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  • Writer's pictureChoice Recovery


Dialectical Behavior Therapy is the standard and recommended treatment for those suffering from borderline personality and suicidal behavior. Developed in the late 1980s by Marsha Linehan, Ph.D., ABPP at the University of Washington, DBT encourages an individual to combine acceptance and change to produce healthy responses to uncomfortable circumstances.

Like so many others that share their talents in the behavioral health field, Dr. Linehan’s struggles with mental health issues as a teenager helped forge her passion and dedication to treating others with similar conditions. Still today, Linehan focuses her work on treating and educating others on how to address mood swings, self-harm, addiction, self-image issues, and in some instances, posttraumatic stress disorder.

Through the creation of the Linehan Institute Training Company, Dr. Linehan teaches clinicians on the techniques she has discovered to effectively treat individuals with borderline personality disorder and co-occurring suicidal tendencies. Her training focuses on the development of skills related to:

Mindfulness: through her mastery of Zen meditation, Dr. Linehan developed an understanding of the value mindfulness plays in the regulation of emotional response.

Distress Tolerance: Managing response in a seemingly uncontrollable situation is an important practice for anyone who has a mental illness and or substance abuse issues. Dr. Linehan shows how acceptance and tolerance, rather than avoidance or impulse, are the primary components to successfully regulating negative emotions.

Interpersonal Effectiveness: The capacity to understand the basis of another’s opinion and the ability to find value in their stance is the key to building strong supportive relationships. The use of DBT allows individuals to recognize how their beliefs, which may seem contrary to another’s, can have a commonality in the desired outcome which when understood, can lead to an inspired unity between the parties.

Emotion Regulation: The intensity of emotions can negatively direct behavior in personal and professional environments and relationships. The ability of an individual to dictate action in emotionally stressed times reduces regretful responses and other destructive behaviors that may lead to self-harm or other unwanted consequences.

Dr. Linehan’s work is used successfully around the world with various age groups, ethnicities, genders, and sexual orientations. While research shows DBT is most effective with borderline personality disorder and suicidal behavior, it has been proven to work with individuals who have ADHD, Depression, Anxiety, Bipolar Disorder, Substance Abuse, Binge Eating Disorder, and more.

Dialectical Behavior Therapy and Substance Abuse

Using Dr. Linehan’s theories to address substance abuse has proven to be successful and are used regularly in treatment centers globally. Through the application of the four skills above, mindfulness; distress tolerance, interpersonal effectiveness, and emotional regulation, addicts can learn healthy methods to control their addictive tendencies and the reactionary responses these tendencies cause.

Mindfulness: An addict’s mind is continually working on getting them to use again. Through negative thoughts associated with past or predicted future outcomes, the brain regularly promotes the value of using drugs or alcohol to deal with life. Through various techniques, clinicians teach mindfulness so individuals base reaction on the here and now (the controllable) rather than past experiences or imagined future events (the uncontrollable).

Distress Tolerance: Using drugs and alcohol is, an easy escape from reality for the addict. Addressing current situations is often no fun, so when uncomfortable circumstances arise, an addict’s first choice is usually to medicate rather than do the work to rectify the situation. The ability to accept the situation for what it is and emotionally endure the feelings it generates without avoidance or blame is the essence of distress tolerance.

Interpersonal Effectiveness: Few situations can send an addict into negative behavior faster than a differing of opinion or the pressure of unrealistic expectations from a loved one, friend, or authoritative figure. An addict seeks treatment because they wish to stop using. Those supporting the addict in this endeavor hope for their success, but often voice strong opinions and beliefs about how to approach treatment. In such a situation, DBT might be used to help the addict understand the merits of another’s position, even when they seem to differ from their own. Through acceptance, the addict learns to focus on the congruency of the desired outcome (sobriety), rather than get stuck on the specific differences in how one believes they should get from B to A.

Emotional Regulation: An addict’s triggers create intense emotions that for years have led them to use drugs or alcohol. With DBT, an addict is taught to identify and even prepare for the feelings that trigger destructive behavior. This identification and preparation allow for a change in response. These emotional triggers might be reminders of childhood abuse, abandonment, or other life adversity. When these unwanted emotions are generated, rather than turning to drugs or alcohol for solace, an addict learns to react based on possibility rather than fear, anger, sadness, or other emotion.

About Choice Recovery:

Located in Mesa, Arizona, Choice Recovery is an intensive outpatient treatment facility serving individuals struggling with substance use disorders. Our individualized programs take an evidenced based holistic approach to care which are designed to foster personal growth that will endure long after treatment ha concluded. Learn more at


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