Marsha Linehan’s Dialectical Behavioral Therapy

Marsha Linehan is a psychologist, professor, American writer, and creator of dialectical behavior therapy. Dialectical behavioral therapy is a treatment model developed for patients with an unstable personality. Linehan’s therapy combines various behavioral therapy techniques with principles based on Zen Buddhism and dialectical philosophy, such as acceptance of reality.

Linehan himself carries the scars of an unstable personality he experiences. The marks and scars on his arms are evidence of his history. At a younger age, Linehan got a really bad prognosis  and had to be in the hospital for 2 years and 2 months. Today, when he talks about this experience, he says “he was in hell.”

The chronic feeling of emptiness, emotional instability, and the need to constantly please others is a real nightmare for those who suffer from this disorder. Their identity constantly depends on how others see them. They experience a strong fear of being rejected, and this fear may, after all, be what makes people leave them.

The painful life of Marsha Linehan with an unstable personality

Linehan knew that people with an unstable personality have a low survival rate, and as a result, he spent 20 years desperately to get a speech from a professional and get treatment. Linehan tried to commit suicide several times. Every company ended up in the hospital. Despite all this, Linehan wanted to get better. He fought persistently against this disorder, and he found a job with an insurance company. During this time, he also began attending university courses in the evenings.

Linehan’s faith was really strong and he often went to church. For once, Linehan remembers: ” One night, I was at church. I looked at the cross and the whole place turned golden. Suddenly I felt like something was coming towards me. I ran to my room and for the first time spoke to myself in the first person: I LOVE MYSELF. I felt changed. ”

For a year, he dealt with his depressing thoughts. During this time, he understood and accepted his own emotional storms. He learned to deal with his feelings because he felt better now. Linehan also continued his studies. He received his doctorate from Loyola University in Chicago in 1971, which also supported his understanding of the disorder.

What changed Linehan’s experience was that he accepted himself as he is. This acceptance became extremely important as he began working with his patients, first in clinics with people with suicidal thoughts, and then in studies.

Linehan’s treatment proposal

Linehan wanted to convince people that therapy would allow patients to adopt new behaviors and learn to act differently. The problem faced by Linehan was that deeply self-destructive people had “failed” in their attempts to get rid of an unstable personality. Marsha’s approach set a new line of reasoning: the behavior of these people was really logical in the face of suffering.

He emphasized two ideas:

• Accepting life as it is, not as it “should” be.
• The need to change and accept reality.

Later, Linehan tested his theory in the real world. He said, ” I decided to help people who are prone to suicide because they are the most unhappy people in the world. They think they are evil, and I realized they are not. I understood this because I experienced the sufferings of hell myself, and I had no hope of getting out of there. ”

Linehan decided to create a diagnosis of unstable personality characterized by dangerous behavior, including self-destruction or self-harm. He did this in the form of a “reciprocal” connection with these people: they had to commit to following the therapy until the end until they had a new opportunity to live.

Linehan as an academic figure

Dr. Marsha Linehan climbed the academic ladder from U.S. Catholic University to Washington University in 1977. In the 1980s and 1990s, Marsha conducted studies that showed a process of about 100 patients with a precarious personality at risk of suicide. Patients participated in dialectical behavioral therapy on a weekly basis. Compared with other therapies, patients who received dialectical behavioral therapy tried to commit fewer suicides and were less likely to be hospitalized.

The fundamental goal of dialectical behavioral therapy is for the patient to learn to regulate extreme emotions and impulses. This, in turn, counts for poorly adaptive behavior that is dependent on state of mind. In addition to this, the patient learns to trust and appreciate their own experiences, feelings, thoughts, and behaviors.

Unlike other cognitive behavioral therapies, dialectical behavioral therapy is an invention based more on therapeutic principles than a treatment manual. This program is based on a hierarchy of therapeutic goals that are used according to their importance. This hierarchy is established in individual therapy:

• Solving suicidal behaviors.
• Changing behaviors that affect the course of therapy.
• Destroying behaviors that affect quality of life.
• Developing behaviors that help achieve well-being.

This structure allows for a flexible approach based on the needs of each patient. In addition, it is important because it refers to changes in central intervention.

Traditional cognitive therapy focuses on achieving a solution to emotional problems through behavior and cognitive change. Linehan emphasizes accepting appreciation. He believes these thoughts bring about the most change in his patients. Thousands of lives have been saved around the world through his work.