Marsha Linehan is an American psychologist, teacher, author and creator of Dialectical Behavior Therapy. It is a theoretical and treatment model developed for patients with borderline personality disorder (BPD) in which behavioral therapy techniques are combined with principles of reality acceptance derived from Zen and of dialectical philosophy.
However, this woman still has the stigma of her past with borderline personality disorder, the burns and cuts on her arms are proof of that. In the past, Marsha was a patient with a very severe prognosis who was hospitalized for 26 months. “I was in hell,” she went so far as to say.
Chronic feelings of emptiness, emotional instability, and the urge to please others become a nightmare for those with BPD. In fact, their identity continually depends on the evaluation of others. The fear of abandonment is such that they may experience it that they may even end up inadvertently provoking it.
The painful life of Masha Linehan, suffering from BPD
Marsha Linehan wandered desperately from specialist to specialist for 20 years, her prognosis being that she had little chance of survival. Suicide attempts followed and with them new hospitalizations. Yet despite everything, this impressive woman wanted to recover. Endlessly in her struggle, she found a job as an employee in an insurance company. And at the same time, she started taking evening classes at the university.
Very religious, Marsha often went to a chapel. From that moment on, she remembers the following: “ One night I was kneeling there looking at the cross and the whole place turned golden. Suddenly, I felt that something was approaching me. I ran to my room and, for the first time, I spoke to myself in the first person: I LOVE ME. From that day on, I felt transformed ” .
For a year, she worked on her feelings of devastation. During this time, she came to understand and come to terms with her emotional storms: she learned to deal with her feelings from a better understanding of herself. In addition, she completed several years of study in psychology during which she obtained a doctorate from Loyola University in Chicago in 1971 which helped her understand her metamorphosis.
What transformed Marsha Linehan’s experience was that it was accepted as it was. This acceptance became more and more important when she began working with patients, first in a clinic with suicidal people, and then in research.
His treatment proposal
She wanted to convince herself that therapy could allow patients to acquire new behaviors and learn to react differently. However, deeply suicidal people have generally “failed” in their attempts to overcome their disorder. Marsha’s approach imposes a new reasoning: the behavior of these people is largely logical in the face of suffering.
Marsha Linehan emphasizes two ideas :
- Acceptance of life as it is, not as it is meant to be.
- The need to change, despite the acceptance of reality.
Later, this researcher scientifically tested her theory in the real world. “ I decided to help suicidal people because they are the most miserable in the world. They think they’re bad, and I realized they weren’t. I understood it because I went through hell of suffering, without any hope of getting out of it ”.
Marsha chose to treat people diagnosed with borderline personality disorder characterized by dangerous behaviors, including self-harm or self-harm. It does so in the form of a reciprocal “contract” with these people: they had to commit to following the therapy to the end in order to have the possibility of living.
Consolidation of Marsha Linehan as an academic personality
Marsha Linehan climbed the academic ladder from the Catholic University of America to the University of Washington in 1977. In the 1980s and 1990s, studies were conducted which showed the progress of approximately 100 suicidal patients to high risk with BPD who had received dialectical behavior therapy (DBT) in weekly sessions. Compared with other therapies, patients made fewer suicide attempts during the first year of treatment than in conventional hospitals.
The fundamental goal of Dialectical Behavior Therapy is that the patient learns to regulate extreme emotionality and its impulses. This reduces maladaptive and mood-dependent behaviors. In addition, he is taught to learn to trust and validate his own experiences, emotions, thoughts and behaviors.
Unlike other cognitive behavioral programs, Dialectical Behavior Therapy is an intervention based on therapeutic principles and not an intervention based on a treatment manual. This program is based on a hierarchy of therapeutic objectives which are approached according to their importance. The hierarchy established in individual therapy is as follows:
- Resolve suicidal and parasuicidal behaviors
- Change behaviors that interfere with the course of therapy
- Eliminate behaviors that affect quality of life
- Develop behavioral skills that help achieve well-being
This structure allows a flexible approach according to the needs of each patient. It is also important because it refers to the change in approach to the intervention.
Traditional cognitive behavioral therapy focuses on solving emotional problems through behavioral and cognitive changes. Instead, Marsha Linehan emphasizes acceptance and validation, in order to get changes from there. Through their work, thousands of lives have been saved around the world.