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Building a Life Worth Living: A Memoir Hardcover – January 7, 2020
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“This book is a victory on both sides of the page.”—Gloria Steinem
“Are you one of us?” a patient once asked Marsha Linehan, the world-renowned psychologist who developed Dialectical Behavior Therapy. “Because if you were, it would give all of us so much hope.”
Over the years, DBT had saved the lives of countless people fighting depression and suicidal thoughts, but Linehan had never revealed that her pioneering work was inspired by her own desperate struggles as a young woman. Only when she received this question did she finally decide to tell her story.
In this remarkable and inspiring memoir, Linehan describes how, when she was eighteen years old, she began an abrupt downward spiral from popular teenager to suicidal young woman. After several miserable years in a psychiatric institute, Linehan made a vow that if she could get out of emotional hell, she would try to find a way to help others get out of hell too, and to build a life worth living. She went on to put herself through night school and college, living at a YWCA and often scraping together spare change to buy food. She went on to get her PhD in psychology, specializing in behavior therapy. In the 1980s, she achieved a breakthrough when she developed Dialectical Behavioral Therapy, a therapeutic approach that combines acceptance of the self and ways to change. Linehan included mindfulness as a key component in therapy treatment, along with original and specific life-skill techniques. She says, "You can't think yourself into new ways of acting; you can only act yourself into new ways of thinking."
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.
- Print length384 pages
- LanguageEnglish
- PublisherRandom House
- Publication dateJanuary 7, 2020
- Dimensions6.36 x 1.18 x 9.53 inches
- ISBN-100812994612
- ISBN-13978-0812994612
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Editorial Reviews
Review
“In Building a Life Worth Living, Marsha Linehan shares her experience of suicidal depression to help others who may be experiencing this themselves or in someone they love. Since using what happens to us to help others is the final stage of healing, this book is a victory on both sides of the page.”—Gloria Steinem, New York Times bestselling author of My Life on the Road
“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.”—Angela Duckworth, New York Times bestselling author of Grit
“To read this book is to understand how a life is built. In dark, there is light. Everything in Marsha Linehan’s life and remarkable memoir uncovers the dark—the hell of the unhappy self and the hell of inadequate help—and brings us into the light, with humor and detail in describing her grappling and growth, and her courage and vision of how to create a treatment for even the most unhappy of us.”—Amy Bloom, New York Times bestselling author of White Houses
“Powerful and intimate . . . Linehan ably guides readers along her roller-coaster life as she conquers the male-dominated world of academia while hiding her physical and emotional scars. . . . Readers looking to overcome their past will find inspiration in this dramatic, heartfelt narrative.”—Publishers Weekly
“Practical and engaging. . .Linehan leads readers through her life and details how key moments brought her to develop DBT [Dialectical Behavior Therapy], bringing mindfulness into psychotherapy. Weaving the instructive with the personal, she alternates anecdotes with universal tools for approaching life with a combination of acceptance and motivation to change.”—Booklist
“Gripping . . . An inspiring account of healing and helping.”—Kirkus Reviews
About the Author
Excerpt. © Reprinted by permission. All rights reserved.
Building a Life Experienced as Worth Living
It was a beautiful summer’s day, toward the end of June 2011. I was standing in front of an audience of about two hundred in a large auditorium at the Institute of Living, a renowned psychiatric institution in Hartford, Connecticut.
Uncharacteristically for me, I was anxious about giving my talk. I was there to tell the story of how, more than two decades earlier, I had developed a type of behavioral treatment for highly suicidal people, known as Dialectical Behavior Therapy (DBT for short). It was the first successful treatment for this population of people who experience their lives as being in hell, so miserable that death seems to them a reasonable alternative.
A lot of people were at the institute to hear me talk that June day. There were people from all around the world who had been trained in the therapy, people who knew me or knew of my research, former students and colleagues, my family. I’d given talks about DBT many, many times before. When I did, I usually titled the talk “DBT: Where We Were, Where We Are, and Where We Are Going.” I would describe how I had developed the therapy through several years of exploratory research, often involving trial and error. I would describe its impact on suicidal people, what other conditions it was proving to be beneficial for, and so on.
