Kathryn Burnett, Psy.D. | November 11, 2026
Discovering DBT
Visionary psychologist and creator of Dialectical Behavior Therapy (DBT) Dr. Marsha Linehan passed away yesterday at the age of 83.
I feel the loss both personally and as a member of the profession she helped shape. Dr. Linehan's work has become a fundamental part of who I am as a person. Before becoming a psychologist, I worked in a community mental health organization where I learned about DBT, and that experience changed my life. I entered my position at Cornerstone Montgomery's DBT program with no idea what DBT was. Over the next year and a half, I became increasingly awed by Dr. Linehan's work and the way it influenced how therapists understood and responded to human behavior.
Co-leading a weekly DBT skills group gave me the opportunity to learn and teach skills that have had an enormous impact on mental health treatment. I watched people who struggled to regulate their emotions, navigate relationships, and connect with others learn practical ways to approach those challenges. The group itself gave them opportunities to connect, support one another, and practice doing things differently.
What struck me was how practical and, in some ways, intuitive many of these skills were. They addressed experiences that are fundamentally human: managing emotions, asking for what we need, setting boundaries, tolerating distress, and navigating relationships. Yet the treatment Dr. Linehan built around them was extraordinarily sophisticated.
DBT changed my understanding of what it meant to be a therapist. I learned that I could sit with people in very difficult situations and have the tools to help them. Just as importantly, DBT allowed me to develop new skills to manage my own emotions, maintain boundaries, communicate effectively, and take care of myself while doing that work. About a year into my time at Cornerstone Montgomery, I decided to pursue my doctorate in clinical psychology. The skills I learned in that program, along with the therapeutic principles I learned from Dr. Linehan's writing, became the foundation of who I am as a therapist, psychologist, and person.
The Depth of Dr. Linehan's Work
Before graduate school, I read Dr. Linehan's Cognitive-Behavioral Treatment of Borderline Personality Disorder, a book I still return to when I encounter challenging clinical situations. I think it is essential reading for anyone who wants to really understand DBT. The skills are only one part of the treatment, and the book provides a much deeper understanding of the theory, philosophy, and behavioral principles that inform them.
Dr. Linehan integrated behavioral science, biosocial theory, dialectics, mindfulness, acceptance, and validation into a comprehensive approach to psychotherapy. She considered virtually every aspect of treatment, from understanding how problematic behaviors develop to determining treatment priorities, responding to therapy-interfering behaviors, and helping patients identify what would make their lives worth living. The depth and sophistication of her thinking continue to challenge and inspire me.
One of the things I appreciate most about her work is how compassionate it is while remaining so thoroughly behavioral. Her approach encourages us to move away from judgment and blame and toward understanding what people are trying to accomplish, how their behavior developed, and what might help them respond more effectively. Consider how often someone is described as manipulative. From a behavioral perspective, we are all trying to influence our environments and get our needs met. Some ways of doing that are more effective than others, and some come at a significant cost to ourselves or the people around us. Understanding the function of a behavior doesn't mean approving of it. It gives us a way to understand why it's happening and what might need to change.
Although DBT was originally developed to treat people with borderline personality disorder and chronic suicidality, I believe its principles and skills are relevant to everyone. We all have emotions to regulate, relationships to navigate, boundaries to establish, and difficult experiences to tolerate. We all struggle at times to balance accepting things as they are with working to change them. I don't think there is a person in the world who couldn't benefit from learning something from DBT. The skills themselves can seem surprisingly intuitive, even common-sense, but learning to apply them consistently and effectively is another matter entirely. Dr. Linehan took these fundamental human challenges and developed a thoughtful, systematic approach to addressing them.
Dr. Linehan as a Clinician
I never had the honor of meeting Dr. Linehan, but watching videos of her conducting therapy has always been impactful for me. She could be funny, direct, irreverent, strategic, and extraordinarily validating. She made people feel understood while challenging them to change, and underneath interactions that appeared so natural was an incredible amount of behavioral sophistication. She was paying attention to what she reinforced, how she responded, and how her own behavior could influence the interaction. I have always admired the way she could be so deliberate in her clinical work while remaining so genuine and human.
