Thank you for this article. I found it really interesting. I think I understand the concept but wonder if you could provide a real-life example of when you have used this strategy? 🙏🏼
Hi Fiona - sorry for the delayed reply to this, have only just remembered. I don't have time to reply to this fully, but wanted to acknowledge that I have seen the question and will come back to answer it ASAP.
That IS very infantasizing, and it's abusive. But then DBT does tend to view patients that way: as being "willful" children that need to be disciplined, if not out right punished. It's very much a case of "I only beat my child when it is necessary - as soon as they stop misbehaving, I stop beating them. It comes from a place of love; I am trying to teach them right from wrong. They know that if they want to avoid a beating, they only need to do as they are told".
Though "withdrawing warmth" is perhaps more like when a parent withdraws love when the child doesn't conform or obey. It's a common type of emotional abuse, even in adult relationships. One that patients put through DBT have probably encountered many times before, and that is likely to retraumatize them.
Is trauma boning really an ethical way to create patient compliance?
Withdrawal of warmth by a therapist is manipulative and abusive, PERIOD. Most therapists who do DBT don't even know the definition of "negative punishment," which is exactly what this technique is. Negative punishment is the removal of anything the person values in order to decrease the strength of a behavior. And yet DBT practitioners continually deny that it is punishment. At least a behavior "therapist" should know the basic definitions in behaviorism.
DBT is NOT therapy, despite its name. It is a set of coping skills to tolerate and regulate emotional pain. There is NO HEALING involved, and when punishment is added, what is accomplished is greater trauma--replication of the abuse so many clients have suffered. In addition, DBT practitioners do not allow their clients to discuss their trauma at all. It's called "therapy interfering behavior." Questioning DBT is also "therapy-interfering-behavior." And if a client doesn't shut up and comply, the solution is easy--TERMINATE the client and move on to the next one.
DBT also includes a lot of double-talk disguised as "dialectic." The gaslighting involved in convincing clients that "there is no right or wrong" (right out of the DBT playbook) as well as the contradictory language written in the worksheets is not helpful; it's crazy-making.
The so-called research backing up the effectiveness of ANY and ALL of the behavior "therapies" (CBT, DBT, ACT, ya-da-ya-da-ya-da) is flawed in its very design. When you compare two groups (one that gets DBT, the other that gets nothing or a placebo), what isn't clear to the reader of such research is that the group that got DBT includes people who are harmed or don't benefit. BUT, because they almost always drop out of the study (they always have that right at any time), their data is not included in the final results--thus, the DBT group ALWAYS shows benefits. This is true of all research into the behavior therapies that involves at least 2 groups of people.
Make NO MISTAKE--a practitioner who TEACHES DBT knows that it's nothing more than a cookbook formula. It doesn't require any real empathy or concern for the clients at all. Just run through the education, give out a worksheet each week, have clients keep a diary (most of which clients fake if they would admit that to their so-called "therapists'), and viola--"therapy." It's easy to implement--just follow the book; no therapeutic skills (like empathy, compassion, or even listening) required. It's not more complicated that a recipe for lasagna.
How many clients whose therapists have "withdrawn warmth" and refused to speak to them for a period of time (between 24 to 72 hours depending on the practitioner) have committed suicide during that period? I have searched for such data, and it does not exist. (I'm a PhD therapist and a researcher/statistician). Who would publish such data showing the tremendous harm such abuse can cause clients? The evidence that such tactics can drive people over the edge isn't something anyone who is making money on DBT (the "gold standard") wants to publish. Many people with BPD are in fact suicidal, so when their so-called therapists refuse to interact with them in a time of crisis, the threat dramatically increases. And if the client does complete suicide, the therapist brushes it off as "oh well" and moves on to the next client who has been told that DBT will help him/her heal. Failure in DBT is ALWAYS blamed on the client.
Thank you for this article. I found it really interesting. I think I understand the concept but wonder if you could provide a real-life example of when you have used this strategy? 🙏🏼
Hi Fiona - sorry for the delayed reply to this, have only just remembered. I don't have time to reply to this fully, but wanted to acknowledge that I have seen the question and will come back to answer it ASAP.
Nope. This is abusive.
That IS very infantasizing, and it's abusive. But then DBT does tend to view patients that way: as being "willful" children that need to be disciplined, if not out right punished. It's very much a case of "I only beat my child when it is necessary - as soon as they stop misbehaving, I stop beating them. It comes from a place of love; I am trying to teach them right from wrong. They know that if they want to avoid a beating, they only need to do as they are told".
Though "withdrawing warmth" is perhaps more like when a parent withdraws love when the child doesn't conform or obey. It's a common type of emotional abuse, even in adult relationships. One that patients put through DBT have probably encountered many times before, and that is likely to retraumatize them.
Is trauma boning really an ethical way to create patient compliance?
Withdrawal of warmth by a therapist is manipulative and abusive, PERIOD. Most therapists who do DBT don't even know the definition of "negative punishment," which is exactly what this technique is. Negative punishment is the removal of anything the person values in order to decrease the strength of a behavior. And yet DBT practitioners continually deny that it is punishment. At least a behavior "therapist" should know the basic definitions in behaviorism.
DBT is NOT therapy, despite its name. It is a set of coping skills to tolerate and regulate emotional pain. There is NO HEALING involved, and when punishment is added, what is accomplished is greater trauma--replication of the abuse so many clients have suffered. In addition, DBT practitioners do not allow their clients to discuss their trauma at all. It's called "therapy interfering behavior." Questioning DBT is also "therapy-interfering-behavior." And if a client doesn't shut up and comply, the solution is easy--TERMINATE the client and move on to the next one.
DBT also includes a lot of double-talk disguised as "dialectic." The gaslighting involved in convincing clients that "there is no right or wrong" (right out of the DBT playbook) as well as the contradictory language written in the worksheets is not helpful; it's crazy-making.
The so-called research backing up the effectiveness of ANY and ALL of the behavior "therapies" (CBT, DBT, ACT, ya-da-ya-da-ya-da) is flawed in its very design. When you compare two groups (one that gets DBT, the other that gets nothing or a placebo), what isn't clear to the reader of such research is that the group that got DBT includes people who are harmed or don't benefit. BUT, because they almost always drop out of the study (they always have that right at any time), their data is not included in the final results--thus, the DBT group ALWAYS shows benefits. This is true of all research into the behavior therapies that involves at least 2 groups of people.
Make NO MISTAKE--a practitioner who TEACHES DBT knows that it's nothing more than a cookbook formula. It doesn't require any real empathy or concern for the clients at all. Just run through the education, give out a worksheet each week, have clients keep a diary (most of which clients fake if they would admit that to their so-called "therapists'), and viola--"therapy." It's easy to implement--just follow the book; no therapeutic skills (like empathy, compassion, or even listening) required. It's not more complicated that a recipe for lasagna.
How many clients whose therapists have "withdrawn warmth" and refused to speak to them for a period of time (between 24 to 72 hours depending on the practitioner) have committed suicide during that period? I have searched for such data, and it does not exist. (I'm a PhD therapist and a researcher/statistician). Who would publish such data showing the tremendous harm such abuse can cause clients? The evidence that such tactics can drive people over the edge isn't something anyone who is making money on DBT (the "gold standard") wants to publish. Many people with BPD are in fact suicidal, so when their so-called therapists refuse to interact with them in a time of crisis, the threat dramatically increases. And if the client does complete suicide, the therapist brushes it off as "oh well" and moves on to the next client who has been told that DBT will help him/her heal. Failure in DBT is ALWAYS blamed on the client.
Thank you for your comments. I appreciate it. :-)