Posts Tagged ‘low self esteem’

Prayer and Meditation for Saturday, September 29, 2018 — “There is no duplicity in him.” — “Being Beloved constitutes the core truth of our existence.”

September 29, 2018

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“Over the years, I have come to realize that the greatest trap in our life is not success, popularity, or power, but self-rejection (low self esteem). Success, popularity, and power can indeed present a great temptation, but their seductive quality often comes from the way they are part of the much larger temptation to self-rejection. When we have come to believe in the voices that call us worthless and unlovable, then success, popularity, and power are easily perceived as attractive solutions. The real trap, however, is self-rejection. As soon as someone accuses me or criticizes me, as soon as I am rejected, left alone, or abandoned, I find myself thinking, “Well, that proves once again that I am a nobody.” … [My dark side says,] I am no good… I deserve to be pushed aside, forgotten, rejected, and abandoned. Self-rejection is the greatest enemy of the spiritual life because it contradicts the sacred voice that calls us the “Beloved.” Being the Beloved constitutes the core truth of our existence.” 
― Henri J.M. Nouwen

Art: Jacob wrestling with the Angel by Gustave Doré 1885

Feast of Saints Michael, Gabriel, and Raphael, archangels
Lectionary: 647

Reading 1 DN 7:9-10, 13-14

As I watched:

Thrones were set up
and the Ancient One took his throne.
His clothing was bright as snow,
and the hair on his head as white as wool;
His throne was flames of fire,
with wheels of burning fire.
A surging stream of fire
flowed out from where he sat;
Thousands upon thousands were ministering to him,
and myriads upon myriads attended him.

The court was convened, and the books were opened.
As the visions during the night continued, I saw

One like a son of man coming,
on the clouds of heaven;
When he reached the Ancient One
and was presented before him,
He received dominion, glory, and kingship;
nations and peoples of every language serve him.
His dominion is an everlasting dominion
that shall not be taken away,
his kingship shall not be destroyed.

Or  RV 12:7-12AB

War broke out in heaven;
Michael and his angels battled against the dragon.
The dragon and its angels fought back,
but they did not prevail
and there was no longer any place for them in heaven.
The huge dragon, the ancient serpent,
who is called the Devil and Satan,
who deceived the whole world,
was thrown down to earth,
and its angels were thrown down with it.

Then I heard a loud voice in heaven say:
“Now have salvation and power come,
and the Kingdom of our God
and the authority of his Anointed.
For the accuser of our brothers is cast out,
who accuses them before our God day and night.
They conquered him by the Blood of the Lamb
and by the word of their testimony;
love for life did not deter them from death.
Therefore, rejoice, you heavens,
and you who dwell in them.”

Responsorial Psalm PS 138:1-2AB, 2CDE-3, 4-5

R. (1) In the sight of the angels I will sing your praises, Lord.
I will give thanks to you, O LORD, with all my heart,
for you have heard the words of my mouth;
in the presence of the angels I will sing your praise;
I will worship at your holy temple
and give thanks to your name.
R. In the sight of the angels I will sing your praises, Lord.
Because of your kindness and your truth;
for you have made great above all things
your name and your promise.
When I called, you answered me;
you built up strength within me.
R. In the sight of the angels I will sing your praises, Lord.
All the kings of the earth shall give thanks to you, O LORD
when they hear the words of your mouth;
And they shall sing of the ways of the LORD
“Great is the glory of the LORD
R. In the sight of the angels I will sing your praises, Lord.

Alleluia PS 103:21

R. Alleluia, alleluia.
Bless the LORD, all you angels,
you ministers, who do his will.
R. Alleluia, alleluia.

Gospel  JN 1:47-51

Jesus saw Nathanael coming toward him and said of him,
“Here is a true child of Israel.
There is no duplicity in him.”
Nathanael said to him, “How do you know me?”
Jesus answered and said to him,
“Before Philip called you, I saw you under the fig tree.”
Nathanael answered him,
“Rabbi, you are the Son of God; you are the King of Israel.”
Jesus answered and said to him,
“Do you believe
because I told you that I saw you under the fig tree?
You will see greater things than this.”
And he said to him, “Amen, amen, I say to you,
you will see heaven opened
and the angels of God ascending and descending on the Son of Man.”
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Reflection by The Most Rev Msgr William Goh Archbishop of Singapore

