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The Four Options for any Problem (Linehan, 1993)The Four Options for any Problem (Linehan, 1993)
Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.
When we are overwhelmed by a life challenge, one way we might naturally respond is by defending our position. Perhaps, we’ll resort to an effective yet temporary coping strategy like denial, projection, victimhood, or blaming. We attempt to cope in ways that lessen the stress – the internal discomfort and unpleasantness. Coping strategies that offer temporary relief generally make the situation worse in the long run, especially when fostering relationships at work and in our personal lives. For example, crawling back into bed when you need to work or have commitments with friends. Maybe you over-eat, use chemicals or resent the world, which alleviates the immediate emotional pain, then feel guilty or ashamed afterward.
Sometimes, in an effort to take action, people attempt to solve problems cognitively – problems that cannot be solved, becoming more and more frustrated when their efforts don’t work. Others become paralyzed or dissociate, unable to decide what to do. Intense emotions can be overwhelming, fatiguing, and compromise our ability to think with an open heart and a clear mind. Searching endlessly for the right solution adds to anxiety and distress.
Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.
Choice 1: Solve the Problem.
There are many problem-solving strategies, but most use the same steps. First, define the problem. Be as specific as possible. Use numbers whenever possible. For example, “I’ve been late for work four days this week.”
Next, analyze the problem. Is it in your power to solve the problem? If not, then consider one of the other three options. If yes, then continue to analyze the problem.
What are the reasons you’ve been late? Is the reason always the same? Does it depend on your mood or what time you went to bed? Does it depend on what tasks you have to do at work? Who you work with? Where you went the night before? Consider the who, what, when, and where of the behavior you want to change.
The third step is to consider possible solutions. Think of various solutions that could solve the problem. Evaluate the solutions carefully to determine which might work best for you. What are the pros and cons of different actions? What could go wrong? What can you do to make the solution more likely to work?
For example, if you decide to give yourself a weekly budget and to freeze your credit cards in a block of ice, what would you do in case of an emergency? Would giving yourself a certain amount of spending money for the day work better than an amount for the week?
A key variable to remember is how difficult it is to make changes in behavior. A strong commitment to change is important. Be specific in stating the change you want to make. Be willing to make small changes at first. Implement the solution: Take action. Trouble-shoot as you go along, tweaking it to resolve any issues you didn’t anticipate.
Choice 2: Change Your Perception.
Changing your perception of the problem can be a challenge. An example of changing your perception of a problem might be to see a difficult boss as an opportunity to work on coping with someone who is disorganized and demanding. If you feel irritated because your house is cluttered with toys, maybe change your perception to one that the clutter is a signal to be grateful for young children in the home. Changing your perception could also mean changing your view of emotion. Instead of trying never to feel anger, look at your frustration as a source of information, perhaps a signal that you need to speak up for yourself.
Choice 3: Radically Accept the Situation.
Radical Acceptance means wholeheartedly accepting what is real. Radical acceptance is like saying, “It is what it is,” and giving up your resistance to the situation. Radical acceptance could be about issues we can’t control or concerns that we decide not to change, at least for the time being. It doesn’t mean you agree with what has happened or that you think it is reasonable.
Choice 4: Stay Miserable.
Of course, staying miserable is not a choice anyone wants to make, and no one would want to consider it as an option. But if you can’t solve the problem, can’t change your perception, and you aren’t ready to radically accept the situation, then staying miserable is the only option left.
Staying miserable may be all you can do in certain situations. Sometimes staying miserable may be what you have to do until you are ready to do something else. There are ways to cope that can help until another option can be used.
In future posts, we’ll look at specific skills that enhance your ability to problem-solve, change your perception, or radically accept situations. We’ll also consider ways to get through the times when you can’t make any of those choices.
Suicidality: Talking About Suicide and SupportSuicidality: Talking About Suicide and Support
Supporting someone who’s having thoughts of suicide is one of the most important, and at times most challenging, parts of a support persons role. People who experience suicidality can vary from passing ideas to serious planning and often come from a place of deep emotional pain. We all have a duty to respond with care, compassion, and an attempt to understand the experience in a way that keeps safety at the heart of every conversation.
Firstly, if you or someone you know is having thoughts of suicide, please know that you’re not broken or beyond help. These thoughts often come when emotional pain feels unbearable and we can’t see a way out. But things can shift, and help is available. We may spend much of our time alone, and we can feel alone even in a crowded room, but you are not alone in this. Suicidality is not uncommon.
The Numbers Today
According to the latest figures (ABS, 2023):
Suicide is the leading cause of death for Australians aged 15 to 44.
