Translator’s Preface to the Revised Korean Edition
Thirty-two years have passed since the first edition of Marsha Linehan’s original manual on Dialectical Behavior Therapy (DBT) was published. Eighteen years have passed since the Korean translation of this book was first introduced in Korea, and eight years have now passed since the publication of the second edition.
During this time, DBT has been applied in many clinical and educational settings, both in Korea and around the world. It has offered new possibilities and hope to many people suffering from emotion regulation difficulties. For those who thought of death in the midst of intense emotional pain, for those who repeatedly came into conflict with others despite their intentions, and for those who could not find a way to regulate their emotions or live a meaningful life, DBT has become a treatment that brings real change into everyday life.
Around 1996, while conducting research to develop a suicide prevention system in the military, I was struck—and disappointed—by how little scientific evidence existed for therapeutic interventions that could actually reduce suicide rates. Most studies remained focused on suicidal ideation, risk factors, or prevention education. In contrast, Dr. Linehan’s controlled research showing a significant reduction in suicidal behaviors among individuals in chronic suicidal crisis revealed a new possibility in the midst of despair. That experience became a major turning point in my professional direction and clinical path.
During my doctoral training and clinical work in the United States, I had the opportunity to learn the clinical practice of DBT in depth through the DBT program at Zucker Hillside Hospital / Long Island Jewish Medical Center, now part of Northwell Health. There, I worked with outstanding supervisors and colleagues, as well as clients from diverse cultural backgrounds.
With the support of John Kane, MD, who was then the hospital director, I established the Asian American Family Clinic in the early 2000s and began providing treatment for Korean and other Asian immigrant clients. I was also able to begin a DBT skills training group in Korean. The early skills training groups included first-generation immigrants in their 50s and 60s, international students in their 20s and 30s, and second-generation Korean Americans.
At that time, I led skills groups while translating Dr. Linehan’s workbook page by page. The verbal and nonverbal feedback that Korean-speaking clients gave to those early translations offered me profound clinical insight. Concepts that felt natural and immediately understandable in English sometimes carried a different emotional meaning in Korean or shifted the direction of understanding. In some cases, the therapeutic response expected in English-speaking contexts did not occur in Korean-speaking contexts.
These experiences became an important foundation for developing a Korean translation system for DBT treatment terms. They also strengthened my conviction that the translation of a treatment manual must be completed as “living language”—language that breathes and moves in the actual treatment setting.
After returning to Korea in 2003, I began working with Marsha Linehan’s team at the University of Washington in Seattle to formally establish the DBT Center of Korea and prepare for the ethical introduction of DBT in Korea. The first task that had to be completed was the translation of the DBT treatment manuals. It was not possible to provide treatment without Korean-language manuals.
Throughout the many years of translating Dr. Linehan’s DBT books, I have held to one consistent principle: the translation of the DBT workbook and professional manual is not a purely linguistic or academic task performed outside the therapy room. It must be composed in living clinical language created between client and therapist in the treatment setting.
This is fully consistent with the way Dr. Linehan wrote the original English manuals. It is also a process that resembles what Gadamer’s hermeneutics calls a “fusion of horizons.” In other words, the translation of the DBT manuals is a living process of therapeutic integration. The horizon of Linehan’s scientific rigor, deep Christian spirituality, Zen Buddhist realization, and the sociocultural background of the United States meets the horizon of the Korean translator, shaped by an understanding of various religious traditions, especially Buddhism, as well as cultural psychology and bilingual experience. It also meets the unique horizons of readers and clients. In that meeting, therapeutic fusion takes place.
This integrative therapeutic process is, in itself, what Dr. Linehan might call a dialectical process. In DBT, the term “dialectical” or “dialectics” is too rich and specific to be fully captured by existing philosophical terms or Sino-Japanese-based vocabulary. In many ways, the Korean understanding of harmony between yin and yang, and the processes of transformation found in Confucian and Buddhist insight, can offer a deeper understanding of the therapeutic process of DBT.
At the same time, one cannot ignore the discomfort or sense of distance that some generations in Korea may feel because of the country’s ideological division and historical trauma surrounding ideology and thought. I discussed these issues several times with Dr. Linehan in the mid-2000s. In 2008, while in Korea, we also discussed how to minimize distortion of the term and honor Dr. Linehan’s intended meaning as faithfully as possible.
For this reason, I have chosen to transliterate “Dialectical” in DBT as “다이어렉티컬” and “dialectics” as “다이어렉틱스.” In DBT, “Dialectical” functions almost as a proper term for the innovative therapeutic process that the author and developer devoted her life to researching and organizing into a treatment. By preserving the English term through transliteration, I found that Korean clients—who are already familiar with many transliterated terms—could avoid unnecessary misunderstanding. It also became possible to teach Linehan’s concept of dialectics in roughly the same amount of time it would take to introduce the concept to English-speaking clients.
Still, I know well, and have not forgotten, that what Dr. Linehan truly hopes for is that all people around the world who suffer from emotional pain may begin a new life through DBT. Just as the author expresses gratitude in the acknowledgments of the revised edition to the teacher who taught her “how to let go of language,” what matters in DBT is not the name or terminology itself. What matters is letting go of the frame of dichotomous language and using language as a means to reach clients effectively and provide treatment.
This revised edition was completed by members of Dr. Linehan’s core DBT group, including Jennifer Sayrs, Emily Cooney, Jill Rathus, Shireen Rizvi, Katherine Comtois, Kathryn Korslund, and Janice Kuo. Some of these experts have visited Korea directly to train Korean DBT professionals, while others have been connected to us through their writings. For decades, they have worked to preserve and develop the original DBT model, and they have continued to offer steady interest and support so that DBT may take root in Korea with fidelity.
As I look back on my 25-year clinical journey with DBT, I still clearly remember meeting Dr. Linehan in 2006. In her office, with a firm and serious expression, she asked me, “Why do you want to begin DBT treatment and training in Korea?” It was a solemn question, like that of a Zen teacher testing the sincerity of one’s heart.
“For whom, and for what, are you doing DBT?”
Her penetrating gaze and question purified my heart in that moment. Since then, whenever I have faced difficulty, they have become a standard that helps me realign my heart as a clinician.
At that time, I shared two hopes with her: first, to offer new hope to people suffering in Korea through high-quality DBT treatment comparable to what is available in the United States; and second, to train DBT professionals with deep humanity and genuine sincerity.
In that moment, there was a clear and mindful exchange of hearts. Dr. Linehan immediately picked up the phone and said, “It will be difficult to do this alone. You need a team. You must meet the team I completely trust.” The person she called was Tony DuBose, PhD, then the director of Evidence Based Treatment Centers of Seattle and now the leader responsible for education and training at Behavioral Tech. Since then, Dr. Linehan and Dr. DuBose’s team have visited Seoul in person and have continued to support the mission of DBT Korea.
DBT is more than a set of clinical skills. It is a treatment system that brings together deep spiritual reflection, genuine humanity, and rigorous academic and ethical standards. I offer my deepest gratitude to all therapists who are practicing DBT at this very moment and supporting the lives of their clients, and to all clients who are building new lives through DBT.
I offer special thanks to Songhee Chae, who reviewed every manuscript of this revised edition with me and walked through the publication process together. I also sincerely thank the many people who offered valuable comments and suggestions through the multiple printings of the second edition, the professionals who participated in the DBT Experiential Class and other training programs and shared their guidance, and above all, the clients who helped create the living clinical language that became the foundation of this workbook.
2025
Translator, Yong Cho, PhD