29 SEPTEMBER, 2018, Saturday, The Holy Archangels, Michael, Gabriel and Raphael


SCRIPTURE READINGS: [ DAN 7:9-1013-14 (OR REV 12:7-12A); JN 1:47-51  ]

It is a beautiful Catholic tradition to pray the Prayer of St Michael for divine protection against the snares of the Evil One.  Even I make it a point to pray this prayer at least once a day as I go about fulfilling my responsibilities for the day.  Turning to St Michael for protection is encouraged by the tradition of the Church because St Michael the archangel is seen as our protector from the Evil One.  In the book of Revelation, St Michael is depicted as the Prince of the Heavenly Host who fought back the Dragon and his angels and drove them out of heaven. “The great dragon, the primeval serpent, known as the devil of Satan, who had deceived all the world, was hurled down to the earth and his angels were hurled down with him.”  Following this tradition, Catholics would seek the intercession of St Michael to shield them from all evil and the temptations of Satan and his angels.

This is even more urgent today, especially when there is a growing skepticism of the presence of the Evil One.  Because of science and technology, many of us are misled into thinking that Satan and Evil Spirits do not exist; that they are mythological figures and only for children.  They are not real and so we do not need to be alert or be on the defensive.  This is precisely what the Evil Spirits want us to believe so that we will not be aware of the subtle influence they have on us and on the world.  This is the deception of the Evil One.   Those who claim to be wise in the world, those who are intellectually brilliant in world sciences, have become so arrogant to think that such spiritual powers do not exist.

On the contrary, the scriptures are full of admonitions to withstand the temptations of the Evil One.  The whole life of Jesus was a warfare against the Kingdom of Satan.  Jesus revealed to us who the real enemy of God’s rule is.  He cast out the devils and spoke of His victory over the devil as a sign of God’s rule making itself felt.  He said, “But if it is by the finger of God that I cast out the demons, then the kingdom of God has come to you.” (Lk 11:20) For Jesus, the real enemy was Satan who was tempting them to sin and idolatry, not the Romans, as the Jews thought.  St Peter reminds us, “Discipline yourselves, keep alert. Like a roaring lion your adversary the devil prowls around, looking for someone to devour.”  (1 Pt 5:8)  St Paul himself declared, Finally, be strong in the Lord and in the strength of his power. Put on the whole armor of God, so that you may be able to stand against the wiles of the devil.  For our struggle is not against enemies of blood and flesh, but against the rulers, against the authorities, against the cosmic powers of this present darkness, against the spiritual forces of evil in the heavenly places.  Therefore, take up the whole armor of God, so that you may be able to withstand on that evil day, and having done everything, to stand firm.”  (Eph 6:10-13)

In recent times, the Popes, from Pope Paul VI to John Paul II, Pope Benedict and Francis, have spoken quite often about the existence and the work of the Evil One.  They never failed to remind us of the need to take the existence of the Evil Spirits seriously.   According to a renowned Vatican exorcist, “Of course the Devil exists and he can not only possess a single person but also groups and entire populations… The Devil resides in the Vatican and you can see the consequences.  We need to pray for every single soul of bishops and priests in our world with special emphasis for those that have been deceived beyond rational thinking by the master of confusion. Lost sheep are increasing by thousands daily as evidenced in rampant narcissism, materialism, immorality, and violence. It is also essential that we pray and fast for our bishops and priests who are under constant demonic attack since Satan knows that clouding the clarity of our shepherds and seducing them into watering down truths will destroy many souls that rely on them for guidance.”

Most of all, we must be careful of any involvement, even passive participation in the occult. The consequences can be disastrous.  A person who plays with the devil and engages in occult activity can be affected physically, psychologically, spiritually, and morally.  Often the manifestations of occult involvements would include anxiety, panic attacks, nightmares, self-mutilation, suicidal thoughts and in severe cases, occult activity leading to demonic possession.  It often starts out of ignorance and curiosity.  Some even participate out of fun or amusement in Spiritism and then get themselves trapped.  Quite often too, people are misguided into making contact with the spirits of their deceased loved ones when in fact the devil and evil spirits come under the guise of them.  They are misled into believing and welcoming them into their lives.