But my talk that June day was going to be different. I was going to tell people for the first time how I really came to develop DBT. Not just the years of research and trials that went into it, but my personal journey, too. “Writing this talk has been one of the most difficult things I have done in my life,” I began.
I Didn’t Want to Die a Coward
I have done many hard things in my life, most prominent of which was having to come to terms with a totally unexpected complete and devastating breakdown of me, of who I was in the world, which you will get a glimpse of shortly. As a result of that episode, I had to fight to rebuild my high school education, which required me to go to night school while doing a day job to support myself. It was a day-job-and-night-school life again for me as I then strove to be a university undergraduate. By this time I had spent a lot of time living in small rooms in YWCAs in different cities. Most of the time I was friendless. And at almost every step of the way, I faced rejection after rejection that might easily have derailed me on my journey. Later, in my professional life, I had to battle to have my radical ideas and approach to therapy accepted by my peers and by the world of psychiatry more generally, and struggle as a female in male-dominated academia.
I had been working on the talk for three months. Many times, I rued the fact that I had put myself into this predicament. I had to compress my life into the space of ninety minutes. Another problem was that I have almost complete amnesia of my life before my twenties, and up to twenty-five, for reasons I will explain. What I have instead are “lightbulb memories,” bright moments of recollection sparsely scattered across a dark canvas. It’s like looking at the night sky in the city, where you see points of light from planets and stars here and there, but mostly it is unbroken blackness. I therefore had to turn to family, friends, and colleagues to help me reconstruct my life story, drawing on their vastly superior memories of my past. It was a difficult process—and, more than that, I was about to reveal publicly for the first time extremely intimate details about my life that for decades I had kept a carefully guarded secret, outside of a few very close friends and my family. So why did I want to do this?
Because I didn’t want to die a coward. Continuing to keep quiet about my life seemed to me a cowardly thing to do.
Could I Make It Through the Talk Without Tears?
The Institute of Living had been an important part of my life, and I therefore thought it would be a good venue for me to give the talk I was planning. I had called David Tolin, who was director of the institute’s Anxiety Disorders Center, and said I wanted to give an important talk on the East Coast and thought the IOL would be a good place to give it. He was thrilled, until I told him I wanted to give the talk in one of the large rooms, because I knew it would draw a big audience. He agreed, but only if I would tell him why. I did.
Now that I was there, in front of several hundred people, I wondered, “What have I gotten myself into?” I was worried that I would not be able to make it through the talk without tears, and I absolutely did not want to cry.
I began by telling the audience that, when I give talks about the development of DBT, I usually say that it began in 1980, when I was awarded a grant from the National Institute of Mental Health. The grant was for me to conduct research on the efficacy of behavior therapy for individuals diagnosed with borderline personality disorder. “But this wasn’t when my passion for getting people out of hell started,” I said.
I looked at the audience for a few seconds, casting my eyes here and there at the gathering of so many wonderful people in my life—friends, colleagues, students and former students. I knew that my sister, Aline, would be there, and I had especially wanted my brothers, John, Earl, Marston, and Mike, to be there, but I wasn’t sure Aline would be able to get them to come. Yet there they were, sitting in the front row. Right behind them were Geraldine, my Peruvian daughter, and her husband, Nate, with whom I have lived ever since they were married. Geraldine’s brother and his partner were also there. I thanked them and everyone else for coming. In this very emotional moment, I was on the edge of tears. Fortunately, none showed up.
The Real Beginnings of DBT
“In reality, the seeds of DBT were planted in 1961,” I continued, “when, at age eighteen, I was admitted here, to the Institute of Living.”
