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HOW DIALECTICAL BEHAVIORAL THERAPY IS BEING APPLIED TO THE TREATMENT OF SUBSTANCE ABUSE, AND OTHER SELF-INJURIOUS BEHAVIORS?
It seems that over the past few years the expansion of Dialectical Behavioral Therapy (DBT) into treatment programs has been ever growing. More and more people have heard about this treatment option or have had it recommended by providers. But what is DBT, and why does it help people who are struggling with substance abuse, and self- injurious behaviors?
DBT is a broad-based cognitive behavioral treatment model that was developed by Marsha Linehan, Ph.D. in order to assist patients who are struggling with Borderline Personality Disorder. It is the first model that has proved effective with these clients who have difficulty getting their needs met through conventional therapy.
The most important aspect of DBT is the understanding that at the core of Borderline Personality Disorder is emotional dysregulation. This is thought to be the outcome of biological and environmental factors and the interaction of the two. The theory behind DBT asserts that individuals who have Borderline Personality Disorder have difficulty regulating their emotions.
What is emotional regulation? How is it related to substance abuse, and self-injurious behaviors? When we feel emotionally regulated, we are able to control the intensity of our emotional waves. It’s similar to the volume button on the remote control. When a potentially negative, painful, triggering emotion comes up we are able to turn down the volume of the feeling by using various coping skills, or we choose to change the channel altogether. People who have difficulty regulating their emotions struggle with this precise skill. They feel things very strongly and become easily overwhelmed, lost, and controlled by their emotions. It is as if the volume on the remote control is stuck on the highest level, and they become engulfed in the emotion. Some people report feeling swept away by their feelings, and others report drowning in them.
This emotional dysregulation forms one of the strongest cycles maintaining substance abuse, and self-injurious behaviors. People who feel emotionally dysregulated often turn to substance abuse, cutting, and other unsafe behaviors in an attempt to decrease the intensity of their internal pain, anxiety, and emptiness. Many times these types of unsafe behaviors are stumbled upon by adolescents, but the immediate and intense emotional relief may reinforce the use of these behaviors. Thus, the cycle of addiction, depression, and self-injury begins.
At Balance we utilize tenants of Dialectical Behavioral Therapy (DBT) in order to increase the capacity our clients have for tolerating negative and uncomfortable emotions. We engage our clients in DBT skill building groups in order to assist them with expanding their coping skills through the DBT skills of Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. By increasing their ability to cope safely with internal and external stimuli, our clients begin to lay a new foundation – one in which they are truly able to make free choices that guide them toward a feeling of wellbeing and a Balanced way of living and loving life.