Last week, the New York Times profiled Marsha Linehan, currently a researcher at the University of Washington, though most famous as the mother of Dialectical Behavior Therapy (DBT).
DBT builds on the very effective Cognitive Behavior Therapy (CBT) theory and techniques with the addition of "validation strategies" (you are acceptable as you are and your behaviors make sense given your situation) and "dialectics" (holding two seemingly contradictory feelings at the same time: acceptance and change).
The Times piece told the story of DBT's creation by telling Linehan's story: as a young woman, she struggled with severe mental illness, self-injury, and suicidal ideation. Her experience in treatment got her thinking about what worked and what didn't work, as Times reporter Benedict Carey states: "Any real treatment would have to be based not on some theory, she later concluded, but on facts: which precise emotion led to which thought led to the latest gruesome act. It would have to break that chain - and teach a new behavior."
Linehan's life experience, coupled with good science, created a critically important intervention. DBT works with, as therapists will attest, the most difficult-to-treat patients, helping to save many lives. It's listed in the highly selective National Registry of Evidence-Based Programs and Practices, which means that in addition to people on the ground saying it works, it's been scientifically evaluated to be effective.
What I find most compelling about Linehan's story is not its beginning, her experience being hospitalized, nor its conclusion, her telling of her story in such a public way. It's that she's been living her story all this time.
As the article stated, "No one knows how many people with severe mental illness live what appear to be normal, successful lives, because such people are not in the habit of announcing themselves. They are too busy juggling responsibilities, paying the bills, studying, raising families - all while weathering gusts of dark emotions or delusions that would quickly overwhelm almost anyone else."
What other treatment techniques can be created out of the experience of suffering? How might thinking about mental illness change if it's more widely acknowledged that "successful" people suffer? Who else in the mental health field could tell their stories so that there's less of an "us/them" dynamic between those who provide services and those who participate in them?
Linehan's story of an encounter with a patient, told at the beginning of the Times piece, sends an important message. "If you were [like us]," the patient said, "It would give all of us so much hope."
Copyright 2011 Elana Premack Sandler, All Rights Reserved