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December 21, 2020

Commitment and Grace (Part 2) Making a Dialectical Abstinence Plan

In my last post, I introduced the dialectical behavior therapy skill of dialectical abstinence, which marries the concepts of traditional abstinence and harm reduction to successfully rehabilitate addictive behaviors. A skill like this can be particularly useful as we approach the holiday season, a time that makes many of us more vulnerable to falling into old patterns. These patterns can include shame and negative self-talk, drug and alcohol abuse, disordered eating, and toxic relationships.

There is hope and power, however, in acknowledging that this season can be very challenging. And with this acknowledgement, we can make a plan.

A dialectical abstinence plan prepares us for situations where our addictive patterns might take hold. By building a toolkit of healthy coping strategies now, we can better support ourselves in moments of intense emotion and negative feelings. A dialectical abstinence plan should include strategies for both abstaining from the detrimental behavior as well as harm reduction tools that you can lean on if you do find yourself in a relapse.

Some elements to consider for building your plan are listed below (adapted from the second edition of DBT Skills Handouts and Worksheets by Marsha Linehan).


Planning to avoid the addictive behavior altogether

1.  Enjoy your success, but with a clear mind. Plan for temptations to relapse.

2.  Spend time or check-in with people who will reinforce and encourage your new behaviors for abstinence.

3.  Plan new, revitalizing activities to do instead of activities that encourage addictive behaviors.

4.  Burn bridges: avoid cues and high-risk situations for addictive behaviors.

5.  Build new bridges: cultivate images, smells, and mental activities (such as urge surfing) to compete with information associated with craving.

6.  If the addiction serves as a rebellion against something troubling you, find alternative ways to rebel.

7.  Publicly announce abstinence; deny any idea of lapsing to addiction.

Harm reduction 

Reducing the negative impact when relapse occurs

1.  Call your therapist, sponsor, or mentor for skills coaching.

2.  Get in contact with other effective people who can help you in your process.

3.  Do away with temptations; surround yourself with cues for healthy behaviors.

4.  Practice opposite action to combat guilt and shame. Consider going to an anonymous meeting of any sort and publicly report your lapse.

5. Build mastery by accomplishing small tasks. Check the facts of the situation to ground yourself in reality.

6.  Ask for help from family, friends, sponsors, ministers, or counselors. If you are isolated, find help through online support groups.

7.  Conduct a chain analysis to analyze what prompted the lapse

8.  Problem-solve right away to find a way to “get back on the wagon” and repair any damage you have done

9.  Distract yourself, self-soothe, and improve the moment.

Remember that healing addiction requires both abstinence and harm reduction because relapse is a part of the healing process. Being prepared for difficult situations with a dialectical abstinence plan can help us avoid the cycles of shame and feelings of failure that often reinforce addictive behaviors. 

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