Have you struggled with the negative effects of alcohol or substance use on your life and relationships? Have you invested time in DBT skills courses and wonder if the rooms of Alcoholics or Narcotics Anonymous are consistent with what you are practicing in DBT?  If so, then you are not alone. Substance misuse is often one of the potentially dangerous and impulsive behaviors reported by DBT skills class participants.  DBT can be a powerful treatment approach when other clinical interventions haven’t helped, and combined with outside peer support like in AA or NA, you can begin your journey towards a life worth living with a firm footing.

While there are many pathways to sobriety, 12-Step programs are a popular accompaniment to therapy, and are highly accessible because they are held so frequently and there is no cost associated with membership. At the core, all of the “Anonymous” groups related to substance use encourage abstinence, and invite members to complete step-work as a fundamental component to engagement in these recovery programs. If you are participating in a DBT class and have considered attending 12-Step meetings for outside peer support, be reassured that it is possible to do so by focusing on how they rely upon some of the same fundamental principles.

For example, the Serenity Prayer is a staple of AA/NA culture, and represents an overarching and core belief promoted by 12-Step groups: that a person has the power to take positive action in their lives while at the same time accepting that there is much in life, and in relationships, that is out of their control, too.  This balanced approach is similar to the foundational DBT dialectic that unites acceptance and change.  In DBT, like in the rooms of AA/NA, we are encouraged to both accept things as they are (via radical acceptance and other distress tolerance techniques) AND to take responsibility for changing our circumstances (no matter whether we caused them).

Another commonality between DBT and the 12-Steps is the assumption that participant’s lives have been colored by immeasurable suffering prior to beginning the respective programs, akin almost to living “in hell” (as put by Marsha Linehan). In the rooms of AA/NA, taking the First Step reflects this assumption by supporting members in acknowledging their feelings of powerlessness in their addiction and reflecting that their “lives have become unmanageable.” In DBT, a similar fundamental assumption is that all clients’ lives have been unbearable as they were being lived. These validating beliefs about participants’ suffering pave the way for acceptance and are the precursors for the commitment and motivation for change also at the center of both programs.

Recovering from addiction when we have also struggled with emotional dysregulation and other self-destructive behaviors can feel difficult. Nonetheless, be assured that you can live in a way that is consistent with both the principles of the 12-Step programs and DBT as you navigate the challenges along the path towards your best life. 


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