The fast pace of the world, daily stressors, and challenging life experiences may prove too demanding for some people.

Drugs and alcohol make a “grand entrance” when introduced to a person who is vulnerable and feels overwhelmed. Emphasis placed on finding balance occurs in recovery in the area of emotional and mental health.

Interpersonal experiences for someone with a substance disorder becomes like a roller coaster of ups and downs and directly influences how an individual will mentally construct their perceived reality. Substance-induced mood disorders may increase a dependence for self-medicating by using drugs and alcohol.

Life can quickly become out of balance in the midst of the deception that alcohol and drugs can bring a person happiness. When the use of substances becomes the pursuit of happiness, the drug is now in control.

However, when the addiction brings the person to the bottom of themselves, the light will appear at the end of the tunnel. The daily life which formed this path of a false sense of self-comes out of distortions manifested by dependency on drugs and alcohol. Out of the desperation to find an authentic connection with self and others the meaning of a life worth living becomes a search for the meaning of life.

It is in searching for purpose and meaning that a person must learn to be still and be mindful of presenting life experiences which will open the heart and reveal a person’s strengths and gifts. The balance point happens when all aspects of a person’s life are taken into consideration.

DBT is a cognitive behavioral treatment which emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as “worth living.”

The DBT skills include skill sets for,

• Mindfulness
• Emotion regulation
• Distress tolerance
• Interpersonal effectiveness

New Roads Behavioral Health has found that DBT is especially helpful for treatment for clients with Borderline Personality Disorder. The Woman’s Road or WoRTH program is structured to offer the kinds of help, healing, and support. The program provides services for young women, ages 18-28, dual diagnosis, with an emphasis on mental health, primarily borderline personality disorder. You can learn more about the WoRTH program here.

All of the New Roads WoRTH therapists have been extensively trained, at the Portland DBT Institute. The balance between acceptance and change strategies in therapy formed the fundamental “dialectic” which resulted in the treatment’s name. “Dialectic” means to weigh and integrate contradictory facts or ideas to resolve apparent contradictions. Using DBT, therapists and clients work hard to balance change with acceptance, two seemingly contradictory forces or strategies (Linehan, M. M., 1995).

As human beings, we struggle to find balance in our actions, feelings, and thoughts. Consider the task of integrating our right brain hemisphere (creativity, passionate feelings) with the left brain hemisphere (logical thoughts). The four main skill sets to begin to balance actions, feelings, and thoughts begin when an individual learns to address acceptance and change to find a perspective of “worth living.”

Mindfulness and Meditation

These techniques are derived from Buddhist practices and assist clients with learning to focus non-judgmentally on the world around them. Mindfulness begins to bring their “rational and emotional minds in balance.”

Client’s will learn to stop judging themselves so hard and to quietly observe their intense thoughts and feelings rather than immediately react to them. Dr. Daniel Siegel stated,

“Mindfulness is a very important, empowering, and personal internal experience, a necessity blend of personal ways of knowing along with external visions from the nature of the mind.”

Mindfulness is realized when illuminating the nature of the mind itself as you help the client consider a form of interpersonal attunement and resonance. Introducing the client to mindfulness is life-enhancing and allows self-actualization and transcendence to occur, unencumbered by their mental health diagnosis, i.e., BPD.

Emotional Regulation

DBT techniques help clients learn to control their feelings rather than being controlled by them.

Emotions which arise during a time of crisis can be damaging but as a client begins to gain skills to identify, understand, and manage these emotions they find strength and resolve no matter how difficult the crisis may seem.

Distress Tolerance

With DBT skills the client will find a healthier alternative to handling distress and turning to drinking or using drugs.

Mindfulness and radical acceptance will help the client to learn how to accept and tolerate distress in an observant, nonjudgemental fashion and then make more appropriate decisions.

Interpersonal Effectiveness

The focus for interpersonal effectiveness is to help clients learn how to interact positively and productively with others.

DBT is divided into four stages of treatment. These stages are defined by the severity of the client’s behaviors, and therapists work within this frame to support clients in achieving his or her individual goals. There is no set timeframe allotted to each stage; instead, a therapist and client will spend a much or as little time as needed, based on the client’s goals.

Stage #1

The client is often miserable, and they present with out of control behaviors including, attempted suicide, self-harming, using drugs and alcohol in excess and engaging in other types of self-destructive. Dr. Marsha Linehan reports this stage in DBT treatment when the client describes their mental illness as “being in hell.” The goal of Stage 1 is to move from the out-of-control to achieving behavioral control. The feeling of being out of control only increases fear of not gaining control.

Stage #2

Clients may feel they are living a life of quiet desperation. Although they have their life-threatening behavior under control from a behavioral approach, they report still suffering, and many times this is due to past trauma. The silent movie continues to play the traumatizing event over and over again in their minds. The goal of Stage 2 is to help move the client from a quiet desperation to one of a full emotional experience. The PTSD is then treated if it is a part of the client’s diagnosis.

Stage #3

The challenge is to learn to live, to build interpersonal skills, define life goals, learn self-respect, find self-worth and find peace and happiness. The client will learn to live an ordinary life of facing unhappy events but learning how to navigate the rough water without turning to destructive behaviors to cope. Life is full of happiness and unhappiness. However, this is the point of surrender and considering deeper meaning.

Stage #4

For some people becomes the stage to seek a deeper meaning through a spiritual existence. Dr. Marsha Linehan developed Stage 4 for clients for whom a life of ordinary happiness and unhappiness fails to meet a further goal of spiritual fulfillment or a sense of connectedness of a greater whole. The goal of this stage is to help the client move from a sense of being incomplete and finding a life that involves an ongoing capacity for experiencing unconditional love, joy, and freedom.

The basic ingredients of well-being and compassionate social living are teachable. Mindfulness then is a teachable capacity for reflection. Reflection is the common pathway by which our brain support such abilities, our relationships come to thrive in them, and our mind can achieve a state of internal attunement and a sense of harmony. The “life worth living” is attainable and comes from the reflection of three dimensions: receptivity, self-observation, and reflexivity. Receptivity, self-observation, and reflexivity all lead to self-awareness and meta-aware – the awareness of awareness (Siegel, D. J, 2007).

The WoRTH program helps the client move into this place of authenticity and acceptance and “live a life worth living.”

References
Behavioral Tech: A Linehan Institute Training Company retrieved September 26, 2017, from https://behavioraltech.org/
McFeature, B. & Herron-McFeature, C. (2017). Integrated health heartpath practitioner assessment and intervention for the trauma-exposed patient. Melbourne, Florida: Motivational Press, Inc.
Linehan, M. M. (1995). Treating borderline personality disorder: The dialectical approach. New York, NY: The Guilford Press.
New Roads Behavioral Health retrieved September 26, 2017, from https://newroadstreatment.org/womans-road-to-healing/
Siegel, D. J. (1999). The developing mind. How relationships and the brain interact to shape who we are. New York: Guilford Press.