Dialectical behavior therapy (DBT) is an evidence-based psychotherapy model that helps people increase their distress tolerance, enhance interpersonal effectiveness, and strengthen emotional regulation.

Implementing the core principles of DBT can be particularly helpful for treating substance use disorders. The good news is that you can apply many of these DBT skills independently and without any additional preparation or training.

Urge Surfing

Urge surfing is a mindfulness intervention where you practice observing your craving like a wave. Notice how it rises, peaks, and eventually wanes.

Urge surfing reminds you that everything is transitory. The more you can ride out a craving, the more you strengthen those neural pathways reinforcing addiction. Over time, this feels incredibly empowering, and it can support your overall recovery efforts.

Opposite Action

Opposite action entails doing the very opposite thing you want to do at a given moment. For example, when it comes to substance use, the craving is to use your drug of choice.

The opposite action, of course, isn't just about not using. It's also about implementing those other coping skills that you may not want to use (reaching out to friends, going to a support group, meditating for a few moments).

So, when you feel angry, instead of lashing out at someone, find a person you can connect with. Or, when you feel sad, instead of isolating yourself, consider going to the gym and taking care of your body.

STOP Skill

The STOP skill can be highly effective for people with histories of chronic relapse or those in the early phases of substance abuse treatment (when cravings often feel sharp and even relentless).

Stop: Pause before doing anything.

Take a step back: Reflect and look at the entire situation.

Observe: Take in your emotions, urges, and external environment.

Proceed mindfully: Select from your healthy coping skills instead of engaging in any self-destructive behaviors.

Wise Mind

DBT focuses on helping people understand the intersection between their emotional mind and their logical mind. When we feel too pulled in either direction, we often feel imbalanced, and this can emerge in themes of rigidity, impulsivity, or disconnection from self.

Familiarizing yourself with your 'wise mind' starts with getting quiet with yourself. You can gently ask:

• "What is the best thing for me to do in this situation?""What does 'future me' need me to take care of right now?"

• "How can I take care of myself best in this specific moment?"

Pay close attention to your intuition. Even if you've struggled to trust yourself in the past, you have wisdom and inner strength stored in your body. DBT teaches individuals to slow down and focus on the present moment while balancing both logic with emotion.

TIPP

TIPP is one of the more common behavioral skills that can offer immediate distress tolerance when managing cravings. The next time you're struggling with negative emotions, try one of these quick techniques:

Temperature: Rapidly change your body temperature to calm your central nervous system. This helps when your mind and body feel activated. Either splash cold water on your face and consider taking a brief cold shower.

Intense exercise: Commit to a short burst of hard, intense physical activity lasting between about 10-20 minutes. The idea is to spike your adrenaline and release endorphins- this process reduces stress and supports overall emotion regulation.

Paced breathing: Mindfulness slows down the nervous system and helps you feel more centered. Breathe in for five counts, hold for a moment, and then exhale slowly for five more counts. Practice this technique for at least five rounds.

Paired muscle relaxation: Integrate deep breathing with progressive muscle relaxation to release body tension. Scan through your body, tensing and releasing different muscle groups.

Pros and Cons

Listing out a specific decision's pros and cons is a well-known DBT skill that is often used in treating drug addiction. The premise is simple:

Listing the pros of giving into your cravings: Identify all the pros associated with your addiction. Don't hold back, even if it feels like you may be glamorizing parts of your drug or alcohol use. For example, you might highlight 'temporary comfort' or 'allows me to not feel this pain' or 'just feels really good.'

Listing the cons of giving into your cravings: Then, identify all the cons associated with giving into your cravings. Just like with the pros, avoid holding back and be as honest as you can. Write down any negative consequences, negative feelings, or negative behaviors that come to mind.

Listing the pros of staying sober: To add to this list, part of effective treatment is reinforcing why you've chosen a particular path. Write down the benefits of sobriety- indicate any that come to mind, both short-term and long-term.

Spend some time reviewing each of your lists. Notice what comes up. Think about the best way to proceed, regardless of your impulses.

Strengthening Your Addiction Recovery With Resurface Group

At Resurface Group, we offer dynamic addiction and mental health treatment for clients of all ages, backgrounds, and demographics. Our clinicians use evidence-based models, integrating components of cognitive-behavioral therapy, dialectical behavioral therapy, interpersonal therapy, and trauma-focused therapy to provide comprehensive addiction treatment.

We provide both individual therapy, group skills training, and family involvement throughout our care. Our comprehensive treatment is intended to support you at all stages of care.

Contact us today to learn more about our mental illness and substance use disorders programs.