How DBT Supports Recovery from Substance Abuse: Unlock Emotional Healing

How DBT supports recovery from substance abuse

If you or a loved one is facing the challenges of substance abuse, you’ve likely encountered mentions of Dialectical Behavior Therapy (DBT) and its potential effectiveness.

While it might sound complicated, it’s a valuable tool.

You see, DBT is a unique approach that combines ancient mindfulness techniques with modern psychology, offering you a chance to manage your addiction at its roots and regain control of your life. (1)

Rooted in cognitive-behavioral therapy (CBT) principles, this approach encourages you to explore your inner world with curiosity rather than judgment, opening up new avenues for healing. (1)

But, what is ​Dialectical Behaviour Therapy (DBT)?

The term dialectical means that two seemingly opposite things can coexist. In DBT, you are taught two strategies that might appear contradictory at first glance but are essential: acceptance and change.

Acceptance involves recognizing that your experiences and behaviours are valid and real. It’s about acknowledging that it’s okay to feel the way you do and to be yourself.

Change, on the other hand, means understanding that you have the power to make positive changes to manage your emotions and move forward. It’s about recognizing that you can take action to improve your well-being.

Now, let’s look at the different stages of DBT treatment, which can be thought of as steps in a journey: (1)

Stage 1: When you begin DBT, you’re more likely to feel overwhelmed, and your behaviour is unpredictable. In this stage, the primary goal is to gain control over your behaviour. It’s about transitioning from being out of control to one where you’re in charge of yourself.

Stage 2: After Stage 1, you may still find life challenging. While you no longer engage in risky behavior, you might still struggle emotionally. In this stage, the aim is to help you fully experience and understand your emotions. It’s like moving from mere survival to a place where you truly embrace your feelings.

Stage 3: Now, it’s time to learn how to live life to the fullest. You’ll set life goals, build self-respect, and seek peace and happiness. The objective here is to lead a life filled with ordinary ups and downs, just like everyone else.

Stage 4: Stage 4 isn’t necessary for everyone, but for some, it’s about discovering deeper meaning through a spiritual journey. 

In DBT, you’ll learn to accept yourself and your experiences while also embracing positive changes. As you progress through these stages, you’re on a journey toward a life characterized by happiness and personal growth.

How DBT Supports Recovery from Substance Abuse

When someone turns to alcohol or other substances, it’s often a way of trying to find relief or change their intense emotions. Emotions can become strong and overwhelming, pushing people to look for ways to calm down, which sometimes leads to becoming addicted.

Now, here’s where Dialectical Behavior Therapy, or DBT, comes in. 

It’s a treatment that helps manage those intense emotions. With DBT, instead of turning to substances, you can learn healthier ways to cope and gain better control over your emotions. 

When you’re in therapy with DBT, here are some of the things you’ll be working on: (2)

  • Decreasing the use of substances like alcohol or drugs, including those prescribed by doctors that you might not be taking as instructed
  • Dealing with physical discomfort for withdrawal symptoms
  • Handling cravings
  • Spotting triggers and avoiding them

The Inner Workings of DBT

When therapists use DBT, they teach these crucial skills in different ways. They might show you how to do things, explain step by step, share stories to help you understand, practice with you, give you feedback on how you’re doing, and provide guidance like a coach.

DBT uses many strategies and techniques to help you learn these skills, including mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance. (2)

We often receive numerous inquiries regarding the initial two skills – mindfulness and emotional regulation, which are vital for the effectiveness of DBT in addressing substance abuse. Let’s have a deeper look into these critical skills.

Emotional Regulation

Emotional regulation revolves around the idea that substances offer relief from overwhelming emotions. Consequently, individuals who develop substance use disorders often lose their ability to manage their emotions independently.

To achieve emotional maturity and lasting sobriety from alcohol and drugs, you must embrace the practice of emotional sobriety. 

Through emotional regulation, you break free from reliance on substances as a way to cope with emotions. Instead, you learn to confront your emotions directly. (3)

This transformation turns emotions into a powerful tool, offering strength and self-insight.

Emotional regulation focuses on emotional sobriety and equips you with essential emotion regulation skills. Coping with the full spectrum of emotions, once dulled by substance use, can be overwhelming. (4)

This overwhelming feeling sometimes leads you to succumb to addiction triggers and relapse. Hence, mastering emotion regulation is a crucial aspect of recovery from addiction.