Consequently, today, we must be discerning about what we do and whom we believe.  We need to discern the movement of the spirits, distinguish between good from evil spirits.  How often, as St Paul warns us, the evil spirit comes to us under the guise of the angel of light. He wrote, “For if someone comes and proclaims another Jesus than the one we proclaimed, or if you receive a different spirit from the one you received, or a different gospel from the one you accepted, you submit to it readily enough.” (2 Cor 11:4)  That is why we need to be alert and watchful of how evil is spreading its influence in the world today through ideologies that advocate sensuality, individualism, relativism and humanism.

Such are the subtle ways the devil seeks to confuse us and mislead us by making his temptations appear to us as good, as in the case of the temptations of Jesus when He was asked to change stone into bread when He was hungry after 40 days of fasting, to use His divine powers for Himself and not for others; or to display His power by jumping down from the pinnacle to attract attention and command respect; or worse still, to worship Him in exchange for power and glory and wealth.   Such ideologies will lead one to deny the reality of the spiritual world and our nature as body and spirit.  Once we come to reduce ourselves to pure matter which is extinguished upon death, we deceive ourselves because we believe we are created in the image and likeness of God, and we have an immortal soul.

The best way to defeat the devil is to follow the examples of the archangels.  Angels are denoted by their functions rather than by their nature.  This is what Pope St Gregory the Great taught.  They are called to reflect the nature of God.   Thus their names reflect what they are called to do.  Hence, “Michael – Who is like God”, “Raphael – God has healed” and “Gabriel – Power of God”.  Through their actions and services, they make known to us the glory of God and proclaim His majesty.  God works through His angels and they are therefore considered His messengers and intermediaries.

In the gospel, Nathaniel presented himself as an angel because of his sincerity in love and in truth. Jesus said of Nathanael, “There is an Israelite who deserves the name, incapable of deceit.”  He was a man who was able to see and discern Jesus as the Son of God, the King of Israel.  He was a man of prayer and contemplation as Jesus found him under the fig tree, a symbol of prayer.  The Lord said, “You believe that just because I said: I saw you under the fig tree. You will see greater things than that I tell you most solemnly, you will see heaven laid open and, above the Son of Man, the angels of God ascending and descending.”  For those of us who manifest the glory of God in our lives, we too become His angels and messengers of love and hope.

So the best way to overcome evil is to do good.  This is the way we fight with evil.  This is what St Paul urges us,  “Do not repay anyone evil for evil, but take thought for what is noble in the sight of all.  If it is possible, so far as it depends on you, live peaceably with all.  Beloved, never avenge yourselves, but leave room for the wrath of God; for it is written, ‘Vengeance is mine, I will repay, says the Lord.’  No, ‘if your enemies are hungry, feed them; if they are thirsty, give them something to drink; for by doing this you will heap burning coals on their heads.’  Do not be overcome by evil, but overcome evil with good.” (Rom 12:17-21)

Indeed, victory is certain when we fight the battle with Christ.  This is what the book of revelation says, “Victory and power and empire for ever have been won by our God, and all authority for his Christ, now that the persecutor, who accused our brothers day and night before our God, has been brought down. They have triumphed over him by the blood of the Lamb and by the witness of their martyrdom, because even in the face of death they would not cling to life. Let the heavens rejoice and all who live there.”  Christ, by His death and resurrection, has won victory over death and Satan, and having forgiven our sins by His death on the cross, He enables us to share in His death to sin and the new life in His resurrection. 

Let us in our battle against the Evil One and his angels implore the help of St Michael.  He will bring our prayers to the Lord as the responsorial psalm says, “I thank you, Lord, with all my heart: you have heard the words of my mouth.  In the presence of the angels I will bless you. I will adore before your holy temple. I thank you for your faithfulness and love, which excel all we ever knew of you. On the day I called, you answered; you increased the strength of my soul.”  May the Holy Angels, especially St Michael, protect us from all evil and harm, especially division and deception.

Written by The Most Rev William Goh Roman Catholic Archbishop of Singapore





Morning Prayer for Monday, July 9, 2018 — Humble Faith is The Pre-Requisite to Healing and God’s Power In Us

July 9, 2018

Disillusionment and spiritual confusion mark our age. Many of us have cast aside old ideas without acquiring new ones. Many men and women are creeping through life on their hands and knees, merely because they refuse to rely on any power but themselves. Many of them feel that they are being brave and independent, but actually they are only courting disaster. Anxiety and the inferiority complex have become the greatest of all modern plagues.

