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Marsha M. Linehan (born May 5, 1943) is an American psychologist and author. She is responsible for the development of Dialectical Behavior Therapy or DBT. The purpose of Dialectical Behavior Therapy was first designed for the treatment of Borderline Personality Disorder, but it has been found to be useful in the treatment for other diagnoses as well. Linehan’s DBT module has been adapted to assist in the treatment of Depression, Anxiety, Anger, Impulsivity, and periods of Cognitive Disfunction. As well as suicide, and areas of impulse control such as substance abuse, eating disorders, problem gambling, and over spending. An adaptation of Linehan’s work is being currently used in treatment of individuals with developmental disabilities, mental illness and with Juvenile Offenders in Washington State.
DBT is based much after behaviorism theory, while implementing areas of Cognitive Behavioral Therapy or CBT as well and eastern zen practices. From combining both Eastern Zen and western Cognitive Behavior Therapy, Linehan discovered Dialectics, an approach in which thesis is paired with anti-thesis bringing synthesis. Linehan's DBT works with helping people move past the tendency to bounce back and forth from one extreme to another. These extremes usually occur on three axes: from emotional vulnerabliltiy to self-invalidation, from active-passivity to apparent competences, and from unrelenting crisis to inhibited grieving (Linehan 7-10).
Linehan was born in Tulsa, Oklahoma,
During a speech at the Institute of Living in Hartford, Connecticut on June 17, 2011, Dr. Linehan disclosed that she suffers from borderline personality disorder. In an article published at the New York Times website on June 23, 2011, she disclosed her own history of self-harm and multiple suicide attempts, as well as her own efforts through therapy to recover from the disorder and live a healthy, productive life.
Dr. Linehan developed DBT as a result of her own transformation that occurred in 1967, while she prayed in a small Catholic chapel in Chicago. She describes the situation in detail; "One night I was kneeling in there, looking up at the cross, and the whole place became gold - and suddenly I felt something coming toward me… It was this shimmering experience, and I just ran back to my room and said, 'I love myself.' It was the first time I remembered talking to myself in the first person. I felt transformed." Linehan, then, takes this “radical acceptance,” as she calls it, and incorporates it into the techniques of cognitive behavioral therapy meant to change the harmful behavior of a self-cutter or a person who battles chronic suicidal ideations. In essence, DBT strives for a balance between acceptance and change, or integrating contradictory philosophies (“you are loved the way you are,” however, “you must strive to change”).
She attended Loyola University in Chicago in 1968 where she graduated Cum Laude with a B.S in Psychology. Following earning her bachelors degree, she continued her education at Loyola University and was able to accomplish earning her M.A in 1970 and Ph. D. in 1971, both in Psychology. During her time at Loyola University, Linehan served as lecturer for the psychology program. After leaving Loyola University, Linehan started her post doctorate internship at The Suicide Prevention and Crisis Service in Buffalo, NY between 1971-1972. During this time, Linehan served as an adjunct assistant professor at State University College of Buffalo. From Buffalo, Linehan completed her Post-Doctorate fellowship in Behavior Modification at the State University of New York in Stony Brook.
Linehan then returned to her alma mater Loyola University in 1973 and served as an adjunct professor at the university until 1975. During this same time frame Linehan also served as an Assistant Professor in Psychology at The Catholic University of America from 1973 to 1977. In 1977, Linehan took a position at the University of Washington as an Adjunct Assistant Professor in the Psychiatry and Behavior Sciences department.
Linehan’s DBT module
In the development of Linehan’s treatment model of DBT she came up with four skill modules to aid the patient reach a state of what she calls wisemind. This state of mind is area between the rational, and emotional state of mind. In the rational mind, the individual is solely focused on the facts and observations, and a suppression of emotions occurs. Oppositely, in the emotional state of mind the patient can be experiencing such high levels of emotions that she/he does not see the positive/negatives of their behavior; this is also identified as emotional hijacking. In the emotional mind the individual tends to ignore the facts leading to a cognitive distortion of their thoughts and experiences in their environment.
Mindfulness is considered the most important part of Linehan’s DBT skill module. The mindfulness skills focus on "what" and "how" skills; "what" the individual needs to do in order to be mindful and "how" to do this. For example, a typical approach to developing the "what" skill would include an intent and attempt to observe, describe and participate in open dialogue. The "how" skill may require non-judgement, one-mindfulness, and collaboratively determining what is effective.
Interpersonal Effectiveness skills that are used in DBT sessions focus on assertiveness in saying no, making a request, and coping with problems. The purpose of the Interpersonal effectiveness skills are to allow the individual to increase the likelihood of goals being met, while maintaining self respect and keeping the relationship.
Distress Tolerance is the skill set for accepting, finding meaning for, and tolerating distress. This area of DBT focuses on learning to bear the emotional pain resulting from distressing circumstances and events in the individual's life. An important focus in Distress Tolerance is the idea of radical acceptance. Linehan describes radical acceptance as a means by which to free oneself from suffering, and requires a choice to let go of fighting with reality. These skills in "letting go" promote acceptance without judgment or evaluation of the self, others or the situation in general. In theory, focusing on the acceptance of reality rather than the approval of reality will foster a clearer understanding of controllable vs. uncontrollable factors and help facilitate manageability of emotional pain.
Emotional Regulation assists individuals with reducing their vulnerability to an emotional state of mind. This is accomplished by providing methods to identify and label emotions, finding barriers in changing emotions and applying distress tolerance skills. The other key component of this skill set is to find ways to increase positive emotional events through healthy living and participation in activities that increase self-confidence.
While at the University of Washington, Linehan as furthered her career and is now a Professor of Psychology; a Professor of Psychiatry and Behavioral sciences. Linehan has earned several awards for her work. She has been recognized for her research and clinical work dealing with the behavioral sciences, including the Louis I. Dublin award for Lifetime Achievement in the field of suicide in 1999, The Outstanding Educator Award for Mental Health Education from the New England Educational Institute in 2004, and Career Achievement Award from the American Psychological Association in 2005. Linehan is the past-president of the Association for the Advancement of Behavior Therapy, a fellow of both the American Psychological Association and the American Psychopathological Association and a diplomat of the American Board of Behavioral Psychology.
Linehan has authored three books, including two treatment manuals: Cognitive-Behavioral Treatment for Borderline Personality Disorder and Skills Training Manual for Treating Borderline Personality Disorder. She has also contributed to and has been published extensively in scientific journals.
- *Lineha M et al. Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder. Arch Gen Psychiatry. 2006;63:757-766.Research Article]
- Aaron Beck
- Albert Ellis
- Marshall Rosenberg
- Dialectical behavioral therapy
- Cognitive behavioral therapy
- Rational emotive behavior therapy
- Nonviolent Communication
- Expressive therapy
- *Lieb K et al. Borderline personality disorder. Lancet. 2004;364:453-61.Review Article:
- Curriculum Vitae regarding Marsha M. Linehan (and biography).
- Behavioral Research and Therapy Clinics.
- Link is to a site that gives a brief overview of DBT.
- Interesting article on how DBT has been used in the treatment of Female Juvenile Offenders
- Report of success of Linehan's treatment model in Washington State with Juvenile Offenders.
4.)Linehan, M.M (1995). Understanding Borderline Personality Disorder:The Dialectic Approach program manuel. New York: Guilford Press
5.)Linehan, MM (1993). Skills Training Manuel For Treatment of Borderline Personality Disorder. New York Guilford Press.
- de:Marsha M. Linehan
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