I’ve mentioned before that one of the therapeutic tools I find helpful is DBT – Dialectical Behavioral Therapy. DBT is an offshoot of cognitive behavioral therapy. It began as a treatment for borderline personality disorder (BPD) and today is also used to treat other mental health challenges – particularly when intense emotions impede someone’s progress. Taught in groups as well as in individual therapy, DBT teaches skills in four modules – core mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation.

Central to DBT is dialectics – the fact that two opposites can be true at the same time. There are many examples of dialectical truths in all aspects of life. It sometimes rains when the sun is out (and we are rewarded with a rainbow). Some of us have love/hate relationships with a family member. There’s also the classic DBT standard – I can be doing the best I can, but still need to learn to do better.

Dialectics tend to throw many of us, and this is especially true of people with BPD. I have BPD in addition to PTSD and depression, and am no exception to this rule. When two opposites seem true, I feel confused and overwhelmed – it’s almost as if something inside snaps. I like my reality to fit neatly into a box, and when it doesn’t, I have strong emotional reactions, DBT or not.

I had one of those reactions last week.

I would like to find a new part-time job in the field for which I’m trained and am seeking some assistance in that area. Vocational Rehabilitation (VR) helps people with disabilities who want to work. I know I qualify. My mental illness alone makes it hard to function in the world, but I also have mobility issues related to an accident I had many years ago. Still, VR had to assess my disability in order to prove I qualified for their services.

When I received the letter, I did qualify for services. Yay, right? Except they stuck me in the category “Most Significantly Disabled,” which was an emotional blow even if it prioritized my case. Who wants to be disabled, no less, most significantly so?

I recognize that I’m disabled but I work so hard to do everything I can do. I work as much as I’m able (sometimes more so – that always gets me in trouble). I do the things around my house that I’m able. I refuse to use my disability as an excuse. I don’t think of myself as “most significantly disabled.”

I was happy VR was granting me services, but I felt hopeless about being so categorized. That’s a dialectic. I was very confused because the letter was good news, but the label didn’t fit neatly in the good news box. My emotions swirled!

This is where DBT helped. I used my skills. I recognized all my feelings and gave them a little room to be. My natural inkling is to shut down when I have intense emotions, and then behave in ways I regret. I was mindful instead – taking a step back and observing. Then I called a trusted friend, telling her I was having mixed feelings over the letter. She helped me accept that my reaction was valid. I did nothing I regret and am now more focused on moving forward with my VR plan. Victory!