Meditation for the Day

Disillusionment and doubt spoil life. The doubting ones are the disillusioned ones. When you are in doubt, you are on the fence. You are not going anywhere. Doubt poisons all action. “Well, I don’t know”-so you don’t do anything. You should meet life with a “Yes,” an affirmative attitude. There is good in the world and we can follow that good. There is power available to help us to do the right thing; therefore we will accept that power. There are miracles of change in people’s lives; therefore we will accept those miracles as evidence of God’s power.

Prayer for the Day

I pray that I will not be paralyzed by doubt. I pray that I may go along on the venture of faith.

From The Book “Twenty Four Hours a Day”


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Art: First Century, Rome, catacombs. “If only I could touch the hem of his cloak, I will be healed.”

Spike in Number of American Women Who Die of Pain Medication Overdose

July 4, 2013

Crystal D. Steele spoke with other patients on Monday at the Counseling Center, a drug rehabilitation center in Portsmouth, Ohio.  Photo: Tom Uhlman for The New York Times

By Sabrina Tavernise
The New York Times

PORTSMOUTH, Ohio — Prescription pain pill addiction was originally seen as a man’s problem, a national epidemic that began among workers doing backbreaking labor in the coal mines and factories of Appalachia. But a new analysis of federal data has found that deaths in recent years have been rising far faster among women, quintupling since 1999.

More women now die of overdoses from pain pills like OxyContin than from cervical cancer or homicide. And though more men are dying, women are catching up, according to the analysis by the Centers for Disease Control and Prevention. And the problem is hitting white women harder than black women, and older women harder than younger ones.

In this Ohio River town on the edge of Appalachia, women blamed the changing nature of American society. The rise of the single-parent household has thrust immense responsibility on women, who are not only mothers, but also, in many cases, primary breadwinners. Some who described feeling overwhelmed by their responsibilities said they craved the numbness that drugs bring. Others said highs made them feel pretty, strong and productive, a welcome respite from the chaos of their lives.

“I thought I was supermom,” said Crystal D. Steele, 42, a recovering addict who said she began to take medicine for back pain she developed working at Kentucky Fried Chicken. “I took one kid to football, the other to baseball. I went to work. I washed the car. I cleaned the house. I didn’t even know I had a problem.”

Ms. Steele, now a patient at the Counseling Center, a rehabilitation center here, remembers getting calls about deaths of high school classmates while working at an answering service for a local funeral home. She counted about 50 women she had known who had drug-related deaths. She believes that had it not been for a 40-day stint in jail for stealing pain pills, she would have been among them.

“I felt like I sold my soul somewhere along the way,” said Ms. Steele, whose father was an alcoholic and abusive. “I didn’t feel like I deserved to be given a second chance. I thought my kids would be better off without me.”

For years, drug overdose deaths in the United States were seen as mostly an urban problem that hit blacks hardest. But opioid abuse, which exploded in the 1990s and 2000s and included drugs like OxyContin, Vicodin and Percocet, has been worst among whites, often in rural places. The C.D.C. analysis found that the overdose death rate for blacks in 2010, the most recent year for which there was final data, was less than half the rate for whites. Asians and Hispanics had the lowest rates.

According to the report, 6,631 women died of opioid overdoses in 2010, compared with 10,020 men.

While younger women in their 20s and 30s tend to have the highest rates of opioid abuse, the overdose death rate was highest among women ages 45 to 54, a finding that surprised clinicians. The range indicates that at least some portion of the drugs may have been prescribed appropriately for pain, Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in an interview. If death rates were driven purely by abuse, then one would expect the death rates to be highest among younger women who are the biggest abusers.

Deaths among women have been rising for some time, but Dr. Thomas R. Frieden, the C.D.C. director, said the problem had gone virtually unrecognized. The study offered several theories for the increase. Women are more likely than men to be prescribed pain drugs, to use them chronically, and to get prescriptions for higher doses.

The study’s authors hypothesized that it might be because the most common forms of chronic pain, like fibromyalgia, are more common in women. A woman typically also has less body mass than a man, making it easier to overdose.

Women are also more likely to be given prescriptions of psychotherapeutic drugs, like antidepressants and antianxiety medications, Dr. Volkow said. That is significant because people who overdose are much more likely to have been taking a combination of those drugs and pain medication.