She demonstrated that a sophisticated understanding of human behavior could make us more compassionate, more genuine, and more effective in our relationships with the people we treat. Her use of radical genuineness and irreverent communication is a particularly good example of this. These are not simply personality traits. They are therapeutic strategies that require careful attention to the person, the situation, and the function of the therapist's response.
During my doctoral training, I had the privilege of studying with Dr. Edward Shearin, who worked with Dr. Linehan at the University of Washington and later became my dissertation chair. Through him, I developed an even greater appreciation for the depth of thought that went into developing DBT and the work therapists need to do on themselves to practice effectively.
The Influence of DBT on My Work Today
Today, I specialize in the treatment of obsessive-compulsive disorder (OCD). Although I no longer practice comprehensive DBT, I still draw on Dr. Linehan's work constantly. Her approach taught me to look beyond what a behavior looks like and consider what it accomplishes, what maintains it, and how to help someone respond differently. She also taught me to pay attention to my own behavior as a therapist, including how I communicate, what I reinforce, and how I can use the therapeutic relationship to support change.
I think having a strong foundation in DBT before learning to treat OCD and body-focused repetitive behaviors (BFRBs) has been particularly valuable. It gave me a way to understand complicated behaviors without judgment, to be comfortable with intense emotional experiences, and to approach difficult clinical situations with confidence. Dr. Linehan's use of irreverence has always resonated with me, and I think of myself as an irreverent therapist at heart.
Even as a child, I was comfortable sitting with friends through difficult experiences. I could be patient, listen, and support people who were struggling. I understood that there was value in being able to sit with someone through painful moments. What I hadn't considered was that being playful, provocative, and human could also serve an important purpose in helping people.
Dr. Linehan helped me appreciate that irreverence wasn't simply permissible in therapy. Sometimes it was necessary. There's an old idea that the fool is the only person who can mock the king. Someone has to be willing to challenge what everyone else is afraid to question. I think about that often in my work treating OCD, phobias, and BFRBs.
I genuinely enjoy treating OCD and phobias, and humor is a significant part of how I approach that work. OCD can convince people to do some pretty absurd things. Phobia treatment can involve asking someone who is terrified of spiders to imagine one crawling up their nose while they sleep. Treating BFRBs can involve examining behaviors that people have spent years feeling embarrassed or ashamed of. These are difficult experiences, and we don't have to approach them solemnly all the time. We can laugh at the demands of OCD without laughing at the person experiencing it. We can find humor in an exposure exercise while still feeling genuinely frightened, and we can approach behaviors with curiosity rather than shame.
I think it's often easier to be brave when we can laugh at something that scares us. The fear doesn't necessarily disappear, and the work doesn't become less important. We simply have another way to approach it. This is something I learned from Dr. Linehan. She helped me understand that being genuine, playful, and irreverent can be part of doing thoughtful, effective clinical work. Dr. Linehan showed me that I didn't need to become a different person to be a therapist. I needed to learn how to use who I am skillfully. I’m so grateful for my career as a clinical psychologist, a career I never would have chosen if it weren’t for the work of Marsha Linehan.
Remembering Dr. Linehan
Marsha Linehan’s contributions to psychotherapy are enormous. She developed a way of looking at behavior and suffering that is transformative. She created skills that anyone could learn and then gave therapists the tools they needed to engage people in building these skills as part of a process of lifelong change.
Her influence extends well beyond developing DBT skills. She taught generations of clinicians to think carefully about behavior, to examine their own responses, and to recognize that the way we relate to patients is part of the work of helping them change. Her willingness to share her own history of psychological suffering also meant a great deal to the field. She spoke openly about experiences that carry enormous stigma, including psychiatric hospitalization and self-injury, and devoted her career to helping people build lives worth living.
I am grateful for the thought and care Dr. Linehan put into developing DBT, for the example she set as a clinician and researcher, and for the influence her work continues to have on psychotherapy. Personally, I am grateful that her work helped me understand myself, inspired me to become a psychologist, and continues to shape how I communicate, how I understand other people, and how I practice therapy.
Two truths: I am so sad that our world has lost her brilliant mind and amazing spirit, and I am so grateful for her work and know that her legacy will continue to help people build lives worth living.
Goodbye Dr. Linehan, and thank you for your impact on our world.