According to the American Psychological Association, dialectical behavior therapy (DBT) combines aspects of behavior therapy, cognitive-behavioral therapy (CBT), and traditions of mindfulness. In DBT, clients learn skills to change unhelpful thoughts and behaviors. DBT can help people who have difficulty with emotional regulation or who exhibit self-destructive behaviors rooted in unresolved trauma. It is also an effective treatment modality for substance use disorder (SUD).
The main goals of DBT are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. Some of the core tenets of DBT, such as improving communication skills, coping skills, and self-image, are critical to helping people with SUD to overcome their addiction.
In order to better understand how DBT works, it helps to understand that this therapeutic approach is based on four core tenets:
DBT works because it helps people unlearn unwanted thoughts and behavior patterns through a number of exercises and coping skills. It also works because of its four tenets and the idea that as unwanted behaviors and thoughts were learned, so they can be unlearned.
DBT uses four core skills and tools to help shift unwanted or destructive thoughts and behaviors into more positive, healthy ones.
Therapists using DBT teach new behavioral skills by modeling, providing instructions, telling stories, providing opportunities for practice, giving feedback, and coaching. The primary tools used to help in letting go of old, negative thoughts and behaviors and replacing them with positive thoughts and behaviors are mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance.
Mindfulness means being able to be fully immersed in the moment while also being able to observe one’s thoughts and feelings with a degree of impartiality. Mindfulness is at the core of treatment as it is central to all other skills in DBT.
Through mindfulness, individuals can learn about and practice bringing awareness to the moment. By doing so, they are able to observe their thoughts and feelings. They can also tune in to their senses and the environment around them, which allows them to effectively slow down and focus on healthy coping skills when they are experiencing unwanted thoughts or behaviors.
When a person has developed Interpersonal effectiveness, they are better able to repair, maintain, and establish healthy relationships. Interpersonal effectiveness helps people improve their communication and conflict resolution skills. Training in interpersonal effectiveness also incorporates assertiveness training to help individuals create and enforce healthy boundaries with others. This helps people find balance in their relationships and in their lives.
Emotions are a normal part of everyday life, but it’s important to recognize that there is a difference between having emotions and being controlled by them. Emotional regulation focuses on identifying, naming, and changing the negative effects of an emotional response by helping to recognize and cope with intense negative emotions and develop a positive response.
The goal of developing emotional regulation is to help individuals have more positive emotional experiences by learning how to manage overwhelming or unwanted feelings and by understanding one’s own emotions.
When people experience distress, the immediate desire is to get rid of that feeling. Distress tolerance teaches individuals to sit with discomfort and accept negative emotions. Techniques such as distraction and self-soothing skills empower individuals to cope with intense emotions. These techniques help people learn to live with emotional discomfort.
Oftentimes, substance abuse is driven by feelings of discomfort and a need to escape unwanted thoughts and feelings. When DBT is used in treating substance abuse, individuals are encouraged to commit to abstinence. Their motivation to change their behavior and work through the painful emotions that may have led to addiction is bolstered by the various activities and techniques used in DBT.
DBT is also used to help people get back on track after a relapse. DBT treats relapse as a problem to solve and an opportunity to learn, not as a failure. Using DBT, therapists help individuals assess the events that led to the relapse and help them repair any harm caused by the relapse. Individuals become more aware of the negative consequences of substance abuse and the emotions and situations that led them to abuse drugs or alcohol in the first place. Incorporating techniques such as adventure therapy in addiction recovery can further enhance an individual’s healing process. This experiential approach encourages individuals to step outside their comfort zones, build resilience, and develop new coping strategies in a supportive environment. By engaging in these activities, participants can foster meaningful connections with others, breaking the isolation often felt during recovery.
Oftentimes, substance use disorders (SUD) are driven by the need to alleviate feelings of distress or discomfort through self-medicating. By confronting these feelings of discomfort and realizing we can control them, we are able to move through a successful recovery process, all while keeping negative feelings at bay and replacing them with more positive ones. Here at Bella Monte Recovery Center in Desert Hot Springs, California, we believe in treating the trauma that leads to addiction rather than treating substance abuse alone. At Bella Monte Recovery Center, we lead individuals through dialectical behavior therapy (DBT) in conjunction with other therapeutic modalities to help ease the recovery process and teach new skills and behaviors. If you or someone you love is struggling with addiction and you want to learn more about what we have to offer, call (800) 974-1938 for more information.
