Module 2. Distress Tolerance: (Discussion #8) Radical Acceptance

DBTuesday is a series of posts where we explore skills and concepts from dialectical behavior therapy (DBT).

This is one of several posts focusing on distress tolerance, which is the second module of DBT skills training. See this post for general info about DBT and this post for more info about distress tolerance.

What is radical acceptance?

In last week’s post on problem-solving (link), it was mentioned that there are four general ways of coping with a problem:

• Solve the problem
• Change how you feel about the problem
• Accept the problem and your feelings about it
• None of the above

Radical acceptance is the third option. It involves acknowledging what is happening and that things are what they are, even if maybe it would be a lot easier if things were different.

When is radical acceptance appropriate?

Radical acceptance works best for situations that are outside your control.

Radical acceptance is not inactivity or helplessness in situations where you have some power or control. If a situation is in your control and you *want* to change it and you’re *able* to change it, then it makes sense to try to change it.

However, if you are in a difficult situation that’s outside of your control, radical acceptance would suggest being honest and truthful with yourself about the fact that you’re in that situation (as grim as it may be) and working as effectively and realistically as possible with what is there.

Examples of what radical acceptance isn’t

One way of thinking about radical acceptance is making a choice to abstain from fighting against situations outside one’s control.

Here are a few examples of thought patterns that might involve this sort of fighting or resisting:

• “This isn’t fair”
• “This can’t be happening”
• “This shouldn’t be happening”
• “I can’t believe this is happening”
• “Why is this happening to me?”
• “This is wrong”
• “This is terrible”

These thoughts can be grouped into a few categories:

• Disbelieving that a situation it is happening
• Focusing on how awful, outrageous, unjust, or undeserved a situation is
• Focusing on the desire for the situation to be something different

Radical acceptance is the opposite of these things:

• Don’t amplify thoughts denying or questioning the reality of a situation
• Don’t amplify thoughts you may have about a situation being painful or wrong
• Don’t amplify thoughts wishing that a situation weren’t there

Radical acceptance is non-judgmental

I personally struggled with this topic when I read about it because of what I saw as a possible conflict between radical acceptance and non-judgmentality.

• Non-judgmentality suggests that all thoughts and feelings are okay and allowed to exist
• Radical acceptance could be understood as saying that certain thoughts and feelings (i.e. struggling with situations outside one’s control) are bad or wrong

The resolution to this conflict is to expand the scope of radical acceptance to include not just external events but also internal mental states: apply radical acceptance to your own thoughts and feelings of non-acceptance.

• “I should be radically accepting this situation but I can’t” => “My thoughts and feelings aren’t within my control and they are what they are”

Willingness vs. willfulness

DBT identifies two states of mind that are relevant to radical acceptance:

• Willingness = practicing gracefully responding to whatever comes
• Willfulness = rejecting the current situation

Willfulness can manifest in a few different ways:

• Giving up on taking action in a situation where action is possible and needed
• Working hard to try to fix a situation that cannot be changed
• Using harmful methods of coping instead of known alternatives
• Getting stuck in self-pity

Turning the mind

DBT suggests “turning the mind” from willfulness to willingness.

• Notice if you are in a willful state of mind
• Radically accept the fact that you’re in that state of mind
• Gently try to turn your mind toward acceptance and willingness

Here are some examples of possible coping statements to use for turning the mind:

• “I can only control the present moment”
• “I can get through this even if it is hard”
• “I can manage this”
• “I will take whatever actions are needed”

Reflection

What is an example of a situation where radical acceptance might be helpful?

Sources:

https://dbtselfhelp.com/dbt-skills-list/distress-tolerance/radical-acceptance/

https://www.verywellmind.com/what-is-radical-acceptance-5120614

https://dbtselfhelp.com/dbt-skills-list/distress-tolerance/willingness-half-smile/