Dr. Marsha Linehan, long best known for her ground-breaking work with a new form of psychotherapy called dialectical behavior therapy (DBT), has let out her own personal secret — she has suffered from borderline personality disorder. In order to help reduce the prejudice surrounding this particular disorder — people labeled as borderline often are seen as attention-getting and always in crisis — Dr. Linehan told her story in public for the first time last week before an audience of friends, family and doctors at the Institute of Living, the Hartford clinic where she was first treated for extreme social withdrawal at age 17, according to The New York Times.
At 17 in 1961, Linehan detailed how when she came to the clinic, she attacked herself habitually, cut her arms legs and stomach, and burner her wrists with cigarettes. She was kept in a seclusion room in the clinic because of never-ending urge to cut herself and to die.
Since borderline personality disorder was not discovered yet, she was diagnosed with schizophrenia and medicated heavily with Thorazine and Librium, as well as strapped down for forced electroconvulsive therapy (ECT). Nothing worked.
So how did she overcome this tragic beginning?
She was not much better 2 years later when she was discharged:
A discharge summary, dated May 31, 1963, noted that “during 26 months of hospitalization, Miss Linehan was, for a considerable part of this time, one of the most disturbed patients in the hospital.”
A verse the troubled girl wrote at the time reads:
They put me in a four-walled room
But left me really out
My soul was tossed somewhere askew
My limbs were tossed here about
She had an epiphany in 1967 one night while praying, that led her to go to graduate school to earn her Ph.D. at Loyola in 1971. During that time, she found the answer to her own demons and suicidal thoughts:
On the surface, it seemed obvious: She had accepted herself as she was. She had tried to kill herself so many times because the gulf between the person she wanted to be and the person she was left her desperate, hopeless, deeply homesick for a life she would never know. That gulf was real, and unbridgeable.
That basic idea — radical acceptance, she now calls it — became increasingly important as she began working with patients, first at a suicide clinic in Buffalo and later as a researcher. Yes, real change was possible. The emerging discipline of behaviorism taught that people could learn new behaviors — and that acting differently can in time alter underlying emotions from the top down.
But deeply suicidal people have tried to change a million times and failed. The only way to get through to them was to acknowledge that their behavior made sense: Thoughts of death were sweet release given what they were suffering. […]
But now Dr. Linehan was closing in on two seemingly opposed principles that could form the basis of a treatment: acceptance of life as it is, not as it is supposed to be; and the need to change, despite that reality and because of it.
Dialectical behavior therapy (DBT) was the eventual result of this thinking. DBT combines techniques from a number of different areas of psychology, including mindfulness, cognitive-behavioral therapy, and relaxation and breathing exercises. Research has demonstrated its general effectiveness for people with borderline personality disorder. She should be very proud of her work with developing and helping people learn about DBT:
In studies in the 1980s and ’90s, researchers at the University of Washington and elsewhere tracked the progress of hundreds of borderline patients at high risk of suicide who attended weekly dialectical therapy sessions. Compared with similar patients who got other experts’ treatments, those who learned Dr. Linehan’s approach made far fewer suicide attempts, landed in the hospital less often and were much more likely to stay in treatment. D.B.T. is now widely used for a variety of stubborn clients, including juvenile offenders, people with eating disorders and those with drug addictions.
Dr. Linehan’s struggle and journey is both eye-opening and inspirational. Although long, the New York Times’ article is well worth the read.
Read the full article: Expert on Mental Illness Reveals Her Own Struggle
37 comments
Most people who enter the psychological professions have “a story.” Going public when one is as well known as Linehan is a big step and a courageous one. The New York Times is no small forum in which to do so.
I have a new hero!
While I applaud Dr. Linehan’s bravery in telling her story, I’m a little concerned that she describes her recovery as having resulted from “an epiphany” and a subsequent complete change of her views about everything. There is not a lot of detail there, and I feel this makes the recovery process sound like a storybook ending which is not at all an accurate representation of the extremely complex process of recovering from this disorder. I think this might give sufferers the sense that recovery is as simplistic as waking up one day with a new outlook on life, and may lead them to false expectations for recovery. Having recovered from BPD myself I can say that the process was long, intense, and the most emotionally grueling process I have ever experienced. It took me three years of weekly therapy, laden with repeated conflicts and rivers of tears, to finally come back to reality from that hell. It is not an epiphany at all, but rather very, very hard therapeutic work, which can often seem painfully slow. That is the reality of recovery from the complex world of BPD, and I really wish Dr. Linehan’s story would have reflected that reality more.
