You can see a free preview here.
I skimmed parts of it as my primary interest was in getting to how she developed DBT.
I took copious notes to refer back to as I'm amazed by how well this therapy works, in particular in suicidal individuals. It seemed to me that for many individuals this model of therapy works far better than trying to make sense of one's past. This is perhaps more a collection of my key notes that a true book review. Most of the content is quotes from Lineham's book, although I have not put quotes around everything.
Lineham says: "You can't think yourself into new ways of acting; you can only act yourself into new ways of thinking."
She is a spiritual person and also someone who was suicidal, so she brings these lenses to the development of distress tolerance skills. "I saw that my clients very probably had experienced an invalidating environment for much of their lives, and probably a traumatic invalidating environment."
Lineham reminds us that pain and distress are part of life; they cannot be avoided or removed. Learning how to tolerate and accept distress is part of change towards self-improvement. The goal of skills training is to give people a means of being effective in their worlds - in the relational world and the practical world. The skills engender mindfulness. Learning mindfulness skills will lead to other behaviour changes that help people function more effectively in the world.
The concept of "willingness" speaks to letting go of battles you will never win, and even some you could win. Letting go of being right, even when you are right. With willingness, you accept with grace what is happening.
Acceptance is acknowledging or recognizing facts that are true and letting go of fighting your reality. Radical Acceptance is accepting all the way, with your mind, your heart, and your body - opening yourself to fully experience reality as it is in this one moment. If you practice turning the mind toward acceptance, eventually you'll practice acceptance more often and suffering will go down to being ordinary pain.
The acceptance part reminds me of the lesser known continuation of the Twelve Step program's Serenity Prayer:
Enjoying one moment at a time,
Accepting hardship as a pathway to peace,
Taking, as Jesus did,
This sinful world as it is,
Not as I would have it,
Trusting that You will make all things right,
If I surrender to Your will,
So that I may be reasonably happy in this life,
And supremely happy with You forever in the next.
Mindfulness practice is the repeated effort of bringing the mind back to awareness of the present moment, letting go of judgements and of attachment to life situations. Strength to bear the suffering of our lives is also in this moment. Mindfulness is just this breath, just this step, just this struggle.
Mindfulness skills help to balance emotion mind with reasonable mind, with the goal of making wise decisions using the wise mind.
You are more than your diagnosis. You have made bad decisions in the past, but you still have the capacity for wisdom, you have the capacity to know what is right for you. The opposite of dysfunction is functional behaviour.
Being able to practice mindfulness and wise mind is a key step in the journey toward building a life experienced as worth living. Wise mind creates a new context where a person can access effective behaviour or wisdom.
Included in the book is a "Reasons for Living Inventory by Subscale," a helpful tool to help those who may feel their life is not worth living. Lineham asks "If we can find a way to get your life to be experienced as worth living, would you be willing to work on finding that?"
I would recommend this book for people wanting to understand loved ones with suicidal ideation, or people who have some knowledge of DBT and are curious about its origins.
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