Radical Acceptance

Welcome to the first Skill of the Month for the new year!

Today's skill of the month comes from Dialectical Behavioral Therapy (DBT) which was developed by Marsha Linehan in the 1990's as a treatment for Borderline Personality Disorder. I always tell my clients when introducing them to the concepts in DBT that since then, DBT has been found to be an effective treatment for a variety of mental issues including but not limited to anger, bipolar disorder, anxiety, and eating disorders.

Radical acceptance is, in a nutshell, "radically" (all the way) accepting what is reality. This is deceptively simple. You may be thinking, I always accept reality. Truth be told, you probably do, eventually. But what about in the time between reality happening and you accepting it? That's where radical acceptance comes into play.

To better understand how this concept can be used in your daily life, I will use an example from my life. When I was about 25 years old, I was working at a hospital and had to get an endorsement on my driver's license in order to drive a minibus. I was a pretty good student in high school and college so I was completely blindsided when I failed the behind-the-wheel part of the test for the endorsement! "What? This is unfair! I studied! I'm a good driver! That examiner asked me a hard question that I didn't know I needed to know and it sure isn't so important that I didn't know it to be FAILED because I didn't know it!" I was not radically accepting that I had failed the test. I was way too busy complaining and feeling very angry, upset, and frustrated at the unfairness of it all--not to mention the hit to my ego! What good did all that anger do me? Not a bit. Did it change the fact that I failed. Nope. It only made my blood pressure increase, made me think dark thoughts, and feel miserable. The failure itself was painful there is no doubt about that. But what I did in not accepting it was cause myself to suffer. 

Marsha Linehan says "Suffering is optional. Pain is not." What does she mean by this? Life is painful. Think about it. At some point in your life you will die. Those close to you will die. Less extreme: you will loose jobs, loose friends, relationships will end. Traumatic events may occur like car accidents or natural disasters. These things really do happen and no one can say they're NOT painful. They are. And you will have to go through one or more of them at some point in your life. There's no way to escape it. Suffering, however, is what happens when we start saying "Its not fair! It shouldn't be this way!" (much like I did when I failed my test.) It almost feels like a "normal" response to go about saying "its not fair!" and perhaps it is but the point Marsha Linehan is trying to make is that it doesn't change what reality is. Life ISN'T fair and thinking it should be is only setting yourself up for suffering.

It is really important to understand that radical acceptance does NOT mean that you LIKE what the reality is. It does not mean you "agree" with it. So, when I failed my test, I most definitely did not LIKE it or AGREE that it was justified. I accepted that I had, in fact, failed.  

Once that happens, the doors of possibility can be opened. What, if anything, can you do now that this reality has occurred (or is occurring, depending on what the reality is)? For me, I recognized that "I will have to take the test again and this time, I will know that that question is really important and now I know the right answer! I will need to study more, though, to reduce the possibility that this will happen again."

Accepting the reality allows you to look for options. If you're too busy yelling and being upset and saying "its not fair!" you're too busy to see that you have options. Let's use another, more extreme example. I had a client that was diagnosed with MS. He was still able to walk but would become tired easily. He refused to accept that he had the diagnosis. He would continually seek "second opinions". He then refused to accept that he needed help in walking. He felt that if he used a cane or, heaven forbid, a walker or wheelchair, he was saying "I have lost. MS has won." So he just began to isolate himself, refusing to go out as he normally did or, when he would go he would take extreme measures like waiting in his car until the closest possible parking spot would open up (because he refused to accept his neurologist's suggestion that he utilize his handicap placard.) He would then carefully plan very short trips, knowing that his energy would have to be carefully preserved and then he would clear out his schedule for the remainder of the day so that he could rest after his 10 minute trip to Trader Joe's. Of course, this refusal to accept reality only intensified his symptoms because in addition to all of the MS stuff he was experiencing, he was getting depressed and noticing more negative thinking as well. His refusal accept reality (first the diagnosis and then that he needed assistance) caused extreme suffering.

Life is painful. We will be given opportunities to practice radical acceptance on really big issues but life gives us painful little pinpricks perhaps on a daily or almost daily basis. When I read about a shooting, I feel a painful pinprick. Its not me that is directly affected. I don't know anyone that was killed, but it hurts. I could refuse to accept that there are really terrible acts that occur in the world--saying "that's not fair! it shouldn't be that way!" or I can say "this is a terrible thing that happened" and see if I can do something, any small effort, to change it whether it be write a letter to a congressperson, or talk to my children about weapons or even just recognize the fragility of life and not take it for granted. 

There may be nothing that one can do about the reality of a situation. Accepting the reality of it (that it exists or occurred) will allow you to be free from the suffering. It will allow you to look for ways to mitigate the pain. Marsha Linehan suggests radically accepting that there is a cause or reason that this event occurred--one which we may not be aware of. Then, she suggests radically accepting that you can still have a life worth living DESPITE the fact that this thing happened.

As I said at the beginning of this post, you probably do, at some point, eventually accept reality. Radical Acceptance is doing this with intention and recognizing that not accepting only leads to suffering. So radical acceptance is the way to avoid the suffering.