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

Mortality DeterminantsMortality Determinants


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?

Inattentional Blindness: What else are we missing?Inattentional Blindness: What else are we missing?

Inattentional Blindness is the failure to notice an unexpected object in a visual display.

Cognitive Psychology is an approach to understanding human cognition by observing behaviour of people performing cognitive tasks. It is concerned with the internal processes involved in making sense of our environment, and deciding what behaviour to be appropriate. These processes include attention, perception, learning, memory, language, problem-solving, reasoning, and thinking.

Re-write: Distract!

The most famous experiment that shows evidence for inattentional blindness is the Simons and Chabris (1999) experiment where an audience or viewer watches a group of people pass a ball to one another wearing either black or white, and a woman dressed as a gorilla enters the frame for 9 seconds, then walks off. Results reported that 50% of the observers did not notice the gorilla enter the frame. In all honesty, when I saw the video for the first time at university, I did not see the gorilla enter the frame either.

In reality, we are often aware of changes in our visual environment because we detect motion cues accompanying the change. This information suggests that our ability to detect visual changes is not only due to the detection of movement. An obvious explanation of the gorilla experiment findings is that the visual representations we form in our mind are sparse and incomplete because they depend on our limited attentional focus. Simons and Rensick (2005) point out that there are other explanations, such as: detailed and complete representations may exist initially but may either decay rapidly or be overwritten by a subsequent stimulus. It needs to be said that in the gorilla experiment, the observers are instructed to count how many times the ball passes, so really, our attention is deliberately compromised. The real-life implications of inattentional blindness reveals the role of selective attention in human perception. Inattentional blindness represents a consequence of this critical process that allows us to remain focused on important aspects of our world without distraction from seemingly irrelevant objects and events.

Being present, in the moment (mindfulness) can help aid our attention. Distractions such as using our mobile phones, advertising material, other people, “multi-tasking” and internal emotional states all contribute to our lack of focus and attention. Think of a magician’s ability to manipulate their audiences attention in order to prevent them from seeing how a trick is performed. There are also safety implications, as you would know … if you’ve been paying attention, haha.

Just food for thought, my readers, and friends 🙂

Self-sabotage is self-sabotaging. Why would anyone do this?Self-sabotage is self-sabotaging. Why would anyone do this?

As I always like to say, there are as many reasons why people self-sabotage as there are people. A common theme is to protect the self from failure, feeling things we don’t want to feel, and to control our experiences.

One of the hidden culprits behind self-sabotage is the need for perfection and control. Self-sabotage has a strange way of helping us maintain the illusion that if only we had put in more effort or had better circumstances, everything would have worked out as it should. Social psychologists call this counter-intuitive strategy of regulating self-esteem ‘self-handicapping.’ It’s very seductive to engage in self-sabotage because the hidden payoff is high. It’s often easier to be a perfect whole rather than a real part. It’s a short-term solution that sidesteps the more arduous but ultimately more fulfilling work of individuation and self-realization. It takes risk, patience, suffering, and ultimately wisdom to come to the place where you can let go of self-sabotage and learn how to be real.

Behaviour is said to be self-sabotaging when it creates problems in daily life and interferes with long-standing goals. The most common self-sabotaging behaviors include procrastination, self-medication with alcohol and other drugs, comfort eating, and forms of self-injury such as cutting.

Self-sabotage originates in the internal critic we all have, the side that has been internalized by the undermining and negative voices we’ve encountered in our lives. This critic and ‘internal sabotuer,’ functions to keep the person from risking being hurt, shamed, or traumatized in the ways they had been in the past. While it keeps the individual safe, it does so at a very high cost, foreclosing the possibility of new, creative, and three-dimensional experiences. Like an addiction, self-sabotage insidiously lulls and deludes us into thinking that it has the answer. In fact, it is the problem masquerading as the solution. Nothing stops self-sabotage faster in its tracks than shining this particular light on it. Consciousness is true power. We need to let go of our illusions of omnipotence and perfection and see that it is only when we are real and imperfect that we can create a true work of art. Then and only then we can enjoy the gifts of being Real.

– Michael Alcée, Ph.D., Relational therapist/ Clinical psychologistArt: Bawa Manjit, Acrobat

Self-Sabotage | Psychology Today Australia