I was born in the fifties and my father refused to get me therapy as suggested by a Dr. After reading this article maybe i now see why he did.
good point Martina
I have a wife whom I strongly think is living with BPD. Two Counsellors confirmed it though it is an unofficial diagnosis. I also enquired from SADAG (I am South African) and they also think so. What was sad is that SADAG, of all people, told me to run away very fast and far away. Is it a curable illness? I honestly want to be there for my kids, myself and my wife. Alternatively, to help her for her own sake, sake of the marriage or for the kids even if marriage fails. We have two schools of thought, Run like hell, it is Curable. I do not wish to waste my time, I am 48yrs and the marriage was a rollercoaster. We married ten yrs. She filed for divorce, stopped process, I filed bcos she said she is not longer coming back. Left home 11 months ago after discovering infidelity with her boss. She left previously on two occassions for 8 months at a time. An honest response please.
You married for better or worse, and sounds like you’ve gotten worse. It is possible to remain legally married and not abandon your spouse, while at the same time protecting yourself from much of the downside, and not allowing your energy to be fully absorbed by her, instead investing yourself in activities and relationships which do not involve her. If necessary, it is possible to live apart while retaining the marital bond.
Hi, leat32. Dr. Linehan directly addresses your concern in the article. She says that her epiphany was not normal–that the process is usually a slow one.
Dr Linehan’s truth won’t be the same as yours so it is indulgent & unrealistic to expect her personal story to be an exact replica of your experiences.
The point she intended was:BPD can be worked with & mitigated to varying extents.
Dear Leat32, That may have been the way the story was written by the journalist. I too had concerns about that, but feel that was perhaps the epiphany was the beginning of her recovery. I can imagine time constraints shortened her story somewhat.
Also too, she is sharing her story at a level with which she is comfortable with. She did not say much about her childhood but I can imagine that would have had an impact on her BPD.
I did not like the use of the word “stubborn clients” in the article as well – that implies we have a choice in gaining insight into our condition, which of course is the hardest part. So my thoughts are that journalist bias has something to do with the way this story comes across.
I agree with leat32. Linehan’s account of her recovery looks more like what we see in hollywood movies: an insight, leading to a sudden, miraculous “cure” and then everything start to work! I’ve been struggling with BPD for 20 years now, including 3 years of therapy. I never experienced such debilitating symptoms as hers (perhaps because I also suffer from severe OCD which has a restrictive effect on my personality as a whole) but I haven’t fully recovered yet. Recovering from BPD, OCD and depression is the most challenging experience of my life. Spiritual highs never last more than a couple of hours,insights and therapeutic gains have to be worked through over and over again, which is a very painful and often frustrating process. I admire her will to change and the power to make it happen, but I expected to hear something more real. I think it’s crucial for therapy seekers to have a realistic view of the process, and for those in therapy to know that stamina and hard work are among the most important factors that make the recovery possible.
Keep in mind she struggled for 17 years before getting “treatment.” Then she struggled for another 6 years before entering grad school. I’d hardly say she experienced some sort of miraculous cure, as the New York Times’ article makes clear it was an ongoing, relentless struggle with her suicidal thoughts during most of that time.
All during a time when borderline personality disorder wasn’t even known, so she was misdiagnosed and treated for the wrong thing to boot.
Hardly a Hollywood story by any means. The fact she went on to create an effective treatment for what she suffered from is very inspiring to me. But it didn’t happen overnight — it took many long, hard years of self-work, failure and education.
well said sir. To many people pick hole-in-the-wall anythink today. Instead of looking at thing’s someone has written or verbally expressed, should look at it all possertively. Not finding a fault. Ofcourse their is no crime in debating any article, book or theory. But to constantly take on the points that one presumes to themselves in a negative approach is worthless ldeology. Having BPD myself I appreciate what you have wrote. And I do like the fact that she pushed herself to fight such a harmful mental disability. That to me is worth a go myself to fight for my own life. Thankyou.