Broader social trends, like unemployment, an increase in single-parent families, and their associated stressors, might have also contributed to the increase in abuse, but they are slow moving and unlikely to be a direct explanation, Dr. Volkow said.

Stella Collins, who runs group therapy sessions at the Counseling Center, said her patients, most of whom are poor, feel trapped. They are squeezing a living out of tiny paychecks. Many get no financial support from the fathers of their children and come from families where alcohol or drugs were abused. Their feelings of inadequacy and shame over not properly caring for their children help drive their addictions, she said.

“Poverty is depression, it’s failure, it’s sadness, it’s low self-esteem,” said Ms. Collins. Her mother, an addict, died of a heart attack at age 56 after spending money meant for heart medication on pain pills, she said.

“These women are stuck, emotionally and financially,” Ms. Collins added.

But some of the women also fight their way back.

Kathy Newman, 35, who started using pills in her 20s, after her older sister overdosed, and whose oldest son was born addicted, has been drug-free for two years. She now takes classes, and travels around the county telling her story at schools.

For Ms. Steele, the most motivating image is that of her 12-year-old son’s face streaked with tears, looking at her through the glass of the prison visiting area. Her eldest son now has custody of him.

“I was at a big stop sign and it was like, ‘O.K., which way are you going to go?’ ” she said.

Portsmouth has worked hard to stop addiction. Easy access to prescription pain pills has been shut down. Mothers of dead addicts give talks at schools. And while Ohio’s death rate from overdoses, like the national rate, is still climbing, the rate in Scioto County, where Portsmouth is located, has declined in recent years, according to the city health department.

Ms. Collins works with women in group sessions, teaching them how to like themselves again.

“Watching them die is the hardest part,” Ms. Collins said. “You sit in this room and you don’t know who’s going to make it.”


Grade “A” Student, 16, killed herself after buying ‘death row drug’ on Internet

February 27, 2013

A gifted A-level student killed herself after being able to buy online a drug used for lethal injections on death row in the United States, an inquest heard.

Coroner calls for crackdown on online drugs after judge's daughter takes her own life

Isobel Narayan, 16, pictured with her dog Bracken, had ‘unfathomable’ low self-esteem Photo: Cavendish Press
The Telegraph

A coroner called for tighter controls on selling lethal drugs over the internet after hearing that Isobel Narayan, 16, came across the substance having searched online forums about suicide.

Nigel Meadows said he would be writing to the Chief Pharmaceutical officer to see if anything could be done to tighten regulations about access to harmful drugs.

He said policing the internet was “virtually impossible” but it was a “matter of public concern” that Isobel was able to get hold of the drug.

Isobel, the daughter of a barrister, was found dead by her parents at their home in Didsbury, Manchester, in December 2011, having drug the drug mixed with mouthwash.

An inquest heard that there was nothing to suggest she was unhappy but a police interrogation of her computer revealed she suffered “misplaced” and “unfathomable” feelings of low self-esteem and worthlessness.

She had ordered a drug online and in the months before her death had looked up forums giving guidance on assisted suicide for people with terminal illnesses, Manchester Coroner’s Court heard.

Isobel wrote a document entitled: “Reasons why I should kill myself or why my life is not worth living”, the hearing was told.

Her father, Harry Narayan, a barrister and crown court recorder in Manchester, told the inquest his youngest daughter, who had gained top marks at GCSE, was top of her year in physics and studying A-levels with the hope of studying to be a vet like her older sister, Freya.

A keen horse-rider she was also on the student council at Xaverian College in Manchester but was “so able”, her studies did not really challenge her and she craved more homework to do.

There had been a “mini crisis of confidence” the month before she died, he said, but Bell, as he called her, returned to college a week later and got back into the rhythm of student life with everything appearing normal.

He said on the night before the tragedy Freya had gone out and he had waited up for her.

He said: “I stayed up waiting for Freya to come back in the early hours of the morning. At 1am, I heard Bell cleaning her teeth in the downstairs bathroom. I said, ‘Are you all right’? Everything was normal.”

The inquest heard that around noon, Mrs Nayaran went upstairs to rouse Isobel to see if she wanted a bacon brunch.

Mr Narayan added: “Anne went to ask her about a bacon butty and came back down and asked if I could go and see her. She was dead.”

The parents raced up to her room where Isobel was lying on the top bunk of her bed, which has a desk underneath.

He added: “She was lying in her usual sleeping position right arm over her head. I felt her forehead and it was cold.