The more you learn and apply these skills, the less likely you are to yield to addiction triggers and experience relapse. 

Furthermore, emotional regulation plays a pivotal role in enhancing mental health, a vital component of addiction treatment and recovery, as many individuals turn to substances initially as a way to cope with underlying mental health issues. (3,4)

The goal of emotional regulation is to: (4)

  • Recognize, distinguish, and articulate a range of emotions
  • Foster greater acceptance and flexibility in emotional responses
  • Reduce reliance on methods of emotional avoidance
  • Enhance the capacity to harness emotional insights for identifying personal needs
  • Improve behavioural choices and interpersonal relationship management in various contexts

Mindfulness

According to the National Center for Complementary and Integrative Health (NCCIH), mindfulness interventions significantly reduce the intake of substances, including cigarettes, alcohol, and opiates. (5)

Here’s how it works:

Studies have proven that people with substance abuse experience dysfunction in crucial brain areas responsible for attention, emotion, and behavioural regulation. The structure and function of these vital brain areas are compromised. (6)

So, someone with a substance use disorder responds to environmental triggers associated with substance use, connects emotions to these cues, and forms behavioural decisions influenced in distinct ways compared to those not affected by a substance use disorder.

They tend to develop repetitive patterns of reacting, processing information, and behaving that reinforce drug use as their primary coping mechanism for stress and emotional management. 

Over time, these patterns become ingrained and automatic, often making them challenging to recognize and break free from.

This is where mindfulness steps in.

Mindfulness practices revolve around three key aspects: awareness, disengagement, and perception, which influence brain areas affected by substance abuse. (7)

Firstly, mindfulness cultivates a heightened awareness of everything unfolding in the present moment—thoughts, emotions, physical sensations—without exception. This heightened awareness constitutes the first element. 

Secondly, mindfulness trains you to detach from the thoughts, emotions, and sensations you experience, thereby fostering disengagement. 

Lastly, it helps you perceive the world as it truly is, free from the biases introduced by habitual thoughts, feelings, and physical sensations. This aspect is perception.

When these three elements of mindfulness are combined, you learn to regain control over your reactions, effectively manage your emotions, and make decisions grounded in reason rather than impulse.

Don’t Delay. Seek Help

If you or your loved one is battling substance abuse, DBT can help. 

At Centres for Health and Healing, we specialize in personalized DBT approaches using evidence-based programs.

Many clients respond well to emotional regulation, mindfulness, and other aspects of DBT.

Now, it’s your time to get free from substance abuse.

Please contact us today for further information and guidance.

Our team would be glad to help you.

References:

  1. Chapman AL. Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont). 2006 Sep;3(9):62-8. PMID: 20975829; PMCID: PMC2963469.
  2. Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract. 2008 Jun;4(2):39-47. doi: 10.1151/ascp084239. PMID: 18497717; PMCID: PMC2797106.
  3. Martin RE, Ochsner KN. The Neuroscience of Emotion Regulation Development: Implications for Education. Curr Opin Behav Sci. 2016 Aug;10:142-148. doi: 10.1016/j.cobeha.2016.06.006. PMID: 27822488; PMCID: PMC5096655.
  4. Stellern J, Xiao KB, Grennell E, Sanches M, Gowin JL, Sloan ME. Emotion regulation in substance use disorders: a systematic review and meta-analysis. Addiction. 2023 Jan;118(1):30-47. doi: 10.1111/add.16001. Epub 2022 Aug 11. PMID: 35851975; PMCID: PMC10087816.
  5. NCCIH. Mind and Body Approaches for Substance Use Disorders: What the Science Says https://www.nccih.nih.gov/health/providers/digest/mind-and-body-approaches-for-substance-use-disorders-science 
  6. Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 2, THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND ADDICTION. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424849/
  7. Korecki JR, Schwebel FJ, Votaw VR, Witkiewitz K. Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Subst Abuse Treat Prev Policy. 2020 Jul 29;15(1):51. doi: 10.1186/s13011-020-00293-3. PMID: 32727559; PMCID: PMC7392831. 
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