Dependent personality disorder (DPD) can impact your relationships, self-image, and ability to set important boundaries. Unfortunately, having DPD can impact your own ability to heal and negatively affect a loved one’s ability to heal. This article explains DPD and its role in enabling addiction, how it’s a form of addiction on its own, and how it can influence addiction treatment and recovery. Understanding DPD is crucial in recognizing the complex interplay between personal struggles and addiction. By addressing the dependency issues inherent in DPD, individuals can pave the way for healthier relationships and better self-image. Additionally, integrating spirituality and addiction recovery can be an essential component of the healing journey, fostering a deeper connection to oneself and others.
Dependent personality disorder is defined as a mental condition where a person relies entirely on others to meet their physical and emotional needs even though they may be able to take care of themselves. The exact cause of DPD is unknown, but the disorder often begins as a result of childhood or adolescent trauma that leads to the person developing a fear of abandonment. A psychiatrist usually won’t diagnose a person with DPD until they are an adult, as symptoms relating to care and dependence are contingent on the person’s age, and whether or not the level of dependency is age appropriate. Symptoms of DPD include:
It is not uncommon for personality disorders to co-occur with addiction. DPD isn’t an exception. There are many factors in DPD that contribute to the development of substance use disorder (SUD). How and why a person started using substances might depend on the person’s specific experience, but symptoms of DPD can influence decision-making and a person’s ability to get help on their own. Factors that might contribute to a person with DPD developing an addiction can include an inability to set boundaries, lack of personal identity, direct influence from their support system, and inability to advocate for themselves. Understanding the science behind addiction mechanisms is crucial for addressing the unique challenges faced by individuals with DPD. This knowledge can inform treatment approaches that cater to their specific needs, helping to break the cycle of addiction. Additionally, incorporating therapies that focus on building self-advocacy skills may empower individuals with DPD to make healthier choices and reduce their reliance on substances.
Those with DPD tend to have a hard time saying no. This can become dangerous, especially when it comes to substance use. If someone they care about also uses substances, they are more likely to give into the pressure to use substances, even if they are uncomfortable or want to stop. They might struggle to set boundaries with a partner they know also struggles with substance use, and then consequently enable their addiction. An inability to set boundaries can also lead to exposing themselves to mistreatment and abuse. This can impact a person’s mental health, leading them to self-medicate as a way to cope. Additionally, those with DPD might find it challenging to communicate effectively about their experiences, which can hinder proactive measures like talking to kids about addiction. By not addressing these issues openly, they risk perpetuating cycles of substance use and unhealthy behaviors within families. It’s essential to foster an environment where such conversations are encouraged, helping the younger generation recognize the signs of addiction and understand its consequences.
Those who rely solely on their partner most likely believe they don’t need to develop the skills needed to be independent. Important life skills, such as cooking for themselves, practicing physical fitness, and self-care, can help a person be responsible for their own well-being as well as help them progress in life. A person relying on others might feel stuck or dissatisfied. They might rely on substance use to cope with any underlying feelings of helplessness that they might blame on themselves and their perceived inability.
It’s harder to help someone be their own person and take care of themselves if they believe they don’t have the ability to do it. DPD can complicate the success of a person’s treatment because of how much they rely on others. They don’t believe that they are able to be their own person and make their own decisions. They think they need others in order to function. This becomes a problem in treatment because addiction treatment and recovery require a person to become their own advocate. During treatment, they might have the complete support of the staff, but outside of treatment, they’re reliant on themself and their ability to take care of themself.
A person with DPD might appear as if they are passing the requirements of treatment with flying colors on the surface, but underneath they may only be agreeing and complying with treatment expectations because of disorder symptoms, and not because they are actually improving and getting better. While the consequences of this might not be obvious during treatment, it can become complicated when the person leaves treatment. During recovery, they might resort back to their old ways. If they haven’t learned how to be independent, they still fear abandonment, or they avoid disagreements, it will be difficult for them to commit to their recovery and develop the personal resiliency required to live a sober life.
In a way, those with dependent personality disorder have an addiction to relationships. They tie their entire worth into who is caring for and supporting them. This develops a toxic situation that makes it hard for a person to get better. In order to be successful in treatment, you need to be your own advocate. Support systems are important in addiction treatment and recovery, but they can’t be something that you rely on completely. When a person is diagnosed with DPD, they need to unlearn these behaviors. With the help of talk therapy and learning independence, a person with DPD can become their own advocate and source of support. At Bella Monte, we focus on treating every factor of the person, including underlying mental health. If you would like to learn more about how personality disorders impact addiction, call us today at (800) 974-1938.
