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“The bottom line is that if you are in hell, the only way out is to go through a period of sustained misery. Misery is, of course, much better than hell, but it is painful nonetheless. By refusing to accept the misery that it takes to climb out of hell, you end up falling back into hell repeatedly, only to have to start over and over again.”
― Marsha M. Linehan, DBT Skills Training: Manual

“DBT's catchphrase of developing a life worth living means you're not just surviving; rather, you have good reasons for living. I'm also getting better at keeping another dialectic in mind: On the one hand, the disorder decimates all relationships and social functions, so you're basically wandering in the wasteland of your own failure, and yet you have to keep walking through it, gathering the small bits of life that can eventually go into creating a life worth living. To be in the desolate badlands while envisioning the lush tropics without being totally triggered again isn't easy, especially when life seems so effortless for everyone else.”
― Kiera Van Gelder, The Buddha and the Borderline: My Recovery from Borderline Personality Disorder through Dialectical Behavior Therapy, Buddhism, and Online Dating

“The great thing about treating borderline patients is that it is like having a supervisor always in the room.”
― Marsha M. Linehan, Cognitive-Behavioral Treatment of Borderline Personality Disorder

“The desire to commit suicide, however, has at its base a belief that life cannot or will not improve. Although that may be the case in some instances, it is not true in all instances. Death, however, rules out hope in all instances. We do not have any data indicating that people who are dead lead better lives.”
― Marsha M. Linehan, Cognitive-Behavioral Treatment of Borderline Personality Disorder

“It is hard to be happy without a life worth living. This is a fundamental tenet of DBT. Of course, all lives are worth living in reality. No life is not worth living. But what is important is that you experience your life as worth living—one that is satisfying, and one that brings happiness.”
― Marsha M. Linehan, DBT Skills Training: Manual

“Acceptance can transform but if you accept in order to transform, it is not acceptance. It is like loving. Love seeks no reward but when given freely comes back a hundredfold. He who loses his life finds it. He who accepts, changes.”
― Marsha M. Linehan

“I honestly didn’t realize at the time that I was dealing with myself. But I suppose it’s true that I developed a therapy that provides the things I needed for so many years and never got.”
― Marsha Linehan

“When emotions turn and stay sour, when thoughts become cynical and judgmental, good and compassionate treatment is on the line. Helpers who become sour and cynical tend to begrudge their high need clients for their neediness. There is a risk that helpers become too well-practiced at taking a bleak view of those they have avowed to assist. There is a temptation to begin to blame clients for their failure to improve. If treatment ends pre-maturely, with either a client never returning to treatment or a helper 'firing' them out of frustration, there is a tendency for the client to take the fall. Of course what we are talking about here are signs of burnout.”
― Scott E. Spradlin

“It's important to keep in mind that most people have no idea how to respond effectively to someone who self-harms.”
― Kim L. Gratz, Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments

“This might surprise you, but one of the best ways to manage your emotions is simply to experience that emotion and let it run its course.”
― Kim L. Gratz, Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments

“We want to be clear: The skills we [teach] you for managing your emotions and controlling your urges to self-harm will never be quite as effective or satisfying as self-harm in the short run.”
― Kim L. Gratz, Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments

“Acceptance is the only way out of hell.”
― Marsha M. Linehan

“Even you, the professional helper, often mistaken for the enlightened Guru or Staretz, can become lost in your thoughts that you must be competent without fault. You may become enthralled with your identity as a professional, even the pressures of the culture of mastery that expects you to heal your clients without fail. Never mind all of the variables over which you have no control, it is up to you, according to the canons of mastery, to control the health and well-being of those for whom you provide professional care. This potentiates a furthering alienation between you and your clients. You are at risk to become, if you have not already, the one who does to your clients; to be the one the active subject acting upon the passive and receptive objects, your clients; to be the one in possession of special knowledge, technique and mastery. All of this conspires to coax or coerce you into treating your client as reduced, a mere case. Unawareness to these influences gives you little chance to consider their influence on your practice in the clinical setting, much less give attentive efforts to resist or change them.”
― Scott E. Spradlin

“Keeping a stiff upper lip may be needed while around the person invalidating you, but on your own, there is every reason to be compassionate and self-­soothing. It does hurt to be invalidated.”
― Marsha M. Linehan, DBT Skills Training: Manual