I had been a happy-go-lucky, confident high school girl, popular among my classmates, often the one to initiate activities—organizing concerts, for example, or simply getting together a group of us to go to the drugstore for ice cream. I was always careful to make sure everyone’s needs were met, that no one was left out of the action. In my junior year I was nominated to be class Mardi Gras queen. My popularity extended beyond having a lot of friends to being elected and nominated to important class roles in junior year and senior year. I was the kind of girl who might be voted “most popular” or “most likely to succeed.”
But then, as my senior year progressed, this confident girl began to disappear.
I did not know what had happened to me. No one knew. My experience at the institute was one of descending into hell, an out-of-control storm of emotional torture and absolute anguish. There was no escape. “God, where are you?” I whispered each day, but got no answer. I find the pain and turmoil hard to describe. How do you adequately describe what it is like being in hell? You can’t. You can only feel it, experience it. And I did. I felt this inside myself, and it came out finally as suicidal behavior.
But I survived. And toward the end of my time at the institute, I made a promise to God, a vow, that I would get myself out of hell—and that once I did, I would find a way to get others out of hell, too.
Product details
- Publisher : Random House (January 7, 2020)
- Language : English
- Hardcover : 384 pages
- ISBN-10 : 0812994612
- ISBN-13 : 978-0812994612
- Item Weight : 1.4 pounds
- Dimensions : 6.36 x 1.18 x 9.53 inches
- Best Sellers Rank: #225,752 in Books (See Top 100 in Books)
- #162 in Coping with Suicide Grief
- #489 in Religious Faith
- #6,734 in Memoirs (Books)
- Customer Reviews:
About the author

Marsha Linehan is a Professor of Psychology and adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington and is Director of the Behavioral Research and Therapy Clinics, a consortium of research projects developing new treatments and evaluating their efficacy for severely disordered and multi-diagnostic and suicidal populations. Her primary research is in the application of behavioral models to suicidal behaviors, drug abuse, and borderline personality disorder. She is also working to develop effective models for transferring science-based treatments to the clinical community.
She has received several awards recognizing her clinical and research contributions to the study and treatment of suicidal behaviors, including the Louis I. Dublin Award for Lifetime Achievement in the Field of Suicide, the Distinguished Research in Suicide Award (American Foundation of Suicide Prevention), and the creation of the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior established by the American Association of Suicidology. She has also been recognized for her clinical research including the Distinguished Scientist Award from the Society for a Science of Clinical Psychology, the award for Distinguished Scientific Contributions to Clinical Psychology (Society of Clinical Psychology,) and awards for Distinguished Contributions to the Practice of Psychology (American Association of Applied and Preventive Psychology) and for Distinguished Contributions for Clinical Activities, (Association for the Advancement of Behavior Therapy).
She is the past-president of both the Association for the Advancement of Behavior Therapy and of the Society of Clinical Psychology, Division 12, American Psychological Association. She is a fellow of the American Psychological Association and the American Psychopathological Association and is a diplomat of the American Board of Behavioral Psychology.
She is the developer of Dialectical Behavior Therapy (DBT) a treatment originally developed for the treatment of suicidal behaviors and since expanded to treatment of borderline personality disorder and other severe and complex mental disorders, particularly those that involve serious emotion dysregulation. In comparison to all other clinical interventions for suicidal behaviors, DBT is the only treatment that has been shown effective in multiple trials across several independent research sites. It has been shown both effective in reducing suicidal behavior and cost-effective in comparison to both standard treatment and community treatments delivered by expert therapists. It is currently the gold-standard treatment for borderline personality disorder, a disorder with a 8-10 suicide rate that afflicts between 4-6% of the population.
Linehan is the founder and the convener of both the Suicide Strategic Planning Group and the DBT Strategic Planning Group. Both groups meet annually or bi-annually at the University of Washington. The goal of the suicide group is to jump start the building of a field of suicide treatment research. The further goal of both groups is to bring together both expert, new and potential treatment researchers to collaboratively evaluate the state of current research in the respective areas, chart necessary studies to advance the development of more effective treatments and build a rigorous and cohesive next generation of young clinical-scientists.
