[content warning: discussion of substance abuse and self-injury]
I will be right upfront here that this is one section where I have some disagreements with DBT. Specifically, I disagree with the concept of behavioral addictions. I believe a concept like “sex addiction” conflates people using sex as a coping mechanism for other problems (functionally or non-functionally), people with hypersexuality symptoms due to a condition like bipolar or borderline, and people who happen to like sex more than their subculture is willing to tolerate. And none of those groups seems similar to someone who has an actual, physiological addiction to a substance. But a lot of the other advice is fairly sensible, so I will instead be referring to “compulsive behavior”, and we can all agree it refers to substance addictions and unwanted behaviors which are not the same thing as addictions.
Compulsive behavior is behavior that has net-negative consequences for you and that you can’t stop. Before you try the techniques in this post, check that the problem isn’t just that you aren’t accepting your behavior. On online support groups for people who identify as addicted to porn, many of the participants say they “hit bottom” when they started jerking off to kinky porn or porn with trans women in it. It seems like a lot more efficient, in that case, to just accept that you’re a guy who’s attracted to feet, dommes, or trans women, as the case may be, rather than going to all the bother and effort of quitting. On the other hand, if you’re jerking off to porn instead of going to class, your problem can hardly be solved by self-acceptance.
There are roughly two strategies for approaching addiction. The first is abstinence: trying to get addicts to shoot up for the last time today and never shoot up again. The second is harm reduction: trying to reduce the negative consequences of addiction, such as with clean needle programs and safe injection sites.
Part of harm reduction is making sure that your relapses, when they occur, are as harmless as possible. If you have problems with overspending, you might want to consider canceling your credit cards and getting a debit card instead, so you can’t spend more money than you have. Similarly, if you are trying to stop self-injuring, it might be a good idea to keep around alcohol wipes and bandages.
Planning for harm reduction can be difficult if you’re currently attempting to abstain from your compulsive behavior, because a lot of the strategies for harm reduction also make it easier to do the thing you’re trying to stop. Be thoughtful. If you are trying to recover from the use of heroin, it might not be a good idea to keep clean syringes around. However, it might be wise to have some naloxone.
Another aspect of harm reduction is planning what you’ll do after a relapse. Are there people you can call for support who will be supportive and nonjudgmental? How can you get rid of temptations (your razors, that half-full bottle of whiskey)? A lot of people feel shame and guilt after they relapse; what’s your plan for keeping yourself from coping with those feelings by going on a binge? How can you encourage yourself to keep going? How can you keep a slip from turning into a disaster? Thinking about this ahead of time means you don’t have to think of it in the moment– when the thing you want the most is to keep binging.
At the same time you plan for harm reduction, you can also plan for abstinence. (Sorry, people who want to keep using their compulsive behaviors. Harm reduction is for you guys too, but this blog post is about quitting.)
Reinforcement. Your compulsive behavior feels good in the short run, which is why you do it. It just feels like shit in the long run. So what you need to do is restructure your environment so that instead of reinforcing your compulsive behavior, it’s reinforcing your abstinence. It isn’t enough to rely on the delayed consequences; your compulsive behavior is immediately reinforcing. So find a different reinforcer. Find friends who will praise you for staying away from your compulsive behavior. Find entertaining things to do that aren’t your compulsive behavior and that you can’t do if you’re also doing your compulsive behavior (staying busy also helps). If you don’t know what to do, try a lot of different groups of people and activities. If your environment is low on reinforcers, consider rewarding yourself: you can eat a Skittle when you successfully resist an urge, read a chapter in your favorite book every day you abstain, or even just get a big calendar and put a check on every day you abstain. In addition, for many people, recovery groups are very reinforcing; if that is something that would work for you, try it out!
Burning bridges. Make an absolute commitment to yourself that you are not going to do your compulsive behavior. Slam the door shut.
Now, list everything in your life that makes addiction possible: people, places, and things. Avoid those things. Throw out the contact information of the friends you go drinking with. If you cut yourself with razors, it’s time to grow a mountain man beard. Make it as difficult as possible for yourself to do your compulsive behavior.
One really great strategy is to publicly announce that you’re abstinent now. Indeed, you never intend on doing [insert compulsive behavior] here again! You do not have even a THOUGHT of doing it. Publicly post about your milestones. Identify as A Person Who Does Not Do This Thing Anymore. If anyone catches you doing it, they have your complete permission to shame you as much as you want. That way, if you find yourself tempted to do your compulsive behavior again, you can imagine having to admit to everyone you know “yeah, you know all that stuff I said about abstinence… uh… I fucked up.” And then you don’t do it. This is the Nanowrimo principle: once you’ve told everyone you plan on writing a novel in a month, you feel like a real idiot if you don’t actually do it.
