MBT: The "Missing Link" of DBT? (Mentalization Based Treatment / Dialectical Behavior Therapy)

Many of you know that after many years of hard work, I recently graduated from DBT (Dialectical Behavior Therapy).  I had lots of questions within me, including "What comes next on the path of recovery?"

Shortly after I graduated, I received an intriguing email from Amanda Smith, creator of the psychoeducational daily email My Dialectical Life, to which I subscribe.  She's starting a new endeavor, called "30 Days of Mentalizating."  I immediately signed up to be a part of the pilot group that starts in June, as did many of my readers when I shared the information on my Facebook page.

I asked Amanda to share a bit more about why she is doing this program and what we can expect to gain from it.  Here is her guest post.  I look forward to connecting with others who sign up for this program to discuss how it's going and what we are learning.

Talk soon!

-- Debbie

What comes after DBT?
Guest post by Amanda Smith of Hope For BPD

You've been working hard every day at a being skillful and are dedicated to a mindfulness practice but there's still work to be done. What's next? What about trauma work or expressive therapies? Do you take a year or two off? Is now the time to train for that half-marathon or complete your degree? 

It can be challenging to know what to do after DBT, and I know that I'm not the only one who wants to continue to grow so that I really can keep moving forward in recovery. I'm ready for new challenges, and I bet that so are you!

While DBT really is the gold standard in treatment for emotion regulation disorders, Mentalization-Based Treatment (or MBT) isn't far behind. In fact, TARA's Valerie Porr has called it the "missing piece" of DBT, and I agree. 

MBT is therapy that can help us to close the gap in helping us to understand ourselves and others. It's about keeping the "mind in mind" and may help us to create more meaningful and sustaining relationships. For me, that's definitely a part of a life worth living.

30 Days of Mentalizing is a way to introduce mentalization into our lives in a manner that is easy to understand and implement.

Also, one of the coolest things about MBT is that it incorporates art so there will be several
activities each week that will use things like painting, music, photography, and video to help us connect with our emotions and thoughts in a new way.  

I'd love for you to learn more about 30 
Days of Mentalizing. 

Participants will receive their very first program email on June 1 at 12:00 pm Central, and the investment is just $15. I'd love for you to be a part of something I hope will be both beneficial to our recovery and fun at the same time.

Please e-mail if you have any questions, please email me here.

Thank you!

Click HERE to sign up for the program!


  1. Thanks for the information! I think I may sign up tomorrow. It sounds very promising.

    1. Wonderful! I hope we're in the pilot group together! ♥

  2. Do you have to have already completed DBT?

    1. Since this is not a treatment or therapy program, there are no such requirements. :)

      I have, however, reached by limit of 30 participants and have now started a wait list for the next cycle. Please e-mail me at amanda@hopeforbpd.com for more information.

  3. Hi Debbie, I think it's great that you are helping so many people in the infancy of DBT and/or those who do not have access to formal DBT therapy. I do however, have a few questions that arose in my mind when I read this post. I hope you don't mind me posing them and of course, you don't need to answer them.

    Do you ever see yourself out of therapy? I get the impression that you have a had a fair amount - not just years of DBT group but other therapeutic interventions. Are you participating in the Mentalisation programme as a way of testing it out for others or is it a way of clinging to a therapeutic environment in one form or another?

    Do you find that whilst helping so many other people through your blog and trying out these various online therapy support ideas that you are holding yourself back? For example, on here and on Twitter, every daily activity (from something as simple as a shower or a cup of tea or watching a TV programme)is being related to a particular DBT skill. Although helpful for others, does it not prevent you from incorporating DBT skills into your own life as they were intended - automatic i.e. 6s and 7s on the DBT diary card?

    I'd love to see Debbie rather than Debbie + DBT skills. Perhaps your followers on your blog etc would benefit even from seeing you move away from therapy as an occupation in your life? Debbie branching out from an identity as someone who had BPD and someone who needs constant therapy and skills reminders to be able to enjoy her life?

    I'm curious because I am coming to the end of my DBT programme. It's been life-changing, no more self-harm or lengthy, compulsory hospital admissions etc. I've much still to learn in terms of my thought processes unrelated to DBT skills but I'm excited to leave behind a therapy environment/occupation in favour of a "life worth living". The thought of constant skill referral is awful for me. I use skills automatically and I thought that the aim of DBT - become skilful and then move on.

    Sorry, this has turned out to be a lengthy reply but the blog post has given me food for thought as to how differently people navigate leaving therapy and life beyond therapy as an occupation.

  4. Hi Carrie,

    Thanks for taking the time to leave such a lengthy and thoughtful post. I'll ask you to consider the concept of judgments that you no doubt learned in your DBT program. Our perception of another, our thoughts, opinions, and assessments, are not necessarily facts or accurate, such as your implication or thought that I may be in therapy as an occupation. Even if it were so, each of us are on a different path to get to where we need to be. Some may need 1 year of therapy, some 40.

