Dialectical Abstinence

The DBT Skills Challenge

Skillset

Distress Tolerance Skills: Skills for when the Crisis is an Addiction

Overview

Dialectical Abstinence is the practice of striving for complete abstinence from addictive behaviors while simultaneously acknowledging and preparing for the possibility of slips, aiming to minimize harm and quickly return to abstinence.

Description

Dialectical Abstinence is a key skill in Dialectical Behavior Therapy (DBT) tailored for managing addictive behaviors. It embodies a balanced approach by integrating the goal of total abstinence with the practicality of harm reduction. This skill advocates for a firm commitment to abstaining from addictive behaviors, paralleling a professional musician who practices diligently to perform flawlessly at every concert. However, just as a musician prepares for the possibility of mistakes during a performance, this approach also plans for and addresses potential setbacks in recovery. By acknowledging that slips can happen, individuals are equipped with strategies to handle them effectively, reducing their impact and facilitating a quicker recovery to abstinence.

The skill involves creating detailed plans that cater to maintaining sobriety and managing potential relapses. This dual planning makes the recovery process more robust, accommodating the complexities of human behavior and addiction. For instance, while the primary aim is to prevent any lapse, the strategy also involves preparing for the potential emotional and physical responses to a slip and having concrete steps to limit any damage. This preparation includes identifying triggers, having a support system on call, and setting up immediate therapeutic interventions if needed.

When to Use

Dialectical Abstinence is particularly useful for individuals dealing with substance abuse or other addictive behaviors. It helps in various scenarios:

Initial Recovery Efforts: When first attempting to abstain from addictive behaviors, this skill provides a clear framework for aiming for total abstinence.
After a Relapse: If a slip occurs, this skill helps minimize the harm caused by the relapse and supports a swift return to abstinence.
Ongoing Management: In long-term recovery, this approach assists in maintaining abstinence while staying prepared for and resilient against potential relapses.

Benefits

Practicing Dialectical Abstinence offers several key benefits:

Reduced Risk of Major Relapse: By planning for both abstinence and harm reduction, individuals can prevent minor slips from turning into major setbacks.
Enhanced Recovery Confidence: Believing in the possibility of complete abstinence while being realistically prepared for challenges boosts confidence and resilience in recovery.
Greater Flexibility in Approach: This dual strategy allows for adjustments based on personal experiences and challenges, fostering a more personalized and effective recovery process.

Common Challenges

Implementing Dialectical Abstinence can present several challenges:

Balancing Optimism and Realism: Maintaining belief in complete abstinence while realistically preparing for potential slips can be psychologically challenging.
Managing Expectations: There may be internal or external pressure to adhere strictly to abstinence, making planned harm reduction strategies feel like failures.
Consistency in Application: Applying this approach consistently requires continuous effort and adaptation, especially after experiencing setbacks.

By understanding and integrating Dialectical Abstinence into recovery efforts, individuals can achieve a more balanced and sustainable approach to overcoming addictive behaviors, leading to improved long-term outcomes and emotional stability.