Building new bridges. For many compulsive behaviors, cravings are visceral– you can almost taste the cigarette you’re trying not to smoke or feel the sharp pain of cutting. If you have this problem, whenever you experience a craving, look at new, moving images and smell something unrelated to your compulsive behavior; these new sensations compete with your cravings. The more intense, the better. You can also practice imagining different things– for instance, you can visualize being on the beach as clearly as possible to compete with your craving.
Alternative rebellion. A lot of times, when people do compulsive behavior, part of their motivation is the fun and excitement of breaking rules and rebelling against authority. So if that’s part of it for you, make sure you find other ways to rebel. Shave your head. Get a tattoo. Wear pajama pants everywhere. Worship Satan. Break into places you aren’t supposed to be. Look into chaos magick. Start reading 3edgy5me blogs and talking about how, if you think about it, all PIV is rape/we should really have kings/whatever. Paint your face like a tiger. Refuse to do things you don’t want to do. Ignore people when they offer you their hands to shake. Whatever. The point is, if you’re one of those people who likes breaking rules, you’re going to be one of those people who likes breaking rules. However, you can totally do some goal factoring here! You can break rules in a way that won’t hurt you.
Adaptive denial. This one tests your denial and rationalization skills– something we’ve all been working on for a while. Don’t argue with yourself; give logic a break for a minute. Convince yourself that your desire is for something other than your compulsive behavior. If you find yourself craving a cigarette, say “oh, I really want a carrot!” If you want to gamble, say “gosh, I am really looking forward to this new TV show!” You can get pretty silly with this– one of Marsha Linehan’s patients got herself a big jar of dimes, and whenever she wanted a drink, said to herself “ah, yes, I want to move a dime from this jar into an empty jar. Man, I have been REALLY craving those dimes lately.” You can also try convincing yourself that it is physically impossible to do the thing that you want to do. Or try putting it off– say “I will definitely do my compulsive behavior tomorrow/in an hour/in five minutes, but right now I’m waiting.” (That last is a great one for suicidality, by the way, and has been one of the tools in my toolbox for years.)
Abstinence sampling. Maybe you’re looking at this whole long list and saying “man, I don’t want to do all this. Maybe I can just stick with my compulsive behavior.” In that case, try abstinence sampling! Pick a length of time and commit to not doing your compulsive behavior for that long. How long you pick depends on your compulsive behavior– a week might be enough time to see the beneficial effects of quitting compulsive use of social media, while with some drugs you’d still be mired in withdrawal symptoms at that point. But if it turns out that your life is worse without your compulsive behavior, great! Guess you don’t have to quit it then. But if you quit your compulsive behavior and it turns out your life just gets tremendously better– well, maybe you should see about staying quit.
Now, it is important to make a serious go of abstinence sampling. Don’t just white-knuckle it for a week and then say “see! It doesn’t help!” Work on creating an environment which reinforces your abstinence: replacement activities, supportive friends.
Finally, I will talk about addict mind, clean mind, and clear mind. Addict mind is impulsive, single-minded, and willing to do anything to be able to do your compulsive behavior, no matter how much it hurts you. In addict mind, you may think rationalizing thoughts like “I don’t really have a problem” or “I can stop after a little”; you may buy things to make it easier to do your compulsive behavior or look on the Internet for techniques for doing it; you may conceal things that would make your supportive friends go “buh?”; and, of course, you may do your compulsive behavior.
Clean mind is naive, risk-taking, and oblivious. When in clean mind, you feel invincible. You may do things which set yourself up for failure: for instance, if you’re an alcoholic, you may meet up with your friends in a bar, thinking “oh, I’ll just order a water.” The steps you take towards relapse may seem reasonable and sensible at the time, but they’re a slippery slope that bring you closer to things that cue your compulsive behavior. When in clean mind, you might quit medication that helps you with your addiction; you might not tell your doctor about your history of eating disorders when he suggests going on a diet; you might carry around extra money; you might think “all I need is willpower” or “I’ve beaten the habit.”
Clear mind, however, is the synthesis of those minds. It is abstinent and vigilant. Imagine that you were fighting a long war. Addict mind is surrendering; clean mind is forgetting that the war is going on and deciding to have a dance party; clear mind is thoughtfully preparing for battle, ready to do what it takes to prevent the compulsive behavior.