In 1947, the USA Olympic trials for track and field were held at Public School Stadium in St. Louis.  My dad was in attendance, and it is one of his favorite childhood memories.  He was five years old and escorted by his well-admired older brother.  The layout of the stadium provided them with an excellent view of the events, and the boys were filled with anticipation, most notably for the star of the trials, Bob Richards.  Bob had dominated in pole vault competitions, and the USA had high hopes for him in the Olympics. 

In the sport of pole vaulting, an athlete is given three tries.  Bob was the last athlete to compete that day.  He was attempting to clear 15 feet, which only one man before him had ever done.  He had taken two tries and failed.  Bob left the field after his second attempt.  The lights in the stadium were shut off.  What the crowd did next was indelible.  The crowd of about 2,000 fans began chanting his name.  As the chanting continued, the lights went back on, and Bob made his final appearance.  He took his position, and ran down the track, directly in front of my dad, and…… landed it.  The crowd went crazy!

The joy in this story, for my dad, isn’t about the gold medal, as much as it is about the fact that Bob didn’t give up.  He didn’t let the two prior failures stop him from pursuing his dream.  To this day, my dad will tell you that the experience greatly influenced him, leaving him with an underlying notion of what it means to do your best, and never waiver in your pursuits. 

In DBT, we approach the pursuit of abstinence in very much the same way as Bob pursued the record-breaking pole vault.  The client is committed to sobriety, yet there is a backup plan.  The client is like an Olympic athlete and we, the skills trainers, are the coaches.  For Olympic athletes, absolutely nothing is discussed before the race except winning or “going for the gold”.  If Olympic athletes thought or said that winning a bronze medal “would be just fine”, then their training mentality, performance, and push would all be affected.  Olympic athletes must also not think about failing in a race or about what would occur if they should twist an ankle before the race.  Those types of thoughts must stay out of their minds, even though these are possible outcomes.  The athletes must only strive for the gold.  In other words, the client is encouraged to think of themselves as Olympic athletes in the Stop Addictive Behavior Event.  The only thing that the client can possibly allow themselves to think about and discuss is absolute and total abstinence. 

This skill is called dialectical abstinence in DBT.  It synthesizes two common approaches to addictive behavior:  abstinence and harm reduction.  The focus is complete abstinence, for every moment that the client is sober and quickly shifts to a harm reduction plan following any slip.    

A harm reduction plan is prepared, because, like Bob Richards, the client must be prepared for the possibility of failure.  If there is a miss, like Bob, the client must pick himself back up, and dedicate himself fully to the task of getting the gold.  The client adopts a dialectical view and prepares for the possibility of failure.  The client must keep in mind (way back in their mind, in the very farthest part, so that it never interferes with their resolve) that if they do slip, they will deal with it effectively, be accepting of it, and nonjudgmentally pick themselves back up.  This is done through the relapse prevention plan which outlines exactly what they will do if they slip. 

There is a famous quote from Benjamin Franklin, “By failing to prepare you are preparing to fail.”  The approach of harm reduction is ubiquitous in our lives.  Small businesses, mountain climbers, airplane pilots, surgeons, to name a few, all utilize harm reduction plans. 

The documentary, Meru, beautifully illustrates the dialectic of the pursuit of success, and harm reduction.  The movie documents the story of Conrad Anker, Jimmy Chin and Renan Ozturk’s attempt to summit the Shark’s Fin on Mount Meru in 2008.  Meru is a 21,000-foot mountain in India, and the Shark’s Fin has been touted as the ultimate prize in the game of big-wall climbing.  Meru is a 21,000-foot mountain in India.  The Shark’s Fin has seen more failed attempts by elite climbing teams over the past 30 years than any other ascent in the Himalayas. What was meant to be a seven-day trip became a 20-day odyssey.  The setback of a massive storm that showered the mountain with at least 10 feet of snow, resulted in a failed attempt to conquer Shark’s Fin.  Like all the other climbers before them, their journey was not a successful one.  The three climbers would not have survived without a harm reduction plan in place, and like the process employed in dialectical abstinence, the three athletes continued training in pursuit of conquering Shark’s Fin.   In 2011, the three returned to Shark’s Fin, and did just that. 

I love the metaphor of the mountain climber and the pursuit of sobriety.  It’s truly heroic to be in recovery, and incredibly hard, and the reward is the summit, a clear view of the world from above.  Rene Daumal explains the importance like this: 

“You cannot stay on the summit forever; you have to come down again. So why bother in the first place? Just this: What is above knows what is below, but what is below does not know what is above. One climbs, one sees. One descends, one sees no longer, but one has seen. There is an art of conducting oneself in the lower regions by the memory of what one saw higher up. When one can no longer see, one can at least still know.”