Marsha M. Linehan

At the core of DBT is the dynamic balance between opposing therapeutic goals: acceptance of oneself and one’s situation in life, on the one hand, and embracing change toward a better life, on the other. That is what ‘dialectics’ means: the balance of opposites and the coming to a synthesis of two opposites. This focus on pursuing change strategies balanced by acceptance strategies is unique to DBT.

People who are depressed often say, ‘Oh, there’s something wrong with me.’ They act as if depression is something over which they have no control. Mostly, that is not true. Mostly people get depressed because they are doing something that is causing the depression. Saying to them, ‘Buck up and stop being depressed’ does not help. But identifying what is causing them to be depressed, and getting them to stop doing that, does help. It is an entirely different mentality.

The day when I was sitting in the piano room by myself, a lonely soul in the midst of other lonely souls in the unit, I am not sure what made me do what I did next. Whatever it was, there and then I made a vow to God that I would get myself out of hell and that, once I did, I would go back to hell and get others out. That vow has guided and controlled most of my life since then. At that point, I didn’t know what I would have to do to fulfill the vow. But I was determined, and that determination was crucial.

The way I describe the situation is that Mother saw me as a tulip and desperately wanted to make me into a rose. She thought I’d be happier as a rose. But I did not have what it took to be a rose, not then and not now. This tulip/rose conflict eventually became part of the way I talk to my clients in DBT. This is what I tell them: If you’re a tulip, don’t try to be a rose. Go find a tulip garden.

This dynamic became something of a pattern in my life: people telling me what I couldn’t do, and me thinking: ‘You just wait and see. I’ll show you.’ And eventually it became a good message for me, and also for my clients and their families: Believe, whether you believe or not. I tell them that it may be difficult to believe, but believe you must. You can do it.

When someone is in distress, the best compassion you can give is to be effective in helping them.

It’s a useful exercise for anyone—make a mental list of those things that make you happy and those things that make you sad or depressed. Then act on it. I urge you to try it.

If I can do it, you can do it.

It doesn’t matter how many times you fall; what’s important is that you get back up.

A common element of all the DBT skills—indeed, the key to DBT as a whole—is the determination to be effective in whatever it is you are doing. Being effective is the key to success, in all walks of life.

Persistence has pretty much defined me throughout my life: I doggedly pursue my goals, never giving up. Fulfilling my vow to God is an overarching theme, of course. ... It’s something I try to inculcate with my clients: Never give up. It doesn’t matter how many times you fall; what’s important is that you always try again.

The specific thing from my life that was helpful was: I actually know what hell is, and I know how to get out. The path out of hell is hard work, a sea of misery, but I know a person can get out.

So my last message to you is that I hope that you will develop the skills you need and that you will also help others have the skills they need to experience life as worth living—if I can do it, you can do it, too.