BORDERLINE PERSONALITY DISORDER - Marsha Linehan, Phd

Introduction: Marsha Linehan, Ph.D.
At: The Institute of Living, Hartford Connecticut
Date: June 17th 2011
By: Martin Bohus, MD

When Marsha first asked me to introduce her I thought this is a joke - why introduce her to this group of family members, close friends and companions. Everybody knows her personally; everybody admires her and her work… on the other hand, there are some important issues in her life most of us do not know or do only assume.

So you could say private issues are private and sometimes should remain private. But Marsha is a special case. She is not just anybody- she not only developed a new treatment for one specific psychiatric disorder, she developed a new type of treatment which impacts the entire field of psychiatry and psychotherapy.

And in this role - as a treatment developer – not only a composer - you step out of privacy and enter public space. Like an artist – you attract attention since you are somebody who is converting his inner experiences into a perceivable form. And since our sources, or point of views impact the results, from a scientific perspective it’s a must to disclose your sources.

This sounds clear- but is more than complicated. Most human beings simply are not aware of their sources.

But talking about borderline experiences with Marsha is sitting on the floor of her home, early in the morning or late at night transgressing the level of an intellectual debate about psychopathology. Not always, but in these precious moments I am grateful for - these conversations become some kind of a very personal experiential search. Trying to gradually approach the essentials of borderline experience like these feelings of chronic abandonment, being lost, homesick for love, and hypersensitivity for rejection - the gaining of insight becomes a process of hard and craggy self-exploration. Where does these experiences come from - how much is biology, or could they be explained by personal experiences only? And how to treat and how to cure - and always- what does social psychology teach us about. So in the midst of these contemplative experiences we jumped up to do a little internet search on state of the art on items like self-contempt, before we get refocused to biographic experiences.

Marsha sees empirical science always as a source of help when we dared to get lost.

I think this is Marsha. Taking her experience as a deep source of knowledge but always questioning herself – and her ideas by science. And from these essentials comes the power and vividness of DBT.

Another essential of DBT is honesty: honesty towards the clients, honesty towards the DBT group and honesty towards the scientific community. But sometimes – for sake of the treatment it’s better to wait with honesty -

On the other hand:

One of DBT essentials is to teach the balance between past and present. Whenever you neglect one side, this part takes over.

Neglecting the present and putting too much emphasis on the past immediately causes you troubles. Neglecting the past, - it takes a bit longer to notice the price you pay for. But you pay.

We meet here today at the Institute of Living as a biographically relevant and important site in Marsha Linehan`s life. Something becomes full circle. It is an act of balancing present and past. It took a long time to make the present so precious and strong to balance her past. And I am sure everybody in this room contributed a bit to make the present strong enough. So I am sure you can face her past.

DBT has gone through three major metamorphoses:

1. Developed for chronic suicidal patients

2. Changed to the #1 treatment for borderline personality disorder

3. Expanded to a treatment for emotion dysregulation in general

It will be extended to an art of living

And, I am sure this talk will be a milestone on that way.