DBT 101: White-Knuckling Through Emotions Isn’t a Life Skill
At some point in your life—possibly during a group therapy session, a podcast binge, or while scrolling through #mentalhealth memes—you’ve probably heard someone mention “DBT.” Maybe you nodded along like you knew what it meant, but internally you were thinking, “Is that like CBT’s cooler cousin?” (Short answer: kind of. But with more drama and fewer spreadsheets.)
Dialectical Behavior Therapy (DBT) may sound like something you’d learn in an upper-level psychology class, but trust me—it’s one of the most practical, life-saving tools in addiction treatment. This claim applies to both substance abuse (alcohol, drugs) as well as to what we call process or behavioral addictions (gambling, work, sex, etc.). DBT is especially for folks who are trying to not only quit maladaptive behavior, but also stop the emotional rollercoaster that often fuels relapse (for more on this read Gabor Mate’s iconic book InThe Realm of Hungry Ghosts [2018]). So let’s talk about DBT, what it is, and why it might just be the MVP of your recovery journey.
So, What Is DBT?
Dialectical Behavior Therapy was created by Dr. Marsha Linehan for people struggling with intense emotions, self-harm, and behaviors that often leave them thinking, “Why did I do that… again?” (Sound familiar?) Originally developed for borderline personality disorder, it’s now widely used in treating substance use disorders, eating disorders, depression, and basically any situation where someone’s inner chaos is doing a hostile takeover of their better judgment.
DBT is based on the idea of dialectics—the concept that two opposing things can both be true. For more context on this idea, you may find the recent Sobriety House blog on ambivalence vs. equanimity helpful. Examples of dialectics would include:
“I am doing the best I can” and “I can do better.”
“I want to stay sober” and “I want to scream into a pillow and sprint to the liquor store.”
“My feelings are valid” and “My behavior needs to change.”
These aren’t contradictions. They’re the tension DBT helps us learn to manage. Put a bookmark here…we will come back to this.
The Four Skills You Didn’t Know You Needed
DBT teaches four core skill sets, and together they’re like a survival kit for the emotional wilderness:
Mindfulness – Becoming aware of your thoughts and feelings without immediately reacting. This means taking a pause, acknowledging the good/bad/ugly of your situation and engaging with boundaries.
Translation: Not texting your ex at 2am just because you “felt like it.”Distress Tolerance – Learning how to survive a crisis without making it worse. One of the most oft used phrases in my therapy office is “we can do hard things.” That isn’t said flippantly—it is rather a reminder of capability and capacity.
Translation: Not calling your dealer because you had a terrible day.Emotion Regulation – Understanding and managing your feelings so they don’t hijack your life. Without boundaries, our emotions do a number on us as they are most likely driving behavior.
Translation: Crying is allowed. Flipping a table at your locally-owned coffee shop because they skipped the dusting of cinnamon on your latte? Less ideal.Interpersonal Effectiveness – Asking for what you need and setting boundaries without burning every bridge.
Translation: Saying “no” without turning into a people-pleasing puddle or an angry porcupine.
Why DBT and Addiction Go Together Like Coffee and Group Therapy
I tend to write humorously, but let’s be serious for a moment. Addiction is often more about how we’re feeling than what we’re using. Substance use is frequently a coping mechanism for overwhelming emotions, unstable relationships, or a desperate need to not feel anything at all. DBT doesn’t just tell you to stop using—it teaches you how to live without needing to. You may not be comfortable in DBT but you will be building safety and, in the long run, that is so much more life-giving and life-supporting.
DBT gives you concrete tools to manage cravings, ride out emotional storms, and deal with interpersonal chaos without picking up. Plus, it acknowledges something that most people in recovery know deep down: we are not bad people trying to be good. We’re people who have experienced suffering of some sort and have done the best we could to survive. Changing how you hold emotion and how you stand in the tension of dialectics takes practice, patience, and usually a few awkward attempts at radical acceptance.
The Humor Is Free. The Work Is Real.
Here’s the thing: DBT is not magic. It won’t turn your life into a zen garden overnight. But it will give you tools that help you stop making things worse, tolerate the stuff you can’t change, and actually start liking the person you’re becoming.
At our Sobriety House, we integrate DBT into addiction care because we know recovery isn’t just about sobriety—it’s about building a life that feels worth staying for. Sometimes that means learning how to breathe, how to say “no,” and how to ride the wave of craving without paddling headfirst into chaos.
If that sounds like the kind of toolkit you need, you’re not alone—and we’re here to help you build it. Give our admissions line a call at (720) 381-4337 or email us at admissions@sobrietyhouse.org.
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Dimeff, L. A., & Linehan, M. M. (2001). Dialectical Behavior Therapy in Clinical Practice: Applications across Disorders and Settings. Guilford Press.
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
Mate, D. G. (2018). In the realm of hungry ghosts. Vermilion.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). TIP 42: Substance Use Disorder Treatment for People With Co-Occurring Disorders.
Josh Wilde, LAC, LSW