In 2022, over 3,100 people died by suicide—about 8.6 deaths each day.
Men account for 75% of those deaths, though women attempt suicide more often (but less often fatally).
According to the Black Dog Institute, roughly 65,000 Australians attempt suicide each year, while around 3,200 die by suicide annually.
Rates among Aboriginal and Torres Strait Islander peoples are more than double the national average.
People living in rural and remote areas face higher suicide risks due to isolation, limited services, and other pressures.
Why Does the Mind Think About Suicide?
From a humanistic psychology point of view, suicidal thoughts are not signs of illness or failure, they are a deep emotional signal that something in your life or environment needs care, change, or healing.
Each person and living creature on the planet are inherently worthy, with an innate drive to survive, grow, connect, and for humans, find meaning. When life feels full of suffering, such as grief, isolation, trauma, shame, or hopelessness, the mind may start to believe that death is the only way to stop the pain.
In this view, suicidal thoughts are often not about wanting to die—but about wanting the pain to stop.
They arise when:
You feel disconnected from others or from yourself.
You feel stuck in circumstances that seem unchangeable.
You believe your worth or purpose has been lost.
You’re exhausted from holding on or pretending you’re okay.
But the humanistic perspective also holds this powerful truth: you are more than your pain, and within you is a capacity for healing, choice, and change, even if it doesn’t feel like it right now.
Treat Yourself with Compassion, Not Criticism
It’s easy to get caught in a spiral of self-blame. But you are not weak or selfish. You are a human being who is hurting—and just like you wouldn’t shame someone for being in physical pain, you deserve the same care when your pain is emotional.
Ask yourself:
If someone I loved felt this way, what would I want them to know?
Then try to offer yourself the same kindness.
Reach Out – Connection Saves Lives
Talking to someone can ease the intensity of what you’re feeling. You don’t have to explain everything. Just saying, “I’m not okay right now,” is enough to start.
Lifeline 13 11 14
Beyond Blue 1300 22 4636
Suicide Call Back Service: 1300 659 467
Beyond Blue: 1300 22 4636
13YARN (Support for Aboriginal and Torres Strait Islander Peoples): 13 92 76
QLife – National LGBTQIA+ Peer Support and Referral Service: 1800 184 527
Hours: 3pm – Midnight (local time), every day
What they offer: Confidential, non-judgemental, and inclusive support from trained LGBTQIA+ peer workers. They are not a crisis line like Lifeline, but they can support people in distress and connect you with further help if you’re at risk.
How Counselling Can Help: Evidence-Based Approaches
Counsellors and Psychologists don’t rely on guesswork when helping someone who’s feeling suicidal. They use researched strategies to support recovery. Here are a few key approaches:
Collaborative Assessment and Management of Suicidality (CAMS): This method focuses on working together with the person in distress, rather than telling them what to do. It aims reduce suicidal thoughts more effectively than traditional therapy.
Cognitive Behavioural Therapy for Suicide Prevention (CBT-SP): This version of CBT focuses specifically on managing suicidal thoughts by teaching problem-solving and positive thinking strategies.
Dialectical Behaviour Therapy (DBT): Originally designed for people with intense emotions or borderline personality disorder, DBT is now widely used to reduce suicide risk by teaching emotional regulation, mindfulness, and better relationship skills.
Safety Planning: This involves creating a personalised plan for what someone can do when they feel at risk, including who to call, calming strategies, and safe places to go.
Means Restriction Counselling: This involves helping someone reduce their access to anything they might use to harm themselves, like certain medications or weapons, done through sensitive, respectful conversations.
Barriers to Speaking Up
Even with growing public awareness, there’s still a strong stigma around suicide. Many people worry they’ll be judged, locked up, or shamed if they admit they’re struggling. These fears can stop people from reaching out for help, which is why creating a safe, non-judgmental space is so important in counselling.
Rural and Remote Communities
People in regional and remote parts of Australia often find it harder to access mental health support. Telehealth (online or phone sessions) has helped bridge that gap, but it’s not always easy to pick up on non-verbal cues or respond to crises from a distance.
Cultural Awareness Matters
For Aboriginal and Torres Strait Islander peoples, suicide cannot be separated from the impacts of colonisation, loss of culture, and ongoing trauma. Culturally safe, community-led solutions are essential and more effective in these contexts.
Remember That Feelings Change—Even the Darkest Ones
It may not feel like it right now, but these feelings will pass. Emotions are like waves—sometimes crashing, sometimes calm—but never permanent.
What you feel today is not a life sentence. With support and time, things can change. You deserve the chance to see what healing and hope feel like.
