When you didn't pass the math test, or the guy you liked didn't like you back, you could tell yourself "maybe next year," or "better luck next time." That's the beauty of youth: Second chances are abundant. But what happens when those chances, those next times, start to dwindle? How do you acknowledge, as you get older, that things you'd dearly hoped to achieve are never going to happen—and do so in a way that doesn't lead to despair?

Marsha M. Linehan, PhD, a professor of psychology at the University of Washington in Seattle, is best known for working with suicidal patients and those with the psychiatric condition known as borderline personality disorder. But there's a good reason we turned to her for counsel about the angst of dashed dreams: Her pioneering "dialectical behavior therapy" incorporates a unique practice, derived from Buddhism, called radical acceptance. The term refers to a willingness to recognize and tolerate what is, rather than fight it or judge it. It's a way to free yourself from wanting something to be or not to be—and that, as Linehan explains to O contributing editor Aimee Lee Ball, is a way to free yourself to live.

O Magazine: We're wondering about life's coulda/woulda/shoulda's. Suppose you always wanted to have a painting hanging in a museum, and instead you became an accountant. Or you wanted children, and now you're perimenopausal. How do you live with that kind of existential disappointment?
Marsha M. Linehan, PhD: Life is a series of situations in which you don't get what you want. When you're younger, you make it through emotionally by telling yourself it's not too late. But at some point you cross a line that means what you're continuing to hope for won't be found. The question is: How do you both accept that fact and still build a full and vibrant life?

O Magazine: Can you answer that question?
Marsha M. Linehan, PhD: Yes. But let me backtrack for a moment. I've gotten in the habit of saying there are only five responses to any given problem. The first is to solve the problem—either change the situation or leave it. The second is to change how you feel about the problem. Say you're in a job or marriage where you're not getting what you want. Often people become bitter because they focus on the one negative thing, instead of opening their perspective to their entire life. Can you reevaluate and find the parts of the picture that are good and focus on them?

O Magazine: And if that's not possible, what's number three?
Marsha M. Linehan, PhD: Many people are in situations where whatever is missing in their lives, they're never going to feel different about it. Enron employees are a good example—they're not ever going to be able to say that what happened to them is okay. In that case, radically accepting and living with the unhappiness is your only option. You don't deny the pain of what's missing, but you learn to live with it.

O Magazine: You can learn that?
Marsha M. Linehan, PhD: Yes. I'm going to come back to this because I think it's most people's issue. But there's a fourth alternative: Stay miserable. And a fifth, which a client pointed out to me: You can make things worse.

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