Understanding Dialectical Abstinence
Dialectical Abstinence is a DBT approach that balances two seemingly opposite ideas: the commitment to complete abstinence from problematic behaviors and the acceptance that lapses may occur along the recovery journey.
This approach recognizes that while the goal is abstinence (the "change" side), if a lapse occurs, the focus shifts to harm reduction and getting back on track (the "acceptance" side) rather than falling into shame, self-criticism, or giving up entirely.
Clear Mind: Understanding the Dialectic
The States of Mind in Recovery
Addict Mind
Ruled by urges
- Impulsive
- One-minded
- Willing to do anything for a "fix"
When in addict mind, you are ruled by the addiction. The urges for habitual problem behaviors determine your thoughts, emotions, and behaviors.
Example thinking:
- "Just one more time won't hurt."
- "I need this to feel better right now."
- "Nothing else matters but getting this."
- "I'll deal with the consequences later."
Clear Mind
Balanced awareness
- Aware of vulnerabilities
- Committed to abstinence
- Prepared with strategies
- Mindful of triggers and risks
Clear mind integrates awareness of your vulnerability with a strong commitment to change. You are both vigilant and committed.
Example thinking:
- "I'm committed to abstinence AND I know I have vulnerabilities."
- "This situation could be triggering, so I'll use my coping skills."
- "I need to both avoid high-risk situations and be prepared if they arise."
- "I can be proud of my progress while staying vigilant."
Clean Mind
Denying vulnerability
- Naive
- Risk-taking
- Oblivious to dangers
When in clean mind, you are clean but oblivious to dangers that might trigger relapse. You believe you are invincible and immune to future temptation.
Example thinking:
- "I've got this under control now, no problem."
- "I can handle being around triggers; I'm stronger now."
- "I don't need to keep working on recovery anymore."
- "That was my old self, I'm completely different now."
"The goal of Dialectical Abstinence is to achieve Clear Mind—finding the balance between acknowledging vulnerability while maintaining commitment to change."
Core Principles
Commitment to Abstinence
Making a clear, firm commitment to abstain from the problematic behavior. This commitment establishes a solid foundation and clear direction.
- Create a written commitment statement
- Identify specific behaviors to abstain from
- Establish meaningful personal reasons for abstinence
Acceptance of Imperfection
Recognizing that recovery isn't perfect and that lapses may occur without defining the entire journey as a failure.
- Practice self-compassion when setbacks occur
- View lapses as learning opportunities
- Avoid black-and-white thinking about progress
Clear Path Forward
Having a specific plan for what to do if a lapse occurs, focusing on minimizing harm and returning to abstinence.
- Develop a detailed relapse response plan
- Identify immediate actions to take
- List supportive people to contact
Building a Life Worth Living
Creating a fulfilling life beyond just avoiding problematic behaviors, making recovery sustainable and meaningful.
- Cultivate positive activities and relationships
- Develop meaningful goals and values
- Practice skills that increase quality of life
Applying Dialectical Abstinence
Before Situations of Risk
- Identify personal triggers and high-risk situations
- Create detailed cope-ahead plans for challenging scenarios
- Practice mindfulness to increase awareness of urges
- Build supportive relationships and accountability structures
During Moments of Temptation
- Use crisis survival skills like STOP, TIPP, or distraction
- Practice urge surfing—observing urges without acting on them
- Implement your pre-planned coping strategies
- Reach out to supports before acting on impulses
After a Lapse (If One Occurs)
- Practice self-compassion instead of shame or criticism
- Analyze what happened without judgment (chain analysis)
- Identify what skills were missed and what could help next time
- Return to your commitment to abstinence immediately
- Update your relapse prevention plan with new insights
Dialectical Abstinence in Practice
Example: Substance Use
Abstinence commitment: "I commit to complete abstinence from alcohol because it damages my health and relationships."
Acceptance component: "If I have a drink, I will not use it as an excuse to continue drinking. I will immediately reach out to my sponsor, practice self-compassion, and recommit to my recovery plan."
Example: Emotional Eating
Abstinence commitment: "I commit to eating only at planned meal times and avoiding emotional eating as a coping mechanism."
Acceptance component: "If I engage in emotional eating, I will practice mindfulness about what I'm feeling, use that insight, and return to my regular eating plan at the next meal without restricting to 'make up for' the lapse."
Integrating with Other DBT Skills
Mindfulness Skills
Use mindfulness to increase awareness of urges and triggers without automatically acting on them.
Explore Mindfulness →Distress Tolerance
Apply crisis survival strategies when facing strong urges to engage in problematic behaviors.
Explore Distress Tolerance →Emotion Regulation
Develop healthier ways to cope with difficult emotions that might trigger problematic behaviors.
Explore Emotion Regulation →