She has written four books, including two treatment manuals: Cognitive-Behavioral Treatment for Borderline Personality Disorder and Skills Training Manual for Treating Borderline Personality Disorder. She serves on a number of editorial boards and has published extensively in scientific journals.
She is the founder of Behavioral Tech Research, Inc., a company that develops innovative on-line and mobile technologies to disseminate science-based behavioral treatments for mental disorders.
Linehan was trained in spiritual directions under Gerald May and Tilden Edwards and is an associate Zen teacher in both the Sanbo-Kyodan-School under Willigis Jaeger Roshi (Germany) as well as in the Diamond Sangha (USA). She teaches mindfulness via workshops and retreats for health care providers.
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Learn more how customers reviews work on AmazonCustomers say
Customers find the book amazing, interesting, and excellent. They describe the story as absorbing, inspiring, and a nice blend of personal life and professional life. Readers also mention that the pacing is very moving, captivating, and enlightening.
AI-generated from the text of customer reviews
Customers find the book amazing, interesting, and excellent. They say it's wonderful for mental health professionals and family members of those with mental illness. Readers also mention it's eye-opening, phenomenal, and the best memoir from a psychologist who has been there.
"...No problems. Read it and loved it! Couldn't put it down. Very interesting, wish it was even longer." Read more
"...as acceptance, distress tolerance, emotional regulation skills, self soothing skills, communication skills, limit setting skills, assertiveness..." Read more
"...As such she was well ahead of her time. It was a very interesting read for me and I am glad I purchased the book on my kindle." Read more
"This is a great book for anybody interested in learning about the background of the development of DBT. Marsha is very brave for sharing her story...." Read more
Customers find the story absorbing and inspiring. They say the book is a nice blend of the author's personal life story and professional life story. Readers also say the concepts of DBT can be helpful for anyone. They find themselves deeply touched, connected, and inspired by Marsha.
"...assertive, disruptive within limits (and without), empathic, highly empathic, and contrary within limits (and without), innovative, all DBT skills..." Read more
"...Marsha is very brave for sharing her story. The concepts of DBT can be helpful for anybody...." Read more
"...gives a glimpse into the experience of mental illness while also instilling hope." Read more
"...Her book is raw, inspirational and my recommendation for all to read if you want to get out of the hell you're in...." Read more
Customers find the pacing of the book very moving, captivating, and enlightening.
"...you’ve finished the last page, you’ll be momentarily breathless and deeply moved...." Read more
"...Very moving." Read more
"This is a beautiful and moving book. The story is very touching to those who are familiar with DBT!" Read more
"Deeply moving and inspiring!..." Read more
Reviews with images
Marsha Linehan tells a harrowing story of what she had to survive to invent DBT
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Top reviews
Top reviews from the United States
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Linehan is on a tear – standard behavioral therapy doesn’t work with the most seriously distressed (suicidal) patients and cognitive behavioral therapy has serious issues, too. You have to get a person whose life and all-available-evidence “prove” that “all the good one’s are taken” or “life sucks” to be reasonable and admit that “some of the good ones are not taken” or “life does not have to suck at all times.”
The thing about the iceberg [of life] is that it’s the iceberg “all the way down.” The visible part of the iceberg is not a different iceberg than the less visible part submerged beneath the water. The behavior is visible, but the biology is not visible, what the individual had to survive is not visible, how the community reacts to the individual of is not visible. But unlike – or perhaps just like – the iceberg, research treats these all as different siloes. It is true that we all – including Linehan – now speak of the bio-psycho-social individual and express authentic commitment to integration. But the effort required to integrate just shows how dis-integrated the entire phenomenon is.
The tip of the iceberg does not regard itself as distinct from the iceberg. The “tip” is our abstraction. Likewise, with behavior. Linehan demonstrates this compelling as she takes the psychoanalytic distinction of “introject,” operationalizes it, and shows collects evidence that DBT improves measures of introject over against a stricter behavioral intervention. Amazing.
