Reading Notes for "Building a Life Worth Living" (2020), by Marsha Linehan

This book is a very personal account of the life of the psychologist who created DBT (Dialectical Behavior Therapy), Marsha Linehan.

DBT is a psychotherapeutic approach originally developed in the late 1970's to tackle the most challenging clinical psychiatric cases: patients diagnosed with borderline personality disorder (BPD) and suicidal patients, for both of which there was no effective treatment -- either medicinal or psychotherapeutic -- at the time.

Since then DBT has undergone extensive clinical trials, which have been replicated independently, demonstrating experimentally its effectiveness in tackling those more challenging personality disorders by measurably reducing the reincidence of self-harm, substance abuse behavior and suicide.

The book, though, is as much about psychotherapy and as it is about the person. The author recounts the series of setbacks a frustrations in her own personal life, spiritual life, and in the academic world, from a very personal and candid perspective, and how she persevered to fulfill a vow of “getting [herself] out of hell, and helping other get out too”.

The most interesting points from my point of view is how the seemingly opposite aspects of, on one side, validation and acceptance; and, on the other side, changing behavior by developing skills; can be integrated into single process.

I emphasize, though, that this opposition can not be simply summarized as “moderation” or “temperance”, where the sweet spot is found in the middle: It means starting from -- what the author calls -- a radical acceptance of everything as it is, only then followed by incrementally building a small set of skills to handle one's own responses to external circumstances.

The author goes on chronological order, so what can be more notable is how she herself has been hospitalized in mental institutions at a young age -- “gone through hell” -- and how she managed to seemingly will herself out of all those circumstances related to her own BPD diagnosis.

Overall, the book is a very humane take on the often invisible but very real suffering due to mental health challenges, encouraging validation, acceptance and empathy towards each other.