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.
Marsha M. Linehan, PhD: Radical acceptance comes from the depths of your being, and it involves a number of skills you can practice. In fact, the most important thing is to say to yourself that it is practice—rather than telling yourself that you're flat-out going to accept. Once you put the demand on yourself to accept, every failure to accept makes things worse.
O Magazine: So it's a bit like physical therapy: You're not there quite yet, but you're working on it.
Marsha M. Linehan, PhD: Right. You can let yourself think about what's not in your life, what you don't have that you want, as you relax your body and your face. Then you can practice saying out loud that this is a fact and you can accept it. What I call half-smiling sounds weird, but it works: You relax your entire face and then let your lips come up just slightly on either side, and you think about what it is that you're trying to accept. There's a lot of interesting research indicating that you can change emotions simply by changing your face. You're sending a message to your brain through your face that things are not so bad.
O Magazine: Making it okay that you're not going to achieve what you'd hoped to achieve could be seen as rationalization.
Marsha M. Linehan, PhD: What's wrong with that? But the truth is, we're not trying to make it okay or not okay. We're trying to accept it as fact, because that's a way to get unstuck. If you wanted children and you don't have them and you radically accept that, you can go out and build nurturing relationships with young people. I was meant by God to have 12 children, but that isn't what I got. I don't have a biological child, but in my life there's a child who's like my own. The failure to accept is the failure to replace. Because you won't accept that there's a hole in your life, you do nothing to fill the hole. Maybe you can never fill it all the way, but believe me, a hole three-quarters filled beats an empty hole.
O Magazine: So do you give up on your original goal?
Marsha M. Linehan, PhD: Not necessarily. Radical acceptance doesn't mean you don't reach for achievement. You just can't catastrophize not being the one who makes it. Once you tie your identity and happiness to achieving some goal, you're in trouble. I will tell you my sperm theory of life: All sperm swim, but only one fertilizes the egg. In life it's unreasonable to expect to be that one. You can demand only that you swim to the best of your ability.
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From the October 2006 issue of O, The Oprah Magazine