Women living with untreated Borderline Personality Disorder (BPD) and addiction often experience feelings of hopelessness and isolation. Fortunately, many individuals living with these conditions have found great success with a therapeutic modality known as Dialectical Behavior Therapy (DBT). Developed by Dr. Marsha Linehan originally for women with suicidal ideation and self-harm impulses, Dialectical Behavior Therapy is the only empirically supported treatment for Borderline Personality Disorder. Since its inception, DBT has been found to aid a variety of mental health conditions such as psychiatric disorders, mood disorders, substance use disorders, and Post Traumatic Stress Disorder (PTSD). 

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy is a form of talk therapy that helps clients develop skills to acknowledge, address, and find acceptance and understanding for intense emotions and related behaviors. Rooted in mindfulness practices, DBT can broaden an individual's window of tolerance and support emotional regulation. Trained DBT clinicians validate their client’s experiences, while also teaching clients how to let go of rigid “black and white” thinking. Through this work, clients gain awareness that multiple perspectives and feelings can exist within themselves — even those that are opposing. 

Borderline Personality Disorder & Addiction 

Substance abuse is one of the most common self-destructive behaviors individuals with Borderline Personality Disorder experience. Additionally, substance abuse is a factor of diagnostic criteria for BPD — one of the things that doctors look for when diagnosing patients. A study by the National Institutes of Health shows that 78% of adults with Borderline Personality Disorder develop a co-occuring substance use disorder. It is also common for BPD and addiction to be paired with other mental health conditions such as anxiety and depression. DBT also has been found to treat other Borderline Personality Disorder symptoms, such as mood swings, suicidal ideation, self-injury, and identity complexities. With a primary focus on acceptance and change, Dialectical Behavior Therapy has also been found to support women struggling with substance abuse by encouraging abstinence from substances and reducing the likelihood of relapse. 

DBT for BPD & Substance Use Disorder

Therapists may work with clients experiencing BPD and substance use disorder by validating a client’s lived experience, while also motivating the client to make healthy changes within their capacity. The clinician works with the client to shift their rigid beliefs from a place of seeing their behavior as a direct reflection of their self-worth. They do so by building self compassion and aiding the client in acknowledging their pain and naming the feelings associated with their lived experience. From there, the client will work with their therapist to find healthier coping mechanisms, increasing confidence and aiding the healing journey. 

For example, a young woman experiencing BPD and alcohol addiction may talk to their therapist about how they need alcohol to navigate an emotionally abusive relationship that they can’t get out of. The client may also experience guilt and shame relating to their substance use, and have the belief that they are a terrible person because of this behavior — which in turn, makes them believe they deserve to be in a toxic relationship. Through DBT, the clinician will validate the young woman’s experience, but gently challenge the assumption that she needs alcohol to cope, as well as the misconception that she is a terrible person because of that behavior. With time and encouragement, the hope is that the young woman will make positive changes, such as leaving the emotional abusive relationship and abstaining from substances. 

Get Help for Borderline Personality Disorder & Addiction 

At Grace & Emerge Recovery, we find Dialectical Behavior Therapy to be an integral piece of women’s treatment for co-occurring Borderline Personality Disorder and Substance Use Disorder. DBT is just one piece of the holistic, individualized, and comprehensive treatment we offer at our women’s treatment program in Austin. To learn how you can join our supportive community and get help, contact our team today.