Dear Dialectical Behavioural Therapist…

Rebecca Donaldson writes.

I am not sure how to respond to your request for me to be more open-minded. I think I have voiced my concerns respectfully and am balanced in doing so while also validating DBT. I believe it is important to question the language being used and ask what we are attempting to do with DBT for this population labelled as having “Borderline Personality Disorder” who often have a history of child abuse and/or neglect. Some of your language and examples so far have hurt me, and it is upsetting that questioning this is viewed as possibly not being open-minded. I do not believe we should be open-minded about harmful language being used to describe people and their lived experiences. We are not working with pigeons. Rather, in DBT, we are most often working with trauma survivors. 

I know you are only teaching a programme that was taught to you, but phrases and sentences such as “problem behaviours”, “therapy-interfering behaviours”, “swallowing the Kool-Aid” and saying that a child crying about Bambi’s mom dying was what caused a negative reaction from the parents rather than acknowledging that the parents responded poorly, are difficult to hear. 

I do not feel DBT does a good job discussing the systems that have harmed these children, and while it claims to be dialectal, in does not feel to be. Its goal is behavioural change, and it uses, as Marsha Linehan would often say, “validation as sugar-coating so that the distasteful medicine of cognitive behavioural strategies go down” (Swenson, 2016, p.263). 

I am not sorry for having a problem with this language and for not being open-minded about it. I am a positive developmental psychology student, and I had hoped that DBT would look through this lens. It continues to feel though as if the environment these individuals were raised in is an after-thought and their feelings are “therapy-interfering behaviours”. Yes, drinking hot things, taking a cold shower, and practicing mindfulness have been wonderfully helpful. What has not been helpful to me, and many other survivors like me, is this silencing of our lived experiences that occurs in DBT because you label them “therapy-interfering behaviours”. 

I think it is time we begin discussing our experiences that we are told not to talk about in DBT. Our histories are not “interfering behaviours”. Our words are insights into the real problem. The personalities of these individuals are not disordered. Their environments are. There is nothing wrong with a sensitive baby. There is something wrong with a parent becoming angry at a child who is crying.

I have decided to withdraw from your DBT course, as it does not align with my values. I wish you and the rest of those in DBT the best. While I know many promote DBT as the 'gold standard', following an examination of its Kool-Aid, I have decided I will not be drinking it. 


Rebecca Donaldson, doctoral student, Claremont Graduate University, California


Swenson, C.R. (2016). DBT® principles in action: Acceptance, change, and dialectics. Guilford Press.

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