DBT for Addiction

DBT for Addiction

The National Center for Drug Abuse Statistics (NCDAS) has released data showing that in 2020, 37,309 million Americans aged 12 years and older had a substance abuse disorder. A separate study done by the Substance Abuse and Mental Health Administration (SAMHSA) reveals that at least 15.4% of all adults in America, which translates into nearly 39 million people, struggle with a substance use disorder (SUD) each year.

There are mental health specialists who believe that this number could be significantly decreased if the right therapy approach is utilized for people with substance abuse. One example is dialectical behavior therapy (DBT), which many medical professionals have utilized and proven to have resulted in optimal recovery outcomes.

At The Freedom Center in Maryland, our facilities believe in providing treatment in conjunction with therapy services to help people effectively manage and cope with their behavioral health conditions.

What is Dialectical Behavior Therapy (DBT)?

Dialectical behavior therapy (DBT) is a structured form of psychotherapy with an educational component designed to equip people with skills for managing intense emotions and negotiating social relationships. This approach is based on cognitive-behavioral therapy (CBT), another form of psychotherapy, although DBT is particularly adapted for people who experience emotions very intensely and might not be able to handle these intense emotions.

DBT also focuses on helping people accept the reality of their lives and their behaviors because a lot of the trouble stems from the fact that many people cannot accept certain realities or truths because they could be too harsh for their sensibilities or goes against their fundamental beliefs. The useful component of DBT for substance abuse is mostly aimed at helping these people in learning ways to change their lives for the better, primarily by removing their unhelpful behaviors.

The very first instance of using DBT to treat mental health issues was when it was used to treat borderline personality disorder (BPD). The relatively high success rate it produced as a treatment for the more difficult mental health issues prompted mental health specialists to see if it could be adapted to treat other mental health conditions as well.

The component of DBT that helps people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors, including eating disorders and substance use disorders, further prompted mental health specialists to try it as a type of therapy to treat post-traumatic stress disorder (PTSD), to which it has varying degrees of success.

Substance abuse disorder is classified as a mental health issue because of the powerful influence the habit has on a person’s behavior and in creating an altered mindset in people. Using DBT as an approach to treat addiction puts a great focus on how emotions tend to influence a person’s actions and decisions.

This approach takes a look at how people’s inability to manage their emotions pushes them to substance abuse, which is why this psychotherapy approach shines a light on these emotions that push people to addiction. Once these emotions have been identified, the person learns specific coping mechanisms that are tailored to address the stress, anguish, or fear that drives the person to take substances.

What Issues Can Be Addressed and Treated Using Dialectical Behavior Therapy?

Mental health experts believe that most people experience intrusive and unwanted thoughts from time to time. This experience does not necessarily qualify as a mental health issue in itself. What makes it problematic is when these thoughts trigger specific emotions that could prove to be too much for some people that they have to act on it, regardless if the action is harmful to them or others. This is why the main focus of the dialectical behavior therapy approach is on these emotions, as they are being seen as the main driver of the potential problems that result from unwanted and intrusive thoughts.

Dialectical behavior therapy can be used to treat numerous mental health issues, including:

dbt for substance abuse

Substance Use Disorder (SUD)

Some emotions are simply too much for some people, and when confronted with these emotions, some people look for the easiest way out, which could come in the form of either drugs or alcohol. As some substances leave the person with feelings of euphoria, the strong emotions they felt that were troubling them no longer become as problematic as they were.

In other instances, some substances simply blank out the mind of the person and leave them in a stupor, or alter their perception of reality so much that they simply forget whatever thoughts or emotions were troubling them. There are also substances, such as alcohol or sleeping pills, that negate the negative emotions by simply putting the person to sleep so that they don’t feel the emotions anymore.

Post-Traumatic Stress Disorder (PTSD)

Trauma has a way of severely damaging the mind of a person. This damage could manifest in several ways, such as fear of continued abuse, immense aversion to specific things such as bodies of water or fire, or even loud noises that could remind the person of gunfire or explosions. This trauma becomes immensely troublesome as they cause the person to develop PTSD and addiction, which often floods their mind with intense memories of the trauma that affected them.