Safe Haven NSW Services (for suicidal distress, NOT EDs)
Please check official websites for update information re contact information, hours of operation, and status of operation i.e., still operating. The information on this website has been collected June 2025.
Safe Havens are calm, non-clinical spaces where you can talk with peer workers and mental health clinicians if you’re in emotional crisis — no appointment needed.
No police or emergency involvement unless requested or necessary.
Warm, trauma-informed and recovery-focused.
🔗Find your local Safe Haven: nsw.gov.au/mental-health-initiatives/safe-haven
Examples:
Safe Haven locations across NSW — these are welcoming, non-clinical places where anyone feeling suicidal or in deep distress can drop in and speak to peer workers or mental health clinicians. No appointment, referral, or Medicare card needed. Visit the following for operating hours and locations across NSW: Safe Haven
Regional & Metro Locations
Campbelltown / Ambarvale (SWSLHD)
Address: 80 Woodhouse Drive, Ambarvale (Campbelltown area)
Open Mon, Fri, Sat, Sun 2 – 9 pm
Phone: 0457 093 109 during hours swslhd.health.nsw.gov.au
North Ryde (Macquarie Hospital)
For youth aged 12–17 (sometimes to 18 if still at school)
Open daily 4 – 8 pm and public holidays nslhd.health.nsw.gov.au
Parramatta / Westmead
Drop-in at 26 Grand Ave, Westmead
Open Sun–Wed 3:30 – 9:30 pm
Phone: 0436 377 113
Bega Safe Haven, Bega, NSW, Australia, Supports 14 + in a calm, welcoming space.
Broken Hill Safe Haven, Broken Hill, NSW, Australia, Supports 17 + with peer and clinician support
Brookvale Safe Haven, Brookvale, NSW, Australia, High‑school aged young people support
Darlinghurst, NSW, Australia, 16 + LGBTQIA+ inclusive spot at St Vincent’s
St Vincent’s O’Brien Centre, 390 Victoria Street, Darlinghurst NSW 2010
Hours: Monday: closed, Tuesday: closed, Wednesday: 5:00pm – 8:30pm, Thursday: 5:00pm – 8:30pm, Friday: 5:00pm – 8:30pm, Saturday: 12:00pm – 4:00pm, Sunday: 12:00pm – 4:00pm.
Gosford Safe Haven, General adult Safe Haven
Corner of Ambulance Road and Holden Street, Gosford NSW 2250
Hours: Monday: 9:00am – 4:30pm, Tuesday: 9:00am – 4:30pm, Wednesday: 9:00am – 4:30pm, Thursday: 9:00am – 4:30pm, Friday: 9:00am – 4:30pm, Saturday: closed, Sunday: closed, Closed on public holidays
Phone: (02) 4394 1597
Kogarah Safe Haven, Kogarah, NSW, Australia,16 + adults,
U2/15 Kensington St, Kogarah NSW 2217
Phone: (02) 9113 2981
Eating Disorders DSM-5Eating Disorders DSM-5
Psychologists believe that the core issues of anorexia nervosa and bulimia nervosa are multifaceted, involving a combination of biological, psychological, and social factors. Here are some of the key issues:
Anorexia Nervosa
- Distorted Body Image: Individuals with anorexia often have a distorted perception of their body size and shape, seeing themselves as overweight even when they are underweight.
- Intense Fear of Gaining Weight: There is an overwhelming fear of gaining weight or becoming fat, which drives restrictive eating behaviors.
- Control Issues: Anorexia can be a way for individuals to exert control over their lives, especially if they feel powerless in other areas.
- Perfectionism: Many individuals with anorexia have perfectionistic tendencies, striving for an unattainable ideal of thinness.
- Emotional Regulation: Restricting food intake can be a way to manage or numb difficult emotions and stress.
Bulimia Nervosa
- Binge-Purge Cycle: Bulimia is characterized by cycles of binge eating followed by purging behaviors such as vomiting, excessive exercise, or misuse of laxatives.
- Body Dissatisfaction: Similar to anorexia, individuals with bulimia often have a negative body image and are preoccupied with their weight and shape.
- Impulsivity: Bulimia is often associated with impulsive behaviors and difficulties in regulating emotions.
- Shame and Guilt: After binge eating, individuals with bulimia often feel intense shame and guilt, which perpetuates the cycle of purging3.
- Co-occurring Mental Health Issues: Anxiety, depression, and other mental health disorders are commonly seen in individuals with bulimia.
Both disorders are complex and can have severe physical and psychological consequences. Treatment typically involves addressing these core issues through therapy, medical monitoring, nutritional counselling, and support groups.