Hello everyone. Little background, I'm diagnosed bipolar (personally disagree despite 3 diagnoses) &amp; have considerably severe treatment resistant depression. I also have Complex PTSD and a lot of Borderline traits. I've been through about 4 different therapists, completed individual DBT, and am currently in a DBT Skills Group. I take 300mg Wellbutrin for depression and 100mg Lamictal as a mood stabilizer. I no longer feel as though I am taking any medication, and I don't get out of bed until I have to go to work. My suicidal ideation is worse than ever; it seems I think about killing myself almost every 3 hours. I'm having trouble showering consistently and have disconnected from most of my friends. I torment my boyfriend almost daily despite the DBT and my seemingly constant consumption of Buddhist/Shambhalic texts.


Needless to say, I'm afraid I'm running out of options.


I started seeing a new therapist at my DBT center this week who is trained in Radically Open DBT, or RO-DBT. RO-DBT has essentially the opposite goal of standard DBT, in that it encourages open emotional expression as opposed to emotion regulation, and is for "overcontrolled" people (Cluster C - Avoidant, OCD) instead of "undercontrolled" (B - BPD, Narcissistic, etc.). Because I have extreme bouts of anger to the point of screaming and breaking things, it's pretty needless to say that I've never considered this kind of therapy.


Initially they thought that Prolonged Exposure Therapy for trauma would be best, as I felt my reactions to my environment stemmed from my childhood trauma (neglect, addict parents, etc.). However, during my first session, the therapist was extremely interested in what my reactions were in response to rather than the reactions themselves. She asked me about how I can't focus when the dog makes mouth sounds, how I can't let it go if my boyfriend leaves his guitars in the center of the room, and how I can't get anything accomplished because I get so distracted by details - i.e. going to take a shower and spending 20 minutes making a "shower playlist" to hear the perfect songs. 


Hello everyone. Little background, I'm diagnosed with bipolar 2 (personally disagree that I have bipolar at all despite 3 diagnoses) &amp; have considerably severe treatment resistant depression. I also have Complex PTSD and a lot of Borderline traits. I've been through about 4 different therapists, completed individual DBT, and am currently in a DBT Skills Group. I take 300mg Wellbutrin for depression and 100mg Lamictal as a mood stabilizer. I no longer feel as though I am taking any medication, and I don't get out of bed until I have to go to work. My suicidal ideation is worse than ever; it seems I think about killing myself almost every 3 hours. I'm having trouble showering consistently and have disconnected from most of my friends. I torment my boyfriend almost daily despite the DBT and my seemingly constant consumption of Buddhist/Shambhalic texts.


Needless to say, I'm afraid I'm running out of options.


This week I started seeing a new therapist at my DBT center who is trained in Radically Open DBT, or RO-DBT. RO-DBT has essentially the opposite goal of standard DBT, in that its emphasis is on encouraging open emotional expression as opposed to emotion regulation, and is for "overcontrolled" people (Cluster C - Avoidant, OCD) instead of "undercontrolled" (B - BPD, Narcissistic, etc.). Because I have extreme bouts of anger to the point of screaming and breaking things, it's pretty needless to say that I've never considered this kind of therapy.


Initially they thought that Prolonged Exposure Therapy for trauma would be best, as I felt my reactions to my environment stemmed from my childhood trauma (neglect, addict parents, etc.). However, during my first session, the therapist was extremely interested in what my reactions were in response to rather than the reactions themselves. She asked me about how I can't focus when the dog makes mouth sounds, how I can't let it go if my boyfriend leaves his guitars in the center of the room, and how I can't get anything accomplished because I get so distracted by details - i.e. going to take a shower and spending 20 minutes making a "shower playlist" to hear the perfect songs. She was especially interested in the fact that none of my friends seem to believe I have mental health problems, because aside from lapses in my social involvement, I seem fine when I’m actually around everyone, despite my many explanations and admissions of my struggles at home. I only explode around my boyfriend, never at work, never at school, never with anyone other than him and every other boyfriend. I considered this a Borderline trait, but she seemed extremely surprised that i can go from a huge fight, screaming and crying, then appear at work 15 minutes later and be able to chit chat with co-workers, despite secretly wanting to die. This is generally my life, I feel very uncomfortable and different, but I’m good at being funny, talking expressively, and making self-deprecating jokes.


I know I'm uptight and can be a perfectionist, however, I haven't completed my BA because I keep dropping out (due to depression), I do and have done a lot of drugs, I drink a lot, am and have always been promiscuous and generally impulsive. Perfectionists are successful, right? I'm a broke waitress. I can't even get out of bed. I give up on everything I begin. I'm also a compulsive oversharer, it's a joke among my co-workers and people that know me that I would read everyone my diary if I had the chance. I connect with people all the time. 


Then the therapist asked me, “How do you feel when you’re telling people these personal things? Do you feel closer to them? Do you feel connected to them?” 
I realized I don’t. 


I still feel very far away from people despite my frantic attempts at intimacy. I tell them all about myself but I’ll laugh or smile when talking about childhood trauma or sexual assault. She explained that you can share without connecting, especially when your emotional expression doesn’t fit the words. I’m saying vulnerable things because I’m terrified of actually being vulnerable. This is why I drink so much socially, and why I will do drugs socially. Which even so, I’ve been told I’m a reserved drunk, and that I’m a serious person albeit a very funny one. I am constantly aware of my appearance and generally find myself unattractive despite being told I’m beautiful and getting considerable attention for my appearance throughout my adult life. I’ve had an on-again-off-again eating disorder for over 10 years and a relentless preoccupation with my weight despite being .1 above the underweight BMI. I won’t try new things around people, I never feel like I let loose. If one thing goes wrong I abandon a project. I was once asked to do vocals for a band and had to drink vodka beforehand and would still be singing too quietly, I was terrified and frozen. I refuse to practice anything around anyone.



She suggested that my depression and mood disorder could possibly stem from being overly controlled, that because I can’t let loose and I feel like things absolutely have to be a certain way, I paralyze myself and can’t progress. She suggested that this is why I haven’t pursued a career and why I have never shared my creative writing. On a lighter note, that this is why I refuse to do karaoke. 


She also suggested that the reason I explode on my boyfriend, and those in the past, is because they are the ones to actually see me vulnerable. I no longer have total control over my living environment. He see me in my pajamas on the couch at noon. He sees me sleep past 1. I can’t posture myself around him. So I am scared and I resent him. He’s going to leave me because he knows what I’m actually like. 


I spent the rest of the day in shock. I’m still processing it, which is partially why I wrote this. I’m starting RO-DBT next week. 



**Has anyone here done RO-DBT before?** What can I expect?