Antithetical Behavior Therapy

ANTITHETICAL BEHAVIOR THERAPY:A New Framework For Absolute Moral Correctness

© 2007, SXL. For entertainment purposes only.

From Antithetical Behavior Therapy: A New Framework For Absolute Moral Correctness. © 2007, S.X.L.

Preface to Antithetical Behavior Therapy

Antithetical Behavior Therapy (ABT), formerly known as Black & White Behavior Therapy (BWBT), is a series of skill modules specifically designed to keep the author from going postal during a Dialectical Behavior Therapy (DBT) partial hospital program this fall, where she was subjected to many hours of “training” for skills she's had memorized for at least ten years.

As suggested by the name, ABT is designed to give its adherents skills for maintaining an unrelentingly antithetical position to dialectical behavior modification strategies. It maintains that there are only two realities: RIGHT or WRONG; GOOD or BAD; etc., and that the behavior of people who seek psychiatric treatment will, almost by default, end up in the BAD category. ABT attempts to help patients move into the GOOD category by steely self-will and a relentlessly punishing attitude toward BAD behavior, but understands that, deep down, such striving can only be a farce. At its core, ABT assumes that patients can never get better, and might as well wallow in hopelessness – which is itself BAD behavior.

If DBT is the thesis, ABT is the antithesis. Interestingly, a dialectical position allows flexibility for the synthesis of DBT and ABT; at the same time, ABT absolutely prohibits such a synthesis to occur. I will leave it to the readers to mull over the implications of this, if there are any.

Writing these “handouts” has caused me to feel slightly ill. I have visions of such handouts getting mixed up with legitimate DBT worksheets. Unfortunately, admitting this discomfort violates core principles of ABT. A strictly nondialectical position would argue that all decent spoof artists must maintain the spoof throughout; according to this position, I must unrelentingly advocate ABT as the ONLY solution to life's problems. In support of such an antithetical position, many of my more recent treaters have unilaterally declared that I “hate” DBT because I have refused to attend any day program that involves more than a few hours of DBT-related groups per day. However, my personal experience of DBT does not match these generalizations. I have been treated by a few very excellent DBT therapists; at least one of them was instrumental in rescuing me from a living hell. I know DBT very well and greatly admire it as a coherent system for accepting and navigating reality. In light of that, I do hope that ABT is not seen as some kind of hostile potshot against DBT, but, rather, is just a bit of silliness that is getting me through my day.

SXL


MINDLESSNESS HANDOUT 1---------------------

Firmly Grabbing Onto Your Mind,with no possibility of ever, ever letting go:

States of Absolute Reality

GOOD BAD


MINDLESSNESS HANDOUT 2-----------------

Firmly Grabbing onto Your Mind, with no possibility of ever, ever letting go:

DESERVE

● NOTICE EVERYTHING WRONG WITH THE EXPERIENCE. Notice how your actions and misdeeds have contributed to the pain that you suffer.

● Have a “velcro mind.” Allow minor mistakes to enter into your awareness and stay there, in plain view, so you can fully understand how guilty you really are.

● CONTROL yourself. If you cannot control yourself, beat yourself up, but do so secretly so that nobody else will enter into your little codependent trap.

● Be like a guard at the local penitentiary, ready to mete out punishment for bad behavior as necessary.

PROSCRIBE

● FIND WORDS THAT PROPERLY CONDEMN THE EXPERIENCE. Explain to self or others, in clear moral terms, why the current experience or behavior should not be allowed to continue.

● PUSH the proscribed experience away and do not allow yourself to let it happen again.

EVISCERATE

● Enter into self-condemnation fully, completely, allowing no mercy to hold yourself back. BECOME ONE WITH YOUR CHOSEN METHOD OF SELF-ATTACK, COMPLETELY FORGETTING YOUR MISGIVINGS ABOUT IT.

● ACT SPONTANEOUSLY in response to your pain, firm in your sense of inadequacy and hopelessness. Do not pause to worry about whether you are doing the right thing. If it feels right, it is right.


INTERPERSONAL INVECTIVENESS HANDOUT 1-----------

Helping others get what they want:

SACRIFICE

Surrender your needs to others.

Apologize continuously.

Cry only when locked in bathrooms.

Return to damaging situations, again and again and again...

Isolate yourself, especially when you refuse to have a positive attitude.

Feel the pain of others.

Identify new ways to give of yourself.

Relinquish Control over your life and needs.

Encourage people to walk all over you.


INTERPERSONAL INVECTIVENESS HANDOUT 2

Self-Respect Ineffectiveness:

Treating yourself with proper humility

(be) SLOW

Stutter when trying to assert yourself.

Look down at the floor.

Overreact to minor criticisms.

Wallow, alone in your room.

Guidelines for Relationship Invectiveness:

How to Show Someone Who's Boss

TAKE

Use Threats

Be Arugmentative

Say, “I'm O.K., but you're not!”

Stick to (your) Emotions.



Guidelines for Relationship Invectiveness:How to show someone who's boss.

TAKE

(use) Threats (be) Arugmentative (say, “I'm O.) K., but you're not!”(stick to your) Emotions.

(use) Threats

(be) Argumentative

With attacks

With judgments

(say “I'm O.)K, but you're not

(express your) Emotions

Enter into the discussion by making it clear that YOU MEAN BUSINESS. Discuss all the bad things that will happen to you or to others if your desires are not met.

Remember that the best offense is a good offense. Be prepared for a fight. DON'T LISTEN to what the other person has to say.

