It's in the Irish papers that Marsha Linehan is in Ireland this week to train 150 staff in DBT:

[here](http://www.irishtimes.com/news/ireland/irish-news/new-hse-programme-aims-to-reduce-suicide-rates-1.1841384)

As I said in an earlier reply, I have been excluded from all psychology in my catchment due to inadvertent threats I made about a group psychologist when trying to make a verbal complaint about bullying against that person to my personal psychologist, in a highly distressed state when I was at immediate risk of major self-harm/suicide. 

My complaint was not processed, since all complaints must be received in writing. However my threat was processed immediately (go figure) and they called the police. An administrator contacted me to impersonally inform me that I was cut off from all psychology. No internal review of what happened, no call back from my psychologist, just close in the wagons, get rid of the difficult person who has the cheek to imply that any member of staff has done anything wrong, and there you go. There is no counseling or intermediary party in such a complaint situation. I have become alienated from my (at least well-meaning) psychologist and am completely on my own, *in a far worse state than when I went to these people.*

I think it is relevant that a) we had received a sheet "151 Things To Do Instead Of Self-Harm" which comes from a Canadian self-harm reduction group - "Skills for Safer Living". This included advice such as: hitting the walls with things; screaming; throwing tantrums. We were given the list and told that some things might work for some people and other things for others, but never that anythings were possibly dangerous. Looking back, it seems crazy to give highly distressed BPD people (there were others as well as me on the group) advice that they should consider throwing tantrums when in danger of self-harm, and then go and report them to the police when, in the course of throwing such a tantrum, a few things are said which veer into threat-speak. And I mean veer into: if I had said "Why I oughta..." rather than "I'm gonna..." it would not have been a threat. They were distressed remarks, including some violent language, but absolutely no planning, or even a hint of premeditation - I was crying at the time and was in the course of saying that I had been bullied - in short, it was a tantrum, and I acted as we were advised. (Mind you, I made numerous threats against myself as well as others. No one checked to see if I was okay - and these guys are connected to a hospital - they just called the police to lodge a complaint.) 

Also, I have contacted people involved with setting up the Canadian group and they use it for crisis intervention, prior to referral to DBT. In Ireland, it was being offered as a partial DBT substitute. Indeed, my psychiatrist seems to think it is DBT, but she works too much, and I would guess is either not very bright, or has been dipping into some of the "cooking sherry", if you know what I mean. So I don't know exactly what they were doing with the group in the first place, and I have a sneaky suspicion that they don't have much of an idea what they are doing either.

Which brings us to Linehan's visit to Ireland. Within a week, she is apparently going to teach these people and/or similar (people under the same umbrella organization) how to do DBT. Really? Is it really that replicable? If so, sure I could almost program a computer to do the job - it would have less of a personal agenda. 

*Replicability* is one of the standard definitions of a scientifically proven observation or method. And I am pretty sure I have seen Linehan on a video lecture discuss research they have done into trying to figure out precisely what constitutes the full DBT program - e.g. what unrecognized organizational or institutional contexts might inform the process. Others such as Joel Paris (*Treatment of Borderline Personality Disorder...*) have raised a number of interesting questions about exactly how replicable DBT really is - e.g. how much its success has been informed by the skills of Linehan, not just as a therapist and theorist, but as an administrator, a boss, a leader, and a teacher. They point out less effectiveness at greater removes from the University of Washington core people.

Now all of this is no problem at all if she is such a good teacher that she can teach a room of people everything she knows within a week. Which obviously she's not, if she has anything useful to say. So the problem is that the deep institutional failings in the Irish mental health system will go unchanged, while a new sugary package of "DBT" will paper over the cracks, and in fact give an air of legitimacy to bodies that are receiving a fair deal of criticism in the press. 

Will the success of DBT be replicated? "Sure!" "Of course!" "At any cost!" If someone is a worry.. "Expel them from the group!" If the results seem bad.. "Run 5 groups and only count the best one!" (an old pharmaceutical trick). Be well advised that if the Irish government is spending a load of money on DBT, it expects results... "Then results it shall have!"

If BPD people are still institutionally stigmatized, if BPD people are seen, on the one hand, as difficult but expendable, and on the other as a cash and publication cow for the currently most fashionable psychological treatment going, if BPD people can not articulate problems they are having regarding a mental health worker in a safe, neutral and supportive environment, if BPD people are getting DBT from newly-grads who attended a one-week "Marsha Linehan" course having done one of Ireland's God-awful MScs, then even if any of these people managed to pay attention and not browse facebook, jezebel or pornhub for the duration of the course, the BPD people of Ireland are still pretty much screwed.

Ireland has a very troubling mental health record. In the 1950s, we sectioned more people than the Soviet Union, see e.g. [here](http://www.irishtimes.com/news/social-affairs/ireland-s-mental-hospitals-the-last-gap-in-our-history-of-coercive-confinement-1.1833379) . As with the latter, it was employed as a means of socio-political control which gave almost total power to the Catholic church, and which also confined unmarried mothers, left their young children to die, dumped them in unmarked graves, and institutionalized paedophilia on an epidemic level. 
(Cf. to begin e.g. [here](http://www.irishtimes.com/news/social-affairs/ireland-s-portrayal-of-itself-as-the-purest-holiest-or-richest-country-has-brought-us-lies-and-exclusion-1.1834382), [here](http://www.theguardian.com/commentisfree/2014/jun/04/children-galway-mass-graves-ireland-catholic-church) and [here](http://www.theguardian.com/media/greenslade/2014/jun/20/ireland-childprotection).

There are one or two well-regarded places for DBT in different parts of Ireland, sure. But the Irish government's deeply ingrained response to most issues is to throw money at an overpaid and overlauded consultant to fly over and give a bunch of our own overpaid and overlauded a few seminars. No need to deeply examine our deep institutional failings, no need to question our unchecked ambition and avarice, no need to question the entrenched culture of superiority over and alienation of the mentally ill, because, sure, these foreign, indeed American, experts are walking cheque-in-hand beside us, and begorrah, isn't that what we all really wanted in the first place?!

I have contacted Linehan personally but of course she has not bothered to respond. Why would she if she is busy making a packet of money flying around the world rubber-stamping failed and failing mental health services by her paid presence? 

But, to take the most sceptical position, if that's Linehan's attitude now, do we have any real way of knowing that she has not doctored her own results already? With the massive institutional pressures to get results given her funding from NIMH, it would take a very honest person to turn around and say: "Nope, it doesn't work". So, if Linehan is not very honest (and I don't think she is), then the effectiveness of her method would have little or any bearing on the results she went on to publish.  

BPD people get over-attached, split etc, in part because we acutely realize, without ever really getting used to it, that all of us are completely on our own. And don't kid yourself that you have a friend in Marsha - you've already done a lot more for her than she's ever going to do for you.