Actually, taking her own words at face value, it seems like she struggled along making little progress until 1967. What transformed her was not therapy, but a Jamesian religious experience.
As you put it, she had a religious epiphany in 1967. It took her from being one of the most disturbed patients in the hospital in 1963 to a Ph.D. in 1971. (She must have done undergrad work sometime in there, no? 🙂 )
Fascinating piece. What struck me about it was the issue of how much public disclosure psychotherapists can and should do about their personal lives. This felt like an awful lot, but if I were a patient of hers with the same disorder, it would give comfort to know she’s walked the walk. (Though if I were irreligious, I might feel a little nervous about my prospects!)
Fodder for another post.
I’m sorry but Marsha Linnehan is a coward. If she had been honest about her past ten years ago I would applaud her, but she watched people suffer when she could have offered first hand hope and that is cowardly. DBT is a demeaning treatment to a socially constructed “disease”. Insurance companies like it because it is cheap. If we as a society cured child abuse we would prevent BPD. Yet I don’t hear Linnehan speaking out about stopping abuse. It makes me so sad that we worship this woman instead of finding real ways to help people.
I have experienced a series of epiphanies. That first one is a catalyst for the rest. She is not a coward, it is actually well known in the community that she suffered from BPD, just because she just went public does not make her a coward. DBT did not kill your sister, that is absurd.
Well put. I have PTSD, it’s well documented, but when I lost my job had no insurance the pdocs wanted to write off my real Dx and change it to BPD, despite the fate I had been tested for personality disorders to rule them out and found to have none. But BPD is cheaper, and they don’t have to listen to you because every thing thats wrong with you is a reason for you to be dramatic and lie, even if its the truth. When I went back to work I now kinda wish I had sued those poeple for how they treated me. I certainly did not need more trama in my life.I’m not certain this is a valaid DX, or maybe it’s just over used. If I sound angry, I am, the way I was treated because of that Dx was beyond humiliating and everything I said was assumed to be a lie. Including the childhood trama I went though, and my abusive husband. I was told that I must have done something to cause him to hit me so badly that I ended in the hospital, or perhaps, I did it to myself! Angry doesn’t begain to cover how I feel about being re-tramitized by so called profesionals if this is the way they treat every one they Dx with BPD I’m surprised any “recover”
sorry about your bad experience with “professionals”. I thought these things only happen in my developing country…
Marsha Linehan is not responsible for your sister’s death. Give up the blaming bullshit. IF ML had come up with the program 10 years ago? IF? I’ve read other, more informative articles on Linehan’s process. It wasn’t ‘a-ha’ moments all the time. She was suffering, in the midst of her own chaos, too.
No one in society should ever be forced, or obligated to share something so incredibly personal. Just because she’s a doctor doesn’t mean she has an obligation to tell the world or patients about her own personal experiences. Maybe sharing would have given patients hope, but maybe sharing might have scared some patients into believing that they can’t trust help from a doctor who has a mental illness herself. Regardless, no one is entitled to know her story. It’s her story and her decision whether or not she wants to give that info away. Doctors are entitled to privacy in their lives just like everybody else. She is not a coward for wanting privacy in her life, that is her right.
I don’t know of any respected individual who has previously publicly announced they suffer from BPD. In my book, Linehan is a hero for having done so. I too worry about the epiphany part of her speech, but the example of her life nevertheless sends a powerful message of hope to people diagnosed with this disorder. I intend to share this with my own recently diagnosed daughter who, interestingly, hopes to be a psychologist herself and shares some of the talents that this article describes in Linehan.
I have studied DBT with therapists,doctors and a daily program in Manhattan. I watched Marsha on DVD and worked diligently with her workbooks. I laughed a lot while viewing these DVD’s. I would think to myself who the hell is this woman to preach to me about ‘mindfulness’. Though I maybe still and forever a woman living with Bdp , I know know she is to. Speaking from her own experience gives more hope that BPD is properly on the map. Not being played out theatrically as a Psycho who boils rabbits or runs with scissors.
It all boils down to ego. In our frantic search of an identity, we cling to things which aren’t real and our mind sucks us into this inner battle. If we let go; realize and accept who we truly are, a formless being which needs no label, then we will be at peace with ourself and with the world.
