DBT holds two instructions at the same time: you are doing the best that you can, and you need to do better.
That is the central dialectic of the treatment, acceptance and change, and it is not a paradox to be resolved. Both halves are operative. Drop the first and the work becomes punishing. Drop the second and nothing moves.
In DBT we often talk about the dialectic between acceptance and change. You are doing the best that you can, and you need to do better, try harder.
The change half needs a direction, and that is where life worth living goals come in.
Where the phrase comes from
The term sounds strange the first time. It has a specific and serious origin.
When Marsha was developing DBT, she was working with folks who were experiencing chronic suicidal ideation and behaviors. And the question she would often ask them was, okay, what needs to change in your life to make it worth living? What do we have to do to build a life that is worth living?
Marsha Linehan built DBT for people in acute, chronic emotional pain, where the question of whether to continue was live. In that context, symptom reduction was not a sufficient goal. Removing pain from a life that is otherwise empty leaves an empty life. The question had to be constructive: not what do we take away, but what do we build.
That reframing is easy to miss because it sounds like optimism. It is closer to a design decision. If the target is only the removal of distress, treatment has no way to tell whether it is finished, and the person has nothing to move toward once it is.
Why the question generalizes
The phrase migrated out of that acute context, and not by dilution. It generalizes because the underlying question was never specific to crisis.
That same phrase fits for all folks who are not necessarily experiencing such acuity, in that each one of us has to ask ourselves a question. What do we want our lives to look like?
Very few people are ever formally asked this. School asks what you will study. Work asks what you will deliver. Almost nothing in ordinary adult life prompts the question of what you actually want the shape of your days to be.
What a life worth living goal is
It is not a bucket list and it is not a five year plan. It has three features that distinguish it:
- It is about how you show up, not only what you obtain. Outcomes depend partly on the world. Conduct is yours.
- It connects to a value underneath it. If the goal becomes impossible, the value can still be expressed another way. That is what makes it durable.
- It is specific enough to act on this week. A direction you cannot take a step in is a mood, not a goal.
By thinking in these terms, we begin to connect to life worth living goals. The way that we want to show up in the world.
How to answer the question when you have no answer
The most common response to what do you want your life to look like is a blank. That is normal and it is not a failure of the exercise. The question is unpracticed.
Working backwards is easier than working forwards:
- Think of a recent day you would be glad to repeat. Not a vacation, an ordinary day. What was in it?
- Think of something you did that you were quietly proud of and nobody noticed. What value was it serving?
- Notice what you envy in other people. Envy is imprecise but it points at something.
- Ask what you would want to be true of you regardless of how anything turns out.
These produce fragments, not a manifesto. Fragments are enough. The picture gets built over time and gets revised, which is expected rather than a sign the first attempt was wrong.
It is also worth writing the fragments down somewhere you will see them. Held only in memory, they get quietly rewritten to match whatever you happen to be doing, which defeats the purpose of having them.
What changes once you have one
A life worth living goal reorganizes the rest of the treatment. Skills stop being generic self management and become instrumental: you practice distress tolerance because emotional escalation keeps costing you the relationships you said mattered. That is a reason a person can actually hold on a hard day.
It also gives setbacks a place to sit. A bad week against a direction is a bad week. A bad week against nothing in particular is evidence for a story about yourself.
And it changes what a session is for. Instead of reporting how the week went, the question becomes whether the week moved toward the thing you named, which is a question with an answer and a next step attached.
Going further
Values and resilience covers why this holds up under pain and loss. For the treatment logic underneath, see how DBT differs from talk therapy.
Dr. Jesse Finkelstein offers DBT informed individual therapy at Axis Psychological Services in New York City. You can book a free consultation.
If you want help naming and working toward your own goals, learn about DBT therapy in NYC, or join the DBT skills group in NYC.
Common questions
What is a life worth living goal?
It is something specific you want your life to contain, stated plainly enough that you would know whether you had it. Not a mood, not a diagnosis being gone. Teaching again. Eating dinner with your kids without the evening falling apart. Sleeping through the night in your own apartment. The point is that treatment has a destination, so the skills have somewhere to go.
What if I cannot name one?
That is the usual starting place, and it is not a failure of the exercise. Most people arrive at DBT able to describe what they want to stop, not what they want to build. A useful first move is to borrow. Name a life you have watched someone else live that looked worth living, then ask which single piece of it you would want. The answer gets more honest over a few weeks.
Is a life worth living goal the same as a treatment goal?
Not quite. A treatment goal is usually about reducing something, fewer crises, fewer missed weeks of work, fewer nights that end badly. A life worth living goal is about what fills the space afterward. Both matter, and they do different jobs. The first one keeps you in the room. The second one is the reason to stay in it.
Do I have to be in a DBT program to work on this?
No. The question is useful on its own, and plenty of people work on it in individual therapy without a full DBT program. The structure does help. In a program the goal gets written down, revisited, and used to sort which skill to reach for in a given week, which is harder to sustain on your own.