Express anger, directly (or indirectly). Clench your fists. Raise your voice. Hit the wall. Tell the other person exactly what you think of him or her.

MORALIZE. Make it clear that your argument is the right argument – that any other point of view is simply wrong.

Remember that GETTING WHAT YOU WANT is the most important goal. It's a Dog-Eat-Dog world! If you don't look out for #1, who will?

Validate and ACKNOWLEDGE your feelings. Let others know how much your feelings matter – and how much they will be hurting you if they don't do what you want.



Self-Respect Ineffectiveness:Treating yourself with proper humility

(be) SLOW

Stutter when trying to assert yourself.Look down at the floor.Overreact to minor criticisms.Wallow, alone in your room.

Stutter

Look down at the floor

Overreact to minor criticisms

With apologies

With tears and remorse

Wallow in your room

Give up all hope of speaking clearly and well. A bit of VERBAL HESITATION on your part will help others feel comfortable and not so terribly put upon.

Establishing eye contact may be perceived as too threatening and could also make you feel more upset. PICK A SPOT ON THE FLOOR – maybe a bit of lint on a rug – and stare at it fixedly.

When people criticize you, ASSUME THE WORST, and let the other person know that they are right – that you are excessively needy, unworthy of love and care.

Assure the other person that they have a right to be critical, that everything is YOUR FAULT.

CRY. Refuse to let anyone comfort you. Recognize that you are a fundamentally flawed human being.

WITHDRAW to a place where you will not be seen and reflect on the unreasonableness of your demands.


EMOTIONAL DISREGULATION HANDOUT 1--------

Increasing Emotional VulnerabilityThrough Avoidance and Social Isolation:

ALONE

Avoid anything that makes you afraid.

Leave the phone unplugged.

Other people don't need to know.

Numb yourself.

Eat. Or don't.


DISTRESS INTOLERANCE HANDOUT 1--------

Crisis Revival Strategies

Skills for remembering painful events and emotions, knowing that you can never really make it better.

RE-ENACT with “Good Mind REJECTS”

RegurgitationExecrationJudgment EnvyComparisonsThoughts

“Shoulds”

BLAME YOURSELF with BERATE:

Bash yourself for minor flaws.Judge your Emotions.Ruminate.Assume the worst.Take mood-altering substances.Exclude yourself from the human race.

DISPROVE THE MOMENT:

Self-DoubtsIsolationSarcasmPanicRejectionSelf-OstracizationVentingExaggeration


DISTRESS INTOLERANCE HANDOUT 1:Crisis Revival Strategies (cont.)

RE-ENACTING

A useful way to remember these skills is the phrase“Good Mind REJECTS”

With Regurgitation:

Think of painful events and personal mistakes over and over, considering the ways that they have ruined your life. Imagine going back in time and doing it over, and how much better your life would be now if you had gotten it right the first time....

With Execration:

...but since you didn't get it right the first time, you are obviously the bottom dung on the dunghill, the most horrible person ever created. How can you possibly be so horrible? Why you? Why?

With Judgment:

Consider how good people would have handled themselves in similar situations. Note the disparity between your badness and their goodness. Understand that this is entirely your fault.

With Envy:

Give more thought to how everyone else has got life figured out, while you simply don't. Allow yourself to wonder why this is. Did they get more love than you did? Did they deserve it, or is life just entirely unfair?

With Comparisons:

Think specifically about other people you know who have survived intense personal crises and come out smiling at the other end. Realize that they have shown great valor in the face of adversity, whereas you have not.

With Thoughts:

Think some more. Maybe there's some way you can think your way out.

With “Shoulds”:

Is this what should be happening? I don't think so! What does that tell you?



DISPROVE THE MOMENT

A way to remember these skills is the wordDISPROVE

With Doubts:

Imagine all the possible things that could go wrong with this moment. Consider your complete inability to handle any of this.

With Isolation:

Create distance between yourself and others. Remember that mature people solve their problems on their own. Other people can not help you, so there's no need to reach out to them.

With Sarcasm:

Open your mind to the sarcastic, punishing voice within. You think you're so special? Think you have a right to be happy? Yeah, right.

With Panic:

Notice your heart beating rapidly in your chest. Follow your breathing, in and out, faster and faster, as though you may be suffering from an asthma attack or pulmonary embolism. Consider the fact that you really may be dying, that this could be a heart attack, that something terrible is going to happen at any moment. Think about how horrible and intolerable it will be.

With Rejection:

Close your eyes and pull away from the reality that you are experiencing. Refuse to believe that any of this is real, or that you are real, or that any of your feelings make any sense at all.

With Self-Ostracization:

Focus your entire attention on the fact that you do not deserve to be a member of the human race. Note that any attempt to reveal your true nature would be a selfish and risky ploy for attention you do not deserve. Do not allow this to happen. Keep yourself hidden away.



With Venting:

Break fragile china or the prized possession of a loved one. Write an angry letter to your boss. Rent a motel room and smash it to bits in a drunken frenzy. Ask your roommate to pick up towels that you've dropped all over the floor. Burn photographs of family members, or greeting cards from friends. Scream at the top of your lungs. Leave abusive messages on your therapist's voice mail. Drive like a maniac and honk at people in your way. Frown at people in line at the grocery store. Be aware of how unhappy you really are, and how this unhappiness must come out, one way or another – you really can't help it anyway.

With Exaggeration:

Convince yourself that things are much worse than they are. Repeat over and over: “This is the worst day of my life,” “I can't stand it,” “This is going to last forever,” “My life is over.”


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Antithetical Behavior Therapy