The length of time it took for Marsha Linehan’s epiphany to reveal itself, and for her to regain enough function to begin her professional journey, makes perfect sense to me. I am 52 years old and have worked for 30 years now, both professionally and privately, to overcome what has nearly overcome me many times: complex post-traumatic shock (starting in infancy), major depression, and the metabolic and immune damage that has accrued over decades — the deepening of ‘mood disorders’ into metabolic disorders. My adulthood was fairly functional in all areas (including 18 years working in the psychotherapy field) until severe and relentless stresses over the last five years broke down my health. I salute any professional who chooses courageous revelation of her/his own struggles … We are all in this together, and there is no wisdom like survived experience … especially when it can culminate in an understanding of how to induce meaningful and lasting change in conditions we often judge to be hopeless (as BPD tends to be considered).
I think Marsha Linehan’s story and the responses to her ‘coming out’ underline the continued stigma attached to mental illness in the community,and for affected clinicians. As a therapist who has a history of mental illness (and recovery), I too, remain ‘in the closet’to protect my professional credibility, (and often feel like a coward for doing so) I hear the subject of ‘reducing stigma’ discussed all the time, but know few professionals who would feel safe enough to disclose their own struggles without fear of judgement by peers. I applaud Marsha Linehan for her courage.
I admire Dr. Linehan. I too am a wounded healer, and the techniques she came up with, could only have been created by one who has felt the impact of the illness and recovered.
I had an epiphany 28 years ago when I put down the bottle. Since then it has been a journey or discovery and enlightenment and Dialectal Behavioural Therapy enabled me to deal with my demons. I don’t enterpret the article as a “miracle” awakening, I read about a lady who sought answers and found them – thank God she did. I live Australia and DBT is not as well-known as it is in the US. I’m currently writing my 3rd book about my journey and will go public when it is published. I hope my critics are kinder than some of the critics I’ve read about here. There are always “tall poppies” who think they know it all. But you have to walk in a person’s shoes to be able to walk the walk then you can talk the talk.
Here is the link to the full Article:
http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all
what happenned next:
“The high lasted about a year, before the feelings of devastation returned in the wake of a romance that ended. But something was different. She could now weather her emotional storms without cutting or harming herself. ”
the work begins:
…”she understood from her own experience that acceptance and change were hardly enough. During those first years in Seattle she sometimes felt suicidal while driving to work; even today, she can feel rushes of panic, most recently while driving through tunnels. She relied on therapists herself, off and on over the years, for support and guidance (she does not remember taking medication after leaving the institute). “
I was sad yet relieved that Marsha came out of the “BPD closet.” Ironically my torn feelings are what Marsha asks so many of her Borderline patients to do. That is: Sit with two simultaneously conflicting feelings without judgment, reacting, and knowing that both feelings can be true. Knowing that Marsha’s dedicated work to treat BPD and her own struggle has shed a massive light onto the experiences my own patients have in BorderLand. The DBT approach is now not only evidenced based, but shows to be “personally based.” For all those people who are still not out of the “BorderWoods,” my only hope is that they will one day stumble across her courageous truth. Thank you Marsha. You have changed more lives now than ever before.
I wasn’t shocked to read this article, I once had a psychiatrist who told me it was widely believed that Linehan self-mutilated as she was never seen in public wearing anything but long sleeves, regardless of the temperature. Most people gravitate to psyche to heal their own wounds. I really don’t believe in borderline personality disorder anyway. They are really just addicts with trauma backgrounds and extreme alcoholic thinking. The same techniques taught in DBT can be found in the AA Big Book, as it is based on universal principals found in the bible, the Torah, and the Koran. I believe God worked through Marsha Linehan the same way He worked through Bill Wilson. They were divinely inspired to treat those whom others deemed untreatable. Good for Marsha for releasing herself from the gates of hell and for the courage to mention God in field that is highly scientific. She understands that these are spiritual wounds people are trying to heal from.
You are wrong in saying that people with bpd are ‘just addicts with trauma backgrounds and extreme alcoholic thinking…’
I am neither an addict nor an alcoholic. Although you may not believe in bpd, you should refrain from making assumptions as to what people who have bpd suffer from.
