Marsha Linehan: from the patient to the psychologist to beat the TPL

Marsha Linehan: from the patient to the psychologist to beat the TPL

Marsha Linehan is an American psychologist, teacher, author and creator of Dialectical Behavioral Therapy. This is a theoretical model and treatment developed for patients with borderline personality disorder (BPD) in which behavioral therapy techniques are combined with zen-derived principles of reality acceptance. of dialectical philosophy.

However, this woman still has the stigma of her past with borderline personality disorder, burns and cuts on her arms are proof of this. In the past, Marsha was a patient with a very severe prognosis who was hospitalized for 26 months. "I was in hell," she went on to say.

The chronic feelings of emptiness, emotional instability and the need to please others become a nightmare for those who suffer from BPD. In fact, their identity is continually dependent on the assessment of others. The fear of abandonment is such that they can experience that they may even end up causing it inadvertently.

The painful life of Masha Linehan, suffering from TPL

Marsha Linehan wandered desperately from one specialist to another for 20 yearsher prognosis being that she had little chance of survival. Suicide attempts followed and with them new hospitalizations. Yet, despite everything, this awesome woman wanted to recover. Constantly in her struggle, she found a job as an employee in an insurance company. And at the same time, she started taking evening classes at the university.

Very believing, Marsha often went to a chapel. From that moment, she remembers the following: "One night, I was kneeling there, looking at the cross and the whole place became golden. Suddenly, I felt something approaching me. I ran into my room and, for the first time, I spoke in the first person: I LOVE ME. From that day, I felt transformed” .

For a year, she worked on her feelings of devastation. During this time, she came to understand and accept her emotional storms: she learned to manage her feelings from a better understanding of herself. In addition, she completed several years of study in psychology during which she earned a doctorate from Loyola University in Chicago in 1971 who helped her understand her metamorphosis.

What transformed Marsha Linehan's experience was that she was accepted as she was. This acceptance became more and more important when she started working with patients, first in a clinic with suicidal people, then in research.

His treatment proposal

She wanted to convince herself that therapy could allow patients to learn new behaviors and learn to react differently. However, deeply suicidal people have generally "failed" in their attempts to overcome their troubles. Marsha's approach imposes a new reasoning: the behavior of these people is largely logical in the face of suffering.

"To die does not hurt:
life hurts us more.
But dying is another story,
behind the hidden door:
Southern custom, when the birds
before the ice arrives,
go towards a better climate. We are
birds that stay:
those who tremble on the threshold of the peasants,
that the crumb seek,
and bring it avaration until the snow
Godly take us by the feathers. "

Emily Dickinson

Marsha Linehan focuses on two ideas :

  • The acceptance of life as it is, not as it is supposed to be.
  • The need to changedespite the acceptance of reality.

Later, this researcher has scientifically tested her theory in the real world. ” I decided to help suicidal people because they are the most miserable in the world. They think they are bad, and I realized they were not. I understood it because I went through the hell of suffering, without any hope of getting out of it” .

Marsha chose to treat people diagnosed with borderline personality disorder, characterized by dangerous behavior, including self-harm or self-injury. It does so in the form of a reciprocal "contract" with these people: they had to commit to follow the therapy to the end to have the opportunity to live.

Consolidation of Marsha Linehan as an academic personality

Marsha Linehan climbed the academic ladder of the Catholic University of America at the University of Washington in 1977.In the 1980s and 1990s, studies were conducted that showed the progress of about 100 high-risk suicidal patients with BPD who had dialectal behavior therapy (DBT) at weekly sessions. Compared to other therapies, patients have made fewer suicide attempts in the first year of treatment than in conventional hospitals.

The fundamental purpose of dialectical behavioral therapy is that the patient learns to regulate extreme emotionality and impulses. This reduces maladaptive and mood-dependent behaviors. In addition, he is taught to learn to trust and validate his own experiences, emotions, thoughts and behaviors.

Unlike other cognitive-behavioral programs, dialectical behavior therapy is an intervention based on therapeutic principles and not an intervention based on a treatment manual. This program is based on a hierarchy of therapeutic goals that are discussed according to their importance. The hierarchy established in the individual therapy is as follows:

  • Solving suicidal and parasuicidal behaviors
  • Change behaviors that interfere with the course of therapy
  • Eliminate behaviors that affect the quality of life
  • Develop behavioral skills that help achieve well-being

This structure allows a flexible approach according to the needs of each patient. It is also important because it refers to the change of approach of the intervention.

Traditional cognitive-behavioral therapy focuses on solving emotional problems through behavioral and cognitive changes. Instead of that, Marsha Linehan emphasizes acceptance and validation, in order to get changes from there. Thanks to their work, thousands of lives have been saved around the world.

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