While these memories could be quite fearful, it is the emotion that they trigger that causes the trouble, as these emotions could cause the person to be subdued with great fear, become hostile towards others that they associate with the memory, or cause the person to become highly self-destructive just so they don’t experience the powerful emotions brought on by the trauma.

Suicidal Tendencies

There are quite a few mental health conditions that often push the idea that the best way to not feel the strong emotions plaguing a person is through death. The notion of finally finding peace at last from emotions of fear, extreme guilt, insecurity, or other feelings could become so inviting at times that death simply becomes so an attractive idea.

The finality of the grave becomes quite inviting to some people who spend the better part of their day being plagued by emotions they could not control or shut out even for a brief time. There are many cases when even substances don’t serve to stave off the strong emotions anymore as the effects of substances wear off after a while, which brings all the emotions crashing right back into the person. This is why the permanent peace of death becomes an even better alternative for some.


Individuals who suffer from depression seek depression treatment in Maryland to alleviate the overpowering emotion of sadness. Many people who suffer from depression are so overwhelmed with a crushing sense of melancholy that they would welcome anything that would remove the overpowering emotion of sadness that they feel.

While there are medications that serve to numb these emotions for a time, many who suffer from depression admit to feeling a lingering dread of the intense sadness consuming them completely one day when the medications stop working. The difficulty with depression is that no amount of logic or rationalization could diminish the severe sadness and melancholy felt by someone having a bout of depression.

Eating Disorders

Binge eating and bulimia are believed to be caused by specific emotions, namely fear, and disgust, which is why dialectical behavior therapy could be ideal for people who suffer from eating disorders. In more complex cases, the eating disorder could be linked to other conditions, such as body dysmorphic disorder, in which the person is overcome with disgust or revulsion when they see certain “imperfections” in how they look.

In other cases, people tend to have eating disorders because they suffer from bullying, whereas others might call them names alluding to weight issues. In most cases, people who suffer from eating disorders feel a great sense of sadness, fear, and insecurity which affects how their behavior toward eating and food.


The broad spectrum of conditions that fall under anxiety mostly also have unmanaged emotion as a primary trigger for adverse reactions. This is particularly true for those who have specific phobias, panic attacks, avoidant personality disorder, and social anxiety, as these conditions are dominated by the emotion of fear.

With anxiety and addiction, the simple knowledge of what is causing the adverse emotion is often not enough to mitigate the negative effects. This is where dialectical behavior therapy plays a significant role, as it does not only help in identifying these emotions but also in figuring out the best coping strategies to help in managing them.

What are the Four Modules of Dialectical Behavior Therapy?

The entire premise of dialectical behavior therapy works on the idea of validating the emotions being felt by the person. Regardless if these emotions are real, imagined, or somewhere in between, it is important to address them and acknowledge that they are there. Following the validation, there is also a need to address how they affect the person. If they are harmful in any way, or cause the person to engage in harmful behavior, then there is a need to do something about the situation. This is where the four modules of dialectical behavior therapy come in.

dbt for addiction treatment


While it might sound like something taken from a new-age practice where science does not have much of a say, the practice of mindfulness is rooted in the fundamentals of science. Mindfulness is simply the practice of being in the present. This means perceiving, understanding, and taking in everything that is currently around the person at that specific time. Mindfulness is a practical approach to solving the most basic emotion that causes a lot of trouble for many people: fear.

This fear is primarily directed at things that many people no longer have any control over, which is the past, and in things that might happen, which is the future. By dwelling on the mistakes of the past and possible troubling outcomes in the future, a person could become so fearful that they simply stop functioning.

By living in the here and now, a person can be in a situation where they could still influence the outcome of things, giving them a measure of control. This control translates into power for many people, and power is often the best deterrent against fear. There is simply nothing good that would come out of dwelling so much on past mistakes, as this will only serve to continually wear down a person’s self-worth and instill in them a foreboding and lingering sense of guilt.

Becoming so fearful of the future is also not very healthy. No one could accurately predict what the future may bring, and this is even true for those who are facing judicial action. A person declared guilty of an action today could be exonerated for it with the discovery of new facts that could overturn the ruling. This is why it is far better to live in the here and now, as this is where a person could do something concrete about things.