“I remember everything vividly. She had a bucket which I use when I clean the house, there was a bit of liquid in it. There was a Listerine bottle on her top bunk and there was a tumbler on the window sill that had some dried powder on it.

“She must’ve got the bucket some time after I heard her at 1am”, she said.

Mr Narayan said he had spoken to his daughter about boys, pregnancy and bullying, but there was nothing in her life to suggest she was unhappy or worried.

Det Insp Kevin Marriott, from Greater Manchester Police (GMP) who investigated the death, said searches of her computer found she had made inquiries about obtaining the drug and around a month before her death a quantity was posted to her in two packages.

The hearing was told that Isobel had gone on forums and discussed “the use of the drugs and quantities and dosages and uses and guidance and sources of advice for those people wishing to harm themselves”.

There was also a pamphlet available online designed for those with terminal illnesses who want to end their lives.

Det Insp Marriott said that while Isolbel had low esteem, the “self-deprecating comments” she made in the document “Reasons why I should kill myself” were “totally misplaced”. He added: “It’s unfathomable.”

Ruling that the teenager killed herself, Mr Meadows, the Manchester coroner, said: “There were no indications that she was even contemplating taking her own life. There’s no clue or indication that anything was untoward whatsoever.”

He said it was “inevitable” in such cases loved ones will ask themselves if they could have noticed something wrong, but said there was nothing Isobel’s family should reproach themselves for.

He said: “It’s a strange time of life for teenagers. There’s hormones raging, there’s pressures.”


Religious Experience that Transformed Woman with Borderline Personality Disorder

November 19, 2012

The Power of Rescuing Others: Marsha Linehan, a therapist and researcher at the University of Washington who suffered from borderline personality disorder, recalls the religious experience that transformed her as a young woman.  Damon Winter/The New York Times

By Benedict Carey
The New York Times

HARTFORD — Are you one of us?

The patient wanted to know, and her therapist — Marsha M. Linehan of the University of Washington, creator of a treatment used worldwide for severely suicidal people — had a ready answer. It was the one she always used to cut the question short, whether a patient asked it hopefully, accusingly or knowingly, having glimpsed the macramé of faded burns, cuts and welts on Dr. Linehan’s arms:

“You mean, have I suffered?”

“No, Marsha,” the patient replied, in an encounter last spring. “I mean one of us. Like us. Because if you were, it would give all of us so much hope.”

“That did it,” said Dr. Linehan, 68, who told her story in public for the first time last week before an audience of friends, family and doctors at the Institute of Living, the Hartford clinic where she was first treated for extreme social withdrawal at age 17. “So many people have begged me to come forward, and I just thought — well, I have to do this. I owe it to them. I cannot die a coward.”

No one knows how many people with severe mental illness live what appear to be normal, successful lives, because such people are not in the habit of announcing themselves. They are too busy juggling responsibilities, paying the bills, studying, raising families — all while weathering gusts of dark emotions or delusions that would quickly overwhelm almost anyone else.

Now, an increasing number of them are risking exposure of their secret, saying that the time is right. The nation’smental health system is a shambles, they say, criminalizing many patients and warehousing some of the most severe in nursing and group homes where they receive care from workers with minimal qualifications.

Moreover, the enduring stigma of mental illness teaches people with such a diagnosis to think of themselves as victims, snuffing out the one thing that can motivate them to find treatment: hope.

“There’s a tremendous need to implode the myths of mental illness, to put a face on it, to show people that a diagnosis does not have to lead to a painful and oblique life,” said Elyn R. Saks, a professor at the University of Southern California School of Law who chronicles her own struggles with schizophrenia in “The Center Cannot Hold: My Journey Through Madness.” “We who struggle with these disorders can lead full, happy, productive lives, if we have the right resources.”

These include medication (usually), therapy (often), a measure of good luck (always) — and, most of all, the inner strength to manage one’s demons, if not banish them. That strength can come from any number of places, these former patients say: love, forgiveness, faith in God, a lifelong friendship.

But Dr. Linehan’s case shows there is no recipe. She was driven by a mission to rescue people who are chronically suicidal, often as a result of borderline personality disorder, an enigmatic condition characterized in part by self-destructive urges.

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

‘I Was in Hell’

She learned the central tragedy of severe mental illness the hard way, banging her head against the wall of a locked room.

