When the Crisis is Addiction – Part 1

In addition to being an evidence based treatment for borderline personality disorder and other disorders of emotion regulation, Dialectical Behavioral Therapy (DBT) has been shown to be effective with other mental health conditions, including disorders of addiction. 

While the traditional view of addiction relates it to the development of some sort of physical dependence, how we think about addiction has been evolving to include a much larger array of behaviors and experiences.

According to Dr. Linehan, the definition of addiction is broad and is not limited solely to substance use disorders. She defines it as, “…any repetitive behavior that an individual is unable to stop, despite the negative consequences of the behavior and the person’s best efforts to stop”. 

Thus behavioral addictions, sometimes referred to as process addictions, also respond to DBT treatment including the integration of the specific skills taught for people who are struggling with crisis in their lives due to their addictions. Process addictions can include such behaviors as gambling, video game addiction, food addiction, shopping addiction and social media addiction.

In her 2015 second edition of the DBT Skills Training Manuals Marsha Linehan added a new subsection to the Distress Tolerance skills module. This subsection offers specific skills for people struggling with addiction disorders, also referred to as, “When the Crisis is Addiction”. 

There are seven basic skills for addiction-related disorders:

  • Dialectical abstinence
  • Clear mind
  • Community reinforcement
  • Burning bridges
  • Building new ones
  • Alternate rebellion
  • Adaptive denial

We will explore these in greater detail in a future blog. So stay tuned!


Written By: Keren L Clark, LMFT, DBT Team Leader

DBT-Linehan Board of Certification, Certified Clinician™

Photo By: Markus Winkler


Leave a Reply

Your email address will not be published.