Dr. Christine Dickson, psychiatrist in the DBT Program at the Ottawa Hospital

For patients taking part in the Dialectical Behaviour Therapy Skills Group (or DBT-Lite Program) at The Ottawa Hospital, Dr. Christine Dickson will be a friendly and familiar face. She has co-facilitated the program since 2013, along with social worker Vicki Larsen before Larsen’s retirement in 2021.

Combining a compassionate approach with evidence-based therapy, Dr. Dickson and the team are helping patients live their most fulfilling lives by learning to balance the acceptance of intense and challenging emotions, thoughts, and urges with behavioural changes. Our program is unique, and for a long time, it was the only English DBT skills group available under OHIP in the city.

Q: Who does The Ottawa Hospital’s DBT-Lite program serve, and how is our program unique?

A: This program is for individuals with borderline personality disorder (BPD) who meet either full or partial criteria. These individuals have high sensitivity to emotional cues, with intense reactions and long-lasting feelings. They feel empty and struggle with a sense of self. They have intense interpersonal sensitivity, and relationships can be chaotic. They have urges to, and often engage in, self-harm and other impulsive potentially harmful behaviours. DBT views these behaviours as ways of dealing with painful experiences that work in the short term but are harmful and sometimes life threatening. DBT offers validation of the pain and the desire to find relief, and at the same time engages the patient in learning new effective behaviours.

A principle of DBT is that clinicians treating BPD need support, so we offer the skills group to complement the treatment and support that patients are already receiving from clinicians in the community. That way we are not only supporting the patients but also their clinicians.

Q: What makes DBT different from other therapies, and how does it help patients like Anita who are struggling?

A: It’s a combination of validation and change strategies. DBT has been described as CBT (or cognitive behavioural therapy) plus validation plus mindfulness. DBT sends the dialectical (or seemingly contradictory) message that everything you think, feel, and do makes perfect sense, and here are the tools to help you change, reduce your suffering in more functional ways, and get closer to your ultimate goals. It really reduces shame and self stigma. Overall, we want to convey a message of hope — BPD is highly treatable; it is not static and can go into remission even on its own and much more rapidly with treatment.

Q: What makes borderline personality disorder such a challenging condition?

A: I have loved working with individuals with BPD since my psychiatry rotations in medical school. They are often creative and passionate about life, society, and the environment. They are often empathetic and helpful to others, and they are really trying their best and want to get better.

That said, the suffering that people with BPD experience is intense. Some believe they cannot get better. Some have learned to invalidate and stigmatize themselves. Some clinicians may also believe it is untreatable and may find it challenging to validate behaviours that don’t make sense to them. It is also really important that clinicians treating BPD get support from other treating clinicians. So, time, training, and expenses can be a challenge. Obviously, the resources must be present.