Building a life worth living is the memoir of Marsha Linehan, the revered American psychologist and founder of Dialectical Behaviour Therapy (DBT). The book is more of an intimate personal account and homage to DBT’s formation and evolution and less of a memoir. Marsha guides us through her story in a mostly linear fashion. It begins with her promise to God to help suicidal people as a young woman in the 1960s, progressing to the publication of her first book ‘Cognitive Behaviour Treatment of Borderline Personality Disorder’ in 1993 on her 50th birthday. The linear narrative is broken up with intriguing and effective anecdotes from Marsha and prominent characters encountered throughout her life. There is also notable digression from the narrative as the author elegantly explains the concept of DBT and some of the pertinent skills and practicalities involved. Marsha’s inner turmoil, tenacity and benevolence come to the fore throughout creating a heartfelt underdog story. Given the captivating nature of the author’s story, her inherent charm and the momentous legacy she is leaving, her memoir makes for a fascinating read.

The book is structured in a concise, well-construed manner; at times feeling clinical in nature as might be expected given the author’s background. It is divided into 4 distinct parts which neatly break up the memoir and further subdivided into numerous chapters which come thick and fast. The most fascinating section is Part 1 where Marsha describes her childhood, adolescence and young adult life which culminated in a 25-month psychiatric hospital admission. We learn about her voracious appetite for self-harm and suicidal behaviours which happen expeditiously. Unfortunately, Marsha’s memory of her life prior to 25 years of age is extremely poor. The grim cause of her amnesia is attributed to brain damage, likely suffered during poorly regulated electroconvulsive therapy in combination with repeated acts of self-inflicted head trauma caused by nose diving onto the floor of a seclusion room. Hence, her youth is described through anecdotes of friends and family, her own scattered ‘lightbulb’ memories and a fortunate preservation of letters. This can lead to the writing feeling disjointed at times and does not transition as fluidly as hoped. However, the brutal honesty and portrayal of a young woman in a position of such utter turmoil and self-deprecation are admirable and create an intrigue for the remainder of the story.

The author’s area of expertise comes to the fore as we are immersed into the world of DBT. Her explanations of what she feels are core concepts or skills of DBT are written as elegantly as one might expect. She uses simple yet charismatic and emphatic language. These sections exist sporadically within the book. Some concepts and skills are awarded designated chapters, while other snippets are found in between the narrative. The drawback of these sections being that the transitions to the narrative can have the effect of interrupting the flow of the book if you are hoping for a smooth read. Notwithstanding, the rewarding content outweighs the transitional structural flaws.

The author’s spirituality emerges as a prominent theme throughout. This is no surprise considering the influence of eastern spirituality practices on DBT. It is surprising to learn of Marsha’s strict catholic upbringing and her rigid relationship to Catholicism and God for so long. Her spiritual journey consists of repression, torment, unwavering faith, enlightenment, unconditional acceptance and everything in between. Undoubtedly, the most compelling part of her journey exists in the latter stages when Marsha details how she came to be a Zen master. This was a true breakthrough in the development of DBT and an example of radical innovation for the times. On the contrary to this innovation, the emphasis and detail attributed to her relationship with God prior to her life as a Zen master feels repetitive at times. Marsha’s great story lies in her empathy, courage, tenacity and unrelenting will not to give up. One cannot help feel frustrated at the over-elaborate descriptions of her relationship with God, and particularly, the influence and restrictions the Catholic Church held over her vibrant liberal energy for so long.

Marsha Linehan is undoubtedly an inspiration to all. This is a story of a young girl looking through an opaque window for a glimmer of hope, a female making her mark in a male-dominated field, an underdog in a world of uncompromising governors, a revolutionary thinker battling through a collective conservative mindset and a kind heart with an insatiable hunger to succeed. This book adds colour and personality to DBT and gives the reader an intimate insight into how it came to be. It is a hugely beneficial read for anyone involved in DBT or working with individuals who may benefit from DBT. The book has no target audience in mind and avoids jargon. This makes it suitable for everyone but has also led to less refinement in the writing style and does create a slightly disjointed flow for the casual reader. Overall, I would absolutely recommend this book for anyone with an interest in DBT or emotionally unstable personality disorder or looking to gain an insight into the life of one of the pre-eminent figures in this field over the past few decades.