Finding Healing in Hopelessness: Marsha Linehan, PhD, ABPP
Photo: Psychwire
Out of personal struggle, Dr. Linehan discovered breakthrough psychotherapy treatment
Please be aware: This post contains discussions about suicide and self-harm that may be sensitive for some readers. If you're feeling vulnerable, please consider your mental health before reading further.
Now more than ever, mental health is top of mind for patients and healthcare providers alike. What was once a private, even taboo topic is now increasingly discussed within families, communities, schools, and workplaces — largely due to the tireless work medical professionals and advocates have done to reframe mental health as a vital factor in overall health and well-being.
However, there is still much work to be done. In support of Mental Health Awareness Month this May, the Women in Medicine Legacy Foundation highlights the impact of Marsha Linehan, PhD, ABPP. An award-winning psychologist for over forty years, Dr. Linehan has brought hope and healing to those suffering from severe mental illness using her groundbreaking psychotherapy approach Dialectical Behavior Therapy (DBT).
Dr. Linehan's lifelong commitment to the study of suicidality and personality disorders emerged in response to a psychological break she experienced as a senior in high school. In her memoir, Building a Life Worth Living (2020), she reflected on how she went from a “happy-go-lucky, confident high school girl” in her hometown of Tulsa, Oklahoma to being hospitalized at an East Coast psychiatric institute — all within the span of a year. Retroactively diagnosing herself with a personality disorder, Dr. Linehan described her psychological deterioration during this time as “a descent into hell, an out-of-control storm of emotional torture and absolute anguish.”
For over two years, Dr. Linehan remained at the psychiatric institute, often secluded in a locked ward for her own safety. When she was eventually discharged, she committed herself to helping others overcome the same mental torment she had just endured: “I made a promise to God, a vow, that I would get myself out of hell — and that, once I did, I would find a way to get others out of hell, too.”
Seeking a fresh start, Dr. Linehan moved to Chicago at the age of 20. She attended Loyola University, where she earned her BS in Psychology (1968), MA in Psychology (1970), and PhD in Psychology (1971). Still, her recovery was not linear during her education; she continued to battle feelings of hopelessness even as she delved deeper into the science behind the mind and human behavior. Dr. Linehan attempted suicide two more times before another pivotal moment helped her find a newfound source of resilience — and planted the seed for a major breakthrough in her future research.
As a young woman in Chicago, Dr. Linehan frequently turned to Catholicism for solace. One day, while praying in Loyola’s Cenacle Retreat Center chapel, she found herself basked in golden light. The “shimmering experience” was epiphanic for Dr. Linehan: “I just ran back to my room and said, ‘I love myself.’ It was the first time I remember talking to myself in the first person. I felt transformed.” What she discovered in that providential moment was the practice of radical acceptance — acceptance of life as it is, not as we think it should be. Self-acceptance and self-love gave Dr. Linehan permission to release the guilt and shame she felt for not being who she thought she should be, alleviating some of her deep-rooted psychological distress.
After Loyola, Dr. Linehan’s star rose professionally. True to her promise, she worked extensively with severely suicidal and schizophrenic patients — first as a postdoctoral fellow and later as a researcher and lecturer at the Catholic University of America (1973-1977) and the University of Washington (1977-2019). She observed that the behavioral therapy approach developed during the 1970s was ineffective for this sensitive population, as its emphasis on behavioral change often enraged her patients or left them feeling invalidated. Change was desperately needed and Dr. Linehan began to theorize that what was missing in her approach was precisely what had helped her find a path forward in her own life: radical acceptance.
Drawing from the philosophical tradition of dialectics, Dr. Linehan’s DBT proposed a treatment strategy that embraced the oppositional tension between seeking change and offering acceptance. Within the DBT framework, patients were guided to accept their traumatic histories and heightened emotional sensitivity. Therapists, in turn, accepted and validated that self-harm and suicide were reasonable responses given their lifelong suffering. Blame was taken out of the equation, and focus was instead placed on understanding how conflicting feelings, actions, and concepts could all be true at the same time.
As Dr. Linehan observed, planning a suicide and engaging in self-harm were inherently dialectical behaviors. “Both make you feel better, and both make you feel worse,” she said. “Both sides are true.” It was up to her and other therapists to synthesize these truths and help patients find a way to create a life worth living.
Through decades of research and refinement, Dr. Linehan honed an approach that yielded real results. DBT not only reduced suicidal behavior more effectively than any other behavioral therapy, but it also became the gold standard treatment for borderline personality disorder. According to the Behavioral Research & Therapy Clinic (BRTC) at the University of Washington, DBT today remains “the only treatment [for suicidal behavior] that has been shown effective in multiple trials across several independent research sites.”
Along the way, Dr. Linehan developed treatment manuals and key assessment measures related to suicidal behavior, published over 200 scientific papers, and founded a research clinic and institute. She also co-founded several DBT-related organizations aimed at quality-control and accessibility, such as Behavioral Tech LLC, which provides DBT training to mental health professionals and healthcare systems, and the DBT-Linehan Board of Certification (DBT-LBC), which clearly identifies qualified DBT providers and programs to the public.
For all of Dr. Linehan’s trailblazing contributions to clinical research, psychology, and the study of suicidal behavior, we are honored to showcase her outstanding career and enduring legacy this month.
Sources: