot fail it, you can only try wherever possible as best you can for that moment” to each client’s mind til its belief. Secondly, every client will have at least a day or so break followed by the DBT skills group with peers in the program. This is split into the first 6 months of “teaching the skills and role-modelling them to the group”. The clinicians are to reinforce practicing the skills, asking questions and actually doing the skill taught as a group. Whilst also, discussing everyone’s challenges vs what worked and why, and this is all about reinforcing “we are all different, we each experience BPD differently and despite our commonalities of pain and endless suffering, what works for me and what works for another is uniquely different”. Marsha Linehan helps us here by designing DBT with a plentitude of options, ideas, and you can think of more DBT skills to suit you in the weekly sessions with your psychologist too. The second half of the year the skills group reviews and insists more “thinking DBT and behaving DBT and reacting in a DBT way”. This is again still done with what works best for each person and their best life! This is DBT’s objective and the traditional model. I am very sorry for what your DBT experience was Sydney, it sounds like it was more load on top of BPD, than it was helpful to you. I believe Marsha is very aware of persons like yourself who have been cheated from being treated by an adequately trained therapist in the way that DBT is directed. Thus, her new DBT Skills Training Workbook is a step-by-step manual that Marsha created for you and everyone across the globe that did NOT experience the supportive environment for you to very slowly learn and practice the skills with a professional who is on your team for you to finally live a life worth living because it’s fulfilling you in positive ways. Since I completed the DBT program I have gone on to do a Diploma in Counselling, and am halfway through my Bachelor of Behavioural Science. I will slowly make my way through Honours and Masters of Clinical Psychology and specialise in DBT for you and every person living with BPD. It is my life goal to assist each client to save their own life – reinvent it wholly for their best life and self!! I believed with every fibre of my being that I was a mistake Sydney, all through my entire childhood and up until I did DBT at the age of 33. To say that Marsha saved my life is an absolute understatement. I highly encourage you to try DBT again. You owe it to yourself and to your BPD – it isn’t our enemy, it is what helped us to survive and is apart of us, & once understood we can tame it via DBT. Living with BPD doesn’t have to mean each day is a fight. I sincerely wish you all the best Sydney and thank you for your comment, it raised important issues in our mental health system and the inadequate delivery of a vital life-saving therapy model. Take good care Sydney.