Word: linehan
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Dates: during 2000-2009
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...afflictions remains so limited, psychologists - even when writing in academic publications - still deploy metaphors to understand difficult disorders. And possibly the most difficult of all to fathom - and thus one of the most creatively named - is the mysterious-sounding borderline personality disorder (BPD). University of Washington psychologist Marsha Linehan, one of the world's leading experts on BPD, describes it this way: "Borderline individuals are the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering." (See "The Year in Medicine: From...
...knows exactly what causes BPD, but the familiar nature-nurture combination of genetic and environmental misfortune is the likely culprit. Linehan has found that some borderline individuals come from homes where they were abused, some from stifling families in which children were told to go to their room if they had to cry, and some from normal families that buckled under the stress of an economic or health-care crisis and failed to provide kids with adequate validation and emotional coaching. "The child does not learn how to understand, label, regulate or tolerate emotional responses, and instead learns to oscillate...
...Linehan who changed all that. In the early 1990s, she became the first researcher to conduct a randomized study on the treatment of borderline personality disorder. The trial - which showed that a treatment she created called "dialectical behavior therapy" significantly reduced borderlines' tendency to hurt themselves as well as the number of days they spent as inpatients - astonished a field that had come to see borderlines as hopeless...
...must accept patients just as they are (angry, confrontational, hurting) within the context of trying to teach them how to change. Patients must end the borderline propensity for black-and-white thinking, while realizing that some behaviors are right and some are simply wrong. "The patient's first dilemma," Linehan wrote in her 558-page masterwork, 1993's Cognitive-Behavioral Treatment of Borderline Personality Disorder, "has to do with whom to blame for her predicament. Is she evil, the cause of her own troubles? Or, are other people in the environment or fate to blame? ... Is the patient really vulnerable...
...Linehan's achievement was to realize that borderlines are, in fact, on the border between various dualities - dualities that they have to learn to accept and reconcile in order to change their lives. That's easy to say but seems impossible to do - until you see it work...