By living in the present and focusing on treatment, a person can gain a sense of control over their fear of the past or future. Dwelling on past mistakes or future uncertainties can lead to paralyzing fear and a sense of guilt. However, through treatment such as inpatient residential treatment, outpatient treatment, intensive outpatient program, and partial hospitalization program, individuals can learn to manage their fears and regain a sense of power and control over their lives.

Emotion Regulation

Anger management is a very real thing, and it could be the only thing that prevents a person from an action that they would regret later on. Emotion regulation is important because the phrase ” I could not control myself” will never prevent a person from getting into trouble with the law or with anyone else. The most inflammatory things that others say will not cause a person to die or get sick, but they could cause a person to get into serious trouble if they let their temper get the best of them by reacting to the inflammatory comments.

This also holds when a person is consumed by a great sadness. Doing self-harm or even committing suicide because of feelings of sadness or guilt will not fix anything. Emotion regulation also becomes increasingly crucial if the person happens to be in a situation where they are being goaded into an action that would regret.

This module comes with three goals: to understand the emotion, to reduce emotional vulnerability, and to decrease emotional suffering. Emotion regulation is immensely important because this is often what comes out as the knee-jerk reaction, which usually only serves to make the situation even worse.

Emotion regulation affords a person the benefit of logic in assessing a situation where they could figure out a better and more beneficial response, as compared to lashing out blindly when emotion clouds logical thought.

Interpersonal Effectiveness

Emotion has a way of severely and adversely interfering with communication. Once a person is overwhelmed with emotion, a situation where something needs to be said or done will devolve into a situation where the person caught up in emotion will respond in the worst way possible, or not participate in any kind of interaction at all. Situations like this give rise to instances of victim-blaming because it could become apparent that the bad situation could have been avoided if only the person said something or engaged in assertive communication instead of reacting blindly.

Being able to communicate with others is extremely important because people cannot read minds or sense emotions that are hidden. The act of insufficient communication often leaves both parties guessing and assuming instead of properly communicating and interacting. Being able to effectively communicate is also a survival skill most of the time because a person could potentially be in a life-threatening situation and no one else would know because the person is unable to communicate with others. Being able to communicate and interact properly and appropriately could also serve to diffuse tension and resolve issues that could otherwise turn out badly.

Distress Tolerance

Regardless of what people who engage in toxic positivity might say, there are many situations where nothing could be done by anyone, and the best that could be done is to hope for the best. In some instances, control is an illusion, and in these cases, the best option would be to cope with the crisis. Coping mechanisms will allow a person to weather a highly distressing situation and still maintain a clear mind able to analyze the situation and perhaps find out the best way to come out of it alive.

This is an important module of dialectical behavior therapy because many people put in a highly distressing situation could simply give in to the paralyzing effects of fear and freeze completely. This almost guarantees that the person will not survive a dangerous situation where crucial thinking is required.

Current events all over the world have shown that the people who survived great tragedies and events are those who were still able to keep their wits about them during the crisis. Giving in to extreme emotions like fear and anger will only serve to put the person in a vulnerable position and negate any chance of being able to get out of the situation in a good condition.

Some people say their minds go into neutral during a crisis, which goes against the flight survival instinct that is hardwired into people. During such emergencies, the human mind should work to either find the best mode of escape or brace for conflict to ensure survival.

The Freedom Center Can Help You Achieve True Freedom from Addiction

There are many instances where therapy supposedly does not work and the person who gets it either relapses into old bad habits or avoids any kind of treatment or rehabilitation in the future. Addiction therapy services work, but only if it is appropriate for the person and diagnosis.

This is something that we are very keen on here at our drug rehab in Maryland because we know that countless hours of therapy could accomplish nothing if it is not suited to the issue. We know this because we have helped so many with their issues using this mindset. We could help you too. Talk to us now.

dbt for substance abuse treatment

Break Free From Addiction

At our substance abuse treatment center in Maryland, we do our best to meet each individual where they’re at. Each person comes with a different mold - a different struggle. The best way we can help them is to offer them care that is unique to their own situation; there is no one-size-fits-all method to substance abuse treatment. This is why individualized care is so important to us. If you or a loved one are interested in finding out more, you can contact us here. 

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