Marsha Linehan arrived at the Institute of Living on March 9, 1961, at age 17, and quickly became the sole occupant of the seclusion room on the unit known as Thompson Two, for the most severely ill patients. The staff saw no alternative: The girl attacked herself habitually, burning her wrists with cigarettes, slashing her arms, her legs, her midsection, using any sharp object she could get her hands on.

The seclusion room, a small cell with a bed, a chair and a tiny, barred window, had no such weapon. Yet her urge to die only deepened. So she did the only thing that made any sense to her at the time: banged her head against the wall and, later, the floor. Hard.

“My whole experience of these episodes was that someone else was doing it; it was like ‘I know this is coming, I’m out of control, somebody help me; where are you, God?’ ” she said. “I felt totally empty, like the Tin Man; I had no way to communicate what was going on, no way to understand it.”

Her childhood, in Tulsa, Okla., provided few clues. An excellent student from early on, a natural on the piano, she was the third of six children of an oilman and his wife, an outgoing woman who juggled child care with the Junior League and Tulsa social events.

People who knew the Linehans at that time remember that their precocious third child was often in trouble at home, and Dr. Linehan recalls feeling deeply inadequate compared with her attractive and accomplished siblings. But whatever currents of distress ran under the surface, no one took much notice until she was bedridden with headaches in her senior year of high school.

Her younger sister, Aline Haynes, said: “This was Tulsa in the 1960s, and I don’t think my parents had any idea what to do with Marsha. No one really knew what mental illness was.”

Soon, a local psychiatrist recommended a stay at the Institute of Living, to get to the bottom of the problem. There, doctors gave her a diagnosis of schizophrenia; dosed her with ThorazineLibrium and other powerful drugs, as well as hours of Freudian analysis; and strapped her down for electroshock treatments, 14 shocks the first time through and 16 the second, according to her medical records. Nothing changed, and soon enough the patient was back in seclusion on the locked ward.

“Everyone was terrified of ending up in there,” said Sebern Fisher, a fellow patient who became a close friend. But whatever her surroundings, Ms. Fisher added, “Marsha was capable of caring a great deal about another person; her passion was as deep as her loneliness.”

A discharge summary, dated May 31, 1963, noted that “during 26 months of hospitalization, Miss Linehan was, for a considerable part of this time, one of the most disturbed patients in the hospital.”

A verse the troubled girl wrote at the time reads:

They put me in a four-walled room

But left me really out

My soul was tossed somewhere askew

My limbs were tossed here about

Bang her head where she would, the tragedy remained: no one knew what was happening to her, and as a result medical care only made it worse. Any real treatment would have to be based not on some theory, she later concluded, but on facts: which precise emotion led to which thought led to the latest gruesome act. It would have to break that chain — and teach a new behavior.

“I was in hell,” she said. “And I made a vow: when I get out, I’m going to come back and get others out of here.”

Radical Acceptance

She sensed the power of another principle while praying in a small chapel in Chicago.

It was 1967, several years after she left the institute as a desperate 20-year-old whom doctors gave little chance of surviving outside the hospital. Survive she did, barely: there was at least one suicide attempt in Tulsa, when she first arrived home; and another episode after she moved to a Y.M.C.A. in Chicago to start over.

She was hospitalized again and emerged confused, lonely and more committed than ever to her Catholic faith. She moved into another Y, found a job as a clerk in an insurance company, started taking night classes at Loyola University — and prayed, often, at a chapel in the Cenacle Retreat Center.

“One night I was kneeling in there, looking up at the cross, and the whole place became gold — and suddenly I felt something coming toward me,” she said. “It was this shimmering experience, and I just ran back to my room and said, ‘I love myself.’ It was the first time I remember talking to myself in the first person. I felt transformed.”

The high lasted about a year, before the feelings of devastation returned in the wake of a romance that ended. But something was different. She could now weather her emotional storms without cutting or harming herself.

What had changed?

It took years of study in psychology — she earned a Ph.D. at Loyola in 1971 — before she found an answer. On the surface, it seemed obvious: She had accepted herself as she was. She had tried to kill herself so many times because the gulf between the person she wanted to be and the person she was left her desperate, hopeless, deeply homesick for a life she would never know. That gulf was real, and unbridgeable.

