Linehan Admits Struggle with Borderline Personality Disorder: Why It Matters

Dr. Marsha Linehan, best known for creating dialectical behavioral therapy (DBT), admitted in a New York Times article that she struggles with mental illness, once being called "one of the most disturbed patients in the hospital." She would diagnose her troubled teenage self as having borderline personality disorder, or BPD. So why does this matter?

The first reason is the reason Linehan came forward--to give hope to other people with severe suicidal tendencies or severe BPD symptoms. As one of her patients said "One of us. Like us. Because if you were, it would give all of us so much hope." And yes, it is inspiring to know that it is possible to live a "normal" or "successful" life in spite of BPD.

But the second, more important reason is the message it sends to the "normal" people: quit writing us off.

Shattering the Illusion of Justice

The American mental health system is a disaster. I've had some close encounters of the law enforcement kind because of my BPD symptoms--in fact, many argue that the system criminalizes mental illness.

Medical care in the United States requires health insurance and money. If you have no health insurance but have money, prepare to have your life savings wiped out (as happened to me). If you have no health insurance or money, your treatment provider is probably going to be the county jail.

Sometimes, in order to get a psychotic or suicidal person some help, the police will arrest him/her on a minor violation--I know of one case in which the charge was smoking in a no-smoking zone. While this is a short-term fix, it leads to many long-term problems as the person now has an arrest record that will continue to come up. This makes it more likely for the person to be sent to jail instead of treatment.

Jail can also be used as a literal holding cell. According to a 1993 report by the National Alliance on Mental Illness and Public Citizen's Health Research Group, 29 percent of the nation's jails routinely hold individuals with severe mental illness with no criminal charges against them. These are people who are simply waiting for a psychiatric evaluation or an open bed. Jail is often the only place with medical treatment and 24-hour supervision.

It's easy to write people like this off. However, if a professional-class, highly educated woman like Linehan were facing this injustice, can you imagine the outcry? That hits a little closer to home. It practically screams "Mental illness can happen to anyone!" When the Linehans of the world face an injustice like this, we realize with horror that the current mental health system is far from fair.

Dr. Marsha Linehan: A Face of Mental Illness We Can Relate To

For many people, accused Arizona shooter Jared Loughner is the face of mental illness. This makes it easy for society to write people with mental illness off as "crazy", "dangerous", "disturbed", and so forth. This perpetuates myths of mental illness, such as "they're more dangerous" and "they can't be helped". It doesn't matter that Lougher almost certainly refused to seek treatment--in fact, the detention center is forcibly medicating him, according to the Associated Press. It is also ignored that, with proper treatment, we are no more limited than a person with a more visible physical condition.

"There's a tremendous need to implode the myths of mental illness, to put a face on it, to show people that a diagnosis does not have to lead to a painful and oblique life," Elyn R. Saks, a professor at the University of Southern California School of Law who struggles with schizophrenia. "We who struggle with these disorders can lead full, happy, productive lives, if we have the right resources."

When people like Linehan and Saks come forward with their struggles, it educates the public and makes them more willing to have those resources available. Then we see more Linehans and Sakses. Failure to have those resources available creates more Loughners.

Changing the Mental Health System From Within

According to the Times article, Linehan was treated with powerful drugs (including Thorazine), Freudian analysis and electroshock therapy. Nothing changed, and she was placed in seclusion for a lengthy period of time. She vowed that if she ever got out of this hellish existence, she would help others find a way out. So, after her release, she began studying psychology, and volunteering to work with the worst of the worst cases.

Linehan concluded that treatment should be based on facts, not theory. That is why DBT is used to determine which emotion leads to which negative behavior, and break the cycle by teaching new behaviors as a response to those emotions. While DBT does not work for everyone--it didn't for me--it works for many severe cases.

Other therapies, such as schema therapy, have developed as a result of Linehan focusing a Copernican shift of thinking into psychology. Rather than abstract conjecture, therapies like DBT and schema therapy try to identify the emotion and manage an appropriate response. Linehan changed the system from within. Her story gives us hope that we can do the same, regardless of the severity of our BPD symptoms.