Dialectical behavioral therapy, or DBT, is a new tool for treating addiction that many are saying is showing lots of promise for people who struggle. DBT has actually been around for a while but was originally developed by Dr. Marsha Linehan as a treatment for patients with compulsive behavior and patterns of self-harm.
The techniques of DBT were developed as a result of Dr. Linehan’s own personal struggle with schizophrenia. Her struggle didn’t involve any substance abuse, but she struggled with the same harmful patterns of self-loathing, shame, and deep emotional pain that many addicts also face. The techniques of DBT employ simple and effective methods to address these deep-seated issues.
The original purpose of DBT was to help suicidal patients with strong self-harm compulsions. Many of these patients are also diagnosed with a borderline personality disorder. Mood swings, difficulties with relationships, impulsive behavior, and low self-esteem are just a few of the characteristics of the disorder. Many of those with borderline personalities tend to make several suicide attempts or otherwise find ways to harm themselves.
The therapy developed by Dr. Linehan addressed the core issues behind their behavior: feelings of abandonment and teaching skills to deal with emotional pain in healthy ways. Her approach was developed in hopes of developing these life skills in patients so that their pain could be reduced and the desire to harm oneself could be diminished. Eventually, a patient employing the methods of DBT could create a better life for themselves, one that feels more balanced and fulfilling,
At the core of dialectical behavioral therapy is the idea of simultaneously accepting oneself and admitting that a change needs to be made. These two opposing, or dialectical, ideas coming together are what inspired the therapy that Dr. Linehan developed after having an epiphany of her own.
When it comes to treating addiction, DBT works by showing a patient that they need to accept the fact that they are an addict or alcoholic, and that they also need to make a change to the way they live life. Because addiction is basically a repetition of harmful behaviors, the tools of DBT can also work to successfully treat it. And because no matter what the addiction is, whether it be drinking, using drugs, exercise, work, or sex, the end result is always the same kind of emotional pain that comes from a downward spiral of compulsive and harmful behavior.
DBT works in four ways to address addiction and other behaviors by utilizing mindfulness techniques, strengthening interpersonal relations, increasing emotional regulation, and tolerance for emotional distress. The first thing a person must do though is immediately stopped using drugs or alcohol. As they proceed with their treatment, any relapse is treated as a problem to address and learn from rather than as a sign of failure.
Mindfulness techniques are based on Buddhist practices that place an emphasis on becoming more aware of the present moment. By consistently using a breathing and meditation practice, an individual is able to accept experiences without judgment and to gain a better awareness of the self. Interpersonal relationships are improved with a new skill set that is aimed at setting limits with oneself and relationships.
Regulating emotions is an important step that works to help individuals identify and handle emotions with more objectivity. Tolerating emotional distress is addressed by developing skills to handle emotions in a healthy way, rather than by reacting impulsively (by drinking, using drugs, or otherwise harming oneself) to worsen the situation. This makes living through and learning from crises possible.