Webb Therapy Uncategorized 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.

Related Post


Overall Global Leading Cause of Death

  • Ischemic heart disease (coronary artery disease) – Still the #1 cause of death worldwide.
  • Followed by: Stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, and cancer (e.g., lung, liver, colorectal).

Breakdown by Category

By Age

Age GroupLeading Cause(s) of Death
Infants (<1)Neonatal conditions, birth complications, infections
Children (1–14)Accidents (injuries), infections (low-income countries), cancers (e.g., leukemia)
Youth (15–24)Road injuries, suicide, homicide (varies by country)
Adults (25–44)Injuries (road, drug overdose), suicide, HIV/AIDS (in some countries), heart disease
Middle Age (45–64)Heart disease, cancer (esp. lung, colorectal, breast), liver disease
Older Adults (65+)Heart disease, stroke, cancer, Alzheimer’s disease

By Gender/Sex

GroupLeading Cause of Death
Cisgender MenHeart disease, cancer (lung, liver), accidents
Cisgender WomenHeart disease, cancer (breast, lung), stroke
Transgender IndividualsElevated risk from violence, suicide, and HIV/AIDS (especially trans women of color); limited large-scale data
Non-binaryInsufficient population-specific data, but risks often parallel those of trans populations or assigned sex at birth

By Race/Ethnicity (Example: United States)

GroupTop CausesUnique Issues
White (non-Hispanic)Heart disease, cancer, drug overdose
Black or African AmericanHeart disease, cancer, higher stroke risk
Hispanic/LatinoHeart disease, cancer, diabetes
Native AmericanAccidents, liver disease, diabetes, suicide
Asian AmericanCancer (leading cause), stroke, heart disease

Note: Disparities arise from systemic inequalities, access to care, and social determinants of health.


By Sexuality (LGBTQ+)

  • Limited global data, but in many regions:
    • Higher risk of suicide, mental health disorders, substance abuse, HIV/AIDS (especially among MSM and trans women).
    • Discrimination and healthcare avoidance contribute to worsened outcomes.
  • Common causes of death still include heart disease and cancer, with higher rates of premature death linked to stigma and healthcare disparities.

By Geographic Region

RegionLeading Cause(s)
High-Income CountriesHeart disease, cancer, Alzheimer’s, stroke
Low- and Middle-Income CountriesInfectious diseases (TB, HIV), maternal mortality, stroke, heart disease
AfricaHIV/AIDS, malaria, lower respiratory infections
AsiaStroke, heart disease, chronic lung disease
North AmericaHeart disease, cancer, drug overdose (opioid crisis)
EuropeHeart disease, stroke, cancer
Latin AmericaViolence (in younger adults), heart disease, diabetes

By Profession

  • Agricultural/farm workers: High injury rates, pesticide exposure, suicide
  • Construction workers: Falls, injuries, exposure to toxins (e.g., asbestos)
  • Healthcare workers: Infectious disease, burnout, mental health risks
  • Military/first responders: Combat-related injuries, PTSD, suicide
  • Office workers: Sedentary lifestyle risks (heart disease, diabetes)

Occupation-linked deaths often relate to environmental exposures, physical risks, or psychological stressors.


Conclusion:

Across almost all demographics, heart disease remains the leading cause of death, followed by cancer, stroke, and—in certain populations—accidents, suicide, or infectious diseases. However, the underlying causes (social, economic, political) differ significantly based on identity, geography, and profession.

Would you like this formatted into a chart, infographic, or specific to a country or report you’re working on?

Emotions: Function and MotivationEmotions: Function and Motivation

Joy or happiness can motivate us to join in, take part, flourish, share, be a part of, repeat these activities.

Fear can motivate us to get away, hide, flee, run, keep ourselves or others safe. It protects us.

Sadness can motivate us to withdraw, ruminate, cry, heal, express hurt, seek comfort and bond with others.

Anger can motivate us to attack, defend or stand up for ourselves, identify boundary violation, identify there is a threat to our self or our loved ones or something we value.

Guilt can motivate us to repair what we have done and informs us that we have violated our morals or values.

Shame can motivate us to hide away, to keep things secret, to remember our fallibility and humility, to keep us “right sized”.

Disgust can motivate us to withdraw, keep a distance, get clean or clean our environment to ensure we stay healthy.

Compassion, empathy, or sympathy can motivate us to offer comfort, be with others, relate to one another and form strong bonds.

Confusion (Cognitive with physical sensations) can motivate us to get curious, learn, discover, grow.

Affection (behavioural with physical sensations) can motivate us to give love, get close to specific people who were feel safe with, and want to spend more time with.

Are you feeling Restless, Irritable, and Discontent?Are you feeling Restless, Irritable, and Discontent?

I would infer that you may be depleted in some area of your life. Generally, when I am having any of these experiences I can recognise that my basic needs, and possibly even transformative, needs are not met. My basic needs are food and water, adequate sleep, shelter and safety, social connection (belonging), and esteem needs (e.g., self-respect, self-worth, self-competence, mastery and achievement, integrity, sense of freedom and independence etc.). Perhaps only when all my deficiency needs are met, and I’m experiencing dissatisfaction with my growth needs, do I feel Restless, Irritable, and Discontent in this area of my life – however I assume some would argue that if I am feeling that way when attending to my growth needs, then I may have slipped back to Esteem Needs. You can look up Maslow’s Hierarchy of Needs for a visual representation if you like, using a search engine. Below is a GIF that I created to educate people on how we can buffer ourselves to vulnerabilities. It’s very telling to go into the body when we haven’t eat for a while, may be we’re running on caffeine, and you can feel the restlessness in the body. We have to fuel up when we’re hungry to buffer ourselves from becoming irritable and restless. If you’re feeling discontent with life, I would suggest a social activity, play time with friends, working on a project of some kind, or getting involved in your community.