I was in the first DBT group in the Phoenix area. I ended up there after the residential program I lived in chose to ignore my infected, third degree burns until a emergency room doctor filed a complaints with Adult Protective Services.
One of the most help things about was simply having someone to listen to me who didn’t criticize me or tell me I was only acting out to get attention.
Today, I am completing a master’s program in counseling. I talk a lot about my experiences in the mental health system. But I never, ever mention that I once a had a BPD diagnosis or that I was ever in DBT. May Linehan give other, including me, to come out about their history.
It takes a lot of courage to do what Marsha did. Here is another example of how her model works…It certainly helped a lot of my clients.
Hi. I was diagnosed 1.5 yrs ago with bpd, major depressive disorder,and social anxiety disorder and non-verbal learning disorder. I lived my whole entire childhood and later, adulthood struggling with not being able to understand why I was the way I was. I was so frustrated growing up not being able to understand things taught to me in school. Teachers and just people in general laughed at me, said I was stupid, lazy,and list goes on. The moods swings were awful. I still struggle with them today even being on medication and attending DBT. I truly feel ‘in-side out’. Can anyone tell me when this will ever stop? I truly hate when I obsess on a friend of mine and it seems as though everything revolves around them. I can’t even concentrate on other things. It’s so difficult and the way I feel right now…. I really hate who I am even though non of this is my fault.
Thank you for listening.
As a psychotherapist, at first I resisted the label borderline personality because it is applied mostly to females, and I viewed the behavior as culturally-based on the female role in society. However, my oldest of 4 daughters, a beautiful, intelligent, responsible, warm person who was the apple of my eye, began demonstrating panic behavior when she entered college, with increasing anxiety and depression. She began to “work” therapists for mood-altering meds which exacerbated her behavior, and she became dependent on these.
Over time, when she reached the age of 30, she had become someone we didn’t recognize as the person we had once known. Desperate for an answer to her unhappiness, she entered a phase of false memory syndrome, fueled by an unscrupulous psychologist with motives of his own. She began accusing me of abusing her as a child, though I do not believe in spanking or any sort of physical attack, and I always affirmed her in every way. She estranged herself from her sisters when they would not agree that I was abusive (because it wasn’t true), and she called them delusional.
It went from bad to worse. She poisoned the minds of her two children, telling them I am a dangerous grandmother who wants to kill them. She is now on her 4th marriage, to a man she met on the internet. She has been to jail and on 3 years probation for credit card fraud and property damage. Every man with whom she has lived has been accused of abusing her; I know these men, and this is patently untrue. She just had her 53rd birthday and has been fully estranged from our family for 24 years, refusing all offers of reconciliation.
Because of experiences with 3 female counseling clients and 1 female neighbor, whose self-dramatizing crisis-ridden behavior mimicked that of my daughter, I realized that indeed borderline personality does exist and is one of the most frustrating syndromes to deal with up close and personal. My points in this long post are twofold: why is borderline almost exclusively a female diagnosis, and why does the law not allow parents/grandparents legal standing to constructively intervene in an adult child’s life when this person’s behavior is clearly destructive and aberrant? Families should be the first refuge for ill members, and family resources voluntarily dispensed on their behalf, but too often, because the law prevents any family intervention the ill member rejects, the ill person becomes a financial burden on the larger society.
I would appreciate a response to these two questions.
I need help! My 14-year-old daughter’s stepmom is diagnosed with BPD. My daughter, not my exhusband, is the one she fears will abandon her. They are proclaimed best friends. As can be imagined, I am the one to recieve the brunt of stepmom’s negative BPD symptoms. After a plan for them to move, my daughter told me she wanted to go. Two psychologists and the judge ordered she stay with me. They aren’t moving now. I have no proof, but I know my daughter is made aware of all court issues and treats me with disrespect and distain. I have been taking her to a PhD since the divorce and have been attending sessions with her weekly for a few months now. Things are only getting worse. Any suggestions or feedback is appreciated.
Dr. Linehan,
I am Dee’s husband James. My wife believes I have BPD and have been borderline all my life.
Our 50th wedding anniversary will be November 20th. The past 50 years have been very difficult for her.
Dee is reading two of your books and she thanks you for stepping forward. She hopes I will step forward too.
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