Has anyone had DBT therapy? Was it respectful of your ASD?

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I am due to start a year long group DBT program in a couple of weeks. My diagnosis are Aspergers and Bipolar II. I know that DBT has been developed for people with borderline personality disorder, which I do not have, though they are using it more and more for other mental illnesses.

Anyway, when I did the initial assessments a few things really worried me regarding how they would treat me. I was told that they will not distinguish between mental and physical pain and that we are expected to (learn to) sit with our distress (rather than remove yourself from the distressing situation). Ok. But my distress in a group setting will likely be sensory overload, which I can do my best to manage, but can control no better than a blind person being unable to see.

I informed the assessor that when I am trying to modulate myself (eg. after an unexpected change or overload) that I may stop talking and appear dazed. Again, this is something that I don't control and is my why of managing myself without escalating to meltdown. I was informed that if this happened they would try to "keep bringing me back into the room/conversation" because it is not acceptable to be in the room without being "in" the room.

Another thing that was raised with me is that I would be required to learn to make eye contact. Ethically I believe strongly that a person with ASD should NEVER be made to make eye contact if they don't want. I believe strongly in my right to take care of myself regarding eye contact.

I am really starting to wonder if DBT is somewhat unethical for people with ASDs. Does anyone have any experiences with DBT at all?

I haven't had it. But here is what I know about this, anyway, as I like getting responses sooner than later if I post.

DBT is not unethical for people with ASD. The spirit of DBT is acceptance, while challenging problematic behavior. The words "not acceptable" about a coping mechanism seem antithetical, to me, to what dbt is.

I am wondering, were you referred by a treatment provider who does not do the dbt group? The assessor almost sounds like she/he may have been trying to turn you off of the group, maybe?

And while I personally would say that people in a dbt group should learn, if at all possible, to make eye contact, that would be as a voluntary thing to voluntarily choose to use, or not, as a tool in situations where it's helpful. The wording you used is that you'd be required to learn it, the implication is you'd be required to use it for the group, and that's scary! But this, too, is antithetical to the spirit of dbt which is about finding and using whatever is effective.

The only positive I can say, though is if you try it, I it may be run better once it starts. But I would be scared by that persons tone, too. Also may make a difference whether they are the person running it or just assessing for it, and maybe the leader could be lovely.

But what you describe isn't IMO consistent with what dbt aims to do. Real dbt should be completely respectful of the individual. This did not sound respectful.

Do you have a choice about the group?

Thanks for your reply Waterfalls. Yeah, I found the whole assessment process quite strange. I am an intelligent person and I understand my ASD well. There were quite a few times when she asked questions that were based on stereotypes of ASDs (like, she questioned my suitability for the group because she incorrectly assumed that I could not empathise with others or that I could not validate/ show caring towards others). When she was making these kind of judgements (along with the eye contact issue) I felt quite upset as I believe strongly in the right of people with ASD to speak for themselves as individuals. We are not one single picture of ASD!

Anyway, she then would try to tell me that I was upset because I was misinterpreting her as "being mean to me" or "attacking me". This is not what was happening at all. It was an issue of advocating for myself in a situation where she felt the right to speak for me.

I hope it doesn't turn out to be like this. I want to enter the program with a positive mind set, but fear that my initial negative experience is going to cloud my view. I don't want to be made to feel like my ASD is a mind over matter issue, that I should be able to control the ASD. I work extremely hard to manage my ASD everyday. I don't think I can handle being told that I am somehow a failure because it still affects me.

Sounds like this assessor has a lot to learn about...well, a lot of things, autism and respect among them. You're doing great advocating for yourself, though. Would the assessor be a part of the group, or are they just referring you to it? (Forgive me if you said this already, if so I didn't catch it.)

I hope this works out for you. I think she was saying you misinterpreted her intent (to be helpful) by taking her negative wording literally and feeling cautious. She may be right, but she misinterpreted you, too! Maybe if she's able to understand how you communicate is real for you, things can go better than if she insists her way is the right way. The world isn't literal, but at least in therapy, it's good to be understood.

Alexi, what you're describing sounds very disrespectful on this lady's behalf. It is clear that she doesn't really understand adult ASD well.

Maybe, instead of going into a non-ASD group setting for therapy, you should either try doing CBT with a professional who has specific experience working with adults with ASD, or doing mindfulness therapy in an ASD group? This might be easier said than done because there are services like this where I live but you may not have these resources available in your area. Perhaps you could find at least one psychologist who has experience with adults with ASD and see what treatment options you can explore with him/her?

Research shows that any form of CBT is as effective for verbally expressive individuals with ASD as it is for the typical population.

Thank you everybody for your kind messages. It has helped to hear that the assessor's attitude was indeed out of line. I always left their feeling offended but like I was somehow wrong for trying to address it. It has been a very confusing experience.

Thankfully the assessor will not be running the group, though she normally does run it, so I'm not really expecting any different.

MathGirl, I already have a clinical psychologist who is knowledgable about ASDs. It is a long story why I have been referred to the DBT program. Basically, I had a bipolar manic episode recently (triggered by medication) that involved self injury. It was quite out of character, but on leaving hospital it was insisted that I do the DBT program. To be honest I'm pretty concerned that it will not be relevant enough to me. Self harm is not a normal part of my life, nor is impulsive behaviour. I'll have to just wait and see I guess.

my mum runs dbt groups and Ive read the course materials and I cant imagine an aspie getting anything out of it as the suggestions are all very borderline PD orientated such as comforting and talking things, which may not be soothing to a 'colder' aspie. For example the worksheets said to phone a friend or have a bath when stressed but this would make me stressed.

also it sounds to me like the assessor was interpreting your information on spacing out and eyecontact from a borderline perspective and I think they well might treat you as one in this group and not have enough experience of aspies not to missinterpret you.

I think all the good bits of dbt are in any mindfulness book and you might be better off investing in those instead,