“The trick is, don’t give in to the grief. Instead, I let myself feel it, embrace it, learn from it. In bed by 9:30, up at 7:00, breakfast, then off to school where I spend five mind-numbing hours living by the dictates of San Diego County’s Board of Education, the Western version of Mao’s Little Red Book.”
― Michael Benzehabe, Zonked Out: The Teen Psychologist of San Marcos Who Killed Her Santa Claus and Found the Blue-Black Edge of the Love Universe

“Compassion is a fundamental principle of meditation. Meditation is not a narcissistic, self-interested path. It provides the foundation for love, integrity, compassion, respect and sensitivity (Feldman, 1998, p.2).”
― Christina Feldman

“A patient's passivity must not be unilaterally interpreted as lack of motivation, resistance, lack of confidence, or the like. Many times, passivity is a function of inadequate knowledge and/or skills.”
― Marsha M. Linehan, Cognitive-Behavioral Treatment of Borderline Personality Disorder

“Even when emotions seem to overtake life, such as when we are depressed or anxious or angry, it is important to remember that those emotions still give us important information. Rather than judging our emotions, practice acceptance of them and open your mind to their messages. Rejecting emotions or trying to push them away usually intensifies them. If the message is not heard, it needs to get louder. As an example, invalidation by others tends to intensify emotions, and self-invalidation has the same effect.”
― Lane Pederson, DBT Skills Training for Integrated Dual Disorder Treatment Settings

“Responding to a suicide attempt by insisting that it must stop, and devoting the full resources of therapy to preventing it, is a communication with compassion and care at its very core.”
― Marsha M. Linehan

“The word dialectic (in dialectical behavior therapy) means to balance and compare two things that appear very different or even contradictory. In dialectical behavior therapy, the balance is between change and acceptance (Linehan, 1993a). You need to change the behaviors in your life that are creating more suffering for yourself and others while simultaneously also accepting yourself the way you are. This might sound contradictory, but it’s a key part of this treatment. Dialectical behavior therapy depends on acceptance and change, not acceptance or change.”
― Matthew McKay, The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance

“Should you operate upon your clients as objects, you risk reducing them to less than human. Following the culture of appropriation and mastery your clients become a kind of extension of yourself, of your ego. In the appropriation and objectification mode, your clients�� well-being and success in treatment reflect well upon you. You “did�� something to them, you made them well. You acted upon them and can take the credit for successful therapy or treatment. Conversely, if your clients flounder or regress, that reflects poorly on you. On this side of things the culture of appropriation and mastery says that you are not doing enough. You are not exerting enough influence, technique or therapeutic force. What anxiety this can breed for some clinicians!



DBT offers a framework and tools for a treatment that allows clients to retain their full humanity. Through the practice of mindfulness, you can learn to cultivate a fuller presence to the moments of your life, and even with your clients and your work with them. This presence potentiates an encounter between two irreducible human beings, meeting professionally, of course, and meeting humanly. The dialectical framework, which embraces contradictions and gives you a way of seeing that life is pregnant with creative tensions, allows for your discovery of your limits and possibilities, gives you a way of seeing the dynamic nature of reality that is anything but sitting still; shows you that your identity grows from relationship with others, including those you help, that you are an irreducible human being encountering other irreducible human beings who exert influence upon you, even as you exert your own upon them. Even without clinical contrivance.”
― Scott E. Spradlin

“Emotions are not good, bad, right, or wrong. The first step to changing our relationship to feelings is to be curious about them and the messages they send to us.”
― Lane Pederson, DBT Skills Training for Integrated Dual Disorder Treatment Settings

“The quality of silence in my life speaks to the health of my soul/mind. If the silence is deafening, suppressive, terrifying...
(it speaks to a fever raging silently in the psyche because the life I am living doesn’t align with your core values and/or the presence of something or someone harmful.)

This quality of silence holds within it the unfelt, the unsaid, the unspeakable, the unrecognized, the unhealed, the unreconciled, the unconscionable...in addressing what lives in the silence and learning how to tolerate it—just sit with it—we begin the work that need be done to integrate the parts of ourselves sequestered into suppression.”
― L.M. Browning, Drive Through the Night

“Do what you're supposed to do, regardless of what you're feeling. Regardless of whether it feels right or wrong in the moment. Ignore your thoughts. Just Do the Thing.”
― Mishell Baker, Phantom Pains

“Hear me out. The idea of 'radical acceptance' is that sometimes in order to reduce suffering, you have to stop fighting the situation and do the counterintuitive thing. Wholeheartedly embrace reality, spiky bits and all.”
― Mishell Baker, Phantom Pains