By Cristina Utti MFA, MA


Substance abuse and addiction often stem from troubled interpersonal relationships.

Lacking the proper communication skills and strategies for handling difficult emotions can lead someone to take the “easy way out” by drinking or abusing substances in order to drown out feelings that they do not know how to handle. Once the substances are used and abused for a period of time, chemical changes in the brain occur, causing dependence and addiction, which then leads to more troubled relationships. In the long run, repressing feelings and thoughts with substances is not the easy way out at all.

Dialectical Behavior Therapy (DBT) is helpful in addiction treatment because it helps people examine their thoughts, opinions, and reactions.

The word dialectic is defined as: 1) the art of investigating the truth of opinions, 2) the inquiry into contradictions and their solutions. The therapist helps the client look within to understand which thoughts and feelings should be acted upon, where contradictions lie, and what solutions might be available. The goal is to cultivate a state of mind in which experiences and emotions are acknowledged and accepted but not necessarily acted upon.

DBT therapy clients may spend time with an individual therapist, in group classes, or a combination of both. Journaling assignments are often given for keeping track of the effectiveness of the new skills learned. Since DBT is targeted toward individuals who have poor ability to handle strong emotions, it applies to everyone who struggles with an addiction.

The four areas of emphasis are:

  • Acceptance and validation of behavior as it is in the moment.
  • Treatment of any behaviors that interfere with the therapy.
  • Prioritization of the therapeutic relationship.
  • Dialogue that focuses on reality.

The critical skills learned are:

  • Mindfulness
  • Interpersonal skills
  • Regulating emotions
  • Observance without reaction
  • Being non-judgmental
  • Ability to focus on what is working

The skills learned in DBT are critical for preventing relapse. Many people struggle with emotional crisis from time to time and do not know how to communicate well with others. When in recovery, if tools are not learned to better handle difficult situations and deep emotions, certain life situations can lead one right back to the old way of coping. Dialectical Behavior Therapy is a good choice for those in addiction recovery who want to heal from past wounds and learn new ways of handling whatever may come along.

If you or a loved one are battling substance abuse problems, please call our admission staff at (888) 998-8655. Our admissions specialists are standing by.


Friedman, F. B., PhD, LCSW, RN, CS. (2009, October 16). ABCs of DBT. Lecture presented at NAMI Illinois State Conference.