I think the physical/psychological comparison is a good point.
I also think we understand something about physical health that we don’t about psychological—triage.
If I come into the ER because I just got shot, no one cares if it’s because I was playing with a gun or because my husband is violent Or because gun violence is on the rise. First, they treat the wound. Then comes trying to figure out where it came from. If they’re any good, and nonbiased, etc.
If I walk into a therapist’s office “bleeding” because someone raped me, or I just got brutally fired, etc. I will spend the first 2 sessions talking about my childhood. I will then talk about whether I might have co-occurring conditions.
I may or may not ever get to the actual point, of healing the actual wound.
Personally, I think DBT is useful. I think mindfulness is useful. They are psychological skills. Skills are useful.
Skills don’t heal wounds.
Learning to eat right is a useful skill. It still won’t heal your bullet wound.
No non-quack medical doctor thinks it should.
Yet every psychologist thinks DBT, a skill, will heal the traumatic wounds that cause BPD to develop. ?