I offer a Radically Queer DBT therapy group that adapts DBT to the needs of queer, trans, and neurodivergent people. (The interest list for that group is currently open.) This post is about the background ideas, values, and attitudes of RQ-DBT.
Extending DBT to Serve Neurodivergent People
Dialectical Behavior Therapy (DBT) was originally created by Marsha Linehan to help people with borderline personality disorder. Subsequently, it has shown benefit for many different people and has become a common treatment in in-patient and intensive outpatient programs.
However, because DBT was not made for neurodivergent people (such as Autistic folks, ADHDers, and others with brain-based differences), many of the skills and assumptions of DBT aren’t the best fit for us. In particular, mainstream DBT ignores the sensory sensitivities, processing differences, and social differences that neurodivergent people experience. Many of the difficulties experienced by neurodivergent people are due to differences in neurotype, but clinicians who are ignorant of brain-based differences fail to meet the needs of neurodivergent people.
Social Justice & LGBTQ+ND Resilience
Although DBT acknowledges that a person-environment mismatch can contribute to later suffering, it does not include social justice resilience practices. The minority stress model, originally developed by Virginia Brooks, points out how stigma and discrimination can create adverse life outcomes for queer and trans people, including mental health symptoms. Oueer and trans resilience practices and frameworks provide a basis for developing a critical analysis and cultivating inner strength and skillfulness in the face of cisheteropatriarchal culture. Similarly, neuroqueer pride entails acceptance and accommodation of differences in neurotypes, and the development of neuroaffirmative resistance practices and frameworks.
In my view, DBT is a rich collection of materials for adaptation and extension— for queering. In my own development as an Autistic therapist, I have found embodiment, mindfulness, and neuroaffirming frameworks to be invaluable. For many years, I have also used expressive arts practices to explore and discover the emergent edge of my self-understanding. Therefore, I propose a integrative mashup and critical adaptation of mainstream DBT skills with neuroaffirming, queer and trans resilience, somatics, and expressive arts practices and frameworks.
RQ-DBT Values
Radically Queer DBT is grounded in the following values:
- body-mind holism
- complex integration
- neuroaffirmation, acceptance, and accommodation
- organic aliveness
- queer and trans liberation
- reconstructive postmodernism
- social justice
- pleasure
- fun
RQ-DBT Attitudes
Radically Queer DBT invites clients to try on, and perhaps adopt, the following attitudes:
- a willingness to experiment and find out
- curiosity
- self-acceptance
- a sense of humor
- openness
- embodied mindfulness
- non-conceptual creativity
- unconditional friendliness
- gentleness
- love
RQ-DBT Practices
RQ-DBT includes all the main skills of standard DBT: Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. However, it adds skills and perspectives that help LGBTQIA2S+ and neurodivergent people work with their experience and build resilience. For example:
| New Skill/Framework | How it adapts/extends Standard DBT |
| context and pattern analysis | replaces/supplements ‘behavior chain analysis’ |
| queer mind and organic aliveness | supplements ‘wise mind’ by adding unmasking and non-conceptual embodied mindfulness |
| social justice model of suffering | acknowledges minority stress, identifies forces social oppression, mitigates internalized stigma |
| neuroaffirming framework | psychoeducation on brain-based differences in sensitivity and emotion regulation difficulties; identification of needs, supports, and skills for seeking accommodation |
| experimental attitude | engages learners’ creativity in extending DBT skills to meet their own particular needs |
| queer and trans resilience | active provision of a queer- and trans-affirming learning environment promotes safety, enhances learning, and builds empowerment discourse |
Blending these different practices and perspectives, and integrating standard DBT skills with QT+ND resilience practices and frameworks, are represented in the metaphor of the Cake of Radically Queer DBT. In RQ-DBT, you can have your cake and enjoy it, too. 😉
An Experimental Attitude for Iterative Learning
RQ-DBT is in a process of active development, and the spirit of ongoing experimentation (in the sense of first-person empiricism) is a core attitude. I envision RQ-DBT groups as being a place for group members to come together to learn, discuss, and practice new skills, and to practice critiquing, modifying, and adapting them for their particular needs and desires. It is in this sense that RQ-DBT queers (and neuroqueers!) DBT— by making use of materials from mainstream culture and adapting them to our own ends.
If you’re interested in joining an upcoming RQ-DBT group, please fill out the interest form or click on the button below. (Or to learn more, check out the Radically Queer DBT group page.)
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