    But to generally answer our questions, as my long time readers know, I recently graduated from a DBT program and am excited and proud of this process. It was a choice on my behalf to move on. My decision to relate seemingly mundane or routine activities such as taking a shower or having a cup of tea back to skills around self-care and DBT are in a small way about me as they are reminders to stay skillful, but my work is much larger than being focused on myself. There are thousands of suffering people who stumble across my Twitter ,etc., many of whom are in the beginning stages of BPD, having just been diagnosed, and some who have been suffering for years and are looking for hope. That's what my work is about.

    Another part of this transition is this site is nearing a transition that is quite exciting. (More details and official news/press release coming soon!) This decision was also part of my personal growth, though I've also chosen to stay on as part of the team, continuing to write and connect with the community that's developed as a result of this blog -- a worldwide group of sensitive, caring, helping people that I care so deeply for.

    As far as why I am taking the course -- I consider myself to be a life long learner. As I am currently pursuing my Master's degree to satisfy my academic goals, Amanda's MBT class is to better understand how to enhance that life worth living as well as support those who look to these pages for hope, encouragement, and insights.

    I am also teaching and coaching DBT SKills though DBTpath.com

    So, while you may look at it as being stuck in eternal therapy and grasping to it as my security blanket, I see it quite differently. I see myself as having graduated from that state of mind and continuing to serve a very worthy group of people.

    Thanks again for your comment. The process of replying was very therapeutic for me, indeed. ;-)

    1. Hi Debbie

      Thanks for taking the time to provide such a detailed response, I appreciate it :)

      Firstly, however, I think we need to address your initial point regarding non-judgmental stance otherwise we may get tangled up in something that was never an 'issue' in the first place. You ask me to consider non-judgmental stance, which appears to me that you are assuming I am having judgements and that you are judging me for having such judgments. I didn't intend to come across as having been judgmental (although everybody is in their everyday life, it would be a fallacy to say that anyone can achieve non-judgmental stance entirely). I posed questions. I'm sorry you took that as judgment but by posing questions, I was hoping to explore some of my own observations of the process without jumping to any judgments/conclusions.

      I'm glad you find it helpful to remind yourself of DBT skills with basic, every day tasks. I hope one day you will find the freedom to not have to do so and for them to become automatic rather than a formal therapy skills set.

      It seems you missed in my reply that I noted the very helpful nature of your blog and Twitter for other people. I too care about those who have a BPD diagnosis. In fact, I have actually led and taught a number of sessions for my DBT skills group (instead of the usual DBT psych group facilitators). I suppose for both of us, it is about giving other people hope - seeing how they can get to grips with the skills. I hope you are enjoying teaching DBT skills, I've very much enjoyed teaching the DBT skills group sessions (albeit in person, I suspect it's very different to communicate skills and learning over the medium of the internet).

      I suspect I'll have to wait a wee bit longer regarding the form of transition of your site but if it allows you some time for yourself and take a step back, it sounds like an exciting time.

      How is the master's going? I hope you are enjoying it. I totally understand the lifelong learning - I study archaeology for fun in my free time and I'm going to be taking the KUF PD awareness training over here and then later on in the year be training the trainers ie mental health professionals who come across people with a pd diagnosis in their work. I suppose we are doing similar things but in different ways. I am trying to be more removed and assist people with BPD in more of a professional environment - training those who work with them whereas you are currently taking the path of embedding yourself within the BPD world. Good luck with it! I know I would find it far too emotionally draining as being around other people's suffering is very difficult for me because I feel their pain so much and risk becoming emotionally dysregulated myself, which wouldn't help anyone.

      In addition, it has been highlighted to me recently that there is more of a 'culture' of therapy in America and longer term therapies and therapeutic relationships are kind of the norm over there.

      Finally, I think, again, you have misunderstood or maybe it's actually because I could have better worded the questions I posed. I was expressing a concern as to whether being long term in a number of therapeutic environments would prevent you from growing as Debbie instead of Debbie who used to have a BPD diagnosis. I'm glad you feel that won't be the case and will be able to move on.

      Oops, another lengthy reply again.

    2. Hi There,

      Thank you so much for your kind reply and clarifications. While I can't reply at length at at this time, I want to thank you for taking the time and for sharing a bit more about your experience. Archaeology sounds fascinating. Keep up with the positive personal growth!

      Debbie ♥

  5. We go through each module twice (pretty standard, I believe) and then we are done. I am in the last module of my second time around and feel like I don't know a thing. The DBT team actually talked about it and suggested I go through it a THIRD time since, because I did a lot of dissociation during my first time around, I was basically starting at square one by the time I started going through everything again. I'm getting married this September and moving this July... not far, about 45 minutes away... But there's no DBT program in that county and apparently, though there have been 'out of county' folks in my classes before, they won't take me 'out of county'... Sorry, I sort of went off on a tangent but I read the first part of your first sentence and part of me wished that I had 'years of hard work' available to me...
    Anyway, best of luck :) Im glad I found this blog :)



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