“You can feel like a mental patient, but that doesn’t mean you have to act like one.” – Marsha Linehan
In the Thursday, June 23rd, 2011 issue of The New York Times, renowned leader in the field of mental illness and creator of Dialectical Behavior Therapy, Dr. Marsha Linehan revealed her own personal struggle with mental illness and suicide attempts as a young woman. In this fascinating interview with Dr. Linehan, “Expert on Mental Illness Reveals Her Own Fight,” she explains her reasoning for coming forth with her own story at this point in her career.
Dr. Linehan works primarily with severely suicidal and emotionally distressed patients diagnosed with Borderline Personality Disorder (BPD) at the Behavioral Research & Therapy Clinics (BRTCs) at the University of Washington. Over the years, her patients have commented on Dr. Linehan’s faded scars and markings on her arms, asking her of their origins. Dr. Linehan’s typical response to these inquires has been, “You mean, have I suffered?”
Recently, a patient of Dr. Linehan’s pointedly asked, “No, Marsha. I mean, [are you] one of us? Like us? Because if you were, it would give all of us so much hope.” This particular inquiry hit home for Dr. Linehan and she admitted, “So many people have begged me to come forward, and I just thought – well, I have to do this. I owe it to them. I cannot die a coward.”
The stigma of mental illness – from mild anxiety to schizophrenia and personality disorders – is alive and well. Despite all of the “progress” that has been made in the field of mental health and amongst the general public with letting go of the shame that often accompanies mental illness, many people continue to hide their psychological struggles.
In a previous post where I discussed the function of shame, it is clear that the reasoning behind wanting to hide one’s mental illness is as basic as fear of being cast out or rejected by the larger group/community. As long as people believe that admitting the truth of their own struggles would result in scrutiny, debasement, and rejection, it is logical to keep those “damaged” parts of the self hidden away from the public eye.
Benedict Carey, New York Times journalist, explains that “the enduring stigma of mental illness teaches people with such a diagnosis to think of themselves as victims, snuffing out the one thing that can motivate them to find treatment: hope.” People suffering from psychological disorders benefit greatly from having their suffering validated. Acceptance and validation of emotional pain helps people feel that they are not alone in their suffering. Furthermore, having a prominent figure in the field of mental health, such as Dr. Linehan, come forth with her own account of mental illness provides incredible hope.
Dr. Linehan allows herself to be incredibly vulnerable in this interview, recounting her experience of being in a secluded section of a psychiatric ward, reserved only for the most severely mentally ill patients. At this point in her life, at age 17, she felt hopeless and without any idea of how to access her own internal resources to cope with the intense inner pain she was experiencing. As many with severe emotional troubles, she did the only thing she could think to do: hurt herself.
“My whole experience of these episodes was that someone else was doing it; it was like, ‘I know this is coming, I’m out of control, somebody help me; where are you, God?'” she explains. “I felt totally empty, like the Tin Man; I had no way to communicate what was going on, no way to understand it.” This experience of intense inner pain and emptiness is not uncommon for those diagnosed with Borderline Personality Disorder.
Marsha Linehan’s experience as a mental patient was akin to being in hell. She professed, “I was in hell. And I made a vow: when I get out, I’m going to come back and get others out of here.” After her release from the psychiatric ward, she experienced a few more suicide attempts as she struggled to get her life together.
It took years of experience and an ultimate path towards her Ph.D. in psychology in 1971 to recognize how she had achieved true and lasting change. She realized that not only had she arrived at a place where she fully accepted herself (radical acceptance), but she no longer reverted back to her old patterns of self-harm when feeling intense emotions.
Carey writes, “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.”
Dr. Linehan’s creation of Dialectical Behavior Therapy (DBT) brought her to the realization that “two seemingly opposed principles … could form the basis of a treatment: acceptance of life as it is, not as it’s supposed to be; and the need to change, despite that reality and because of it.” She went on to take her theoretical underpinnings of DBT, which are a mixture of Cognitive Behavioral principles and Zen philosophy, and conduct randomized controlled trials (RCTs) of DBT’s effectiveness.
The result of her commitment to finding an empirically sound treatment for BPD has been an incredible success. Dr. Linehan’s intimate understanding of the intense subjective suffering these patients experience, along with her unrelenting acceptance of them just as they are, have proven to be a catalyst for real change.
It is through the wisdom and acceptance of understanding that people are always trying the best they can given their own particular set of circumstances that she been able to emotionally reach so many of her patients. Dr. Linehan has validated their suffering in a way that perhaps only a “wounded healer” truly can. In turn, she has found the strength and courage to come forth with her own journey towards mental health.
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Carey, B. (2011, June 23). Expert on mental illness reveals her own fight. The New York Times, Retrieved from http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=1
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