How shall I put it delicately? Like every other individual, Linehan has a privileged access to her own first person experience – the golden light moment, the blue hydrangea moment. She also has many advantages in interpreting what that experience means, since, like every other individual, she knows a lot about her own history that others might or might not know. But as to what the experience “really means,” one individual has as good a chance of getting it right as another once the experience has been captured and reported. At first she says “The golden light means God loves me”; but then, since that experience was like [felt like] her love for Ed [a person who she actually loved deeply], she reinterprets the golden light to mean “I love God.” So she has to continue searching for God’s love for her, which brings us to the blue hydrangea by which time the meaning of God and of love have shifted. Hence, the title: Saint Linehan.
But wait. Her Zen experience will eventually have taught her this is just another Zen koan – it is like the ambiguous Gestalt image the duck-rabbit where the rabbit’s ears and the duck’s bill and the figure spontaneously reverses – perhaps she got it right the first time – “God is God” and “love is love.”
In short, Linehan is really slinging it here, and there is nothing wrong with that. It works. Her rhetoric is that of the beginner’s mind after long struggle. She is irreverent, assertive, disruptive within limits (and without), empathic, highly empathic, and contrary within limits (and without), innovative, all DBT skills, and we thank you, Marsha, for being Marsha.
Reviewed in the United States on May 17, 2020
Linehan is on a tear – standard behavioral therapy doesn’t work with the most seriously distressed (suicidal) patients and cognitive behavioral therapy has serious issues, too. You have to get a person whose life and all-available-evidence “prove” that “all the good one’s are taken” or “life sucks” to be reasonable and admit that “some of the good ones are not taken” or “life does not have to suck at all times.”
The thing about the iceberg [of life] is that it’s the iceberg “all the way down.” The visible part of the iceberg is not a different iceberg than the less visible part submerged beneath the water. The behavior is visible, but the biology is not visible, what the individual had to survive is not visible, how the community reacts to the individual of is not visible. But unlike – or perhaps just like – the iceberg, research treats these all as different siloes. It is true that we all – including Linehan – now speak of the bio-psycho-social individual and express authentic commitment to integration. But the effort required to integrate just shows how dis-integrated the entire phenomenon is.
The tip of the iceberg does not regard itself as distinct from the iceberg. The “tip” is our abstraction. Likewise, with behavior. Linehan demonstrates this compelling as she takes the psychoanalytic distinction of “introject,” operationalizes it, and shows collects evidence that DBT improves measures of introject over against a stricter behavioral intervention. Amazing.
How shall I put it delicately? Like every other individual, Linehan has a privileged access to her own first person experience – the golden light moment, the blue hydrangea moment. She also has many advantages in interpreting what that experience means, since, like every other individual, she knows a lot about her own history that others might or might not know. But as to what the experience “really means,” one individual has as good a chance of getting it right as another once the experience has been captured and reported. At first she says “The golden light means God loves me”; but then, since that experience was like [felt like] her love for Ed [a person who she actually loved deeply], she reinterprets the golden light to mean “I love God.” So she has to continue searching for God’s love for her, which brings us to the blue hydrangea by which time the meaning of God and of love have shifted. Hence, the title: Saint Linehan.
But wait. Her Zen experience will eventually have taught her this is just another Zen koan – it is like the ambiguous Gestalt image the duck-rabbit where the rabbit’s ears and the duck’s bill and the figure spontaneously reverses – perhaps she got it right the first time – “God is God” and “love is love.”
In short, Linehan is really slinging it here, and there is nothing wrong with that. It works. Her rhetoric is that of the beginner’s mind after long struggle. She is irreverent, assertive, disruptive within limits (and without), empathic, highly empathic, and contrary within limits (and without), innovative, all DBT skills, and we thank you, Marsha, for being Marsha.
Read it and loved it! Couldn't put it down. Very interesting, wish it was even longer.
