Author: Marsha M. Linehan, Ph.D.
APA Style Citation
Linehan, M. (2020). Building a life worth living: A memoir. Random House.
Building a Life Worth Living – Amazon.com
Marsha Linehan’s memoir, Building a Life Worth Living, is her personal story and the journey that led her to develop a life-saving therapy to treat highly suicidal individuals. She tells the story of how she went from a popular and successful teenager to a suicidal young woman who spent years in a psychiatric facility (The Institute of Living). During her stay in the psychiatric facility, her diagnosis of schizophrenia was treated in the manner typical of the 1960s, including psychotropic medications (e.g., Thorazine, Librium), electroconvulsive treatment (ECT), cold blanket treatments, and isolation. Dr. Linehan states that, in hindsight, a diagnosis of borderline personality would have been more accurate. During her treatment, she became increasingly more troubled, engaging in more and more severe forms of self-harm. She attempted to kill herself numerous times, including cutting and diving headfirst from her bed in an isolation area onto the concrete floor. The popular and highly functional girl from high school was replaced by “one of the most disturbed patients in the hospital,” according to clinical notes. Marsha vowed that if she ever made it out of the institute and out of the emotional hell in which she was living, she would find a way to help others escape and create a life worth living.
After her release from the psychiatric facility where she spent two years, she worked hard to put herself through night school and college while living in a YMCA and taking odd jobs to pay for her basic needs. Ultimately, she graduated college and earned a Ph.D. in psychology with a focus on behavioral therapy. Her primary motivation and research interest remained to help develop effective therapies for highly suicidal individuals, including those with multiple severe mental illnesses (comorbidity). Her work eventually led her to dialectical behavior therapy (DBT), a method considered to be a major milestone in behavior therapy that has saved the lives of many and helped develop a treatment for individuals whom therapists often avoid or refuse to treat because they are high-risk.
The book covers her work on the clinical trials for DBT, her submissions to the Archives of General Psychiatry, and the initial rejections, highlighting the long process of developing a new evidence-based treatment. In clinical trials, DBT, which does not involve medications, dramatically reduced self-harm in individuals with borderline personality disorder and the number of days they spent in the hospital. Many insurance companies typically would not cover treatment for borderline personality disorder unless it involves DBT because of the efficacy of the treatment.
DBT involves building a series of key skills and requires patients and therapists to balance numerous contradictions (dialectics). Therapists must accept their patients as they are (angry, confrontational, in pain) yet guide them in changing disruptive thought and behavior patterns. Patients need to replace their black-and-white thinking patterns and learn to accept contradictions, including that their challenges will never completely disappear but that they can learn to cope and manage their negative feelings.
Despite developing Dialectical Behavioral Therapy, Dr. Linehan kept her personal experiences with mental illness private for most of her career. DBT has helped individuals with depression, borderline personality disorder, and other mental illnesses cope with and overcome suicidal thoughts, but Linehan did not publicly share her experiences with suicidal thoughts. She told her story of suicidal behavior for the first time at the Institute of Living, the Harford Connecticut clinic, where she was treated at the age of 17 when she was 68. According to Linehan, she was sometimes questioned by her patients, “Are you one of us? Because if you were, it would give all of us so much hope”, potentially as a result of the faded scars and burns on her arms.” According to Linehan, “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.”
Marsha Linehan founded the Behavioral Research and Therapy Clinics (BRTC) at the University of Washington, where she led research on developing and improving methods to help individuals with treatment resistance mental illnesses, especially those with high suicidal risk. Her work has focused on helping individuals with PTSD, addiction, and borderline personality disorder through DBT.
In 2018, Marsha Linehan was included in a special issue of Time Magazine: Great Scientists: Geniuses and visionaries who transformed our world. She was listed alongside Albert Einstein, Marie Curie, Galileo Galilei, Isaac Newton, Stephen Hawking, and Charles Darwin. The section in the Time issue devoted to social scientists included Marsha Linehan, Sigmund Freud, Wilhelm Wundt, Margaret Mead, Alfred Kinsey, E.O. Wilson, and Albert Ellis. Despite her enormous contributions to treatment through the development of DBT for highly suicidal individuals, she does not appear in many introductory psychology textbooks. Marsha Linehan is a visionary who should be highlighted alongside other key contributors to treatment, such as Ellis, Beck, Wolpe, and Cover-Jones. Psychologist Angela Duckworth commented on Linehan’s memoir by calling it “ Throughout her extraordinary scientific career, Marsha Linehan remained a woman of deep spirituality. Her powerful and moving story is one of faith and perseverance. Linehan shows, in Building a Life Worth Living, how the principles of DBT really work—and how, using her life skills and techniques, people can build lives worth living.
A brilliant memoir by one of the greatest pioneers in psychotherapy history… Marsha Linehan holds absolutely nothing back, making good on the vow she made as a young woman to escape hell and help others do the same. This book—in its fierce honesty and, for the careful reader, its practical advice—will help anyone who has struggled to build a life worth living.”
Other Related Resources
Author's Website- Marsha M. Linehan, Ph.D., ABPP – the University of Washington
Author's Website – founder of Behavioral Tech
The University of Washington Q and A series with Marsha M. Linehan
National Alliance for Mental Illness (NAMI) article honoring Dr. Masha Linehan.
The University of Washington Center for Behavioral Technology
Background information about suicide prevention from the National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/health/topics/suicide-prevention
Background information on suicide and suicide rates from the World Health Organization (WHO). https://www.who.int/data/gho/data/themes/mental-health/suicide-rates
Psychological Figures and Concepts
Borderline personality disorder
Dialectical Behavior Therapy (DBT)
Electroconvulsive shock therapy
National Alliance on Mental Illness (NAMI)
National Institute of Mental Health (NIMH)
Posttraumatic Stress Disorder
Social learning theory
Suicidal thoughts and behavior
Sympathetic nervous system