That basic idea — radical acceptance, she now calls it — became increasingly important as she began working with patients, first at a suicide clinic in Buffalo and later as a researcher. Yes, real change was possible. The emerging discipline of behaviorism taught that people could learn new behaviors — and that acting differently can in time alter underlying emotions from the top down.

But deeply suicidal people have tried to change a million times and failed. The only way to get through to them was to acknowledge that their behavior made sense: Thoughts of death were sweet release given what they were suffering.

“She was very creative with people. I saw that right away,” said Gerald C. Davison, who in 1972 admitted Dr. Linehan into a postdoctoral program in behavioral therapy at Stony Brook University. (He is now a psychologist at the University of Southern California.) “She could get people off center, challenge them with things they didn’t want to hear without making them feel put down.”

No therapist could promise a quick transformation or even sudden “insight,” much less a shimmering religious vision. But now Dr. Linehan was closing in on two seemingly opposed principles that could form the basis of a treatment: acceptance of life as it is, not as it is supposed to be; and the need to change, despite that reality and because of it. The only way to know for sure whether she had something more than a theory was to test it scientifically in the real world — and there was never any doubt where to start.

Getting Through the Day

“I decided to get supersuicidal people, the very worst cases, because I figured these are the most miserable people in the world — they think they’re evil, that they’re bad, bad, bad — and I understood that they weren’t,” she said. “I understood their suffering because I’d been there, in hell, with no idea how to get out.”

In particular she chose to treat people with a diagnosis that she would have given her young self: borderline personality disorder, a poorly understood condition characterized by neediness, outbursts and self-destructive urges, often leading to cutting or burning. In therapy, borderline patients can be terrors — manipulative, hostile, sometimes ominously mute, and notorious for storming out threatening suicide.

Dr. Linehan found that the tension of acceptance could at least keep people in the room: patients accept who they are, that they feel the mental squalls of rage, emptiness and anxiety far more intensely than most people do. In turn, the therapist accepts that given all this, cutting, burning andsuicide attempts make some sense.

Finally, the therapist elicits a commitment from the patient to change his or her behavior, a verbal pledge in exchange for a chance to live: “Therapy does not work for people who are dead” is one way she puts it.

Yet even as she climbed the academic ladder, moving from the Catholic University of America to the University of Washington in 1977, she understood from her own experience that acceptance and change were hardly enough. During those first years in Seattle she sometimes felt suicidal while driving to work; even today, she can feel rushes of panic, most recently while driving through tunnels. She relied on therapists herself, off and on over the years, for support and guidance (she does not remember taking medication after leaving the institute).

Dr. Linehan’s own emerging approach to treatment — now called dialectical behavior therapy, or D.B.T. — would also have to include day-to-day skills. A commitment means very little, after all, if people do not have the tools to carry it out. She borrowed some of these from other behavioral therapies and added elements, like opposite action, in which patients act opposite to the way they feel when an emotion is inappropriate; and mindfulness meditation, a Zen technique in which people focus on their breath and observe their emotions come and go without acting on them. (Mindfulness is now a staple of many kinds of psychotherapy.)

In studies in the 1980s and ’90s, researchers at the University of Washington and elsewhere tracked the progress of hundreds of borderline patients at high risk of suicide who attended weekly dialectical therapy sessions. Compared with similar patients who got other experts’ treatments, those who learned Dr. Linehan’s approach made far fewer suicide attempts, landed in the hospital less often and were much more likely to stay in treatment. D.B.T. is now widely used for a variety of stubborn clients, including juvenile offenders, people with eating disorders and those with drug addictions.

“I think the reason D.B.T. has made such a splash is that it addresses something that couldn’t be treated before; people were just at a loss when it came to borderline,” said Lisa Onken, chief of the behavioral and integrative treatment branch of the National Institutes of Health. “But I think the reason it has resonated so much with community therapists has a lot to do with Marsha Linehan’s charisma, her ability to connect with clinical people as well as a scientific audience.”

Most remarkably, perhaps, Dr. Linehan has reached a place where she can stand up and tell her story, come what will. “I’m a very happy person now,” she said in an interview at her house near campus, where she lives with her adopted daughter, Geraldine, and Geraldine’s husband, Nate. “I still have ups and downs, of course, but I think no more than anyone else.”

After her coming-out speech last week, she visited the seclusion room, which has since been converted to a small office. “Well, look at that, they changed the windows,” she said, holding her palms up. “There’s so much more light.”