I admire Marsha for daring to come up with a treatment that is unconventional and doesn't rely on dispensing medication. She targeted behaviors. That is how it should be! So many people get misdiagnosed and mislabeled since mental health symptoms tend to overlap. I had been told that the average patient goes through 7 medications till the "right" one is found.
I hope that someday a DBT skillset for parents to use with children is published. Many of the conventional parenting skills do not work well with kids that have trouble regulating their emotions. Marsha doesn't remember much of her life before her time at the Institute of Living. I am guessing there were things her family noticed and could have helped with had they known what skills to use.
Without this book, the DBT would be monotone and statuesque. With this book, the DBT approach gains color and vibrancy.
Books Target Audience:
I fee as if it is written for Therapists, DBT Students, and People interested in learning more about DBT/BPD solves. Not really a book for anybody outside of the interest.
Likes:
Reveals details that help solidify concepts and their origins in DBT.
Raw.
Vulnerable.
Honest.
Unabridged
Dislikes:
Writing was redundant at points.
I was vested as a student of DBT, so I was interested to pull me through. Considering somebody lukewarm on the topic may be something hard to get through.
In sum: Marsha did it. So can I.
I struggle with mental illness, BPD being one of my diagnoses. DBT, created by Marsha Linehan has taught me how to take control of my life. How to finally come to terms with my past. And how to use my past as a stepping stone rather than a stumbling block. It has taught me self-awareness. I struggle with suicidal ideation from time to time and Marsha's book "Building a Life Worth Living: A Memoir" has made me realize that I am not alone. Marsha Linehan is my inspiration and I am so proud of the work she has done. She is a living master of these skills carving the way for many of us who don't wish to live in this hell anymore. She has had a rough life, but despite her hardships she continues to be a living example for those who feel like life is just not worth living. Marsha Linehan, the developer of Dialectical Behavioral Therapy, inspires me in more ways than I can count. I really look up to this woman as my role model and am so grateful to the amount of effort Marsha put in into her own recovery and developing DBT to help guide strangers out of what is seen as a life of hell. Her book is raw, inspirational and my recommendation for all to read if you want to get out of the hell you're in. Never have I read a book so inspiring as this one. This is by far the best book I've ever read.
Thank you Marsha for your story and being a light for the world. You are an inspiration to me and to many I know.
Reviewed in the United States on February 4, 2020
I struggle with mental illness, BPD being one of my diagnoses. DBT, created by Marsha Linehan has taught me how to take control of my life. How to finally come to terms with my past. And how to use my past as a stepping stone rather than a stumbling block. It has taught me self-awareness. I struggle with suicidal ideation from time to time and Marsha's book "Building a Life Worth Living: A Memoir" has made me realize that I am not alone. Marsha Linehan is my inspiration and I am so proud of the work she has done. She is a living master of these skills carving the way for many of us who don't wish to live in this hell anymore. She has had a rough life, but despite her hardships she continues to be a living example for those who feel like life is just not worth living. Marsha Linehan, the developer of Dialectical Behavioral Therapy, inspires me in more ways than I can count. I really look up to this woman as my role model and am so grateful to the amount of effort Marsha put in into her own recovery and developing DBT to help guide strangers out of what is seen as a life of hell. Her book is raw, inspirational and my recommendation for all to read if you want to get out of the hell you're in. Never have I read a book so inspiring as this one. This is by far the best book I've ever read.
Thank you Marsha for your story and being a light for the world. You are an inspiration to me and to many I know.
Top reviews from other countries
Es una experiencia de primera mano de una persona que ha sufrido mucho, y ha encontrado un camino para salir de su laberinto de infierno emocional.
Si te interesa el tema de las autolesiones y el la conducta suicida, deberías plantearte leerlo.
Reviewed in Spain on January 19, 2022
Es una experiencia de primera mano de una persona que ha sufrido mucho, y ha encontrado un camino para salir de su laberinto de infierno emocional.
Si te interesa el tema de las autolesiones y el la conducta suicida, deberías plantearte leerlo.






