Dialectical behavior therapy (DBT) is a form of therapy that was originally developed to treat certain personality disorders. Now the use of DBT has been expanded to treat other self-destructive behaviors including substance use disorders. Dialectic refers to the coming together of two opposites. In the case of DBT, the two opposites are acceptance and change. While a person with a substance use disorder may want change, it can be hard to accomplish that until there is also acceptance. Adjusting to life without the ability to escape using substances can trigger volatile emotions. To successfully transition to a happy and healthy sober life, you will need to be able to accept all aspects of your addiction and your life while you work to attain new coping skills.
Behavioral Skills in Dialectical Behavior Therapy
What makes DBT unique is its focus on acceptance. You will learn to accept yourself, your emotions, your thoughts, other people and the world around you. By being able to accept everything that has happened up to now and everything that is going on in the present, it is possible to move forward. Dialectical behavior therapy includes weekly individual therapy sessions as well as a skills training group run by a group leader who assigns homework. Between sessions, you can call the therapist in order to receive phone coaching. Healthcare providers participate in a weekly consultation group. In DBT, you will focus on learning new life skills that can help you begin to cope with the daily stressors of life rather than turning to substances. The skills you will learn include:
- Mindfulness, which is being fully aware in the present moment.
- Tolerating pain in difficult situations rather than trying to force change.
- Communication skills, such as being able to express what you want or need rather than having high expectations of other people.
Using DBT in Addiction Recovery
The skills taught in dialectical behavior therapy can be effective in addiction recovery. When you have a substance use disorder, you have habitually relied on substances for relief rather than developing healthy coping skills. The key functions of DBT begin with improving life skills and enhancing your ability to deal with changing emotions and tolerating distress without reaching for alcohol or drugs. Efforts to improve life skills are the focus of group therapy and are reinforced with homework assignments between sessions. In individual therapy sessions, the counselor will help you work to apply these life skills to your day-to-day life. Another function of DBT is to help improve your motivation to change and reduce behaviors that create problems for you. This is done by using a diary card in which you log behaviors that interfere with your progress and growth, which could include hanging out with people who threaten your sobriety or any behavior that interferes with your therapy or recovery. You will also work on your emotional reactions and work toward being able to regulate your emotions rather than trying to run from them. While dialectical behavior therapy was first developed to help those with severe mental health problems and suicidal behavior, it has also been found to be an effective tool for addiction recovery. Using this tool, you can improve your skills in regulating your emotions and come to accept whatever is happening in your everyday life without turning to substances. Resource U.S. National Library of Medicine: Dialectical Behavior Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/ WebMD: Dialectical Behavioral Therapy https://www.webmd.com/mental-health/dialectical-behavioral-therapy#1
